Book summary “Doing Good Better”: summary

Introduction

You want to make the world a better place, but your charitable donations and volunteering efforts often rely on emotional appeals and marketing hype rather than evidence. This well-intentioned approach frequently wastes scarce resources on causes that achieve very little.

William MacAskill presents effective altruism as a framework that combines the heart and the head by using evidence and careful reasoning to maximize your impact. Instead of guessing how to help, you can apply rigorous analysis to figure out how to do the most good possible with your time and money.

The book guides you through key questions to transform your approach to philanthropy and career choices.

• How can you evaluate which causes save the most lives?
• Why do popular disaster relief efforts often fail to help?
• Which career paths allow you to generate the greatest positive change?

1. Making a Difference

Good intentions alone do not guarantee positive results. Charitable projects driven purely by emotional appeal and marketing hype rather than evidence can lead to unintended harmful outcomes.

The Failure of Intuitive Aid

Trevor Field sought to supply water to rural African communities using the PlayPump, a merry-go-round that pumped water as children played. By 2009, 1800 PlayPumps were installed across South Africa, Mozambique, Swaziland, and Zambia, with each unit costing 14000 dollars.

Trevor Field secured a $16.4 million grant from Laura Bush and endorsements from Bill Clinton, but UNICEF and SKAT reports later exposed that the pumps were inefficient, frequently broke down, and forced women or children to do exhausting manual labor.

A Zimbabwe Bush hand pump of the same cylinder size provided 1300 liters of water per hour, which is five times the output of a PlayPump.

Michael Kremer applied randomized controlled trials to international development programs in Kenya to test whether extra textbooks, flip charts, or smaller class sizes improved student outcomes. In Michael Kremer's trial, 14 local schools were monitored, with the program implemented in 7 of them and the remaining 7 serving as control groups. When Michael Kremer tested providing additional textbooks to Kenyan classrooms, he found no positive effect on student learning except for the most high-achieving students, because the books were written at too high a level and in English, the children's third language.

The Power of Effective Altruism

Intestinal worms affect over a billion people worldwide and cause severe sickness, anemia, and missed schooling, but they can be cured cheaply using off-patent drugs administered through schools. In Michael Kremer's study, deworming reduced school absenteeism by 25 percent, where every one hundred dollars spent provided ten years of additional school attendance, and children dewormed earned 20 percent more income as adults. Moreover, 3.4 extra hours worked per week by adults who had been dewormed as children helped pay for the interventions through increased tax revenues. The Deworm the World Initiative has provided 40 million deworming treatments, making it a powerful example of low-cost, high-impact intervention.

Effective altruism combines the heart and the head by using evidence and careful reasoning to answer how you can make the biggest possible positive difference. Altruism focuses on improving the lives of others, while effectiveness ensures you do the most good with your available resources.

You can evaluate charitable actions by asking five key questions:

• Ask how many people benefit, and by how much.
• Ask if this is the most effective thing you can do.
• Ask if this area is neglected.
• Ask what would have happened otherwise.
• Ask what are the chances of success, and how good would success be?

2. Global Poverty and the 100x Multiplier

Most residents of wealthy nations severely underestimate their global financial standing. You rank among the richest few percent of the world population. Due to local comparison bias, people in countries like the United States or the United Kingdom view themselves as middle-class relative to domestic elites. However, global income distribution data places anyone earning a standard Western salary squarely in the global top percentiles.

Because money yields exponentially lower utility to the wealthy than to the impoverished, donations to the extreme poor generate vastly greater relative benefits.

The Global Distribution of Wealth

Earnings of 52,000 dollars or more per year put an individual in the global 1 percent. Earning 28,000 dollars per year places you in the richest 5 percent of the world. Earning 11,000 dollars per year places an individual above the US poverty line but richer than 85 percent of the world. There are 1.22 billion people classified as extreme poor, earning less than 1.50 dollars per day.

Charif Souki, president and CEO of Cheniere Energy, took home $141,949,280 in 2014, while 1.22 billion people earn less than $1.50 per day.

