Livre d'Or

It seems to me that this:
If I give what I can afford, which is really quite a lot in relative terms, to buying cheap medicines so that children in the poorest parts of the world are more likely to survive treatable diseases, I don't actually change the situation where there's huge global inequality such that a billion people need handouts from rich Westerners to get basic medical care.

is somewhat in contrast with your earlier:

my tendency to think about individual human beings more than collectives like countries or women or the often nebulous "society".

For me at least, the thing that makes effective altruism so appealing is the knowledge that for the kids who are now surviving their childhood diseases and their families I have, in fact, changed the world.