Good news for many South African HIV patients—with a big glitch

On Wednesday, South African Health Minister Aaron Motsoaledi announced that, as of January 2015, HIV-positive patients in the country would start receiving free antiretroviral treatment once their CD4 count fell below 500, instead of current threshold of less than 350. Some patient groups would start receiving antiretrovirals immediately upon being diagnosed with HIV infection, regardless of their clinical stage.

Last month, Till Bärnighausen, Dan Wikler and I predicted in PLoS Medicine that sub-Saharan nations would move in the direction that South Africa is now moving, and pointed out a big complication. This policy change might make several gigantic trials of so-called treatment-as-prevention in sub-Saharan Africa impossible to complete successfully. As we explained, these trials remain important for assessing the potential of treatment-as-prevention to curb the spread of HIV in general populations (with many different relationship types and different levels of care delivery and support).

In treatment-as-prevention, antiretrovirals are offered to patients immediately upon their diagnosis with HIV. The hope is that very early treatment would be better for these patients and prevent them from infecting others. We also offered some ways out of this mess, but they involve untraditional approaches to research conduct and to policy. Our piece was featured in the June issue of UNAIDS’ HIV This Month.

Harvard Effective Altruism (HEA): Thursday, April 17th: Critch on Aversion Factoring & Career Choice

A communication from Harvard Effective Altruism:

Aversion Factoring & Career Choice

with Dr. Andrew Critch

Thursday, April 17th 7-8:30 PM

Emerson 305

We often limit ourselves by avoiding things we find bothersome or scary.  But for almost anything you find bothersome, there’s someone out there who doesn’t!  How does that work?  Can you copy their enjoyment-powers?  If so, you have many more options for growth, career choice, and general do-gooding.  This presentation is based around a technique Dr. Critch teaches at the Center for Applied Rationality for using aversions as a source of creativity, and then getting over them.

Dr. Critch’s interest in rationality began as a teenager growing up in Newfoundland, Canada, where he says he “just had a lot of time to think about it”. When he was 14, he made his first attempt to extrapolate his instinctive preferences into a function whose expected integral he wanted to maximize. (In college he found out that some economists had been crazy enough to think humans worked this way automatically). He also won numerous national awards in mathematics and public-speaking competitions.

 

Saturday, April 5th: Aid Grade! (from Harvard Effective Altruism)

A communication from Harvard Effective Altruism:

 

Hi altruists,

Saturday, April 5th is a big day for EA at Harvard: we have three different awesome events for you! Our guest for the day, flying up from DC for the occasion, will be Dr. Eva Vivalt, the founder of AidGrade. AidGrade helps figure out what works in international development by doing rigorous and engaging analyses of different interventions to find out their effects. They’re also looking for interns and full-time hires for this work, so please visit if you’re interested!

We’ll be having a talk on AidGrade’s research from 1-2pm, followed by a research-a-thon from 2-6 where we help AidGrade do some meta-analysis. The day will be topped off by a Boston-area effective altruism meetup at Clover–with another special guest, Jacob Trefethen of 80,000 Hours Cambridge UK, and many awesome local effective altruists.

Continue reading

Call for applications: Brocher Summer Academy 2014: Ethical Choices for DALYs and the Measurement of the Global Burden of Disease

Confirmed speakers: Christopher Murray (IHME)—Keynote, Matt Adler (Duke), Greg Bognar (La Trobe U), John Broome (Oxford), Dan Brock (Harvard), Richard Cookson (York U), Owen Cotton-Barratt (Oxford), David Evans (WHO), Marc Fleurbaey (Princeton U), Ned Hall (Harvard), Dan Hausman (U of Wisconsin, Madison), Elselijn Kingma (U of Eindhoven), Jeremy Lauer (WHO), Colin Mathers (WHO), Erik Nord (Norwegian Institute of Public Health, Oslo), Ole Norheim (U of Bergen), Andreas Reis (WHO), Joshua Salomon (Harvard and IHME), Abha Saxena (WHO), Erik Schokkaert (KU Leuven), Drew Schroeder (Claremont McKenna), Alex Voorhoeve (LSE), James Woodward (U of Pittsburgh).

