
The Math of Saving Lives
13 minHow Effective Altruism Can Help You Make a Difference
Golden Hook & Introduction
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Michael: Alright Kevin, what if I told you that one of the most celebrated, celebrity-endorsed charities of the 2000s was a complete disaster, while a program that costs pennies and is, quote, "the least sexy development program there is," has saved and improved millions of lives? Kevin: Really? The "least sexy" program won? That sounds like my high school dating strategy finally being validated. I have to hear this story. What was the celebrated disaster? Michael: It’s a perfect entry point into the book we're discussing today: Doing Good Better by William MacAskill. He's this incredibly sharp philosopher from Oxford who, in his twenties, co-founded the entire effective altruism movement. The book is his attempt to get us to stop thinking about charity with our hearts and start using our heads. Kevin: Okay, using your head instead of your heart. That feels a little cold, but I'm intrigued. So, this celebrity-endorsed failure—what was it? Michael: It was called the PlayPump. And on the surface, it was one of the most brilliant ideas you’ve ever heard.
The Feel-Good Fallacy: Why Good Intentions Aren't Enough
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Michael: The concept was genius. It was a children’s merry-go-round attached to a water pump. So, as kids in a rural African village played, their spinning motion would pump clean water from underground into a storage tank. It’s a win-win: kids get a playground, and the village gets clean water. Kevin: That sounds amazing! It's innovative, it helps kids, it provides a vital resource. I would’ve donated to that in a heartbeat. What could possibly go wrong? Michael: Everything. The idea was so compelling it became a media darling. It won awards from the World Bank. First Lady Laura Bush and the Case Foundation gave it a $16.4 million grant. Jay-Z and Bill Clinton endorsed it. It was the poster child for innovative, feel-good charity. Kevin: I’m still not seeing the problem. This sounds like a home run. Michael: Well, the reality on the ground was very different. First, for the pump to provide a village's daily water needs, the merry-go-round had to be spun for about 27 hours a day. Kevin: Twenty-seven hours? There aren't even that many hours in a day! And kids can't play all day long. Michael: Exactly. So what happened? The children got exhausted. It stopped being play and started being a chore. And when the kids weren't available, the village women—the very people it was supposed to help—had to push this heavy merry-go-round themselves. One woman in Mozambique was quoted in a report saying, "The old hand pump was much easier." Kevin: Oh, that's heartbreaking. So it actually made their lives harder. Michael: And more expensive. The PlayPump cost about $14,000 to install, whereas a traditional, effective hand pump costs around $3,000. When the PlayPumps inevitably broke down, there was no local expertise to fix them. They just became rusted monuments to good intentions. The project was a massive, multimillion-dollar failure. Kevin: Wow. So our intuition is basically useless here. We're drawn to the shiny, clever new toy, not the proven, simple tool that actually works. Michael: Precisely. Now, contrast that with what MacAskill holds up as a prime example of effective altruism: the Deworm the World Initiative. An economist named Michael Kremer went to Kenya to study what actually improves educational outcomes. They tested everything: providing more textbooks, giving schools flip charts, even hiring more teachers. Nothing moved the needle. Kevin: Wait, giving kids more textbooks didn't help them learn? That seems impossible. Michael: It had a very small effect, but only on the students who were already at the top of their class. For most kids, it did nothing. But then they tested a different hypothesis. Many children in the region suffer from parasitic worms, which make them sick and anemic. So they tried a ridiculously simple intervention: giving children a deworming pill that costs less than fifty cents. Kevin: And what happened? Michael: The results were staggering. School absenteeism dropped by 25%. For every dollar spent, they generated 139 additional years of school attendance across all the students. The kids who were dewormed went on to earn 20% more in their adult lives. It was, and is, one of the most cost-effective interventions on the planet. But as one charity worker said, it's "probably the least sexy development program there is." Kevin: There are no celebrity galas for deworming pills, I take it. That’s incredible. It’s a story about humility, really. The humility to admit that your brilliant idea might be wrong and to just follow the data, even if it leads you to something boring. Michael: Exactly. And that leads to the book's most powerful, and maybe most uncomfortable, idea. It's not just about choosing a good charity over a bad one. It's about the magnitude of the difference.
