Wednesday, February 21, 2018

The most Effective Giving / Altruism ? Setting a benchmark $30 per QALY / DALY

Last year I read "Doing Good Better" by William Macaskill and was allowed to take part in an Effective Giving Mini Masters here in the Netherlands.

Summary: I believe that a donation to CHAT Africa could be one of the most effective donations you can make. A $30 donation may result in 1 DALY / QALY (Disability / Quality Adjusted Life Year), that is better than the $100 estimate for the Against Malaria Foundation.

Feel free to let me know how, why and to what extent I might be mistaken.

https://www.effectivegiving.nl/the-frameworks-and-tools-we-use/

1. Cause area (most important): Increasing access to family planning

2. Solution (second step in impact): Mostly in-expensive implants

3. Organisation team: Local Kenyan team

In practice you can use benchmarks to help decide where to give: https://www.effectivegiving.nl/growing-your-effectiveness-with-benchmarks/

The Against Malaria Foundation (‘AMF’) is considered one of the world’s most effective charities. The explanation for this is quite straight forward: AMF provides bednets that stop very young children (mostly under-5’s) dying prematurely from malaria. GiveWell estimates that roughly $3,500 donated to AMF saves a child’s life. More specifically, that $3,500 buys 35 ‘QALYs’ (Quality-Adjusted Life Years), which is more technical way of saying it creates 35 years of healthy life for the beneficiary.

Benchmark: $100 per Quality Adjusted Life Year (QALY)
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Some math on http://www.chatafrica.org/ ( I can send you the spreadsheet, email: ajbrenninkmeijer@gmail.com )

CHAT Africa 2016 efficiently providing access to contraceptives to save the environment
>> GRASS ROOTS << For Kenyans, by Kenyans CHAT Africa
People Years access to contraceptives Expected Value Couple Years of Protection
3-5 year implants           20.000 x 4 =        80.000 years
3 month injectable             6.967 x 0,25 =           1.742 years
Pill (1 year? )             2.381 x 1 =           2.381 years
IUCD  Device in uterus                 310 x 1 ? =              310 years
Condoms distributed         117.800 0,008 120 units per CYP*              982 years
With 2016 budget        85.414 Couple years of protection CYP
*https://www.usaid.gov/what-we-do/global-health/family-planning/couple-years-protection-cyp
Budget 2016 33 million Kenyan Shillings =   €          270.000
 Extra 
 Donation ?   €          200.000 =  2 / 2,7 of 2016 years =        63.270 Possible extra years of access to contraceptives 
74%  higher Expected Value than research suggested 
CHAT Africa
"$ per bottom line" 2016 Budget / Years access  € 270.000 divided by        85.414 =  €         3,2 per Couple Year of Protection "CYP"
"$ per bottom line" Website "$5 or £3 will provide protection for 1 woman for 3 years against unwanted pregnancies."=   €       1,40 per CYP ?
Website is marginal cost? "the cost added by producing one additional unit of a product or service." 

DALY Disability Adjusted Life Year ratio 4,1 to CYP Couple Year Protection ? Ratio by Guttmacher Institute found in a DFID research report
35 DALY = 243 CYP Couple Years Protection = ratio 7 http://www.psi.org/wp-content/uploads/drupal/sites/default/files/publication_files/DALYs%20for%20FP%20final.pdf
Higher Ratio = 7 Couple Years of Protection = 1 DALY , cost per DALY is then  €3,2 / CYP x 7 CYP/DALY = € 22 per DALY = roughly $30 per DALY 

A life = 35x a DALYear = $30 x 35 = $1 050 per life (death averted).

http://www.chatafrica.org/summary.html



Comments, questions or E-mails welcome: ajbrenninkmeijer@gmail.com

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