What's the effect of installing PlayPumps compared to funding hand pumps?

PlayPumps International

Good intentions aren’t enough

Imagine you’re in charge of a hospital…

Causes don't deserve support. People do.

How much should the government pay to save 200,000 birds?

How to avoid scope neglect

Which strategy do you think brings the greatest reduction in CO2e emissions per $100 of US government spending?

How many more lives does the most effective global health charity save per $100 spent than additional UK public health spending?

How much more can be accomplished per $100 implementing the most effective solution for Problem B than Problem A?

What is the best way for you to help?

We are in triage every second of every day

Why the problem you work on is the biggest driver of your impact

How to achieve hundreds of times more

Have more people died from causes directly related to terrorism or COVID-19 over the last 50 years globally? How much more?

Factor 1: Importance

How much does the US government spend on terrorism vs. pandemics?

Factor 2: Neglectedness

Do preventative-care home visits to elderly patients by healthcare professionals improve life expectancy?

Do drug substitution programs reduce criminal offending among drug addicts?

Does formally processing crimes committed by juveniles reduce criminal re-offending?

Factor 3: Tractability

The ITN framework

Which of the following problems is higher impact to work on according to the ITN framework?

The ITN framework, cost-effectiveness, and cause prioritisation

Introduction to EA – Why & How to Prioritize Problems to Work On

Global priorities research & shaping the ideas of intellectuals

We can use science to end poverty faster. But how much do governments listen to it?

Choosing the most critical problem

What happened to GDP per capita in England after 1825?

Our wealth across the ages

The industrial revolution changed everything

Comparing wealth across countries and time

We’ve seen progress across most areas of our lives

Billions now live free from extreme poverty

We’ve become vastly better educated

In what period did global life expectancy grow the most?

Our growing life expectancy

We could make the future radically better

Takeaways

The world is much better; The world is awful; The world can be much better

We radically improved the world, and could again

Know whether you’re actually helping

What impact did your colleague have from pushing the doctor out of the way to do CPR?

The real impact of saving a life

What was your true counterfactual impact?

Real positive change wouldn't have happened without you

Does Scared Straight help difficult kids commit less crime?

Scared straight?

You can accomplish more in hard-to-replace jobs

'Replaceability' isn't as important as you might think (or we've suggested)

Shapley values: Better than counterfactuals

How to be irreplaceable

Who deserves our concern?

Should you report the kidnapping to the police?

Kidnapper conundrum

We should care for moral patients

A golden rule

The all-knowing dictator

The blind dictator

We’re making moral progress

Same-sex relationships are now legal in the majority of countries

Approval of marriage between Black people and White people flipped from 4% to 94%

Many more women now enter the workforce than a century ago

We’re not done yet

Being a moral entrepreneur

Our descendants will probably see us as moral monsters

Identifying and tackling prejudice

Every answer has an element of uncertainty

Expected value is a tool for handling uncertainty

Assuming you could afford to lose, should you take this bet?

Let’s make a bet

Averting a nuclear disaster

What is the expected value, in additional years of healthy life, of a dose of Paxlovid?

Paxlovid

Expected value is used by leaders across industries

Which of your options has the highest expected value?

Sink or swim

Probabilities can be subjective and made up

If we accept GiveWell’s analysis, what increase should we expect for receiving deworming treatment?

Deworm The World

Expected value doesn’t handle extremes gracefully

The Fox And The Hedgehog: A Story of Triumphs and Tragedy

Moral cluelessness, population ethics, and probability within a multiverse

How to manage uncertainty in impact

Which problem should you work on?

Your career is loooooong…

You could change the course of history

There’s never been a better time to change the world

Which option would have a bigger direct impact on CO2 emissions?

Which of these factors has the strongest relationship with happiness on average?

Which graph best describes the relationship between income and happiness?

