Aggregator

In July 2018, we recommended a $5.1 million grant to Evidence Action Beta to create a program dedicated to developing potential GiveWell top charities by prototyping, testing, and scaling programs which have the potential to be highly impactful and cost-effective.

This grant was made as part of GiveWell’s Incubation Grants program, which aims to support potential future GiveWell top charities and to help grow the pipeline of organizations we can consider for a recommendation. Funding for Incubation Grants comes from Good Ventures, a large foundation with which we work closely.

Summary

This post will discuss the following:

• Why Evidence Action Beta is promising. (More)
• Risks we see with this Incubation Grant. (More)
• Our plans for following Evidence Action Beta’s work going forward. (More)

Incubation Grant to Evidence Action Beta

We summarized our case for making this grant in a recently-published write-up:

A key part of GiveWell’s research process is trying to identify evidence-backed, cost-effective programs. GiveWell sometimes finds programs that seem potentially highly impactful based on academic research, but for which there is no obvious organizational partner that could scale up and test them. This grant will fund Evidence Action Beta to create … [an] incubator … focused on interventions that GiveWell and Evidence Action believe are promising but that lack existing organizations to scale them.

We have found that which program a charity works on is generally the most important factor in determining its overall cost-effectiveness. Through partnering with Evidence Action Beta to test programs that we think have the potential to be very cost-effective, … our hope is that programs tested and scaled up through this partnership may eventually become GiveWell top charities.

We believe this incubator has the potential to fill a major gap in the nonprofit world by providing a well-defined path for testing and potentially scaling … promising idea[s] for helping the global poor.

For full details on the grant activities and budget, see this page.

We believe that Evidence Action Beta is well-positioned to run this incubator because of its track record of scaling up cost-effective programs with high-quality monitoring. Evidence Action Beta’s parent organization, Evidence Action, leads two of our top charities (Deworm the World Initiative and No Lean Season) and one standout charity (Dispensers for Safe Water).

Modeling cost-effectiveness

In addition to the theoretical case for the grant outlined above, we also made explicit predictions and modeled the potential cost-effectiveness of this grant, so we could better consider it relative to other options. In this section, we provide more details on our process for estimating the grant’s cost-effectiveness.

The main path to impact we see with this grant is by creating new top charities which could use GiveWell-directed funds more cost-effectively than alternatives could.

This could occur:

1. if Evidence Action Beta incubates charities which are more cost-effective than our current top charities, or
2. if Evidence Action Beta incubates charities which are similarly cost-effective to our current top charities—in a scenario in which we have mostly filled our current top charities’ funding gaps. Right now, we believe our top charities can absorb significantly more funding than we expect to direct to them; this diminishes our view of the value of finding additional, similarly cost-effective opportunities. If our current top charities’ funding gaps were close to filled, we would place higher value on identifying additional room for more funding at a similarly cost-effective level.

This grant could also have an impact if it causes other, non-GiveWell funders to allocate resources to charities incubated by this grant. This incubator may create programs that GiveWell doesn’t direct funding to but others do. If these new opportunities are more cost-effective than what these funders would have otherwise supported, then this grant will have had a positive impact by causing funds to be spent more cost-effectively, even if GiveWell never recommends funding to the new programs directly.

We register forecasts for all Incubation Grants we make. We register these not because we are confident in them but because they help us clarify and communicate our expectation for the outcomes of the grant. Here, we forecast a 55% chance that Evidence Action Beta’s incubator leads to a new top charity by December 2023 that is 1-2x as cost-effective as the giving opportunity to which we would have otherwise directed those funds and a 30% chance that the grant does not lead to any new top charities by that time. (For more forecasts we made surrounding this grant, see here.)

We incorporated our forecasts as well as the potential impacts outlined above in our cost-effectiveness estimate for the grant: note that the potential upside coming from other funders is a particularly rough estimate which could change substantially with additional research.

Our best guess is that this grant is approximately ~9x as cost-effective as cash transfers, but we have spent limited time on this estimate and are highly uncertain about it. For context, we estimate that the average cost-effectiveness of our current top charities is between ~3x and ~12x as cost-effective as cash transfers.

Risks to the success of the grant

We do see risks to the success of this grant:

• Few programs may be more cost-effective than our current top charities, or our top charities may remain underfunded for a long time. If Evidence Action Beta fails to identify more cost-effective giving opportunities than GiveWell’s 2017 top charities, or if it only identifies similarly cost-effective giving opportunities while our current top charities remain underfunded, barring any major upside effects, this grant will have failed to make an impact.
• We expect this partnership with Evidence Action Beta to require a fair amount of senior staff capacity. If other means of identifying cost-effective giving opportunities, such as our work to evaluate policy opportunities, end up seeming more promising, this capacity may have been misused.

