Dissidents and Philanthropists

VALUABLE UPDATE! 12:22 PM 8/2/2012 GiveWell gives its side of the conversation (see end of this post) Had a conversation with Holden Karnofsky and Stephanie Wykstra of the philanthrophy firm GiveWell, along with an anonymous philanthropy adviser.   I enjoyed the spirited give and take.  At the end, had the feeling "well, nice chat, but I failed to be convincing." Stephanie took notes of my side of the conversation; here's the full transcript on our site. Wish I had taken notes on their side! Below are some extracts from my side:

... the “what works in aid” debate is phrasing the question wrong. You really want to know what works for whom, which will then lead to the question at the heart of economics and politics: who gets to decide what happens? This isn’t answered by randomized controlled trials (RCTs) that show that an intervention improves some quantitative measure of well-being. Markets and democracy are better feedback mechanisms than RCTs, and they provide resolution on “who gets to decide?” Seeing what people buy and asking them what they want gives better indicators of what works for them than quantitative indicators...

As an example: recently the World Bank funded a project in Uganda. The project ended up burning down farmers’ homes and crops and driving the farmers off the land. A lot of quantitative indicators like GDP would have shown up as improved as a result of the project, but there were many people whose rights were grossly violated in the process

But researchers don’t want their job to be more difficult than it is. If you ask for not only a RCT but also a guarantee that it’s not concealing unacceptable harm, you’re making it harder, and RCTs are already expensive and hard to begin with. It’s inconvenient for the researchers to acknowledge these problems.

Development happens when people have the opportunity to choose what they want, choose whether or not to give consent for an intervention that affects them, protest if they don’t like what’s being done to them and have a mechanism to exit if they don’t like what’s being done.

Have a system in place to ensure that you’re actually making people better off rather than harming them. Others would be better than I am on how to do this in practice, but just to start the discussion... it could mean offering {beneficiaries} a menu of options that they can choose from, and learning from their responses. More broadly, promoting rights of poor people might have indirect positive consequences that are a lot larger than the benefits of individual interventions.

...a lot of things that people think will benefit poor people (such as improved cookstoves to reduce indoor smoke, deworming drugs, bed nets and water purification tablets) {are things} that poor people are unwilling to buy for even a few pennies. The philanthropy community’s answer to this is “we have to give them away for free because otherwise the take-up rates will drop.” The philosophy behind this is that poor people are irrational. That could be the right answer, but I think that we should do more research on the topic. Another explanation is that the people do know what they’re doing and that they rationally do not want what aid givers are offering. This is a message that people in the aid world are not getting

Funding is biased toward a technocratic approach. Aid agencies do not want to deal with additional complexities like asking the people who they work with for consent or giving them choice. They already have hard jobs. They don’t want to hear about research that makes their job harder.

Dissidents.... say things that people don’t want to hear. Angus Deaton, Lant Pritchett, Ross Levine, and Andrei Shleifer are examples. Dissidents are a positive feature of a system that makes it more robust. A consensus model is prone to groupthink. Even if we dissidents were wrong, it would still be important that people like us challenge the mainstream consensus to make them rethink what they’re doing. Cass Sunstein wrote a book about this (Why Societies Need Dissent.) There are probably many more dissidents that we haven’t heard of. There are a lot of dissident aid workers who can’t speak publically without losing their jobs, and so keep quiet or write anonymous blogs.

UPDATE 12:27PM 8/2/2012: GiveWell has posted its side of the conversation on its blog. Here are some extracts:

• We don’t believe in a “first, do no harm” rule for aid. ... we believe that it isn’t practical to eliminate all risks of doing harm...
• people simply undervalue things like insecticide-treated nets. Brett Keller observes that irrationality about one’s health is common in the developed world. In the developing world, there are substantial additional obstacles to properly valuing medical interventions such as lack of the education and access necessary to even review the evidence.
• We believe that empowering locals to choose their own aid is much harder in practice than it may sound– and that the best way to achieve the underlying goal may well be to deliver proven health interventions. We’ve argued this point previously.
• Bottom line: Prof. Easterly ... see{s} himself as a “dissident”; his role is to challenge the way things are done without recommending a particular course of action. We see ourselves as advisors to donors, helping them to give as well as possible today. So while we share many of Prof. Easterly’s concerns – and would be highly open to new approaches to addressing these concerns – we’re also in the mindset of moving forward based on the best evidence and arguments available at the moment.