Saving lives via bed nets is hard to beat for immediate impact

It seems likely to me that the average life in the developing world is worth living, and that the value of an average year of life in the developing world is no more than 3x lower than the value of an average year of life in the developed world.

I think it should be the marginal life saved by AMF that is relevant here, and it is probably of much lower quality than the average life in the developing world. AMF was chosen by GiveWell because it represents the lowest cost per life saved, which must be because it targets people with the lowest incomes, people who can't afford to purchase even very low cost disease preventions on their own behalf.

Those who live past age 5 have nearly a 70% chance of living until age 60.

The life expectancy of a five-year-old would be more helpful. This just shows that it's at least 38.5.

if one ignores indirect effects

Which means ignoring the things which I think make the most difference - communication and information.

unhelpful comment, disregard<

"To a first approximation, the immediate value of a year of your work is equal to the value of a year of your life."

This statement demonstrates a type error. The value of a year of work is not the same type of thing as the value of a year of life. They are not comparable. We cannot meaningfully compare one to the other, or exchange one for the other. The value of each is found in a different set of intrinsic goods.

Suppose that the value of a year of your own life is no more than 3x the value of a year of life saved.

The latter is how much that person values their own life, or how much I value it? Since I'm not perfectly selfless, the latter is smaller than the former.

• Place yourself in the shoes of the average person in the developed world who makes $60k/year.
• Suppose that the value of a year of your own life is no more than 3x the value of a year of life saved.
• To a first approximation, the immediate value of a year of your work is equal to the value of a year of your life.

Please supply evidence that the average yearly income over the life of the person saved at the margin of malaria-net donation is (at least) US$20,000. If this is not the case please stop inconsistently applying arbitrary metrics in order to support your social-political agenda. It is possible to explain how awesome AMF is without confounding the audience with misleading numbers.

Note: I think malaria nets, efficient charity and AMF are awesome. However, I also oppose bullshit. I even oppose bad arguments for my side. I call for restraint.

"average year of life in the developing world is no more than 3x lower"

I assume you mean "average year of life in the developing world is no less than one third as much". I really don't like the "X times lower" rather than "one Xth as much" construction, and I think this is an example of it being needlessly confusing; presumably, you were thinking "(no more than three) times lower", but I first read it as "no more than (three times lower)".

The reader can draw his or her own conclusion from this. It seems likely to me that the average life in the developing world is worth living,

I don't ask this in the spirit of any disagreement (your post seems to me to be well reasoned), but just curiosity: what do you mean by 'worth living'? What sorts of things need to be present for a life to be worth living? Is it just that, say, my life is worth living if I would choose to live rather than painlessly die on a given day?

It is reasonable to ask the question, “you may be able to save a life in Africa, but will the child child you save from malaria likely die from something else soon after?" The question here is simply how many life-years will a given amount of money actually save?

Indeed, this is a very real, non-hypothetical question in health care within the developed world today, particularly for the old and infirm. We have gone so far in the direction of heroic and expensive interventions to preserve life, that many patients and people who fear they may become patients are actively advocating for the right to refuse treatment and die with dignity. This has led to the development of living wills, for example. Much of this may be due to other factors such as an insanely inefficient and irrational (1) health care system and the reluctance of doctors to provide sufficient pain relief out of misplaced concerns about addiction and demonization of effective narcotics.

Even taking these into account, it is certainly reasonable to account for other likely causes of death when calculating the lives saved for dollar. If X dollars are sufficient to save the life of a five year old with a 65-year life expectancy or a 70-year old with a 10 year life expectancy, and X dollars are all you have to spend, then by all means save the five year old. This is an emotionally difficult choice, one I hope never to face, but it's not especially controversial or challenging.

However, I find it morally repugnant to go from there to the incredibly patronizing position that a year of life for a poor person in the developing world is worth less than a year of life of a rich person in the developed world. I take as one of my fundamental moral principals that "All men are created equal." (2)

I am frankly astonished that people would suggest that "an average year of life in the developing world is no more than 3x lower than the value of an average year of life in the developed world." (I am, of course, not surprised that people would act as if this were true, but most folks are far too polite to say it. I doubt most folks are even consciously aware of this preference.) Have people really suggested this to you? Is this really an expressed concern of donors? The ethnocentrism of such a position is staggering.

In my own moral system, the only approach I accept is that every currently existing (3) person's year of life is worth as much as every other currently existing person's year of life, no more, no less. One criterion I have for where to direct my charity dollars is that the organizations I donate to act as if that were true, which as has been pointed out many times before by GiveWell and others means that most of my donations are directed toward work in the developing world because the same money goes further there. I do not accept that a life in the Congo is worth less than a life in Paris, even if one is on average more pleasant than the other.

(1) In the economic, not LessWrong sense of the word "rational"

(2) I include the usual modern explication of this phrase to include people of both genders in "men", and the understanding that this means "that they are endowed ...with certain unalienable Rights, that among these are Life, Liberty, and the Pursuit of Happiness", not that everyone is identical. Boring, well-known, straw man caricatures of the meaning of "equals" in this context will be ignored.