Organizers: Daniel Wikler (Harvard), Nir Eyal (Harvard), Samia Hurst (U of Geneva)

The biennial Summer Academy in the Ethics of Global Population Health is hosted by the Brocher Foundation on the shores of Lake Geneva June 9-13 2014, introducing faculty and advanced graduate students to population‐level bioethics. This fast‐developing academic field addresses ethical questions in population‐ and global health rather than ones in individual patient care.

The Global Burden of Disease (GBD) project is a systematic, scientific effort to quantify the comparative magnitude of health loss due to diseases, injuries, and risk factors. From its inception in the early 1990s, scientists and philosophers recognized that ethical and philosophical questions arise at every turn. For example, it must be decided whether each year in the lifespan is to count alike, and whether future deaths and disabilities should be given the same weight as those in the present. These choices and decisions matter: the share of disease burden due to myocardial infarction could vary as much as 400% depending on what position is adopted on two of the ethical choices described in the GBD 2010 report.  Continue reading

Harvard Effective Altruism: Josh Greene this Tuesday

Emotion, Reason and Altruism
with Professor Joshua Greene

Tuesday, March 11th, 7 PM,
Fong Auditorium, Boylston Hall
Why do people have radically different opinions as to who to help and how? How can we get along with people who seem to fundamentally disagree with us about what to want? Professor Josh Greene addresses this and more in Emotion, Reason, and Altruism.
Joshua Greene direct Harvard’s Moral Cognition Lab, which uses cutting edge cognitive neuroscience techniques to study how people actually make moral decisions, integrating thinking from philosophy, social science, and social psychology to address questions of why people disagree as much as they do, and what we can do about it.

Trials of HIV Treatment-as-Prevention: Ethics and Science. Friday, March 7

High hopes for overcoming the HIV epidemic rest to a large extent on HIV Treatment-as-Prevention (TasP). Large cluster-randomized controlled trials are currently under way to test the effectiveness of different TasP strategies in general populations in sub-Saharan Africa. At the same time, however, international antiretroviral treatment (ART) guidelines have already moved to definitions of ART eligibility including all – in the US guidelines – or nearly all – in the WHO guidelines – HIV-infected people. In this panel, we are bringing together the leaders of three TasP trials in sub-Saharan Africa, bioethicists, and public health researchers to debate the tension between the policy intentions expressed in these guidelines and the historic opportunity to learn whether TasP works or not. Please join us in considering different options to resolving this tension.

  • Till Bärnighausen, Harvard School of Public Health, and Wellcome Trust Africa Centre for Health and Population Science
  • Max Essex, Harvard School of Public Health
  • Deenan Pillay, Wellcome Trust Africa Centre for Health and Population Science, and University College London
  • Velephi Okello, Swaziland National AIDS Programme, Ministry of Health
  • Dan Wikler, Harvard School of Public Health
  • Nir Eyal, Harvard Medical School

 

Moderator: Megan Murray, Harvard School of Public Health and Harvard Medical School

 

Friday, March 7th, 10am-12pm

Kresge G3, Harvard School of Public Health

Harvard Effective Altruism (HEA): Tuesday, 7pm–Professor “Mad Max” Tegmark on the Future of Life

HEA’s first talk of the semester promises to be a good one, in an area we haven’t covered much before: shaping the far future. In the footsteps of the Future of Humanity Institute, and Nick Beckstead‘s research on the altruistic importance of the far future, we present:

 

The Future of Life: a Cosmic Perspective

 

a talk by Professor Max Tegmark

 

Tuesday, March 4, 7 p.m.

Sever 202

 

Exploring how we humans have repeatedly underestimated not only the size of our cosmos (and hence our future opportunities), but also the power of our humans minds to understand it and develop technologies with the power to enrich or extinguish humanity.

 

Known as “Mad Max” for his unorthodox ideas and passion for adventure, his scientific interests range from precision cosmology to the ultimate nature of reality, all explored in his new popular book “Our Mathematical Universe”. He is an MIT physics professor with more than two hundred technical papers and has featured in dozens of science documentaries. His work with the SDSS collaboration on galaxy clustering shared the first prize in Science magazine’s “Breakthrough of the Year: 2003.”

