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Owain Johnstone

When is systemic change a good idea?

 considering when you might want to pursue systemic change rather than marginal change. In this post I'm going to take a closer look at that.

A system's key elements are: a group of actors (with some interests in common), their interactions, and the outcomes that result from those interactions.

A single actor can be part of more than one system at once, and systems can change over time. They can also vary in size.

Consider the 'donating to charity' system ( the example I discussed in my last post). Its actors include donors, analysts, and aid recipients, and the main outcome of the system we're interested in is how much money gets to the recipients.

A marginal approach to change in that system would simply try to increase the amount of money donated (perhaps by taking a job as an investment banker and earning to give).

A systemic approach to change here might try to suggest that the money should be going to a different set of recipients – maybe by arguing for a new metric against which to assess charitable effectiveness.

If successful, this systemic approach would change a parameter of the system (who the recipients are), which is a potentially powerful way of changing the system's outcomes.

But when should we pursue marginal change and when systemic?

In my last post I suggested that there were at least two factors we would need to bear in mind when making that choice: 

Choosing marginal change or systemic change requires expertise appropriate to the task.

 If you want to earn to give, you need to have the expertise required of, say, an investment banker. If you want to argue for different charitable aid recipients, you need to have the expertise to analyse charitable effectiveness and present your arguments in a compelling manner.

As to mindset, marginal change can be more predictable and controllable. The reward is readily calculable and the risk is comparatively low. 

Systemic change, because of the complexity of even very small systems, is much riskier

 – i.e. far more likely to fail. However, it is possible that the reward (relative to the effort put in) may be greater.

For example, it may take only one report on charitable effectiveness to channel a significant proportion of donations away from some organisations and towards others – that may well be far more money than one person could expect to earn to give over the course of their working life. (This is an idealised example, of course.)

What about qualities of the system itself?

It's not just about expertise and risk/reward mindset. Those terms describe the characteristics I think are important for us to possess if we want to pursue systemic change. But we also need to consider the conditions of the system.

A system can be more or less amenable to change, and we ought to take that into account when choosing whether or not to pursue such change.

The more complex the system, the less likely it is that we can predict the effects of our actions on it

, which makes identifying suitable levers of change extremely difficult.

Generally, the larger the system (so the more actors and/or interactions it has) the more complex it will be.

In terms of what a small group of individuals or organisations can hope to achieve, large complex systems probably aren't worth bothering with – the complexity is simply too great.[1]

a system needs to be dense enough to be worth trying to influence

. In other words, there need to be enough actors with close interactions. If we're talking about a few actors who interact only quite loosely and occasionally, or with little mutual influence, then what we have is barely a system at all. Trying to exert influence in that kind of an environment is like pulling a lever that isn't properly attached to anything – the effect just won't be very big.

So assuming we have a system that is just the right size – neither too complex nor too ill-defined – 

we need to have enough knowledge of that system to identify the levers of change we want to use

. Gathering that information ourselves might not be possible since it could require substantial resources, so it may be that we have to wait for someone else to gain that understanding.

We also need to be able to access the levers of change that we identify.

 In many systems a majority of those levers may belong to national or local government. That means we need to be able to convince others to press those levers for us.

That in turn means that politics becomes a factor. Is the general political environment likely to be in favour of the change(s) we're seeking? Do we have any influence with the rights parts of the government? Can we work with someone who does? (This may mean that a political career could be advantageous to pursuing systemic change. See 

 for further thoughts on the ethical effectiveness of a political career.)

To illustrate the above, I'm going to return briefly to the topic of my own research – human trafficking in the UK.

Human trafficking is a poorly understood problem. There is little robust empirical data on the scope or extent of the problem anywhere, and while the UK has better data than many other countries it's still not much to go on.

However, understanding has been increasing over the past ten years or so.

The anti-trafficking 'system' in the UK consists of traffickers, victims, law enforcement, victim support NGOs and various branches of the Government. They produce several outcomes that we're interested in, such as criminals convicted, and victims rescued.

