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GiveWell aims to find the best giving opportunities we can and recommend them to donors (why we recommend so few charities). 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 (for the time being), we won'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.

PATH does not currently qualify for our highest ratings.

PATH has some arguably impressive achievements to its credit, and its ongoing funded activities may be promising as well. However, when examining the activities on which marginal dollars are likely to be spent, we do not see an outstanding case for impact. This situation may reflect that PATH gets significant funding (some of it with few strings attached) from a major funder, the Gates Foundation.

More information:

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Published: September 2012

Why did we consider PATH promising?

We prioritized analysis of PATH because of its track record of developing technology products for developing world health. These products include its vaccine vial monitor,1 Soloshot AD syringe,2 and its role in developing malaria3 and rotavirus4 vaccines. We haven't deeply investigated these cases, but have the rough impression that the products in question have proven useful, and we investigated PATH further to determine if it had room for more funding for current projects similar to those above.

We spoke with representatives from PATH about its activities; we also spoke with a representative of PATH's Malaria Vaccine Initiative (an initiative that is part of PATH but raises its own funds).

Considering PATH for unrestricted funding

We met with PATH representatives at its office on September 21, 2011 aiming to (a) better understand PATH's approach to development and (b) learn more about how it would use additional funds.5 We were trying to determine whether additional unrestricted funds would be used in a way that would be likely to lead to product developments like the ones listed above.

PATH articulated two potential uses for additional unrestricted funds: 6

  • The "PATH fund." The fund is supported by unrestricted donations. PATH staff can apply for funding for small projects and if successful, these can become larger projects. These funds support projects such as literature reviews, white papers, development of proposals for larger grants, and small-scale testing of new approaches, for example, for diabetes testing. We reviewed several examples of such projects.7
  • PATH-driven health projects. PATH is also seeking to raise $50 million for PATH-driven (as opposed to donor-driven) projects. When we met with PATH, it was still in the process of developing the specific project ideas, but it told us that its MACEPA project (a field project where PATH has a broad mandate to fight malaria) and its BHP Billiton project (a field project where PATH has a broad mandate to improve the health and development of very young children) are broadly representative of the types of programs it would aim to implement.8

We do not feel that the above represent giving opportunities competitive with our top charities.

Considering PATH programs for restricted funding

As part of GiveWell Labs, we may consider specific programs for restricted funding (as opposed to unrestricted funds which the charity can use at its discretion). GiveWell Labs is currently in an early stage and investigating the areas below is not sufficiently high on our agenda (as of June 2012).

PATH listed specific technologies it might develop if it had additional funding for this specific purpose. PATH stated that it is generally hard to get funding for these projects but that a grant from the Gates Foundation allows it to pursue preliminary work on them. One example was developing better tools for dealing with obstetric and neonatal emergencies at the community level, including ways to prevent postpartum hemorrhage (and to treat it if it occurs); ways to get women to referral care; simple anesthetic machines; and simple ways to do Caesarean operations. PATH also mentioned developing technologies for non-communicable diseases, such as effective ways to monitor hypertension.

PATH Malaria Vaccine Initiative. In 1999, the Gates Foundation created PATH MVI to coordinate efforts to develop a malaria vaccine.9 PATH has been involved with a vaccine candidate that has thus far shown promising results.10

Regarding its short-term funding needs, a representative from MVI told us in April 2011, "We're now facing a shortfall of slightly more than $1 million in 2012 and 2013 to complete the MTI research at the RTS,S trial sites."11 Based on strong past support from the Gates Foundation, we believe MVI has a strong likelihood of closing this funding gap.12 PATH MVI also discussed its longer-term funding needs.13

Sources

  • 1.

    PATH, “World's smartest sticker: For ten years vaccine vial monitors have flagged spoiled vaccine.”

  • 2.

    PATH, “ Technology Solutions for Global Health: SoloShot.”

  • 3.

    PATH, “Developing malaria vaccines: Investing in the tools of the trade.”

  • 4.

    PATH, “Accelerating access to rotavirus vaccines: Protection for the world's poorest countries.”

  • 5.

    GiveWell, “Notes from meeting with PATH representatives (September 21, 2011).”

  • 6.

    GiveWell, “Notes from meeting with PATH representatives (September 21, 2011).”

  • 7.
    • Weigl, Drake and Harner-Jay 2011.

    • PATH, "ARV Therapy Proposal."
    • PATH, "Gestational Diabetes Screening."
  • 8.

    PATH, “Window of Opportunity project: An integrated approach to health and development in Africa.”

  • 9.

    PATH Malaria Vaccine Initiative, "About Us."

  • 10.