 

HHIP: Evaluating Effective Charities – GiveWell cofounder Elie Hassenfeld: Tuesday, 8 PM

Harvard High Impact Philanthropy presents:

Evaluating Effective Charities with Elie Hassenfeld of GiveWell

How can you maximize the impact of your charitable giving?  What distinguishes the most effective causes and organizations? Elie Hassenfeld, co-founder and co-Executive Director of GiveWell, will describe how his organization is revolutionizing charity evaluation with completely transparent, rigorous analysis. Q&A to follow.

8 pm, Tuesday, Nov. 12; Sever 102

RSVP here

Elie Hassenfeld graduated from Columbia in 2004 and co-founded GiveWell in mid-2007 where he currently serves as co-Executive Director. GiveWell finds outstanding charity and publishes the full details of its analysis to help donors decide where to give. The Boston Globe has called GiveWell “The gold standard for giving” and its research has attracted attention from Peter Singer and other media. GiveWell has tracked over $10 million in donations to its recommendations as a direct result of its research.

HHIP: Friday, November 8: Peter Singer – Effective Altruism

Harvard High Impact Philanthropy presents:

Peter Singer on Effective Altruism

Effective altruism is a new movement consisting of many individuals and several independent organizations, all focused on the deceptively simple idea that we should try to do as much good as we can. The existence of this movement raises many interesting questions, both practical and philosophical, which this talk will discuss.

Friday, November 8th; 4 – 5 PM, in Science Center D

RSVP to the event

Peter Singer is the Ira W. DeCamp Professor of Bioethics at the Princeton University Center for Human Values and Laureate Professor at the Center for Applied Philosophy and Public Ethics at the University of Melbourne. He is well known for his philosophical work, as well as for his books – most recently including The Life You Can Save.
This event is co-sponsored by the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, with support from the Oswald DeN. Cammann Fund, as well as Harvard’s Departments of Economics and Philosophy.

Prof. Singer will also speak on “Ethics and Animals: Where Are We Now?” at 12 PM in Austin 200 (Ames Courtroom), 1515 Massachusetts Ave.

 

Skype co-founder Jaan Tallinn highlights X-risk

Young people often assume that their life expectancies will remain what life expectancy is today—although life expectancy will grow by the time they are old. When all of us imagine our futures, we often neglect to take account of radical technologies which were not foreseeable prior to their invention, just as the internet wasn’t, and instead imagine something closer to present realities. We do not appreciate how different the future could be.

Among other things, the future might be dangerous to humankind in ways that we fail currently to appreciate. We got lucky, and nuclear energy seems hard for individuals to develop at home, but will that last, and will new WMDs be impossible to replicate with 3D printers or other future technologies? Can anyone guarantee that viruses manufactured for scientific research will not be spread by error or terror? Can we guarantee that robots designed for contained military purposes would not go out of control? Or that once artificial intelligence is advanced enough to design other artificial intelligence, humans will remain safe for long? Some of the greatest dangers to our species are unknown, simply because the technologies that create them have not been invented yet—just as many technologies that exist and threaten us today were not invented 100 years ago.

In a multimedia presentation that drew a prolonged applause from a crowd of Harvard undergraduates, Estonian programmer Jaan Tallin wove together three stories: the story of Kazaa and Skype, which he helped start; his personal journey into studying and promoting the study of existential risk; and a “sermon” (as he put it, tongue in cheek) on the ethical responsibilities of technology developers.

Tallin proposed taking active steps in anticipation of our future errors, both to make businesses robust and to keep our species safe in an opaque future: incorporating safety margins, and continually questioning one’s assumptions. He concluded by arguing, provocatively, that indispensable to both goals is having fun.

The talk was organized by the student organization Harvard High Impact Philanthropy (HHIP).

HHIP: Jaan Tallinn, co-founder of Skype, talks on responsible technology development

So You Want to be a Technology Developer…

The roots of Skype go back to one email. If that email hadn’t been sent, the world today might be different. In general, technology development is not something that “just happens” — instead, it’s a result of particular actions by individual people. Moreover, the responsibility of technology developers must increase proportionally to the power of their creations. The talk sketches out a vision of what it means to be a responsible technology developer, using behind the scenes stories and videos from the early days of Skype development.

 Jaan Tallinn, co-founder of Skype

Wednesday, October 30th

5:30 – 6:30 PM

Science Center A

RSVP to this event

The event is organized by Harvard HIP (High Impact Philanthropy).

Wednesday @ 8pm – Thomas Pogge: Effective Altruism or Mobilization for Institutional Reform?