The Uncomfortable Math of Saving Lives
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Michael: MacAskill introduces a concept he calls the "100x Multiplier." The core idea comes from a basic rule of economics: the law of diminishing marginal utility. The more you have of something, the less value the next unit has for you. Kevin: Right, the first slice of pizza is heaven. The tenth slice is a stomach ache and a cry for help. Michael: Exactly. Now apply that to money. An extra dollar to a billionaire means nothing. An extra dollar to you or me is nice—maybe a coffee. But an extra dollar to someone living on less than two dollars a day can be life-changing. MacAskill and other economists estimate that because of this, a dollar can do at least one hundred times more good for the very poorest people in the world than it can for us. Kevin: One hundred times. That's a mind-blowing number. It reframes everything. Michael: It does. And he puts our own wealth in perspective. He points out that if you earn more than $52,000 a year, you are, on a global scale, in the top 1%. Even someone earning the US poverty-line income of $11,000 is richer than 85% of the world's population. Kevin: Okay, that's a powerful concept. But it also makes every dollar I spend on something non-essential feel... ethically loaded. How do you even deal with that? It feels like a recipe for constant guilt. Michael: And that's a common reaction, which the book addresses. MacAskill argues it's not about guilt, but about opportunity. It’s about realizing the incredible power you have. He uses the analogy of triage, telling the story of James Orbinski, a doctor with Doctors Without Borders during the Rwandan genocide. Kevin: I can only imagine how horrific that was. Michael: The hospital was overwhelmed. Hundreds of wounded people, but only enough resources to treat a fraction of them. Orbinski had to make an impossible choice. He created a triage system: tag 1 for patients who needed immediate treatment to survive, tag 2 for those who could wait, and tag 3 for those who were irretrievable. He had to consciously let people in category 3 die to save those in category 1. Kevin: That is an unimaginable burden to carry. Michael: It is. But MacAskill's point is that Orbinski's choice, as brutal as it was, saved the most lives possible. If he had treated people first-come, first-served, or if he had thrown up his hands and said "I can't choose," he would have made the worst choice of all. And that, MacAskill argues, is the situation we're in with our charity. We have limited resources. Not choosing the most effective cause is, itself, a choice—and it's a choice to help fewer people. Kevin: But that feels so cold! Comparing lives, weighing causes... what about personal connection? What if a cause, like cancer research, matters to me because it affected my family? Is he saying that's a wrong or selfish donation? Michael: He's very careful about this. He says it's understandable and noble, but it's also arbitrary from a global perspective. He asks us to consider fairness. Is it fair that someone gets more help simply because they have a connection to a wealthy donor, while someone else, who could be helped for a fraction of the cost, gets nothing? He's pushing for a kind of radical impartiality. Kevin: It's a tough pill to swallow. It challenges the very idea that charity is a personal, emotional act. He’s turning it into a math problem. Michael: A math problem with incredibly high stakes. He estimates that at the time of writing, a donation of about $3,400 to the Against Malaria Foundation could literally save a life. Once you know that, it's hard to look at a $3,400 vacation or a new laptop in the same way. Kevin: You're not kidding. Okay, so the logic is powerful for donations. But how does this apply to the rest of our lives? Most of us are trying to make a difference in other ways, like how we shop or the careers we choose.
