Effective Altruism focused on bednets while a malaria vaccine was stuck for 35 years. The case for Abundance.
Functional governance and democracy helps many EA cause areas. A thousand small government failures compound into civilizational risk.
This piece is written for the effective altruism community, people focused on finding the highest-impact ways to do good, especially through a lens of whether something is important, tractable, and neglected. I’m giving a version of this piece as a talk at EA Global x DC next week.
Effective Altruism has a great track record. In 2023 alone, an EA-backed organization prevented 40,000 deaths and 20 million malaria cases. Another moved over $1 billion in cash directly to the world's poorest families and changed how USAID measures its own effectiveness.
But EA has a blind spot: systems change. It’s harder to measure, the benefits are diffuse, and it seems less tractable. But it’s often more impactful.
China’s decision to liberalize its economy lifted hundreds of millions out of extreme poverty. The economists who inspired that decision only needed a 10% chance of changing policy for their work to be competitive with EA’s most effective direct interventions.
EA is missing this.
We focused on bednets while a malaria vaccine was stuck for 35 years
Bed nets are remarkable. Saving a life for $5,500 is extraordinary. We should fund this.
But there’s been a malaria vaccine since the 1980s.
RTS,S—the vaccine the WHO finally recommended in 2021—spent decades in clinical trials and agency reviews with no urgency, even though malaria kills over half a million people a year, mostly children.
After Phase III trials confirmed it worked in 2015, the WHO required an additional multi-year pilot program due to meningitis cases in a few tested regions. Those cases turned out not to be caused by the vaccine, which most observers expected.
No institution in the approval chain was required to weigh that six-year delay against the vaccine’s 13% reduction in child mortality.1
Abundance, at its core, is responsive governance
Abundance asks: Is the government actually delivering on what it set out to do? What are the unintended consequences of current methods?
Democracies rarely ask this. Drug approvals take decades. In most U.S. cities, building housing is nearly impossible because rules that were each reasonable in isolation have accumulated into a system where neighbors can block almost anything. The national daycare shortage is made worse by the fact that daycares are illegal above the first floor in most states due to fire codes written before sprinklers existed.
Abundance is the project of finding and fixing these failures in the sectors that make the biggest difference, like science.
Why abundance is important
Science. The federal government almost didn't fund the research that led to the COVID-19 vaccine. Katalin Karikó spent decades trying to get grants for mRNA technology. Her university told her to abandon it or accept a demotion. She took the demotion. mRNA got funded only because DARPA, a small agency that bets on speculative science, took a chance. The federal grant system is now so averse to failure that the next Karikó might not find support.
Cost of Living. The U.S. housing shortage shows up in prices and in lower productivity growth. Austin built a lot of housing; rents dropped and are now cheaper than before the pandemic. The same rules blocking housing also block daycares, medical clinics, nursing homes, and clean energy facilities, and impact prices. Cost of living fuels public discontent, which is bad for democracy.
State Capacity / Democratic Trust. New York City spent six years and millions of dollars failing to repair the Wollman Rink in Central Park. The city kept running over budget and missing deadlines. Donald Trump offered to take it over, finished it in four months, and came in under budget. He became a local hero in 1980s NYC. When the government can’t do basic things, people willing to bypass the usual process appear more competent. That’s a bad norm.
The stakes get higher with forest fires. Controlled burns, where the government deliberately burns smaller areas before the dry season, are the most effective tool for preventing catastrophic wildfires. Californians have lost homes and lives to fires that were likely preventable. But the U.S. Forest Service needs three to ten years to complete the required environmental paperwork for a single controlled burn. Fires happen during that wait.
Toby Ord lists “accumulation of bad bureaucratic features” as a source of existential risk to civilization. This is how it happens: gradually, through a thousand small failures that erode trust in institutions. When government looks incompetent, polarization increases, norms weaken, and authoritarian alternatives look more appealing. Democracy is held together by collective agreement to democratic norms. These failures are what a democracy looks like as it becomes less resilient.
A functional democracy is not just good for Americans. A stable America and international respect for democratic norms are a global public good.
Global poverty. Economic growth is the single biggest driver of escaping poverty, more than foreign aid, direct transfers, or development programs. Almost all of the reduction in extreme poverty from 1990 to 2020 came from Asia. Sub-Saharan Africa received substantial aid over the same period.
What made Asia different? Countries like South Korea, Taiwan, Singapore, and Hong Kong started from roughly the same income levels as many African nations in the 1960s. They invested in infrastructure, reduced barriers to starting businesses, and opened to trade. They adopted abundance-oriented governance.