Harvard High-Impact Philanthropy presents

Effective Altruism or Mobilization for Institutional Reform?

a lecture by Thomas Pogge

Director of the Global Justice Program and Leitner Professor of Philosophy and International Affairs, Yale University

Wednesday, October 9, 8 PM Sever 214

Professor Pogge will discuss whether some institutional reform efforts may be as effective or more effective than “effective altruism” and also whether effectiveness is the only standard by which such alternative ways of protecting people are to be compared.

Thomas Pogge is the Director of the Global Justice Program and Leitner Professor of Philosophy and International Affairs at Yale University. Additionally, he is the Research Director of the Centre for the Study of the Mind in Nature at the University of Oslo; a Professorial Research Fellow at the Centre for Applied Philosophy and Public Ethics at Charles Sturt University; and Professor of Political Philosophy at the University of Central Lancashire’s Centre for Professional Ethics. He is also an editor for social and political philosophy for the Stanford Encyclopedia of Philosophy and a member of the Norwegian Academy of Science and Letters.

Planning on coming? RSVP here

May 22 (note new date): Dan Brock delivering the Gay Lecture on “The Future of Bioethics”

Please join the Division of Medical Ethics for:

The 2013 George W. Gay Lecture in Medical Ethics

Dan W. Brock, PhD
Frances Glessner Lee Professor of Medical Ethics, Department of Global Health and Social Medicine, HMS

“The Future of Bioethics”
Wednesday, May 22, 2013 (note new date)
4:00 PM

Harvard Medical School, Tosteson Medical Education Center

Carl W. Walter Amphitheater
260 Longwood Avenue, Boston

Please pass this invitation along to other interested friends and colleagues.
RSVP to  DME@hms.harvard.edu.

The George W. Gay Lecture is the oldest endowed lectureship at Harvard Medical School, and quite possibly the oldest medical ethics lectureship in the United States. The lectureship was established in 1917 by a $1,000 gift from Dr. George Washington Gay, an 1868 graduate of HMS. Since its inception, many of the nation’s most influential physicians, scientists, researchers and social observers, including Erich Fromm, Felix Frankfurter, Margaret Mead, Elizabeth Kübler Ross, E.O. Wilson, and Joshua Lederberg have given the Gay Lecture. Elie Wiesel, Marian Wright Edelman, Paul Krugman, Nicholas Kristof and Donald Berwick have given recent Gay Lectures.

 

Harvard HIP (High Impact Philanthropy): Toby Ord speaking tonight

Are you interested in foreign aid, global development, medicine? Want to know how philanthropy and charitable giving can do the most good?

Aid Works (On Average) - By Toby Ord

Tuesday, March 26th; Emerson Hall 108; 8 PM

There is considerable controversy about whether foreign aid helps poor countries, with several prominent critics arguing that it doesn’t. Dr. Ord shows that these critics have only reached this conclusion because they have failed to count the biggest successes of aid, such as the eradication of smallpox, which have been in the sphere of global health rather than economic growth. These health successes have often been neglected in analysis of aid because they have only made up a small proportion of aid spending. When we look at the impact of this spending, though, we see that it the big wins have been so utterly vast that they more than justify all aid spending to date.

Dr. Toby Ord is a philosopher at the University of Oxford and a research associate at the Uehiro Center for Practical Ethics and the Future of Humanity Institute. He is also the founder and director of Giving What We Can, an international society dedicated to eliminating poverty in the developing world.

Join Dr. Ord tonight, March 26, at 8 PM for a talk and discussion of the effectiveness of foreign aid. Refreshments will be provided, and a reception will follow.

Planning to come? Please RSVP on Facebook to help us plan refreshments.

March 28: Jessica Flanigan speaking to the HMS Division of Medical Ethics

Please join the HMS Division of Medical Ethics for …

 

“Why patients should have access to all drugs without a prescription”

Jessica Flanigan, PhD

Assistant Professor of Leadership Studies and Philosophy, Politics, Economics and Law

University of Richmond

Thursday, March 28, 2013; 4:00 – 5:30 PM

HMS Division of Medical Ethics

1st Floor Conference Room

641 Huntington Avenue, Boston

RSVP to DME@hms.harvard.edu

Jessica Flanigan is a philosopher whose research interests include the ethics of business and medicine, law, and public policy.  Her current research addresses the ethics of self-medication and looks at the obligations of business leaders, particularly in the pharmaceutical industry, and questions the role of public officials. She asks questions such as: Can business leaders harm consumers simply by giving them more options? Do public officials misuse their power when they prohibit potentially dangerous drugs?  She is working on a book, Liberal Medicine, which is the first sustained philosophical inquiry into the ethics of medical regulations such as premarket safety and efficacy trials and the prescription drug system.

