Global health and poverty fellowship

Global health and poverty fellowship

Last updated: 4th October, 2023


This is the curriculum for One for the World & EA Cambridge’s 4-week seminar programme on global poverty and health, and some possible responses to it. Extreme poverty is one of the greatest problems facing humanity, but also an extraordinarily complex and often under-discussed one. So, we’re organising this group to give students a platform to explore and discuss some of the issues surrounding it and consider what, if anything, can be done to influence it.

Each week consists of different readings (~2 hours) following a specific theme, accompanied by a group discussion on those readings. During the discussion, we’ll delve into some of the ideas from the reading in more depth, focusing on the ideas we find most interesting or thought-provoking.

Week 1: Global Poverty

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?


Questions to think about when reading and reflecting upon this literature

  • What does an extra $1, $5, or $100 mean to people at different income levels? What implications does that have if we're thinking about reducing the most poverty that we can through our donations?
  • What perspectives should we use to think about extreme poverty? E.g. economic, social, nutritional, cultural, multidimensional
  • Why do you think India and China saw such rapid decreases in poverty, while Sub-Saharan Africa saw increases in extreme poverty?
  • What surprised you most from these readings?
  • Can you imagine living in extreme poverty yourself? Is this something you can empathise with, or is it too far from your lived experience?
  • What were your previous conceptions of how the world has changed over the past 2 centuries? Is this different to what the readings were suggesting?
  • How does extreme poverty affect people, in terms of access to healthcare, education, stability, resilience to external shocks, etc.?

Week 2: Global Health

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.

  • Global Burden of Disease - Compare (5 mins)
    • On the treemap (boxes in a rectangle), see how many of the world’s DALYs are caused by communicable diseases (seen in red)
    • Change the location to “Low SDI” (Socio-demographic Index) then change to “High SDI” to compare the types of illnesses affecting people in low- vs high-income countries, especially related to communicable, maternal, neonatal and nutritional diseases.
  • GBD - Mortality Visualization (5 mins)
    • Go to settings, then in the results column, change to life expectancy to see how life expectancy differs across the world

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

  • How much is a year of life worth? - BBC Future (5 mins)
    • This article discusses how much the NHS is willing to spend to reduce a certain amount of disease burden in the UK, using QALYs as a metric (related to the DALY, however we aim to get the most QALYs while we want to minimise DALYs).
    • It suggests the NHS is willing to pay for treatments that are cheaper than £20,000 per extra year of healthy life (per QALY) provided
  • Valuation of a Life (20 mins)
    • This document discussed different methods used to determine the “value of life” - a controversial topic, but necessary for governments to allocate resources effectively.
    • These estimates for the value of life (~35 QALYs is a common definition) range from £100,000 to £10,000,000.
  • 2020 GiveWell cost-effectiveness analysis (5 mins)
    • This spreadsheet comes from GiveWell’s annual cost-effectiveness model, and shows (in the results) that charities such as the Against Malaria Foundation can “save a life” for around £3,000 ($4,100).
    • With a “life saved” equivalent to 35 QALYs (35 additional years of healthy life), it’s suggested that AMF can help to provide one QALY for around £100.

b. Discussion

Questions to think about when reading and reflecting upon this literature

  • Can quantitative estimates of impact be useful even if they’re imprecise? How can we go about comparing different interventions/cause areas?
    • How useful are QALYs?
    • How useful is considering importance, tractability, and neglectedness?
    • How useful is expected value (EV)?
  • How much should we prioritise easily treatable diseases when thinking about charitable giving?
  • Why do you think high-income countries are mostly affected by non-communicable diseases, while low-income countries are affected by communicable diseases?
  • What are some of the best ways for governments to decide how to allocate scarce healthcare resources?
  • How useful are metrics like DALYs to determine where global healthcare resources should be allocated?
  • What did you previously think were the most widespread illnesses that might affect people in low-income countries? How has your understanding changed after the reading, if at all?

Week 3: Morality and our role in the world

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

  • Philosophy Thought Experiment (10 mins) & The Drowning Child and the Expanding Circle - Peter Singer (1997) (10 mins)
  • On Satisfying Duties to Assist - Christian Barry & Holly Lawford-Smith
    • Does there come a point at which one is no longer morally obliged to do further good, even at very low cost to oneself?
  • Supererogation - Stanford Encyclopedia of Philosophy
    • Supererogation: the class of actions that go “beyond the call of duty.”
  • Whether and Where to Give - Theron Pummer (2016)
    • Main claim: in many cases it would be wrong of you to give a sum of money to charities that do less good than others you could have given to instead, even if it would not have been wrong of you not to give the money to any charity at all.
  • Nationalism - Stanford Encyclopedia of Philosophy
    • Nationalism:
      • the attitude that the members of a nation have when they care about their national identity, and
      • the actions that the members of a nation take when seeking to achieve (or sustain) self-determination
  • International Distributive Justice - Stanford Encyclopedia of Philosophy
    • Read section 3: Varieties of Institutionalism

d. Discussion

Questions to think about when reading and reflecting upon this literature

  • How can we find balance between wanting to help others and fulfilling our other goals?
  • Are we faced with a great opportunity to improve the world, or a terrible tragedy that the world contains so much suffering?

Week 4: Effective Giving

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



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

  • If an intervention is not backed by strong evidence, could there still be reasons to pursue it?
  • What kind of problems can we run into when we try quantifying cost-effectiveness? What features are not captured by such estimates? Are there important features of an intervention that are not captured by cost-effectiveness estimates? Which?
  • If there is such high variance in effectiveness, how much effort should we put into figuring out what to do? 10% of the total? 50%? 90%?
  • What are the strongest arguments in favour of more individuals in high- and middle-income countries donating to effective charities? How about the strongest arguments against this position?
  • What are the greatest barriers to inspiring more people to use their own power and influence to reduce wealth, education, healthcare etc. inequality?

d. Further (and longer) reading