Global health and poverty fellowship

Over the first week, we explore what global poverty is, its historical trends, and how some countries saw such rapid decreases in poverty.

Throughout most of history, humans have lived in fairly squalid conditions. Food, fresh drinking water, education, a warm and dry bed to sleep in, and safety from harm were not taken for granted by most of our ancestors. However, many people today hardly think twice about these things, living in relative luxury. Very few people in high-income countries continue to be concerned about whether they will starve or freeze over the winter, or whether they will have clean water to drink. But how representative are the experiences of being humans in the early 21st century in countries like the UK for the entire global community? Do we really understand most people’s lived experiences around the world? How prevalent does poverty continue to be?

Approximately 1 in 10 humans on planet earth today live under “extreme poverty,” whereby their daily income (PPP adjusted) sits below $1.90 or £1.44, with substantial implications for their standard of living. However, it still seems incredibly hard to imagine a situation where 1 in 10 of our friends and family members lived under these conditions, or if we lived under these conditions ourselves.

While the number of people worldwide living in extreme poverty has been steadily reducing for many decades, questions remain as to why so many people continue to suffer from these economic and social injustices.

In this first session, we will delve into what living in extreme poverty is like, how global poverty has been changing over time, what $2 represents to people at different levels of income, where we may lie on the global income distribution, and what kinds of problems people at different levels of income experience.

a. Core Reading (~90 mins)

What is Global Poverty?

What are the historical trends in Global Poverty?

How unequal is the world?

Discussion

Questions to think about when reading and reflecting upon this literature

This week, we look at the health inequalities across countries, some of the most common diseases in low-income countries, and health care costs. We think about how useful metrics such as QALYs or EV are and even importance, traceability, and neglectednesss.

One of the most highly beloved institutions in the UK, the National Health Service (NHS), was created after the second world war as a way to provide healthcare for all British citizens, free at the point of purchase. While this did not entirely eradicate healthcare inequality within the UK (rich British citizens still have far better health than their poorer counterparts), it has meant that all British citizens do have access to some of the best healthcare facilities the world has to offer, with around £3,000 spent per person per year in the UK on healthcare. Partially as a result of this, few people in the UK today die from easily treatable communicable diseases.

While this is the case in many high-income countries, millions of people, largely concentrated in sub-Saharan Africa, still suffer from easily preventable diseases and have little to no access to high-quality healthcare. This has led to enormous suffering in these regions, with communities plagued by diseases that are prevented or treated in high-income countries with effective and well-funded healthcare systems.

Access to healthcare has been steadily improving throughout the world, but a significant proportion of humanity still have healthcare that pales in comparison to that which is available in high-income countries, and millions of people in poverty die every year as a result of illnesses that many nations would prevent or treat without a second thought.

In this second session, we will be evaluating the state of global health, the burden of disease in low-middle income countries, and recent progress in this area.

a. Core Reading (~120 mins)

Global Health

What’s a DALY?

Global Burden of Disease

Spend ~10 minutes exploring the differences between the burden of disease in high-income countries and low- and middle-income countries.

What are some of the common diseases in low-income countries like?

Spend ~15 minutes reading about the causes of these common diseases, how widespread they are, and how they can be prevented or treated.

Healthcare costs in different regions

b. Discussion

Questions to think about when reading and reflecting upon this literature

Now we look at cases for and against being morally obligated to help those in the most need and explore how we can find a balance between wanting to help others and fulfilling any of our other goals.

Thus far in the reading group, we’ve discussed the fact that many millions of people alive today live under extreme poverty, and suffer from entirely preventable and treatable illnesses. While these conditions have been gradually improving globally, they still attract relatively little political or social attention, and their rate of improvement is slowing down.

Meanwhile, most people in high-income countries live in relative affluence, with their basic needs met and a government-funded safety net. What is our moral obligation in this situation? We may believe we’ve worked hard throughout our lives to get to where we are, or that our parents have worked hard in order to provide us with the privilege we currently bestow. These things may well be true. But does that mean it is morally permissible for us to continue to enjoy our privileges, while knowing about the suffering that continues to occur throughout the world?

Some argue that our moral obligations (or most of our moral obligations) are to those within our geographic or familial circle, and therefore we aren’t morally obliged to help people we don’t know in low-income countries. Others argue that what is important morally is what we do, as opposed to what we allow to happen, and that believing in and acting on the obligation to reduce global poverty and suffering is excessively demanding. Meanwhile, some philosophers believe we are morally obliged to help people who live in different countries, even if our daily actions do not directly cause their suffering.

In this session, we will be evaluating our obligations towards those in extreme poverty around the world, from a philosophical perspective.

a. Core Reading (150 minutes)

Read any three of the texts in favour and two against our obligations to help those in need, and don’t just choose the shorter ones!

The case in favour

The case against

b. Other reading

c. Further Reading

d. Discussion

Questions to think about when reading and reflecting upon this literature

Finally, we evaluate arguments that some charities are significantly better than others, whether we should still pursue interventions without strong evidence, and what problems arise in calculating the cost-effectiveness of charities.

Acting under empirical uncertainty is hard, and acting under moral uncertainty is often even harder. We may feel that many aspects of our global society is bad for some people, but we don’t know exactly what’s going on or what our obligations are to contribute to solutions.

In recent years, many organisations have started to work hard to analyse these problems, and to provide us with quantitative estimates for which problems society currently faces are the largest, which of those large problems are neglected by most humans alive today, and how we can go about solving them or reducing their negative effects.

Different problems require different solutions, and it may be the case that the most promising solutions are highly counterintuitive and go against our assumptions about how to do good. Some charities claim to be incredibly impactful per pound donated, potentially over 100 times more “cost-effective” in terms of impact than other charities, while others argue that charities are inherently bad solutions for some of the world’s problems like global health and poverty.

In this final session, we will be evaluating the arguments that some charities are significantly better than others and the implications for ourselves if this is the case, whether we should be trying to “maximise” impact or not, and whether a significant number of people giving a portion of their income to effective charities is a good solution to the problems we’ve been discussing throughout this fellowship.

a. Core Reading (~120 minutes)

Read through the core reading, and a few of the additional articles, papers and podcasts in the "other ideas about ending poverty" and "arguments against charitable interventions" sections.

Differential Impact

Cost-effectiveness

Pledge

b. Further reading

Other ideas about ending poverty

Arguments against charitable interventions

c. Discussion

Questions to think about when reading and reflecting upon this literature

d. Further (and longer) reading