Ten to fifteen years ago it could be said that this system barely existed. There was little awareness of trafficking amongst law enforcement, immigration and social services, and there were fewer active NGOs than there are today.

That's not to say that trafficking didn't exist – it did. But there wasn’t a system that we could hope to influence.

Since then, the UK's trafficking response has developed substantially – such that we can now call it a system. There are enough actors involved with a sufficient density of connections and interactions.

As that system has developed, many NGOs and other actors have identified weaknesses within it that they thought needed to be changed in order to help victims and obtain more convictions of traffickers. In other words, they identified what they thought of as likely levers for systemic change.

However, until relatively recently, few of those changes were successfully introduced.

That changed somewhat in 2013, when a think-tank called the Centre for Social Justice released a report (

'It Happens Here: Equipping the United Kingdom to fight modern slavery'

) on the UK's anti-trafficking response. That report led almost directly to the introduction of the Modern Slavery Bill in Parliament – a Bill that has now become law.

The Modern Slavery Act introduces several new measures that we can see as operating levers of systemic change. A good example is the clause mandating that companies above a certain size report on efforts they are taking (or not) to combat modern slavery in their supply chains. By producing new information that may influence how large numbers of actors conduct themselves (e.g. consumers in their buying choices), the way the system works may change.

Why did this Bill get introduced and become law? Obviously the reasons are complex but I think we can see it as 

a relatively successful example of systemic change that illustrates the importance of the factors I discussed above

 – cohesive enough to identify as such but not too large that its complexity could not be grasped.

sufficient knowledge of that system existed

. Several major NGO reports had thoroughly mapped it over the previous few years and the CSJ report did so again – working on the basis of over 200 interviews with relevant actors. That enabled the CSJ to confidently identify the levers of change.

the general political environment was fortuitous

. Another Bill had been thrown out, leaving Parliamentary time available, and the issue of trafficking (or 'modern slavery' as it has come to be termed) is bipartisan enough that a Bill had a chance of succeeding in the limited time available.

the CSJ had good connections with the Government

 and so were able to communicate their findings effectively.

The vagaries of the political process have meant that although the Modern Slavery Act has on the whole been welcomed as a success, it has not addressed all the points that the CSJ report – and many other actors – would have liked it to. 

Several potential levers of change remain undisturbed.

Further, although the CSJ's report, building on other work, constructed the best map of the UK trafficking system we have yet had, it was of course not perfect. 

Our knowledge will continue to improve and as it does it may well change what we perceive to be the relevant levers of change.

Finally, statistical data (for example on number of victims rescued and numbers of traffickers convicted) remain poor, which means that 

it will be difficult to evaluate the success of the new law.

I think we can cautiously see this as a good example of successfully engineered systemic change, albeit with the caveats noted above.

It suggests that the conditions under which systemic change is an appropriate choice are quite limiting, however. The choice to pursue such change is therefore one that we should take only after careful consideration.

Michelle Hutchinson

Giving What We Can needs your support — only 5 days left to close our funding gap

, we are still £40,000 off our target. We really need your help to help us reach our goal, so that we can make concrete plans for our future, and go back to our main job — getting more people to take the pledge to give.

You can still double the effect of your donation — there is still £10,000 of matching funding for new donors — but it has to be before July!

Over 2014 our membership doubled. Over 2015, using the money we're currently trying to raise, we aim to double again. We plan to do this by focusing on chapter growth and by capitalising on the media attention around Effective Altruism over the summer, to make sure that it results in concrete impact.

It's pretty amazing how much we can each do individually by donating 10% of our incomes to the most effective causes. 

Someone on the median US wage could save a person's life

! But if we could make it the norm in the developing world, we really could 

 around the world. Hopefully this summer will be the start of making that happen!