Your Life as a High-Impact Lever: Rethinking Careers and Consumerism
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Michael: This is where the book gets really counter-intuitive. He applies the same cold, hard logic to ethical consumerism. And his conclusion is that most of it is ineffective. He even makes the moral case for sweatshop goods. Kevin: Hold on. For sweatshops? My whole life I've been told to buy "sweatshop-free" and boycott companies that use them. You're saying that's actually harmful? Michael: He argues that it often is. He tells the story of a Cambodian woman named Pim Srey Rath, who scavenges for plastic in a massive, stinking garbage dump to survive. When asked what she wants, she says, "I'd love to get a job in a factory. At least that work is in the shade." For her, and for millions like her, a sweatshop job isn't exploitation; it's a step up. It's often the best option available. Kevin: So when we boycott those factories, we're not pushing them to improve conditions... we're just taking away the best of a set of bad options? Michael: Often, yes. He cites a case from 1993, when the US threatened to ban imports from Bangladesh over child labor. In response, garment factories preemptively fired 50,000 children. A UNICEF study later found that many of those kids ended up in far worse situations: working in unregistered workshops with even more dangerous conditions, or even turning to street hustling and prostitution. The boycott, meant to help, made their lives worse. Kevin: That is a devastating, unintended consequence. It completely flips the script on what it means to be an ethical consumer. What about something like Fairtrade coffee? That seems like a clear win. Michael: Less clear than you'd think. He points to studies showing that only a tiny fraction—sometimes less than 1%—of the extra price you pay for a Fairtrade product actually reaches the farmer. Most of it is absorbed by middlemen and marketing. A more effective way to help that farmer is to buy the cheapest coffee you can find and donate the money you saved directly to a highly effective charity. Kevin: So the theme continues: direct, measurable impact trumps feel-good gestures. What about careers? That's the biggest choice most of us make. Michael: This was my favorite part of the book. He argues that the most common piece of career advice—"follow your passion"—is just as flawed. Kevin: Oh, come on. That's the one thing every graduation speaker has told me since kindergarten. Michael: He says the data just doesn't support it. First, most people's passions—sports, art, music—don't align with available jobs. Second, our passions change. And third, and most importantly, job satisfaction doesn't come from matching a job to a pre-existing interest. It comes from the characteristics of the work itself: things like autonomy, variety, a sense of completion, and feeling like your work contributes to others' well-being. Passion isn't something you find; it's something you cultivate by getting good at something valuable. Kevin: So instead of asking, "What am I passionate about?" I should be asking, "What valuable, neglected problem can I get really good at solving?" and the passion might follow. Michael: Exactly. And this opens up a radical career path he calls "earning to give." Maybe you're a brilliant programmer or a talented financial analyst. Instead of leaving that field to work for a non-profit for a low salary, you could stay in your high-paying job and donate a significant portion of your income. By funding five researchers at an effective organization, you could have a much larger impact than by becoming the sixth researcher yourself. Kevin: That completely reframes what an "ethical career" can be. It's not just about being a doctor or a teacher. You could be a hedge fund manager and be one of the most impactful people in the world, if you do it right. Michael: It's about finding the best way to use your specific talents as a lever to do the most good. It's a much bigger, more strategic way of thinking about your life's work.
Synthesis & Takeaways
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Michael: Ultimately, the book is a call to shift our mindset. It's about moving from the warm glow of good intentions to the real, measurable, and sometimes uncomfortable, world of impact. It’s not about being a perfect saint; it’s about being a smart altruist. Kevin: And it's not just abstract. The book points to concrete things. You can look at charity evaluators like GiveWell, which do the hard research for you. You can start thinking about causes not just in terms of how sad they make you feel, but in terms of their scale, their neglectedness, and their tractability. Michael: It's a framework for thinking. The five key questions he asks are a great starting point for any decision: How many people benefit, and by how much? Is this the most effective thing I can do? Is this area neglected? What would have happened otherwise? And what are the chances of success? Kevin: It’s a total paradigm shift. It's empowering, but also a huge responsibility. The idea that I, just a regular person, have the power to save hundreds of lives over my lifetime if I'm just a bit more thoughtful with my resources... that's a heavy, but also an incredible, thought. Michael: It is. And it leaves you with one big, life-altering question: Given the incredible power we have, what is the most good I can do? Kevin: A question worth spending a lifetime trying to answer. Michael: This is Aibrary, signing off.