Extreme Poverty Realities

Extreme poverty involves severe material deprivation, chronic malnutrition, and significantly lower life expectancies compared to developed nations. Surveys of extreme poverty across multiple countries show that families consume roughly half of the recommended daily calories and lack basic infrastructure like electricity. Life expectancy in poor countries in sub-Saharan Africa is 56 years, compared to over 78 years in the United States.

Economists Abhijit Banerjee and Esther Duflo surveyed thirteen countries and found that the extreme poor consume an average of fourteen hundred calories per day and live in households where less than 10 percent possess a table or a chair.

Economic studies on subjective well-being demonstrate that a doubling of income increases happiness by the same amount regardless of baseline earnings. A typical US wage is 28,000 dollars per year, where an additional 28,000 dollars generates the same benefit as an additional 220 dollars for a poor Indian farmer. This creates a 100x Multiplier, indicating that resources can do roughly one hundred times more to benefit the extremely poor than typical Western citizens.

3. Hard Trade-offs and the Value of Lives

Because resources are limited, anyone trying to do good must prioritize and engage in triage, evaluating outcomes through systematic metrics like QALYs.

Medical Triage and QALYs

Time and money cannot solve all problems in the world. You must make hard choices.

James Orbinski managed a Red Cross hospital in Kigali, Rwanda, during the genocide on June 21, 1994. Casualties arrived with numbers on their foreheads: 1 for immediate treatment, 2 for treatment within twenty-four hours, and 3 for irretrievable cases left to die. Charitable giving requires similar triage because resources remain scarce.

Economists use the quality-adjusted life year, or QALY, to combine life extension and quality improvements into a single metric. QALYs measure health benefits using survey data on how people trade off health states against perfect health.

People rate different health conditions relative to full health:

• untreated AIDS gets a 50 percent rating;
• life after a stroke gets 75 percent;
• moderate depression gets 30 percent.

Providing antiretroviral therapy to a forty-year-old with AIDS yields 6.5 QALYs. Preventing blindness in a twenty-year-old yields 30 QALYs. The QALY framework expands into well-being-adjusted life years, or WALYs, to compare non-health outcomes.

Fat-Tailed Distributions and Foreign Aid

You might wonder how to compare very different causes, such as providing schoolbooks versus training guide dogs. Guide Dogs of America spends 50,000 dollars to train and provide one guide dog for one blind person.

The effectiveness of charitable and aid programs follows a fat-tailed distribution. Unlike a normal distribution, extreme events generate the vast majority of value in a fat-tailed distribution. A small percentage of activities outperform typical ones by massive margins.

Deworming schoolchildren yields 139 total years of school per 1,000 dollars spent. That intervention is fifteen times more effective than providing free primary-school uniforms.

Foreign aid has achieved historic successes despite aid skeptics. Smallpox killed 1.5 to 3 million people every year and over 300 million in the twentieth century before its eradication in 1977. That campaign saved between 60 and 120 million lives over forty years.

4. Why You Should Not Donate to Disaster Relief

The law of diminishing returns dictates that additional resources have less impact in areas that already receive extensive funding and attention.

Just like the water-and-diamonds paradox where abundant water has low marginal utility, causes that are heavily funded experience diminishing returns. Therefore, effective altruists should focus on neglected areas where the most effective opportunities have not yet been taken.

For every death caused by the 2011 Japanese earthquake, aid organizations received $330,000, whereas only $15,000 was spent in foreign aid and philanthropy per preventable poverty-related death worldwide.

Popular disaster relief appeals receive disproportionate funding based on emotional media coverage rather than the objective scale or poverty of the disaster. Emotional centers of the brain flare up during new and dramatic events, causing you to mistakenly donate to highly publicized disasters while ignoring ongoing, massive everyday emergencies like extreme poverty and preventable disease.

The 2008 Sichuan earthquake in China killed 87,000 people but raised only $500 million in international aid, while smaller or wealthier disasters like Haiti and Japan raised $5 billion each due to higher media visibility.

