GiveWell, and the EA community at large, often emphasize the "cost of saving a life" as a key metric, $5,000 being the most commonly cited approximation. At first glance, GiveWell might seem to be in the business of finding the cheapest lives that can be saved, and then saving them. More precisely, GiveWell is in the business of finding the cheapest DALY it can buy. But implicit in that is the assumption that all DALYs are equal, or that disability or health effects are the only factors that we need to adjust for while assessing the value of a life year.. However, If DALYs vary significantly in quality (as I’ll argue and GiveWell acknowledges we have substantial evidence for), then simply minimizing the cost of buying a DALY risks adverse selection.

It's indisputable that each dollar goes much further in the poorest parts of [...]

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