This still feels like a "we need fifty Stalins" critique.

For me the biggest problems with the effective altruism movement are:

1: Most people aren't utilitarians.

2: Maximizing QALY's isn't even the correct course of action under utilitarianism - its short sighted and silly. Which is worse under utilitarianism: Louis Pasteur dying in his childhood or 100,000 children in a third world country dying? I would argue that the death of Louis Pasteur is a far greater tragedy since his contributions to human knowledge have saved a lot more than 100,000 lives and have advanced society in other ways. But a QALY approach does not capture this. That's extreme obviously, but my issue is that all lives are not equal. People in developed countries matter way more than people in developing countries in terms of advancing technology and society in general.