Deworming a movement
Over the last few days I've been reviewing the evidence for EA charity recommendations. Based on my personal experience alone, the community seems to be comprehensively inept, poor at marketing, extremely insular, methodologically unsophisticated but meticulous, transparent and well-intentioned. I currently hold the belief that EA movement building does more harm than good and that is requires significant rebranding and shifts in its informal leadership or to die out before it damages the reputation of the rationalist community and our capacity to cooperate with communities that share mutual interests.
It's one thing to be ineffective and know it. It's another thing to be ineffective and not know it. It's yet another thing to be ineffective, not know it, yet champion effectiveness and make a claim to moral superiority.
In case you missed the memo deworming is controversial, GiveWell doesn't engage with the meat of the debate, and my investigations of the EA community's spaces suggests that it's not at all known. I've even briefly posted about it elsewhere on LessWrong to see if there was unspoken knowledge about it, but it seems not. Given that it's the hot topic in mainstream development studies and related academic communities, I'm aghast at how irresponsive 'we' are.
What's actionable for us here. If you're looking for a high reliability effective altruism prospect, do not donate to SCI or Evidence Action. And by extension, do not donate to EA organisations to donate to these groups, including GiveWell. I am assuming you will use those funds more wisely instead, say buying healthier food for yourself.
For who don't to review the links for a more comprehensive analyses from Cochrane and GiveWell, here is one summary of the debate recommended in the Cochrane article:
Last month there was another battle in an ongoing dispute between economists and epidemiologists over the merits of mass deworming. In brief, economists claim there is clear evidence that cheap deworming interventions have large effects on welfare via increased education and ultimately job opportunities. It’s a best buy development intervention. Epidemiologists claim that although worms are widespread and can cause illnesses sometimes, the evidence of important links to health is weak and knock-on effects of deworming to education seem implausible. As stated by Garner “the belief that deworming will impact substantially on economic development seems delusional when you look at the results of reliable controlled trials.”
Aside: Framing this debate as one between economists and epidemiologists captures some of the dynamic of what has unfortunately been called the “worm wars” but it is a caricature. The dispute is not just between economists and epidemiologists. For an earlier round of this see this discussion here, involving health scientists on both sides. Note also that the WHO advocates deworming campaigns.
So. Deworming: good for educational outcomes or not?
On their side, epidemiologists point to 45 studies that are jointly analyzed in Cochrane reports. Among these they see few high quality studies on school attendance in particular, with a recent report concluding that they “do not know if there is an effect on school attendance (very low quality evidence).” Indeed they also see surprisingly few health benefits. One randomized control trial included one million Indian students and found little evidence of impact on health outcomes. Much bigger than all other trials combined; such results raise questions for them about the possibility of strong downstream effects. Economists question the relevance of this result and other studies in the Cochrane review.
On their side, the chief weapon in the economists’ arsenal has for some time been a paper from 2004 on a study of deworming in West Kenya by Ted Miguel and Michael Kremer, two leading development economists that have had an enormous impact on the quality of research in their field. In this paper, Miguel and Kremer (henceforth MK) claimed to show strong effects of deworming on school attendance not just for kids in treated schools but also for the kids in untreated schools nearby. More recently a set of new papers focusing on longer term impacts, some building on this study, have been added to this arsenal. In addition, on their side, economists have a few things that do not depend on the evidence at all: determination, sway, and the moral high ground. After all, who could be against deworming kids?
Additional criticisms of GiveWelL charities: http://lesswrong.com/lw/mo0/open_thread_aug_24_aug_30/cp8h
The kind of work I think EA's should be focussing on http://lesswrong.com/lw/mld/genosets/cnys AND
http://lesswrong.com/r/discussion/lw/mk2/lets_pour_some_chlorine_into_the_mosquito_gene/
The problem with MIRI: http://lesswrong.com/lw/cr7/proposal_for_open_problems_in_friendly_ai/cm2j
Forecasting health gaps
You're an average person.
You don't know what diseases you'll get in the future.
You know people get diseases and certain populations get diseases more than others, enough to say certain things cause diseases.
You're not quite the average person.
You have a strong preference against sickness and a strong belief in your ability to mitigate deleterious circumstances.
You have access to preventative research. You know if you don't work in a coal mine, overtrain when running, and eat healthy, you can stay healthier than those who take those risks.