    New England Journal of Medicine, "First Results of Phase 3 Trial of RTS,S/AS01 Malaria Vaccine in African Children."

  • 11.

    GiveWell, “Notes from phone conversation with Sally Ethelston, Director, Communications and Advocacy, PATH MVI (April 14, 2011).”

  • 12.

    This is supported by our conversation with Ms. Ethelston:

    GiveWell: Given Gates Foundation support, why wouldn't the Foundation just fund this?
    MVI: Gates is very supportive of the work we do. I can't speak on their behalf, but we see this as an opportunity to leverage funds and bring in other donors. We have the resources available to take us through mid-2012, so we’re looking to close the gap after that point.

    GiveWell, “Notes from phone conversation with Sally Ethelston, Director, Communications and Advocacy, PATH MVI (April 14, 2011).”

  • 13.
    GiveWell: What are other potential gaps?

    MVI: We want to accelerate development of malaria vaccines which means failing less promising projects quickly and advancing the most promising projects as quickly as possible. We have ambitious plans in terms of where we hope to be by 2025.

    If all goes well with RTS,S, we hope it will be available for use within the next 5 years. We're already working on next-generation vaccines, although the first one of those would likely not be available until after 2020.

    Thus, MVI will have significant resource needs in the future.

    GiveWell: Do you know when money would make a practical difference to your ability to move on those future priorities?

    MVI: We expect to start needing some fairly significant inputs of resources in 2014 which means we'd hope to have commitments in 2012-2013.

    GiveWell, “Notes from phone conversation with Sally Ethelston, Director, Communications and Advocacy, PATH MVI (April 14, 2011).”

PATH'S RESPONSE TO GIVEWELL EVALUATION
September 18, 2012

PATH very much appreciates the time GiveWell devoted to learning about our work and the opportunity to respond to their report. PATH is committed to improving health in the poorest communities around the world, and support from donors guided by GiveWell and other charity-evaluation groups is essential to our work.

Support from individuals is immensely important to PATH’s work because of the flexibility it provides. As our annual budget shows, nearly all of PATH’s funding is restricted—tied to specific grants from governments or institutional funders. Thus, many of our teams rely on “innovation funding”: flexible funds that allow us to proactively respond to challenges in global health. These funds come almost entirely from individuals and family foundations; PATH is fortunate to have more than 1,500 donors who support us in this way.

We use innovation funding in a variety of ways: to explore cutting-edge ideas or establish a foothold in a region where we haven’t worked before; to carry out the early proof-of-concept that can attract major funding; to keep good work in motion over the many years required to develop a new technology or vaccine and bring it into household use. Innovation funding can allow us to respond immediately to truly urgent needs—in one example, gifts from individual donors helped break loose a logjam in the delivery of Japanese encephalitis vaccine to children in North Korea. Within three weeks of the donors’ contribution, the vaccine was shipped and then administered to more than 455,000 children who are now protected against one of Asia’s most debilitating viral illnesses.

PATH applies funding from individual donors strategically and where we believe it will have the maximum impact. More than half of the achievements highlighted in our 2011 annual report received support from individuals at some point in the project’s development. Among them:

  • The Ultra Rice® technology, used to increase the nutritional value of rice, the world’s most common dietary staple. Innovation funding has provided a “bridge” for this project between several stages of the technology development process. We anticipate fortified grain produced through the Ultra Rice® process will reach 10 million people in Brazil over the next two years and are currently planning introduction in Africa and Asia.
  • Strong policies for infants in South Africa. Two projects supported by flexible funds—one to support “milk banks” that provide vital nutrition for orphaned infants, the other to connect new mothers with “buddies” to counsel them in good feeding practices—helped the country make a dramatic shift in policy to support breastfeeding practices that are optimal for the health of vulnerable babies.
  • Cervical cancer prevention and treatment for poor countries. Our work on cervical cancer prevention started in the early 1990s on a shoestring budget with just $25,000 of innovation funding. That investment leveraged more than $50 million from public funders to launch the Alliance for Cervical Cancer Prevention, which brought cervical cancer screening to half a million women in the developing world. Today, PATH is helping bring the cervical cancer vaccine to women around the globe. Private donors continue to play an important role, most recently by supporting pilot vaccination projects in Peru that led to a national vaccination campaign.

Although it is a relatively small percentage of PATH’s budget, innovation funding has a significant influence on our long-term impact. For this reason, we have prioritized increasing the availability of this funding and have launched a major campaign to fund transformative work over the next few years.

More information about the role of individuals in PATH’s work, including a list of projects receiving support through the Catalyst Fund, can be found at www.path.org.

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