Marginal Value and Careers

When evaluating career impact, you must assess marginal value rather than average value, taking into account how readily available labor replaces individual efforts. In rich countries with large pools of professionals like doctors, an additional worker primarily shifts minor tasks rather than unlocking unique lifesaving interventions. Conversely, working in impoverished countries where resources are scarce yields a vastly larger marginal impact.

Medical student Greg Lewis calculated that adding one doctor to the United States provides a benefit equivalent to about four lives saved over a career, whereas working in Ethiopia would provide an impact over one hundred times larger.

5. Assessing Counterfactuals and Earning to Give

You often judge altruism by direct benefits alone without looking at the counterfactual. If someone else would have stepped in and produced the exact smallpox eradication result, your individual net impact is zero.

To measure the true good achieved by an action, you must calculate the difference between the outcome of your actions and what would have happened anyway.

Viktor Zhdanov rather than D. A. Henderson is arguably the person who did the most good regarding smallpox eradication because Zhdanov successfully lobbied the WHO to start the campaign. Henderson merely filled an inevitable job opening.

That smallpox campaign resulted in 120 million lives saved. Zhdanov moving eradication forward by a decade prevented 10 to 20 million deaths.

Well-intentioned social programs can be profoundly counterproductive and actively harmful when evaluated with rigorous trials rather than superficial observations. Programs like Scared Straight appear to succeed because juveniles naturally exhibit regression to the mean after a spike in bad behavior. Controlled studies prove that the program actually increases the odds of juvenile offending.

The television show Beyond Scared Straight features troubled teens like sixteen-year-old Brandon from Detroit who are intimidated by prison inmates. Multi-study reviews by the Cochrane Collaboration show the program increases crime rates.

Nine high-quality studies assessed 1,000 juveniles to find these results. Scared Straight programs caused 60 percent increased odds of offending. That created $203 in cost to society for every dollar spent due to increased crime and penitentiary expenses.

Earning to Give

You can create significantly more good by earning a high salary in a standard commercial career to donate heavily to effective charities than by working directly in a traditional helping profession. Direct career impact is constrained because career slots in nonprofits or medical fields often have rigid limits where someone else will take your place if you decline.

By contrast, earning high wages and donating a large percentage exploits the massive purchasing power difference between rich and poor nations. A UK doctor earns an average salary of £70,000 before taxes.

Greg Lewis chose to become a medical oncologist rather than working directly in a poor country or a standard nonprofit. He planned to donate 50 percent of his $200,000 average annual earnings in medical oncology to save hundreds of lives through malaria bed net distribution.

It takes $3,400 to buy 560 antimalarial bed nets, which prevents one death on average. Greg Lewis donated £20,000 in 2014, which was enough to save ten lives.

6. Risk, Expected Value, and Political Impact

When outcomes are uncertain, decision-making should be guided by expected value, which multiplies the value of an outcome by its probability.

Maximizing expected value prevents you from dismissing low-probability, high-payoff events. Ignoring small probabilities of massive consequences leads to catastrophic failures in risk management, whereas accounting for them justifies long-shot investments.

The Fukushima Daiichi nuclear power plant disaster occurred because operators and regulatory bodies selfishly assumed that natural disasters beyond their imagination would never happen, dismissing low-probability risks. This event led to 160,000 people evacuated after the disaster and 1,600 people who died during the evacuation. A micromort equals a one-in-a-million chance of dying.

The Principle of Expected Value

Voting in a tight election has a high expected value comparable to a large charitable donation because the tiny probability of swinging the outcome is multiplied by massive societal stakes. Statisticians Nate Silver, Andrew Gelman, and Aaron Edlin calculated that voters in the 2008 presidential election had approximately a one-in-sixty-million chance of affecting the outcome.

Multiplying this chance by the $314 billion total benefit to Americans if a better party wins yields $5,200 of expected value generated for the public by casting a vote. The probability rises to 1 in 10 million in swing states like Colorado, New Hampshire, and Virginia, compared with a 1 in 1 billion probability in safe states like Massachusetts.

