What do The American Cheese Society, Oxfam, and Homeopaths Without Borders have in common? The answer is that they’re all non-profit organisations.
‘Homeopaths Without Borders’ has provided ‘treatment’ and ‘education’ in a number of countries, including Haiti after the 2010 earthquake there. There is little reason to believe this intervention can be beneficial (beyond, perhaps, a placebo effect) and good reason to believe it may deter vulnerable people on the ground from seeking genuine medical attention if they believe homeopathy can somehow cure a range of deadly diseases such as cholera and malaria.
Hopefully most readers of this article are knowledgeable enough not to support such a charity. But some charities provide interventions that, on the face of it, sound like fantastic ideas. It’s only when you look at the details that the flaws emerge.
For example, Playpumps International were a charity that received millions of dollars from the US government, as well as celebrity backing, in order to help developing countries improve their access to clean water. The idea was simple: as children play on a merry-go-round they pump water from an underground water source into a storage tank.
Yet the pumps were criticised by other water charities for being far more expensive and complicated (and therefore harder to repair) than conventional pumps. To pump the amount of water that the charity claimed it could provide, it would require children to be ‘playing’ on them for 27 hours a day. Playpumps may well have diverted funds that could have been used to provide water for many more people.
Most charities probably don’t directly cause harm. But even amongst charities that support worthy causes, there are good reasons to favour certain charities over others. Why?
Firstly, some problems are more serious than others. Cancer is worse than the common cold. Being one of the 19,000 children who die every day from mostly preventable disease is worse than being an artisan American cheese manufacturer in need of promotion.
Secondly, some interventions simply cost more to achieve a similar outcome. This means that £1 given to one charity might do as much good as giving £1000 to another.
Giving What We Can point out that if you want to help blind people, you could spend $40,000 training a guide dog to help one person in the US or UK. Or, using the same money, you could cure more than 2,000 people of blindness by paying for surgeries to reverse the effects of trachoma in developing countries. There are similarly impressive differences in the cost-effectiveness of interventions to prevent the spread of HIV; education works out as much better value than anti-retroviral therapy.
This is the rationale behind the ‘effective altruism’ movement, which includes groups such as GiveWell and Giving What We Can (who have a chapter at the University of York). By researching charities to find those that provide the biggest impact for each donation, by ensuring that the charity’s work is backed up by independent evidence, and by demanding openness and transparency, we can support the interventions that help improve the world the most.
We should not merely seek out and support good charities: we should support the best.
(article originally poster on The Yorker)