Abundance in the U.S. has knock-on effects that help global poverty. When the U.S. develops and commercializes a technology, it spreads globally. South Korea, Taiwan, and Singapore built their economies partly by adopting American semiconductor technology as the foundation for export-led growth. They went from poor to rich in a single generation. Solar is following a similar path. Panels are now cheap enough that developing countries can leapfrog fossil fuels.
Energy is a bigger deal than most Americans realize. There is no such thing as an energy-rich poor country. I lived in Nepal. Rolling blackouts hit for multiple hours every day with no warning. It’s hard to hold an internet-dependent job or build industries that can compete globally. The faster rich countries develop clean energy, the sooner the costs drop for everyone else.
When democratic governments visibly build things and work well, they also make that model more attractive globally. Competence is a form of soft power.
Why abundance is neglected
Abundance failures are structurally invisible.
When a housing project dies in permitting or a researcher can't get a grant for speculative science, no one hears about it. We don't know how much better things would be if the federal government didn't need three public notices to create a voluntary 5-minute meeting request form. The people who would have benefited don't know they missed out.
This makes abundance different from most policy issues. Gun violence produces victims with names. Pollution produces sick children. Abundance failures produce a much worse world than it should have been.
There's also no constituency for fixing it. The people who benefit from faster permitting and cheaper housing are everyone, a little. The people who benefit from the current system like incumbent businesses or existing homeowners are concentrated and organized.
Even abundance successes tend to stay invisible. When thousands of bridges get maintained without issue or when the FDA approves a drug faster, it doesn’t make a headline.
Building coalitions around invisible problems is hard.
Why abundance is tractable
Ezra Klein and Derek Thompson’s book Abundance became a bestseller. Abundance groups are popping up. Students for Abundance chapters are forming at universities. Something has shifted.
The work is also more concrete and measurable than it looks. Abundance is a list of specific questions with clear answers.
Why did the infrastructure bill fail to produce more housing?
What would the FDA need to change to approve treatments faster?
What’s blocking nurse practitioners or doctors from opening their own clinics?
Why did the mRNA technology almost not get funded?
The abundance agenda is still being written. The bottleneck is more people to do the sector-specific research and enact fixes.
What this means for AI risk
If you only care about AI risk, abundance is still worth your attention. Almost every AI scenario goes better with a government that works.
COVID is a good example. The U.S. invented mRNA but still lagged on clinical trials. Trials happened partly in the UK because its data infrastructure was better. China sent us face masks during our shortage. The failures e.g. slow diagnostics, slow manufacturing, slow regulatory approvals are what abundance is trying to fix. This boosts government capacity and biodefense.
Abundance also helps the government have surge capacity for shocks like a financial crisis or a jump in unemployment. Medicare, Medicaid, and debt interest are consuming a larger share of federal revenue. Cheaper healthcare, less regulatory drag, and more functional agencies create fiscal room to respond.
Not every way to prepare for AI is about AI itself. Better underlying systems help a lot.
The movement needs people
Abundance won’t solve any single EA cause. But it makes progress on almost all of them. It needs people.
I didn’t mean to start DC Abundance. A friend and I hosted a meetup to see who’d show up. We hoped for eight. Over fifty came. It felt like early EA: good ideas, not much infrastructure yet, and people figuring out what comes next.
You can be a part of that.
To be clear, some EA organizations, like GiveWell, Coefficient Giving, and 1 Day Sooner, are helping accelerate the approval of second malaria vaccine and on post-approval deployment! But the scale of bed-net-style work still vastly outpaces systems-change-style work e.g. focusing on the approval system itself.
I appreciate that this comes from a good place, but it seems like a strawman argument and a bit misleading.
For one, EA hasn't been around for 35 years, making your title quite misleading, and you when you do acknowledge the work that EA organisations have done to accelerate vaccine development and approval its tucked in a small footnote at the end rather than in the body of the article.
This argument, that systems work is important, also isn't new to the community and has been engaged on extensively. But the arguments, both for and against, aren't included in this article whatsoever.
To be honest, this feels like you're both aiming for engagement and pushing abundance as a new cause area (all the while bundling vaccine approval advocacy with housing reform in the most wealthy country in the world), rather than providing good-faith feedback to the EA community.
About a decade ago I needed to get a special permit to put a moving container in front of my house, so I went to the city department to do that. The guy ahead of me was in line to close a lane on one of the largest streets in the city so he could put up a crane to do repair work on a skyscraper. The person processing our paperwork used the same bureaucratic flow. At the time, you could only file online if you were a contractor applying for more then x number of permits a year.
I wanted to run for city council on the platform that we needed to reform bureaucratic processes to make sense, but that was clearly not a winning platform.
I will also say that over the last decade, this bureaucratic morass has been fixed, but the broader point, that basic technocratic competence isn’t how we choose elected officials.