Effective Altruism and Friendship

by Varun Gauri

Effective altruism is having a moment. Books in the field are getting prominent reviews, the Effective Altruism Global conference took place in Washington DC this past weekend, and the movement now has the backing of at least a couple tech billionaires. Not bad for a social movement that celebrates self-sacrifice.

The basic agenda of effective altruism (EA) is that people should a) give to charities; b) give to organizations and in ways that are the most effective, usually understood to be providing the most bang for the buck; c) give as much as they can, up to the point where they begin to sacrifice something of real moral importance.

Most people would agree that it’s good to give and silly to give to hopeless causes. But EA has a particular understanding of effectiveness: One should give to charities that save the most lives or reduce the most suffering, per dollar spent. The rationale for this argument is that the goal of giving (and perhaps of ethical action altogether) is to alleviate suffering and loss, irrespective of the identities of the sufferer and the donor. The goal of giving is not to make yourself feel good by supporting friends and family, your alma mater, a pet cause, or a cute child who happens to resemble your niece. The idea is to give with your head, not with your heart. Because needs are great in developing countries, and the cost of saving a life is so much lower, the upshot is that people should give mostly to organizations that effectively improve the lives of impoverished strangers in faraway places.

Most people would also agree that it’s good to give as much as you can. People praise saints and admire genuine philanthropists. EA, however, argues that everyone should give until they sacrifice something morally important. The reason you should give so much is that you, after all, are just another person, so you should compare the pain from spending marginally less on your own life (fewer dinners out, no luxury brands) to the benefit of spending more on the faraway impoverished stranger (averting episodes of life-threatening malaria, preventing blindness). Obviously, your own money is better spent elsewhere.

I don’t believe that any single theory has a monopoly on sound ethical reasoning. Following EA to its logical conclusions leads to some unsettling inferences. Suppose person A is extremely poor, severely disabled, very sick, and socially marginalized, so much so that charitable giving has little chance of enhancing or prolonging their life. Person B is not as poor, needs cataract surgery, and has access to (but can’t afford) health care. EA might argue that giving to charities promoting the life of person B is always preferable to giving to charities that target person A, given that person A’s quality of life can’t be improved. I’m uneasy with that conclusion because I think resources (and especially government programs) are valuable not only for the suffering they reduce; they are also a signal of respect, a recognition of human dignity, and a commitment to community and social inclusion.

In the mid to late 1990s, I was evaluating the World Bank’s HIV/AIDS programs in Brazil. In 1996, Brazil had begun to provide antiretroviral “cocktails” at a cost of more than $10,000 per patient per year. Many economists, writing at that time, were critical of the decision. They argued that HIV/AIDS spending should go almost entirely to prevention, rather than treatment, because, per dollar spent, one could avert more cases, and save more lives, with condom distribution than antiretroviral therapy.

Traveling across the country, I saw that access to treatment seemed to be making prevention efforts more effective —  when vulnerable individuals and activists experienced hope and dignity, which treatment signified for them, they became more engaged in their own lives, and put more effort into prevention programs both for themselves and on behalf of others. Access to treatment helped to crystallize the Brazilian HIV/AIDS and human rights movement. That movement would eventually play a critical role in lobbying for expanded domestic production of HIV/AIDS medications in Brazil. It also helped inspire the international effort to permit developing countries to circumvent international patent restrictions on the production of generic drugs. Not only Brazil but Thailand, South Africa, and India began producing low-cost AIDS treatments. As a result, the price of those antiretroviral therapy quickly fell to less than a few hundred dollars per patient per year, a price that facilitated HIV/AIDS treatment in places as resource-poor as Haiti and Rwanda.

I’m broadly sympathetic to EA. I believe in reducing charity for vanity projects, like named university buildings or concert halls, and more generally, in making charitable giving more effective. I also believe that people should give more to distant strangers, and that if they did so the world would be a better place. Still, I suspect my work experience in Brazil points to a blind spot in EA. In the long run, most people want help not from strangers but from friends. They not only seek the mitigation of their suffering but the security that it won’t return; they want a measure of social recognition and the guarantees that go with it. The logic of EA, and its accompanying cost-effectiveness calculations, seem most suited to remaining a stranger, not a friend, to the people one is trying to help.

At least one or two of the big EA donors are investing in politics. But a political campaign is not a social movement. Social movements, like the one around HIV/AIDS in Brazil, could help tackle some of the major structural barriers that disadvantage poor people in developing countries. Those include odious debt (the sovereign debt taken on by corrupt and odious leaders, which citizens are obligated to repay), tax havens in rich countries that allow local capital to escape taxation, intellectual property rules raising costs and limiting innovation in developing countries, and the arms trade, to name a few. Those are complex challenges that will not, I believe, be resolved without significant social transformation and a new species of solidarity, which is a kind of friendship.