Is rescuing migrants from the Med good value for money?

Thousands of people die each year trying to cross the Mediterranean to seek asylum in Europe. Christopher and Regina Catrambone, American and Italian entrepreneurs, decided to take matters into their own hands and set up their own private rescue mission.

Naturally when I read that

"a fundraising drive by the activist organisation Avaaz reached $500,000, slightly less than a month’s costs”,

I started wondering about cost effectiveness. Elsewhere the Guardian article states

"Setting up Moas was not cheap, with monthly operating costs of up to €600,000"

and

"The Phoenix rescued 1,462 people in 10 weeks"

So let’s go with the higher figure of €600,000 per month - over 10 weeks (2.3 months) that is a total cost of €1.4m (roughly $1.6m or £1m). And to save 1,462 people, that is a cost of £700 (~ $1000) per death averted.

Is that a lot or a little? As Owen has pointed out, the UK NHS considers anything less than £100,000 per death averted to be good value for money.

At the other extreme, childhood vaccinations, "long recognized as among the most cost-effective uses of limited health resources in low-income countries” (Disease Control Priorities) cost $275 per death averted.

At face value, Catrambone’s "Migrant Offshore Aid Station" (MOAS) looks like a pretty good value for money philanthropic bet.

Effective Altruism, RCTs, NGOs, & the Government End-Game

Good Ventures just gave a $25 million unrestricted grant to Give Directly on the advice of Givewell. That’s a lot of good news in one sentence, but it’s not even the best part. Givewell buried the lede when they mention around paragraph 20 that;

"GiveDirectly plans to discuss partnerships with the following types of institutions:

- Donor aid agencies
- Developing country governments (national and local). (For example, several governors in Kenya have already approached GiveDirectly about running cash transfer programs in their counties.)"

That’s what it’s all about. To really get sustainability and scale in social policy you need government involvement - that’s why the best NGOs combine a mixture of immediate direct service delivery in places where government just doesn’t have the capacity to deliver, with support to interested governments to build that capacity for the longer-term, often at the local level where administrators struggle to actually implement well-designed central policy documents, and with innovation in new models of service delivery, that governments might later adopt, of which GiveDirectly is clearly a strong example. Similarly whilst Innovations for Poverty Action and J-PAL may have started off following that recently infamous Kremer-Miguel deworming study by working on service delivery through small NGOs, their focus is on things that can work at scale, and having built a reputation through working with NGOs have been able to transition to working with governments (for example in Ghana and Peru).

As Jessica Brass writes,

"Government and NGOs learn from each other to improve what they do. In particular, many government agencies notice the successes achieved by NGOs and, whether intentionally or not, mimic their actions"

So yes, maybe some of the effective altruists can be accused of being philosophers not development wonks, and potentially even naive about politics, but for every anecdote-backed theoretical case for how aid might undermine the process of building citizen-state accountability, I can come up with an anecdote-backed theoretical case for how aid can support improved governance through innovation in service delivery models, and until we get some quantitative evidence on the issue, I don’t see how else we’re going to resolve the debate.

Did I miss anything?