Navigating Long-Termism in Global Health

The effective altruist research community tries to identify the highest impact things people can do to improve the world. Unsurprisingly, given the difficulty of such a massive and open-ended project, very different schools of thought have arisen about how to do the most good.

Today's guest, Alexander Berger, leads Open Philanthropy's 'Global Health and Wellbeing' programme, where he oversees around $175 million in grants each year, and ultimately aspires to disburse billions in the most impactful ways he and his team can identify.

This programme is the flagship effort representing one major effective altruist approach: try to improve the health and wellbeing of humans and animals that are alive today, in clearly identifiable ways, applying an especially analytical and empirical mindset.

Links to learn more, summary, Open Phil jobs, and full transcript.

The programme makes grants to tackle easily-prevented illnesses among the world's poorest people, offer cash to people living in extreme poverty, prevent cruelty to billions of farm animals, advance biomedical science, and improve criminal justice and immigration policy in the United States.

Open Philanthropy's researchers rely on empirical information to guide their decisions where it's available, and where it's not, they aim to maximise expected benefits to recipients through careful analysis of the gains different projects would offer and their relative likelihoods of success.

This 'global health and wellbeing' approach — sometimes referred to as 'neartermism' — contrasts with another big school of thought in effective altruism, known as 'longtermism', which aims to direct the long-term future of humanity and its descendants in a positive direction. Longtermism bets that while it's harder to figure out how to benefit future generations than people alive today, the total number of people who might live in the future is far greater than the number alive today, and this gain in scale more than offsets that lower tractability.

The debate between these two very different theories of how to best improve the world has been one of the most significant within effective altruist research since its inception. Alexander first joined the influential charity evaluator GiveWell in 2011, and since then has conducted research alongside top thinkers on global health and wellbeing and longtermism alike, ultimately deciding to dedicate his efforts to improving the world today in identifiable ways.

In this conversation Alexander advocates for that choice, explaining the case in favour of adopting the 'global health and wellbeing' mindset, while going through the arguments for the longtermist approach that he finds most and least convincing.

Rob and Alexander also tackle:

• Why it should be legal to sell your kidney, and why Alexander donated his to a total stranger
• Why it's shockingly hard to find ways to give away large amounts of money that are more cost effective than distributing anti-malaria bed nets
• How much you gain from working with tight feedback loops
• Open Philanthropy's biggest wins
• Why Open Philanthropy engages in 'worldview diversification' by having both a global health and wellbeing programme and a longtermist programme as well
• Whether funding science and political advocacy is a good way to have more social impact
• Whether our effects on future generations are predictable or unforeseeable
• What problems the global health and wellbeing team works to solve and why
• Opportunities to work at Open Philanthropy

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Producer: Keiran Harris
Audio mastering: Ben Cordell
Transcriptions: Sofia Davis-Fogel