Sam Deere

Giving What We Can hosting Skype with Against Malaria's Rob Mather

's top charities) has kindly offered to take some time to chat to supporters over Skype. The format will be a Skype conversation of around 1-2 hours, where participants will have the opportunity to ask Rob questions and discuss ideas relating to AMF's work and related topics (e.g. the process of starting an effective charity, challenges AMF has faced, next steps etc).

Thursday July 2nd, at 5:30PM/1730 London time

If you would like to take part, please get in touch with me (Sam) at Giving What We Can (sam [dot] deere [at] givingwhatwecan.org). Spaces are very limited, so please get in touch ASAP to secure a spot!

Coralie Oddy

Becoming an Effective Altruist

As a young teenager, I remember giving away all my Christmas money after the 2004 Boxing Day tsunami. I understood that I didn’t actually need that money, and there were other people who needed it desperately. As I grew older, I began to realise that this desperate need doesn’t go away just because the news cameras have moved on, or is only present in the wake of a disaster. Extreme poverty is an everyday fact of life for thousands of people, a fact not deemed newsworthy only because of its constant, ongoing nature.

Perhaps because of this, by and large we accept poverty as an insurmountable problem. Sometimes we raise funds or donate money, but most of the time it is something we’d rather forget about, powerless to do much about it. We worry about government corruption and charities working ineffectively. In a way, I think this helps relieve us of a sense of responsibility – if there’s nothing we can do, we needn’t do anything.

Throughout my studies, I continued to try my best to make a difference. I attended protests and did sponsored runs in fancy dress. I baked cakes, rattled tins and raised thousands of pounds organising charity gigs for local bands. All this was deeply rewarding and definitely enriched my life, boosting my CV and my wellbeing.

It was fun. I chose my charities because I liked the sound of their work. I organised events now and again, when a cause or idea took my fancy. I hoped for the best, but I also doubted myself. Was this really making a difference? Was it really helping? I didn’t want to ever stop caring, but neither did I want to be a hopeless idealist.

Faced with a huge problem and no idea how to solve it, we either end up apathetic or cynical, or try our best without much impact. But here’s the thing – 

while poverty remains a huge problem, we are getting better and better at finding the best ways to solve it.

Through much googling and steering by likeminded friends, I found Effective Altruism. Suddenly my hopes and doubts weren’t fighting against one another, but working together. By critically examining how charities spent their money, I could choose to give to only the most effective.

Our evidence about the best methods for tackling poverty is constantly growing. While the News doesn’t dwell on everyday extreme poverty, nor does it focus on our gradual successes in fighting it. You perhaps wouldn’t know it, but 

over the last twenty years, the number of people living in extreme poverty 

So I decided that I needed to give to the most effective charities – you can find these via 

, and the detailed evidence for why they are the most effective from 

. I also decided I needed to give consistently, and hold myself accountable for doing what I’d always wanted – 

to make a difference, and to continue to make a difference throughout my life.

After a period of underemployment, I now have a full time job. I don’t earn a lot (I’m working as a teaching assistant), but I earn more than enough to get by, and enough after that to give away to the people who aren’t able to say that yet. After giving away 10% of my salary, I’m still earning more than 99% of people in the world (you can see where you fit in with Giving What We Can’s 

Now I know I am making a difference – most people could do the same.

Hauke Hillebrandt

An update on the effectiveness of Deworm the World Initiative (DtWI)

The Deworm the World Initiative (DtWI) has been one of our highly recommended charities for several years now.

Our colleagues at Givewell have published an 

 recently that was generally very favourable, and they continue to rank among Givewell’s top charities. You can read more about the general case for deworming on 

In this blog post, we will give you an update about their efforts that we feel complements Givewell’s report. You can find more general information about DtWI on our 

. In our opinion, DtWI continues to be a very promising charity and could be one the most effective charities in the world.

Recent Scientific findings that relate to DtWI’s effectiveness

New findings on whether deworming improves health and cognition

DtWI has traditionally focused on deworming programs in India, where soil-transmitted intestinal worms (soil-transmitted intestinal helminths (STH)) are very common and there is almost no schistosomiasis, which is generally considered to be more harmful. The main STH parasitic worms that infect people are the roundworm (Ascaris lumbricoides), the whipworm (Trichuris trichiura) and hookworms (Necator americanus and Ancylostoma duodenale).

