EA - Comparing Health Interventions in Colombia and Nigeria: Which are More Effective and by How Much? by Alejandro Acelas

Link to original articleWelcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Comparing Health Interventions in Colombia and Nigeria: Which are More Effective and by How Much?, published by Alejandro Acelas on March 24, 2023 on The Effective Altruism Forum.TL;DR: Nigeria bears 10 times the burden of communicable, maternal, neonatal, and nutritional diseases per capita than Colombia, despite both countries having similar health expenditures to combat these diseases. Applying the SNT framework suggests that health interventions are around 10 times more cost-effective in Nigeria even when comparing only the poorest regions within each country.Why I decided to work on this topicChatting with the members of my EA university group in Colombia, I noticed many of them were mainly interested in contributing to problems that affected their home country. Although Colombia is far from being one of the poorest countries in the world, various regions of the country still suffer from similar problems as less developed countries. I thought there might be a chance that we found opportunities with similar cost-effectiveness as those that EA tends to prioritize in the area of health and development.Given that some students from my EA group were considering making career decisions based on a similar perception, I thought it worthwhile to spare a couple of hours to critically evaluate this line of reasoning, in the hope that this would allow them to make a more informed decision. Ideally, this research would answer the following questions:Within the ways to help in Colombia, which problems/interventions represent unusually cost-effective opportunities to help?How do the best opportunities identified in Colombia compare with the best opportunities abroad?Unfortunately, both questions are too broad to cover them appropriately in the short time I dedicated to this work (approx. 40 hours). In order to make progress I decided focus on the much more narrow question:In aggregate, how cost-effective do health interventions addressing communicable, maternal, neonatal and nutritional diseases in Colombia seem when compared to interventions in the same area in a substantially poorer country?Although this question corresponds to only a fragment of our initial concern, a couple of considerations lead me to think that an answer to this question would still be informative to people considering whether to focus their career on helping others within the Colombian territory (even if they don’t plan to focus specifically on health interventions).First, health interventions aimed at fighting communicable, maternal, neonatal and nutritional diseases (from now on CMNN interventions) form a substantial fraction of the EA portfolio of interventions focused on improving human welfare in the short term, which is the focus of most of the students I know who are considering whether to direct their careers at Colombian causes. Second, my impression is that the results of this investigation support certain heuristics for identifying impact opportunities that can be useful even outside health causes. I’ll say more about that in the conclusions section.ApproachI use the Scale, Neglectedness and Tractability (SNT) framework to estimate the cost-effectiveness ratio of CMNN interventions between Colombia and Nigeria. Besides making the comparison for the two countries as a whole, I’ll also try to compare the poorest regions within each country to see if that changes the conclusions.I chose Nigeria somewhat arbitrarily, mainly because several of GiveWell's recommended charities have operations in Nigeria (suggesting that there are unusually effective opportunities in the country) and because among the countries where GiveWell-recommended charities operate, Nigeria It is approximately in the middle of the distribution of poverty incidence.Percentage of the population living below the In...