You know that some disease outcomes are less than predictable, so you want to work towards the available of treatments that fill gaps in the availability of therapeutics. For instance, you might want a treatment for HIV to be developed, in case you become HIV infected, since there is a risk of HIV exposure for almost anyone exposed to unprotected sex, since they won't necessarily know their sexual partners entire serohistory (noologism?)
However, you don't know which diseases you will get. So how do you prioritise?
Perhaps, medical device and pharmaceutical company strategies could be ported to your situation.
Most people, including non-epidemiologist researchers, don't have access to epidemiology data sets.
Most people, don't have the patience to read a book on medical market research
You don't have the funds or connections to employ the world's only specialist in the area of medical market forecasting.
At least he's broken down the field into best practice questions:
- Where can we find epidemiological information/data?
- How do we judge/evaluate it?
- What is the correct methodology for using it?
- What's useful and what's not useful for pharma market researchers?
- How do we combine/apply it with MR data?
The only firm, other than Bill's, that appears to specialist in the area fortunately breaks down the techniques in the field for us:
- Integrated forecasts based on choice modeling or univariate demand research to ensure that the primary marketing research is aligned with the needs of forecast
- Volumetric new product forecasting to provide the accuracy required for pre-launch planning
- Combination epidemiology-/sales-volume-based forecast models that provide robust market sizing and trend information
- Custom patient flow models that represent the dynamics of complex markets not possible with cross-sectional methods
- Oncology-specific forecast models to accept the data and assumptions unique to cancer therapeutics and accurately forecast patients on therapy
- Subscription forecasting software for clients who would like to build their own forecasts using user-friendly functionality to save time and prevent calculation and logic errors
The generalisations in the industry, things that are applicable across particular populations, therapeutics or firms appears to be summarised here:
It's 36 pages long, but well worth it if area is interesting to you.
So now you know how this market operates, what are the outputs:
Mega trends are available here
A detailed review is available here
Do they answer the questions, use the techniques proposed, and answer the ultimate question of what gaps exist in the provision of medical therapeutics?
I don't know how to apply the techniques to tell. What do you think?
I know there are other ways to think about these problems.
For instance, if I put myself in a pharmaceutical company's position, I could use strategic tools like Porter's 4 forces and see whether a particular decision looks compelling.
The 2018 paper suggests that pain killers in developed countries are going to get lots of government investment.
So, does it makes sense to supply that demand?
There are a number of highly risky threats that might suggest say a potential poppy producer shouldn't proceed:
**technological**
Disruptive biotechnology, such as genetically modified yeast which can convert glucose to morphine. There have been suggestions that this invention is overhyped
**political**
Licensing poppy producers who currently supply illicit drug producers
This said, the whole thing is very underdetermined so I suspect actual organisations are far more procedural in their approaches. What do you think?
How to win the World Food Prize
The world is basically [food secure, except Africa](http://blog.givewell.org/2009/03/16/can-the-green-revolution-be-repeated-in-africa).
Things [aren't improving the way people hope](http://www.givewell.org/international/technical/additional/Easterly-paper).
The Gates Foundation [can't spend their way out of this problem the traditional way](http://blog.givewell.org/2009/10/29/gates-foundation-on-agriculture-funding-where-are-the-facts/).
What's to be done?
Reading up on the GiveWell Open Philanthropy Project's investigation of science policy lead me to look up CRISPR which is given as the example of a very high potential basic science research area.
In context, Givewell appears to be interested in the potential for Gene drive. I am not sure if I am using the term in a grammatically correct way.
Austin Burt, an evolutionary geneticist at Imperial College London,[5] first outlined the possibility of building gene drives based on natural "selfish" homing endonuclease genes.[4]Researchers had already shown that these “selfish” genes could spread rapidly through successive generations. Burt suggested that gene drives might be used to prevent a mosquito population from transmitting the malaria parasite or crash a mosquito population. Gene drives based on homing endonucleases have been demonstrated in the laboratory in transgenic populations of mosquitoes[6] and fruit flies.[7][8] These enzymes could be used to drive alterations through wild populations.[1]
I would be suprised if I am the first community member to ponder whether we could just go ahead and exterminate mosquito's to control their populations. Google research I conducted ages ago indicated that doing so resulted in no effective improvement in desired outcomes over the long term. I vaguely remember several examples cited, none of which were Gene Driving, which I have only just heard of. I concluded, at the time, that controlling mosquito populations wasn't the way to go, and instead people should proactively protect themselves.
