- Top charities
This page was published in 2009. For more recent information, see our 2012 update on GAVI.
GiveWell aims to find the best giving opportunities we can and recommend them to donors. We tend to put a lot of investigation into the organizations we find most promising, and de-prioritize others based on limited information. When we decide not to prioritize an organization, we try to create a brief writeup of our thoughts on that charity because we want to be as transparent as possible about our reasoning.
The following write-up should be viewed in this context: it explains why we determined that we wouldn't be prioritizing the organization in question as a potential top charity. This write-up should not be taken as a "negative rating" of the charity. Rather, it is our attempt to be as clear as possible about the process by which we came to our top recommendations.
The last time we examined GAVI was in 2009. In our latest open-ended review of charities, we determined that it was unlikely to meet our criteria based on our past examination of it, so we did not revisit it.
We invite all charities that feel they meet our criteria to apply for consideration.
The content we created in 2009 appears below. This content is likely to be no longer fully accurate, both with respect to what it says about GAVI and with respect to what it implies about our own views and positions. With that said, we do feel that the takeaways from this examination are sufficient not to prioritize re-opening our investigation of this organization at this time.
GAVI provides funds to developing world governments aiming to increase immunization coverage.1 However, based on reviewing available financial reports for GAVI, it appears that GAVI also offers significant funding outside of these channels, by funding "Investment Cases." For example, in 2007, GAVI provided $428.5 million to "Investment Cases." These appear to be direct grants to the Global Polio Eradication Initiative, Measles Initiative, Maternal and Neonatal Tetanus Initiative, and the Yellow Fever Initiative.2
According to GAVI's 2007 Progress Report, cumulative disbursements from 2000-2007 through "normal" channels totaled $1.41 billion.3 Thus, GAVI's "investment case" grants for 2007 alone were almost 25% of their cumulative allocations for 2000-2007.
Given this information, we are unsure of how GAVI allocates its funds and how additional donations would likely be used. (We wonder whether the significant allocation to "Investment Cases" indicates that GAVI has more money that it can reasonably spend through "normal" channels.)
Expanding immunization coverage is a proven, cost-effective means of saving lives and improving health in the developing world. (For more information, see our full report on expanding immunization coverage.) However, because of our questions about how GAVI allocates its funds (see above), we are not confident that GAVI increases immunization coverage.
Immunization is a proven, highly cost-effective method of improving health in the developing world.
For a traditional immunization program (DTP, measles, polio, and BCG) implemented in sub-Saharan Africa, the Disease Control Priorities report estimates approximately $14.21 per fully immunized child, $205 per child's death averted, and $7 per disability-adjusted life-year (DALY) averted.4 (More on DALYs in our overview of the DALY metric.)
Some of the vaccines that GAVI provides (such as those for yellow fever, Hib, and Hepatitis B)5 could increase the cost significantly (for example, nearly doubling the cost per immunized child in Sub-Saharan Africa), depending on the delivery strategy used and the specific vaccines administered.6 For more information, see the cost-effectiveness section of our full report on expanded immunization coverage.
We have not seen any expansion plan, "funding gap" analysis, or list of strong but underfunded proposals from GAVI. In addition, the fact that it makes large grants to other (similar but not identical initiatives) - as noted above - implies that it may have more funding available than it can productively use on core activities.
Update: In 2011, GAVI raised more than enough funds to cover its projected needs through 2015 (full discussion on our blog).
GAVI provides different types of funding:
GAVI, "Progress Report 2007," Pg 77.
GAVI, "Progress Report 2007," Pgs 78-79.
Jamison et al. 2006, Pg 401, Table 20.5.
GAVI, "New and Underused Vaccines."
"The discounted incremental cost [of additional vaccines] per person ranges from less than US$1 to US$16.23, depending on the unit price of vaccine, the type ofvaccine, the delivery strategy, and the coverage levels." Jamison et al. 2006, Pgs 403-404.