You can be financially secure and impactful

Take action

How to Pick a Career (That Actually Fits You)

80,000 Hours: Find a fulfilling career that does good

Making the most of your career

At what age is the average American’s salary the highest?

Build career capital to set yourself up for success

How often do we change our minds about our values, relative to what we expect?

Conduct quick tests to find your best long-term option

To get the best score you can, how many hours should you research before you start writing?

How much should you research?

What percent of technology startups fail to return a positive investment?

Reach high, with a backup

Score your options

Career exploration: when should you settle?

What to do when you’re uncertain

How many citations do the top 20% of scientists account for?

1_How many citations do the top 20% of scientists account for

You won’t know if something’s a good fit for you until you’ve tried it

What percent of American undergraduate students change degrees?

Take small steps to become more confident in a degree

How many passionate students are there in sports, music, or art for every job?

Don't blindly follow your passion

How often, on average, does a member of Gen Z change jobs?

Try out more options than you think you need to

Which undergraduate degree has the highest median salary?

Choose a flexible degree to not lock yourself in

High school is 12 years long. What is the value, in increased earnings, of finishing that last year of high school compared to finishing only 11 years?

Prestigious degrees open doors

Infrequently asked questions

Many Undergrads Should Take Light Courseloads

Half-assing it with everything you've got

What to study at university

Compare your long-term paths

Create a plan that makes sense for you

Your most impactful, fulfilling career

Common misconceptions

How many lives a doctor saves

What's more important to check to find out if this charity would actually help people?

Save The World By Helping Things™

The overhead myth

Compared to a doctor, how many more lives per year does Elijah, the engineer, save?

What does it cost in the field of global health to save a life, to the nearest order of magnitude?

How does the median American income compare to the rest of the world?

How rich will you be?

You can save lives without a medical degree

Join or build a community changing the world

Confidently taking your next steps

How you can help now

How to actually change the world

It can feel great to volunteer at a soup kitchen, but it’s important to know whether you’re really making a difference by doing so. Some factors make a surprising difference.

For example, consider two soup kitchens: one has lots of volunteers, and another doesn’t. A volunteer at the crowded kitchen is making a smaller difference than than one at the second soup kitchen, where showing up might make the difference between the kitchen being open or closed.

To actually improve the world, something needs to be 

 than it would have been otherwise. Your impact isn't real unless it wouldn't have happened without you.

You grab coffee with a colleague who recounts that time they saved someone's life,

I was walking with my friend, a medical doctor, when someone just dropped unconscious right in front of us. I was feeling pretty pumped after watching a few episodes of House, so I pushed the doctor out of the way and did some top notch CPR. After a few minutes, they woke up! My friend was pretty annoyed that I’d pushed him out of the way and broken the patient’s rib, and insisted he would have managed with all ribs intact.

They pushed someone more qualified out of the road who would have saved the patient’s life without breaking a rib. So even though they “saved someone's life,” their true impact was negative because the person would have been saved anyway, and left with all ribs intact.

Even though they “saved someone's life,” their true impact was negative because the person would have been saved anyway, and left with all ribs intact.

They had a negative impact because they pushed someone more qualified out of the road who would have saved the patient’s life without breaking a rib.

As a consultant in a busy teaching hospital, you're asked to give a presentation on your work to medical students. You tell them,

I attend 500 patients having a cardiac arrest per year, and 20% of these patients survive to be discharged from hospital in the following month. When I follow up a year later, 1/2 of those discharged have survived.

However, there are a lot of applicants to medical school. Let’s say the next best applicant who would have been accepted would have had a patient survival rate 99% that of yours.

Half of 20%, so 10%, of the 500 patients this consultant resuscitates survive at the 1 year mark – which is 50 lives total. However, we need to adjust for her being 1% better than the next best candidate, which means she saves 0.5 lives per year.