In 2015, study in Panama reported that such mosquitoes were effective in reducing populations of dengue fever-carrying Aedes aegypti. Over a six month period approximately 4.2 million males were released, yielding a 93-percent population reduction. The female is the disease carrier. The population declined because the larvae of GM males and wild females fail to thrive. Two control areas did not experience population declines. The A. aegypti were not replaced by other species such as the aggressive A. albopictus. In 2014, nine people died and 5,026 were infected, and in 2013 eight deaths and 4,481 infected, while in March 2015 a baby became the year's first victim of the disease.[9]
It's apparent that research is emerging for the efficacy of Gene Driving. In conducting research for this discussion post, I found most webpages in top google results were from groups and individuals concerned about genetically modified mosquitos being released. I am interested in know if that's the case for anyone else, since my results may be biased by google targeting results based on my past proclivity for using google-searching to confirm suspicions about things I already had.
It appears that the company responsible for the mosquitos is called Oxitec. I have no conflict of interest to disclose in relation to them (though I was hoping to find one, but they're not a publicly listed company!). They appear to be supplying trials in the US and Australia. Though, I haven't looked to see if they're involved in any trials in developing countries. It stuns me that I was not aware of them, given multiple lines of interest that could have brought me to them.
My general disposition towards synthetic biology has been overwhelming suspicious and censorial in the recent past. My views were influenced by the caution I've ported from fears of unfriendly AI. I wanted to share this story of Gene Driving because it is heartwarming and has made me feel better about the future of both existential risk and effective giving.
Edit: Synthetic biology for fun and profit! Any biohackers around? I just discovered the [registry of standard biological parts](http://parts.igem.org/Main_Page?title=Main_Page), the [biobrick assembly kit](https://www.neb.com/products/e0546-biobrick-assembly-kit) and [genome compiler](http://www.genomecompiler.com/?_ga=1.251739919.769837041.1438856618). I'm having the biggest nerdgasms I can recall. Who wants to chlorinate the mosquito gene pool with me?
Synthetic biology for good: So who's gonna do the protocol design for the tsetse fly gene drive? Whose gonna model the disease?
How much would it cost? [Here's an esteimate](http://lesswrong.com/lw/mld/genosets/cnys). Seems like an easy investment decision in public wellbeing.
Speculative rationality skills and appropriable research or anecdote
Is rationality training in it's infancy? I'd like to think so, given the paucity of novel, usable information produced by rationalists since the Sequence days. I like to model the rationalist body of knowledge as superset of pertinent fields such as decision analysis, educational psychology and clinical psychology. This reductionist model enables rationalists to examine the validity of rationalist constructs while standing on the shoulders of giants.
CFAR's obscurantism (and subsequent price gouging) capitalises on our [fear of missing out](https://en.wikipedia.org/wiki/Fear_of_missing_out). They brand established techniques like mindfulness as againstness or reference class forecasting as 'hopping' as if it's of their own genesis, spiting academic tradition and cultivating an insular community. In short, Lesswrongers predictably flouts [cooperative principles](https://en.wikipedia.org/wiki/Cooperative_principle).
This thread is to encourage you to speculate on potential rationality techniques, underdetermined by existing research which might be a useful area for rationalist individuals and organisations to explore. I feel this may be a better use of rationality skills training organisations time, than gatekeeping information.
To get this thread started, I've posted a speculative rationality skill I've been working on. I'd appreciate any comments about it or experiences with it. However, this thread is about working towards the generation of rationality skills more broadly.
Entrepreneurial autopsies
Entrepreneurial ideas come and go. Some I don't give a second thought to. Others I commence market research for, examine the competitive landscape and explore the feasibility for development. This can be time consuming, and has yet to have produced any tangible, commercialized product.
I figure it's about time I devote the time I would spend to exploiting my existing repertoire of knowledge to develop an idea, to exploring parsimonious, efficient techniques for assessing viability.
In my search I found [Autopsy.io], a startup graveyard. Founders describe why their startups failed, concisely. It made me think about my past startup ideas and why they haven't flied.