Voting and Climate Change Risks

Individual consumer choices to boycott animal products or ethical goods do make a mathematical difference through expected value market adjustments. Economists studying market responses estimate that giving up specific animal products leads to proportional declines in total production, such as 0.91 eggs reduction in total production per egg given up and 0.68 pounds reduction per pound of beef given up.

Expected value reasoning reveals that mitigating climate change is crucial not because of most likely scenarios, but because of a small probability of catastrophic tail-end outcomes. The Intergovernmental Panel on Climate Change estimates more than a 5 percent probability of temperature rises greater than 6ºC and acknowledges a small risk of catastrophic warming of 10ºC or more.

7. Evaluating Charities and Top Organizations

Financial metrics like administrative overhead and CEO salary are largely irrelevant for determining a charity's effectiveness.

Just as you do not evaluate a computer by checking executive pay, you should focus on tangible impact per dollar. Books For Africa spends only 0.8 percent on overhead costs as a percentage of total expenditure and pays its CEO $116,204, yet the evidence supporting its programs remains weak.

The Overhead Myth

Charity Navigator suggests efficient charities spend 75 percent of their budget on programs. This metric encourages organizations to misreport expenses rather than measure actual outcomes.

Development Media International spends 44 percent of its total budget on overhead costs. Despite this high ratio, it runs cost-effective campaigns that teach life-saving behaviors.

Cash Transfers and Global Health

You can evaluate charities using a rigorous framework derived from GiveWell.

• Ask what the charity does and how many different types of programs it runs.
• Determine how cost-effective each program area is and whether it focuses on an important cause.
• Assess how robust the evidence is behind each program using trials and monitoring.
• Evaluate how well each program is implemented, including leadership success and transparency.
• Check whether the charity needs additional funds and what they would be used for.

Unconditional cash transfers serve as the index fund of giving because they let recipients fulfill pressing needs. GiveDirectly gives a $1,000 lump sum transfer to poor households in Kenya and Uganda.

Innovations for Poverty Action found that recipients spend 39 percent of cash transfers on assets like farm animals and iron roofs. Only 0.4 percent of cash transfer recipients report having to pay bribes to local agents. The M-Pesa system helps deliver 90 cents to the poor for every dollar donated to GiveDirectly in Kenya.

Global health interventions offer reliable cross-border applicability because human biology is uniform worldwide. The Deworming Initiative treats children through government assistance for 3 cents per child treated per year. The Against Malaria Foundation provides insecticide-treated bed nets for $6, covering two children for two years.

8. Ethical Consumerism and Animal Welfare

Boycotting sweatshops harms workers in developing countries because these factories provide crucial jobs that are far superior to the alternatives.

Sweatshops and Fairtrade

Protestors make the mistake of failing to consider counterfactual outcomes, assuming workers would find better jobs if sweatshops closed. In reality, low-wage manufacturing acts as a stepping-stone for economic development, mirroring the Industrial Revolution in the West and the rise of Asian Tiger economies.

Columnist Nicholas D. Kristof interviewed Pim Srey Rath, a Cambodian woman scavenging plastic in hot dumps who stated she would love a factory job because it is in the shade. When US Senator Tom Harkin introduced a 1993 child labor bill, Bangladeshi factories laid off fifty thousand children, many of whom resorted to more desperate measures like prostitution, according to UNICEF.

Fairtrade certification fails to effectively help the global poor because it mostly benefits producers in relatively wealthier countries, while middlemen capture the vast majority of the price premium. Fairtrade standards are too rigorous for the poorest nations, meaning benefits flow to places like Costa Rica rather than Ethiopia. Independent studies show that only a tiny fraction of the extra money paid by consumers reaches actual producers, and certified workers often have lower wages than non-certified peers.

Researchers found that for fair-trade coffee sold in the US, consumers paid five dollars more per pound, but producers received only forty cents, or 8 percent. Dr. Peter Griffiths calculated that less than 1 percent of the additional price reached exporters for one British café chain.

