The good, the bad, and the ugly of altruism

Charities are certainly not all equal. We've seen what makes a charity effective or not - if you missed this, check it out here. But is there really a big difference between them? Is it worth the money/time/effort required to determine the more effective charities, when we could just give that to any old charity? The answer to both of these is, without doubt, YES!

We find that the difference between the most effective charities and typical charities is around a factor of 1000.[1] That is, donating £1 to the most effective charities is equivalent to donating £1000 to a typical one. Therefore it is of utmost importance that we take into account the effectiveness of the charities we donate to, something that very few people do. I certainly want the impact of my donations to be the largest it can be, especially now I know that the most effective charities can have such a large impact with each donation. To understand what types of charities are the most and least effective, here is the good, the bad, and the ugly of altruism. Or, rather, the ugly, the bad, and the good - everyone loves a happy ending!

The ugly


PlayPumps International is a charity that was founded on the seemingly bright idea that we can use the energy generated by children playing on a roundabout to draw clean water from deep underground for local communities that have poor access to water. With support from the US government, public donations, and even sponsorship from music star Jay-Z, PlayPumps International raised a huge amount of money to install thousands of these water roundabouts across Africa. Without considering any research into the effectiveness of this initiative, I would certainly be convinced that it would be a good idea.

Unfortunately, it was too good to be true. PlayPumps actually had a negative impact on these communities for many reasons. The force required to bring the water to the surface gave the roundabouts too much resistance for them to be enjoyable for children to use. Embarrassingly, this meant that often the women of these communities were left to spend hours humiliatingly spinning the roundabout around, expending more energy per litre than using a standard hand-pump. Whatsmore, the cost of these roundabouts was significantly more than the cost of a standard hand-pump, therefore the charity were spending more money on a product that was significantly worse.[2]

This goes to show that we cannot blindly trust our intuition when it comes to helping others. Often, we can avoid disasters like PlayPumps by simply asking those in need help they need before assuming we know best. In any case, evidence must be used to understand the impact of any intervention, then we must act on this evidence by either not supporting ineffective interventions, or adjusting the intervention accordingly.

The bad*

Approximately 83% of British charity donations are to domestic charities.[3] The majority of these donations are to charities that fund medical research, treatment, or prevention of diseases that primarily effect people in the first-world, such as cancer and heart disease. This is understandable because a large proportion of the suffering we, as affluent people from a developed nation, see in our lives is due to terminal illnesses that affect us or those dearest to us. Let's assess these causes with the scale, tractability, and neglectedness criteria introduced in my previous blog post.

These diseases cause a large amount of suffering because they affect many people and are often terminal. That is, the suffering caused by them is of a large scale. In fact, cancer causes more deaths per year globally than malaria does, yet combatting malaria is considered a more cost-effective cause than combatting cancer.[4][5] This is because of the other two important criteria: tractability and neglectedness.

Third-world diseases such as malaria have been fully eradicated in the developed world because they are easier to eradicate than first-world diseases like cancer, for example. We already have cheap, easy, and effective methods for eliminating them, because we have done it before. However, they still cause immense suffering in the developing world. Over 400,000 people, mostly children under 5, die from malaria every year.[6] Almost all of these deaths occur in sub-saharan Africa and, given that malaria has been readily eradicated in the developed world, these deaths are avoidable. Therefore malaria, and many other third-world diseases are very tractable, that is, they can be combatted cheaply and easily. The problem is that, unlike in the developed world, there is insufficient money and infrastructure to accomplish this. First-world diseases receive an enormous amount of funding for research from both government and private donations yet we still struggle to make significant impact in their eradication. There are disasterous diseases currently destroying communities in third-world countries, which this money could go a long way towards eradicating! Generally, third-world illnesses are tractable causes, first-world illnesses are not.

Furthermore, the amount of money donated per person afflicted is much higher for first-world diseases compared to third-world diseases. Third-world diseases are neglected, first-world diseases are not.

