"A QALY is a health metric. Most of Scott's giving targets economic mobility, education, and equity, whose value is largely non-health — income, opportunity, rights, wellbeing. The model therefore understates her total social impact; it answers one specific question. The largest dollar buckets (equity & justice at ~22%, education at ~18%) contribute little health precisely because no credible study ties those grants to QALYs, not because the giving lacks value."

Which other metrics could be included to balance these economically? - society-wide morale lift & improved individual output - international desirability & forex lift

Or just re-weighting giving to normalize out non-health targeted expenditures?

Oh, and f** Malaria. Go get 'em, GiveWell and all working to reduce Malaria deaths. Polio too, heartbreaking that we have not beaten this one down yet. Suspect spend per paralysis/mortality is very high on Polio right now, but probably most agree the spend is very worth it given the payoff of a Polio-free planet.