Carbon Offsetting and Animal Advocacy

Many popular green lifestyle recommendations have a negligible impact on reducing greenhouse gas emissions compared to high-impact actions. Common eco-habits like turning off standby electronics, using fewer plastic bags, or buying locally produced food save tiny fractions of total emissions. Transportation accounts for only 10 percent of food carbon footprints while production accounts for 80 percent, meaning dietary choices matter far more than geographic origin.

One hot bath adds more to a carbon footprint than leaving a phone charger plugged in for a whole year, and leaving a TV on standby for a year contributes less than driving a car for two hours. Locally grown tomatoes in northern Europe had five times the carbon footprint of Spanish imports due to greenhouse heating and lighting.

Carbon offsetting through effective charities like Cool Earth is significantly cheaper and more impactful than making major personal lifestyle changes. Cool Earth prevents deforestation in the Amazon by providing economic assistance and securing property rights for local communities so they find better ventures than selling land to loggers. By conserving key areas, they create a defensive forest wall against illegal logging at a very low cost per metric ton of carbon dioxide prevented.

Giving What We Can assessed over one hundred offset organizations and selected Cool Earth as the top cost-effective charity, estimating a conservative cost of $1.34 per metric ton of carbon dioxide prevented.

From an animal welfare perspective, eliminating chicken, eggs, and pork from one's diet eliminates the vast majority of factory-farming suffering due to stocking densities and lifespans. Economist Bailey Norwood rated farmed animal welfare from -10 to 10, showing that broiler chickens, layer hens, and pigs endure horrific conditions compared to beef or dairy cows. Calculating animal years spent in unpleasant conditions reveals that avoiding chicken has the highest impact.

The average American consumes 28.5 broiler chickens per year which live six weeks each, translating to 3.3 animal years of suffering compared to just 0.1 animal years from beef cows.

Donating to effective animal advocacy charities achieves a greater reduction in animal suffering than changing one's own diet alone. Unlike greenhouse gas emissions where offsetting neutralizes harm entirely, offsetting meat consumption merely shifts which animals are harmed. However, financial contributions to organizations that distribute vegetarian leaflets can convince individuals to stop eating meat at a highly cost-effective rate.

Research by Animal Charity Evaluators estimated that it costs about one hundred dollars to convince one person to stop eating meat for a year through leafleting by groups like Mercy For Animals or the Humane League.

Ethical consumerism can create a moral licensing effect, where performing minor good actions subconsciously gives people a license to act unethically or neglect greater altruism later.

Psychological experiments demonstrate that purchasing green products or even imagining helping someone makes individuals more likely to lie, steal, or give less to charity subsequently. Promoting ineffective acts of altruism can thus become harmful on balance if it crowds out impactful donations.

Participants who chose a green product in an experiment were significantly more likely to cheat and steal money during an anonymous visual perception task than those who chose conventional items.

10 Key Ideas

1. Effective altruism combines the heart and the head by using evidence and careful reasoning to answer how you can make the biggest possible positive difference.
2. Global income distribution data places anyone earning a standard Western salary squarely in the global top percentiles.
3. Because money yields exponentially lower utility to the wealthy than to the impoverished, donations to the extreme poor generate vastly greater relative benefits.
4. Economists use the quality-adjusted life year, or QALY, to combine life extension and quality improvements into a single metric.
5. The law of diminishing returns dictates that additional resources have less impact in areas that already receive extensive funding and attention.
6. To measure the true good achieved by an action, you must calculate the difference between the outcome of your actions and what would have happened anyway.
7. When outcomes are uncertain, decision-making should be guided by expected value, which multiplies the value of an outcome by its probability.
8. Financial metrics like administrative overhead and CEO salary are largely irrelevant for determining a charity's effectiveness.
9. Boycotting sweatshops harms workers in developing countries because these factories provide crucial jobs that are far superior to the alternatives.
10. You can create significantly more good by earning a high salary in a standard commercial career to donate heavily to effective charities than by working directly in a traditional helping profession.