Apr 4: Dan Brock delivering the Gay Lecture on “The Future of Bioethics”

Please join the Division of Medical Ethics for:

The 2013 George W. Gay Lecture in Medical Ethics

Dan W. Brock, PhD
Frances Glessner Lee Professor of Medical Ethics, Department of Global Health and Social Medicine, HMS

“The Future of Bioethics”
Thursday, April 4, 2013
4:00 PM

Harvard Medical School

Tosteson Medical Education Center

Carl W. Walter Amphitheater
260 Longwood Avenue, Boston

Please pass this invitation along to other interested friends and colleagues.
RSVP to  DME at hms.harvard.edu.

The George W. Gay Lecture is the oldest endowed lectureship at Harvard Medical School, and quite possibly the oldest medical ethics lectureship in the United States. The lectureship was established in 1917 by a $1,000 gift from Dr. George Washington Gay, an 1868 graduate of HMS. Since its inception, many of the nation’s most influential physicians, scientists, researchers and social observers, including Erich Fromm, Felix Frankfurter, Margaret Mead, Elizabeth Kübler Ross, E.O. Wilson, and Joshua Lederberg have given the Gay Lecture. Elie Wiesel, Marian Wright Edelman, Paul Krugman, Nicholas Kristof and Donald Berwick have given recent Gay Lectures.

Feb 28: Ruth Grant speaking to the HMS Division of Medical Ethics


Please join the HMS Division of Medical Ethics and Program in Ethics and Health for…

“Strings Attached: Untangling the Ethics of Incentives”

Ruth W. Grant, PhD

Professor of Political Science and Philosophy, Duke University

Thursday, February 28, 2013

12:00 – 1:15 PM

HMS Division of Medical Ethics

1st Floor Conference Room

641 Huntington Avenue, Boston

A light lunch will be provided. RSVP required to DME@hms.harvard.edu.

Ruth Grant is a Professor of Political Science at Duke University and a Senior Fellow at the Kenan Institute for Ethics, specializing in political theory and political ethics. Her most recent book, Strings Attached: Untangling the Ethics of Incentives, examines moral concerns raised by the pervasive use of incentives to shape behavior. Her seminar talk will propose an ethical framework for thinking about the promises and limits of incentives, including the use of incentives in public health.

Feb 13: Peter Ubel speaking to the HMS Division of Medical Ethics

Please join the HMS Division of Medical Ethics for…

“What behavioral science has taught me about the limits of autonomy”

Peter A. Ubel, MD

Professor of Business Administration and Medicine,

Professor of Public Policy, Duke University

Wednesday, February 13, 2013 1:00 – 2:30 PM

1st Floor Conference Room 641 Huntington Avenue, Boston

RSVP to DME [at] hms.harvard.edu

The Society for Philosophy and Disability Is Official

With an approved constitution, elected officials and now, recognition from all three divisions of the American Philosophical Association (APA), a new society is finally official. The Society for Philosophy and Disability, or SPD, will hold its first two sessions at the February 2013 Central APA meeting in New Orleans.

SPD is a non-profit educational organization dedicated to furthering research and teaching on philosophical issues related to disability and to promoting inclusiveness and support for people with disabilities in philosophical education and in the profession of philosophy. SPD aims to provide a forum for philosophical discussion of disability by arranging meetings, maintaining an online presence, and organizing academic projects.

Adam Cureton, President of the Society, invites everyone to join SPD, which they can do on the Society website. You are also welcome to invite colleagues or students who are interested in philosophy and disability to join us.

Last opportunity to donate well

By Nir Eyal

Still deliberating which charity to give money to this year? The best charity evaluator is an organization called GiveWell. With one major reservation, you can safely follow their recommendations.

And yes, you really should donate a bunch–today, and as a New Year’s resolution. If you choose the right cause, you could do ethical wonders, while remaining rich.