 500 crash patients × 20% survive to discharge × 50% 1-year survival = 50 lives saved

 Direct impact × 1% better than next best applicants = 50 × 0.01 = 0.5 lives saved

What’s the impact of a doctor? Doctors don’t just save lives directly – many focus on improving our health instead. So we need to add up improvements to well-being as well as the number of lives saved directly.

Tallying it all up, the data we have suggests an average doctor saves approximately 20 lives in their career.

The main reasons a doctor's impact is lower than people suspect is:

: If you don't become a doctor, many others are available to take your place. However, taking this role as a doctor, you free the next best candidate up to work on something else impactful, so this factor isn’t the most important.

Public health has a bigger impact than medicine

: >80% of improvements to life expectancy over the 20th century came not from personalised medicine, but public health (sanitation, vaccinations, etc.).

: Adding more doctors probably becomes less valuable the more doctors there already are, since early additions would tend to focus on the most serious cases in most need of their care.

An extra doctor in the developed world saves 0.5 lives per year when you adjust for what would have happened without them.

What would happen if you decided not to go to medical school? What would have happened if you studied a bit harder for that exam you failed? What would you do if your screen grew legs and started running away from you?

We use these “what if?” statements to explore hypothetical states of the world, and decide what to do. Another term for these hypotheticals is “counterfactual” – the counterfactual where Hitler died as a baby probably looks a lot different than our world today.

We can also use counterfactuals for making moral decisions. If you don’t volunteer at the food kitchen and someone equally good takes your place, you’re freed up to spend your time on something as or more valuable that won’t be done without you.

Amount of good you did - What would have happened without you

Nerdy aside: Etymology of counterfactual

You work on criminal justice at a philanthropic foundation.

A Concerned Dad sets up a meeting and pleads with you,

My son is going down the wrong path. There’s this [real] program called Scared Straight that stops difficult kids from getting involved in crime. They take kids to meet jail inmates, who scare the sh*t out of ‘em. In a documentary I watched, 94% of the children didn't commit any crimes afterwards. So it’s gonna work for him too. Please, you gotta help him!

After he leaves, you find that you didn’t get the whole story. Without the Scared Straight program, 96% of similar children don't commit any future crimes.

Scared Straight doesn't just not work. It actually increases crime!

Even though the program 'succeeded' 94% of the time, that outcome is actually 

 than what would have happened without the program (96% success rate).

Scared Straight has been extensively studied since it started in the 70s and shown to increase crime. According to an earlier review, each dollar spent on the Scared Straight program made society $200 worse off.

Scared Straight doesn't just not work. It 

 when you adjust for what happens without the program!

If Alexander Graham Bell was never born, would we still have the telephone? We can easily envision a counterfactual. On February 14, 1876 both Bell and another scientist, Elisha Gray, filed patents for the telephone.

There’s a repeated pattern of discoveries and inventions being made in quick succession – such as calculus, oxygen, and the theory of evolution.

Because of this fact, the impact of your work in innovation would be best measured by the amount of time you 

 the discovery. That isn’t necessarily a small impact – for example, rolling out a COVID-19 vaccine one day earlier could have saved tens of thousands of lives.

So how can you find hard-to-replace jobs? One approach is to find projects that are highly valuable for the world, but not financially lucrative. For example, improving the government’s response to COVID, or even more neglected, preventing future pandemics, might not be highly profitable because its benefits are so diffuse.

To establish how much good we actually accomplish, we need to consider what would have happened otherwise (our counterfactual impact)

The equation for counterfactual impact: Amount of good you did - What would have happened anyway

Additional doctors in developed countries save on average 20 lives in their career

Many approaches to helping look much less promising when you account for what would have happened by default.

So to know if we've changed the world for the better, we need to account for what would have happened without our actions (the 

For example, you might think doctors save hundreds of lives in their careers. However, adjusting for the counterfactual and other factors, the best data we have suggests it’s closer to 20 lives for the average doctor.

By finding a hard-to-replace niche, we can do more good.

How to be irreplaceable

What you'll be able to do