Your money will go much further when donated to a third-world country than when donated to domestic charities.

Don't get me wrong, giving to a charity that does at least some good for the world is better than spending that money on unnecessary things for yourself that won't really increase your wellbeing. I feel like most typical charities probably do at least some good. However, I am yet to see any study about whether this is the case - that the ugly charities are in the minority - so maybe that is wishful thinking.

A good rule of thumb is this: if you have heard of a charity, it's probably not an effective one. If you have heard of it, then most likely so have many other affluent people, many of whom will have donated to it, making it no longer a neglected cause.

The good

Against Malaria Foundation (AMF) is a charity that distributes insecticide-treated bednets to the poorest communities in Africa. These bednets vastly reduce the chance of getting bitten by a mosquito and therefore the chance of contracting malaria. The scale of suffering and death caused by malaria is staggering, as we have seen.

You know when you go on holiday and you can often get much more for your money than you can in the UK? A loaf of bread in the UK might be around £1, but you can get it for the equivalent of £0.10 on holiday. This is due to the varying purchasing power that different currencies have. This works for donations to charity too: your money will go much further when donated to a third-world country than when donated to domestic charities.

It is estimated that a life is saved by AMF for every US$500-7000 donated, as well as the huge amount of suffering reduced for those who would have otherwise caught malaria but not died from it.[7] AMF focuses on one method, which has been demonstrated to be the most effective, to help a cause that is one of the most worthwhile.

Combatting malaria in Africa is a cost-effective cause with large scale, tractability, and neglectedness and AMF uses a highly efficacious method to reduce suffering caused by malaria. This makes AMF one of the most effective charities you can support**.


In summary, many charities do only a small amount of good, and some even have a negative impact; the important thing to take away is that there are a few charities that are extremely effective at reducing suffering in the world. Donating to these charities would be a great place to start if you want to make the world a better place in the most effective way possible. If you have a regular charity donation set up (which I highly recommend you do) or if you donate on an as-and-when basis, then consider whether you can improve the impact of your donations by supporting a different charity or a different cause area. Where will you donate to next?


* A typical charity, although ineffective, usually does at least some good. Therefore, this title is probably misplaced, and serves only to make a catchy theme for this post.

** Is it really that simple? No, it's not. Saving (AKA extending, because that's really all we are doing when we 'save' a life) more lives does not necessarily reduce the amount of suffering in the world or improve the world the most. For example, it could be that there are other charities that reduce the suffering caused by nonterminal illnesses and, by doing so, reduce the amount of suffering more than an effective charity that mainly saves lives. Moreover, maybe more lives saved isn't all that great if those lives are lives of immense suffering due to lack of necessary nutrition, or if those people contribute significantly other suffering in the world, such as the suffering of billions of animals that are ruthlessly farmed for food or future human suffering by polluting the atmosphere and accelerating climate change. These are difficult questions.


  1. Teng, T. O., Adams, M. E., Pliskin, J. S., Safran, D. G., Siegel, J. E., Weinstein, M. C., Graham, J. D., 1995: Five-Hundred Life-Saving Interventions and Their Cost-Effectiveness, Risk Analysis, 15: 369–390.
  2. Macaskill, W., 2013: An example of do-gooding done wrong, Effective Altruism Forum. Accessed May 27th, 2017.
  3. UK Civil Society Almanac, 2012: What are the main trends in charitable giving?, UK Civil Society Almanac.
  4. WORLD HEALTH ORGANISATION, Malaria Fact Sheet. Accessed June 11th, 2017.
  5. CANCER RESEARCH UK, Worldwide cancer mortality statistics. Accessed June 11th 2017.
  6. UNICEF, 2017: Malaria mortality among children under five is concentrated in sub-Saharan Africa. Accessed May 27th 2017.
  7. GIVEWELL, 2016: Against Malaria Foundation: Cost per life saved.


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