Going forward

This grant initiates a partnership with Evidence Action Beta toward which we might contribute substantial additional GiveWell Incubation Grant funding in the future. We plan to spend a fair amount of staff time on this ongoing partnership and follow this work closely.

We look forward to sharing updates and the results.

The post A grant to Evidence Action Beta to prototype, test, and scale promising programs appeared first on The GiveWell Blog.

We’ve recently made a number of adjustments to improve our research process. Not all of them are easily visible outside of the organization.

This post is to highlight one of them: Publishing more frequent updates to our cost-effectiveness model throughout the year.

Summary

This post will explain:

• What changed in how we make updates to our cost-effectiveness model. (More)
• Why we made this change. (More)
• How to engage with updates to our model. (More)

What changed?

Last week, we published the ninth and tenth versions of our cost-effectiveness model in 2018. We made a number of updates to the newest versions of the model. They included accounting for reductions in malaria incidence for individuals who don’t receive seasonal malaria chemoprevention (SMC), the treatment one of our top charities distributes to prevent malaria, but who might benefit from living near other people receiving SMC (version 9) and the cost per deworming treatment delivered by another top charity, Sightsavers (version 10). These changes, and six others that were incorporated in the two latest versions, are described in our changelog.

Up until last year, we generally updated our cost-effectiveness model once or twice per year. However, as our model grew in complexity and we dedicated more research staff capacity to it, we decided that it would be beneficial to publish updates more regularly. We published our first in this series of more-frequent updates to our cost-effectiveness model in May 2017, as well as “release notes” (PDF) detailing the changes we made and the impact each had on our cost-effectiveness estimates.

We published five versions of our cost-effectiveness model in 2017. In 2018, we shifted from publishing PDF release notes to creating a “changelog“—a public page listing the changes we made to each version of the model, to be updated in tandem with the publication of each new version.

Internally, we moved toward having one staff member, Christian Smith, who is responsible for managing all changes to our cost-effectiveness model. He aims to publish a new version whenever there is a large, structurally complicated change to the model, or if there are several small and simple changes. Our internal process prioritizes being able to track how each change to the model moves the bottom line.

Changes we’ve published this year include updated inputs based on new research, such as the impact of insecticide resistance on the effectiveness of insecticide-treated nets; changes to inputs we include or exclude from the model altogether, such as removing short-term health benefits from deworming; and cosmetic changes to make the model easier to engage with, such as removing adjustments to account for the influence of GiveWell’s top charities on other actors from a particular tab.

Why we moved to this approach

Although it involves uncertainty, GiveWell’s cost-effectiveness model is a core piece of our research work and important input into our decisions about which charities to research and recommend. However, we believe it is challenging to engage with our model—to give a sense of the scale, our current model has 16 tabs, some of which use over 100 rows—and to keep up with changes we’ve made to the model over time.

Our hope is that publishing more frequent and transparent updates brings us closer in line to our goal of intense transparency and presenting a clear, vettable case for our recommendations to the public. It makes clearer the magnitude of any given change’s impact on our bottom line, and makes the evolution of the model over time easier to track. We also expect that it reduces the likelihood for errors, as fewer elements are being changed at any given time.

How to engage with updates to our model

We update our changelog, viewable here, when we publish a new version.

Going forward, we also plan to publish an announcement to our “Newly published GiveWell materials” email list when we do this. You can sign up to receive alerts from this email address here.

The post Publishing more frequent updates to our cost-effectiveness model appeared first on The GiveWell Blog.

We’ve recently made a number of adjustments to improve our research process. Not all of them are easily visible outside of the organization.

This post is to highlight one of them: Publishing more frequent updates to our cost-effectiveness model throughout the year.

Summary

This post will explain:

• What changed in how we make updates to our cost-effectiveness model. (More)
• Why we made this change. (More)
• How to engage with updates to our model. (More)

What changed?

Last week, we published the ninth and tenth versions of our cost-effectiveness model in 2018. We made a number of updates to the newest versions of the model. They included accounting for reductions in malaria incidence for individuals who don’t receive seasonal malaria chemoprevention (SMC), the treatment one of our top charities distributes to prevent malaria, but who might benefit from living near other people receiving SMC (version 9) and the cost per deworming treatment delivered by another top charity, Sightsavers (version 10). These changes, and six others that were incorporated in the two latest versions, are described in our changelog.

Up until last year, we generally updated our cost-effectiveness model once or twice per year. However, as our model grew in complexity and we dedicated more research staff capacity to it, we decided that it would be beneficial to publish updates more regularly. We published our first in this series of more-frequent updates to our cost-effectiveness model in May 2017, as well as “release notes” (PDF) detailing the changes we made and the impact each had on our cost-effectiveness estimates.