I'm going to work that out, put it in a spreadsheet and regress to whatever problem keeps popping up - then, I'll work on improving my subject matter knowledge in that domain - for example, if its the feasibility of implementing with existing technology - I might learn more about the current technological landscape in general. Or, more about existing services for investors, if my product is a service for investors, like my last startup idea, which I have autopsied in detail here
I just thought I'd share my general strategy for anyone who'd want to copy this procedure for startup autopsy. Please use this space to suggest other appropriate diagnostic methods.
edit 1: Thanks for pointing out the typos :)
'Charge for something and make more than you spend' - Marco Arment, Founder of Instapaper
Inaugral bump thread (12th July to 19th July)
Recently I came across the Akrasia Tactics Review article, then a 'bump' thread which spread the relevant content over multiple places, making tracking the content harder. It's apparent that some people believe some Lesswrong articles may be undervalued by the community (after factoring in karma as an indication of the community's appraisal)
Bump threads crowd out new articles and may annoy the more comprehensive or more experienced readers. This article is prototype for a regular (or whenever anyone else wants to take the initiative to start one) discussion board thread where people can lobby for increased visitation to articles of their interest. Don't make the threads run for too long - 1 week as a guide. Tag them with bump_thread
Future thread starters should not suggest an article in the initial discussion post, as I have. Although, this is useful as a guide for what I have in mind.
Effective Altruism from XYZ perspective
In this thread, I would like to invite people to summarize their attitude to Effective Altruism and to summarise their justification for their attitude while identifying the framework or perspective their using.
Initially I prepared an article for a discussion post (that got rather long) and I realised it was from a starkly utilitarian value system with capitalistic economic assumptions. I'm interested in exploring the possibility that I'm unjustly mindkilling EA.
I've posted my write-up as a comment to this thread so it doesn't get more air time than anyone else's summarise and they can be benefit equally from the contrasting views.
I encourage anyone who participates to write up their summary and identify their perspective BEFORE they read the others, so that the contrast can be most plain.
Goal setting journal (GSJ) - 28/06/15 -> 05/07/15
Inspired by the group rationality diary and open thread, this is the inaugural weekly goal setting journal (GSJ) thread.
If you have goals worth setting that are not worth their own post (even in Discussion), then it goes here.
Here are mine, to illustrate:
11.Go to Centrelink to collect Youth Allowance and complain that you didn't get an SMS notification for reporting.
12. Ask Centrelink to setup SMS notifications for reporting
13. Find out how to report online, or by phone...and mention technical difficulties
26. apply neosporin nightly
28. review pre readings for subjects
Notes for future GSJ posters:
1. Please add the 'goal_setting_journal' tag.
2. Check if there is an active GSJ thread before posting a new one. (Immediately before; refresh the list-of-threads page before posting.)
3. GSJ Threads should be posted in Discussion, and not Main.
4. GSJ Threads should run for no longer than 1 week, but you may set goals, subgoals and tasks for as distant into the future as you please.
5. No one is in charge of posting these threads. If it's time for a new thread, and you want a new thread, just create it.
Min/max goal factoring and belief mapping exercise
Edit 3: Removed description of previous edits and added the following:
This thread used to contain the description of a rationality exercise.
I have removed it and plan to rewrite it better.
I will repost it here, or delete this thread and repost in the discussion.
Thank you.
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= f037147d6e6c911a85753b9abdedda8d)
Since risk from individual SNP's 'should' not be aggregated to indicate an individual's risk based on multiple sources of evidence, how are the magnitudes for genosets determined?. Can bayes or another method be used to interpret a promethease report?
Even genetic epidemiology textbooks seem pessimistic: about the usefulness of the genetic research underpinning precision medicine:
The references in question are about the impact of population stratification on genetic association studies. That doesn’t seem to substantiate such a broad stroke about the non-replicability of genetic epidemiology. I don't know what to make of these findings.
Here is a link to a screenshot of those references
It suprises me that entrepreneurial machine learning analysts don’t beg for genetic research to identify how combinatorial patterns of genes to be able to characterise individual risk. It seems like if/once they can get hold of that information, the sequence from genetic science to consumer actionable health information is bridged. So where are the 'lean gene learning machine' startups? I certainly don’t have the lean gene to do it myself. I don’t know machine learning.
Regulatory issues seems like the biggest hurdle. To the best of my google-fu, 23andme doesn't even disclose what it's 'Established Research' genes are. So, once regulatory hurdles are surmounted, lots of useful research will flood out.