 However, recently DtWI has expanded their deworming program into Africa, namely Kenya and Ethiopia, where schistosomiasis is common and where they help with combination deworming programs against STH and schistosomiasis (we have previously reported on how location matters for deworming [insert link to Eliz post]). Moreover, DtWI is currently thinking about expanding into other African countries such as Nigeria, Namibia or South Africa.

 Hence we will focus our review mainly on new research findings on the effects of only treating STH and refer to our previous update on the Schistosomiasis Control Initiative for new findings relating to combination deworming programs treating STH and schistosomiasis [insert link].

Effects of deworming for treating soil-transmitted intestinal worms on health

A recent Cochrane review summarized studies looking at the effects of deworming drugs for treating soil‐transmitted intestinal worms on nutrition and school performance

. They suggest that deworming may increase the weight of children by over half a kilo and increase haemoglobin levels. It is possible that cognition is improved, but this is based on a few low-quality trials, and Givewell argues that they should have included another trial. Crucially, all of the evidence comes from small trials studying children known to be infected with worms (by screening). In contrast, without prior screening they conclude that it is unclear whether mass deworming of STH is has an effect on weight, height, school attendance, or school performance; and that it may have little or no effect on haemoglobin or cognition. This study has been criticized by Poverty Action

 and a rebuttal of that criticism has also been published

. We generally believe with this rebuttal and that the inferences drawn in the Cochrane review are generally valid.

Moreover, a recent analysis of DEVTA, a large scale cluster-randomized trial from 1999-2004 with 1 million lightly infected Indian children from rural areas

, found weight, height, and haemoglobin were not significantly improved by mass deworming. They furthermore found that in this lightly infected population reduction in mortality could be anywhere from no reduction to 10% reduction in mortality (the overall mortality was 2·52% and 2·65% in the treatment and the control group respectively). It could however be more likely that deworming affects mortality in other, more heavily infected, populations. This trial also had a potential confounder: some children with obvious worms in the control group received treatment

. We believe this is a minor confounder and does not jeopardize the main conclusion drawn from this trial.

However, generally, there is agreement, even among the authors of the Cochrane review and the large DEVTA trial that did not find strong evidence for health benefits on mass deworming 

 that children who were screened for worms and test positive should be dewormed and that, in principle, deworming drugs for STHs have good, reasonably strong effects on health, which is in line with our biological understanding of the parasitic worms. So the question is: if there is consensus that the deworming works in principle, then why don't we see reasonably strong effects of mass deworming in the Cochrane meta-analyses on mass deworming and the very large DEVTA trial? There are some sensible explanations:

The large DEVTA trial, which was conducted between 1999 and 2004, was confounded (see above) and/or conducted suboptimally, since it did not include integrated measures to reduce infection such as hygiene promotion (which is now considered to be best practice for deworming interventions), or it did not deworm frequently enough.

The true effect size of mass deworming on populations with all kinds of infection intensities and prevalence is underestimated because the samples studied had relatively low worm burden.

The trial was not adequately powered to pick up a relatively small effect size on health measures (in fact, the large trial was no better powered than several previous studies to pick up effects on health indicators, but only highly powered to pick up effects on mortality

Blog

When is systemic change a good idea?

Giving What We Can needs your support — only 5 days left to close our funding gap

Giving What We Can hosting Skype with Against Malaria's Rob Mather

Becoming an Effective Altruist

An update on the effectiveness of Deworm the World Initiative (DtWI)

Announcing the Giving What We Can Global Poverty Essay Competition ($2000 in prize money): ‘Where should we donate to do the most good?’

Effective Altruism means Effective Inclusion

SCI in Madagascar

Why averting a DALY through deworming may be better than through malaria nets

Peter Singer's The Most Good You Can Do