Global Health & Development
7 MINUTE READ
Most people tend to see themselves as “average”, as opposed to very rich or very poor. Yet the majority of people who read this article are in the top 5% wealthiest people in the world (or will be in a few years if you’re a student). In fact, many readers have an income that is 10 times greater than the average (or if we’re being technical, median) person on the planet. Due to this vast economic inequality, you (and many others) could potentially save a person’s life with a sum you wouldn’t even notice if it went missing. Perhaps more importantly, regardless of your current income level, you could use your career to do much, much more than save a single person’s life.
The bottom line: We believe global health and development is robustly important, tractable, and neglected. As a result, global health and development can be a highly promising cause area to work on — if you’re a good fit.
Read on to find out how we reached this conclusion.
What is global health and development?
Global health and development focuses on helping improve the health or economic well-being of people across the world. If you want to focus on saving and/or improving the most human lives — regardless of where those people are from — there are many reasons to look to low- and middle-income countries. In addition to being home to the vast majority of extremely poor people, existing healthcare and support systems in such countries are much more limited, and there are lots of cheap and effective opportunities to help that aren’t being funded.
One example of such an opportunity is combating malaria. Every year more than half a million people (most of them children) die of malaria. At the same time, treating even complicated cases of malaria costs around $30 and preventing them costs significantly less — which is why malaria is not a major concern in high-income countries. But for those most at risk, it can be a challenge to afford even such small costs. Another example is lead exposure. One in every three children globally is affected by lead poisoning, which hinders brain development, reduces IQ and increases antisocial behavior. In high-income countries, regulation has all but eliminated high lead concentrations in fuel, paint, etc., but in many low- and middle-income countries, dangerous lead concentrations continue to be ubiquitous. A third example, out of many, is maternal health. If low- and middle-income countries had access to the same healthcare available in high-income countries, almost 300,000 fewer mothers would die in childbirth.
Global health and development interventions focus on addressing these and many other sources of disease burden and income inequality.
How important is global health and development?
Every year, more than 200 million years of healthy life are lost to diseases that we already know how to effectively treat — such as malaria, tuberculosis, and neglected tropical diseases. There’s significant evidence that the scope for improvement from an economic perspective is enormous too. The average income in low- and middle-income countries is around $14 a day — far below the large wage increases achieved in recent centuries by most countries via via better government policies, management, and technology . This gives an indication of just how much economic welfare is lost due to existing policies and lack of opportunities.
How tractable is global health and development?
Significant improvements to global health and development are surprisingly tractable. Let’s start with looking at humanity’s progress in the past. Within 30 years, we’ve reduced extreme poverty (people living on less than $1.90 a day, adjusting to what that money can actually buy locally) from more than a third of humanity to less than 10%. In the past 50 years, global life expectancy has increased by 30% - with most of this change occurring in improvements to health in low- and middle-income countries.
There’s a wealth of proven, cost-effective interventions that help improve people’s health and economic opportunities — as global health charity evaluator, GiveWell, reports. This includes the Against Malaria Foundation, which prevents a child from contracting malaria for every $7 you donate to it; the Schistosomiasis Control Initiative, which on average provides a child with 25% higher income throughout their lives for every $10 you donate to it; and GiveDirectly, which transfers money to those living in extreme poverty to use how they'd like.
The above examples also illustrate that global health and development is among the cause areas with the strongest evidence base and most robust theories of change. This field is quite unprecedented in how many of its tools and opportunities can be (and have been) studied extensively — which significantly increases our confidence in its tractability. However, this doesn’t mean the most promising work in global health and development is necessarily on interventions that already have the most evidence. There are plenty of opportunities for identifying new interventions (and in some cases starting new organizations) that are less certain but may turn out to be even more effective.
How neglected is global health and development?
Global health and development is quite neglected relative to many popular causes, but less neglected than some of our other top cause areas. Governmental and philanthropic spending on health and development in low and income countries sums up to around $200 billion. This may sound like a lot, but it's actually less than half of the total assets of the Italian post company alone.
Most donors (and volunteers, etc.) prefer to help those closer to them, leading to only 6% of donations going to international charities. Since the vast majority of wealthy donors live in high-income countries, most of that money stays at home — and so rich countries (and cities, and neighborhoods) have vastly more resources than poorer ones. For example, the country of Niger loses 750 times more healthy years of life to disease than Silicon Valley, yet Silicon Valley residents receive about 5 times as many donations for health-related causes. This means that someone in Silicon Valley would receive more than 3,500 times more donations for every year of healthy life lost relative to someone in Niger.
Why might you not want to prioritize global health and development?
Many people believe that charity starts at home. As a result, they may prefer to help out in their own neighborhood or country. Donating locally or abroad depends on a host of ethical questions (for example, if you give more weight to utilitarian considerations or reciprocity) — and there’s a wide range of legitimate moral views. If you care about the outcomes of your work, what you should do also depends on empirical questions, like where you can have a larger impact. This question is actually easier to answer. Perhaps unintuitively, regardless of where you are physically, you can often have 100x or more impact in low- and middle-income countries. This is because in richer countries, governmental agencies often already provide the basic services people need for a majority of the population, like education and significant medical care. This inequality exacerbated by most philanthropists sharing the intuition that charity starts at home, as described above.
Another reason you might want to prioritize other cause areas over global health and development is if you want to direct your efforts to help non-human animals. If you believe that animal suffering is even remotely close to being as important as human suffering, there are likely even more cost-effective things you could do to help animals. Once again, this issue depends on your own values — check out our cause area profile on animal welfare (coming soon) to learn more.
Another common reason people end up prioritizing other cause areas over global health and development is because they prefer work that has the potential to be even far more impactful - even if that outcome is not as certain or robust as the opportunities in global health and development. If you take an expected value approach, you might prefer such high-risk high-reward opportunities. For example, one promising cause area under that less-certain-but-more-ambitious approach is preventing global catastrophic risks — such as nuclear war, pandemics, extreme climate change and more.
What can I do to help?
The majority of people can contribute to their top cause areas using their career far more than they can with donations, advocacy or volunteering alone. We’ve reviewed quite a few careers that are especially relevant to this cause area, including Development Economics, Nonprofit Entrepreneurship, and Civil Service in Low and Middle Income Countries. There are many more career paths that can have a significant impact in global health and development, and we’re working on multiple future path profiles in this space.
In addition to using your career, global health and development is a cause area where donations can be particularly useful. This is because there are many proven interventions that are incredibly effective, but need a lot of funding to scale and reach the size of the problem. A great source for recommendations in global health and development is GiveWell - arguably the world’s top charity evaluator. Many of the charities they recommend can, on average, provide people with a full healthy year of life for every $100 you donate (or provide similarly impressive results in increasing education, lifting families out of poverty, and more). One great way to generate large amounts of donations for your favorite cause is by Earning to Give.