We published five versions of our cost-effectiveness model in 2017. In 2018, we shifted from publishing PDF release notes to creating a “changelog“—a public page listing the changes we made to each version of the model, to be updated in tandem with the publication of each new version.

Internally, we moved toward having one staff member, Christian Smith, who is responsible for managing all changes to our cost-effectiveness model. He aims to publish a new version whenever there is a large, structurally complicated change to the model, or if there are several small and simple changes. Our internal process prioritizes being able to track how each change to the model moves the bottom line.

Changes we’ve published this year include updated inputs based on new research, such as the impact of insecticide resistance on the effectiveness of insecticide-treated nets; changes to inputs we include or exclude from the model altogether, such as removing short-term health benefits from deworming; and cosmetic changes to make the model easier to engage with, such as removing adjustments to account for the influence of GiveWell’s top charities on other actors from a particular tab.

Why we moved to this approach

Although it involves uncertainty, GiveWell’s cost-effectiveness model is a core piece of our research work and important input into our decisions about which charities to research and recommend. However, we believe it is challenging to engage with our model—to give a sense of the scale, our current model has 16 tabs, some of which use over 100 rows—and to keep up with changes we’ve made to the model over time.

Our hope is that publishing more frequent and transparent updates brings us closer in line to our goal of intense transparency and presenting a clear, vettable case for our recommendations to the public. It makes clearer the magnitude of any given change’s impact on our bottom line, and makes the evolution of the model over time easier to track. We also expect that it reduces the likelihood for errors, as fewer elements are being changed at any given time.

How to engage with updates to our model

We update our changelog, viewable here, when we publish a new version.

Going forward, we also plan to publish an announcement to our “Newly published GiveWell materials” email list when we do this. You can sign up to receive alerts from this email address here.

The post Publishing more frequent updates to our cost-effectiveness model appeared first on The GiveWell Blog.

Our goal with hosting quarterly open threads is to give blog readers an opportunity to publicly raise comments or questions about GiveWell or related topics (in the comments section below). As always, you’re also welcome to email us at info@givewell.org or to request a call with GiveWell staff if you have feedback or questions you’d prefer to discuss privately. We’ll try to respond promptly to questions or comments.

You can view our June 2018 open thread here.

The post September 2018 open thread appeared first on The GiveWell Blog.

Our goal with hosting quarterly open threads is to give blog readers an opportunity to publicly raise comments or questions about GiveWell or related topics (in the comments section below). As always, you’re also welcome to email us at info@givewell.org or to request a call with GiveWell staff if you have feedback or questions you’d prefer to discuss privately. We’ll try to respond promptly to questions or comments.

You can view our June 2018 open thread here.

The post September 2018 open thread appeared first on The GiveWell Blog.

In April to June 2018, we received $1.2 million in funding for making grants at our discretion. In addition, GiveWell’s Board of Directors voted to allocate $2.9 million in unrestricted funds to making grants to recommended charities. In this post we discuss:

• The decision to allocate the $4.1 million to the Against Malaria Foundation (AMF) (70 percent) and the Schistosomiasis Control Initiative (SCI) (30 percent).
• Our recommendation that donors give to GiveWell for granting to top charities at our discretion so that we can direct the funding to the top charity or charities with the most pressing funding need. For donors who prefer to give directly to our top charities, we continue to recommend giving 70 percent of your donation to AMF and 30 percent to SCI to maximize your impact.
• Why we have allocated unrestricted funds to making grants to recommended charities.

Allocation of discretionary funds

The allocation of 70 percent of the funds to AMF and 30 percent to SCI follows the recommendation we have made, and continue to make, to donors. For more discussion on this allocation, see our blog post about allocating discretionary funds from the fourth quarter of 2017.

We ask each top charity to provide details of how they will use additional funding each year, as part of our process to update our “room for more funding” summary for each top charity. This year, we have asked for this information by the end of July. We also ask each of our top charities to let us know if they encounter unexpected funding gaps at other times of year. We have not learned of new funding gaps in the last quarter.

What is our recommendation to donors?

We continue to recommend that donors give to GiveWell for granting to top charities at our discretion so that we can direct the funding to the top charity or charities with the most pressing funding need. For donors who prefer to give directly to our top charities, we are continuing to recommend giving 70 percent of your donation to AMF and 30 percent to SCI to maximize your impact. The reasons for this recommendation are the same as in our Q4 2017 post on allocating discretionary funding.

We will complete a full analysis of our top charities’ funding gaps and cost-effectiveness by November and expect to update our recommendation to donors at that time.

Why we have allocated unrestricted funds to making grants to recommended charities

In June, GiveWell’s Board of Directors voted to allocate $2.9 million in unrestricted funds to making grants to recommended charities. We generally use unrestricted funds to support GiveWell’s operating costs. The decision was made to grant out some of the unrestricted funds we hold in accordance with two policies:

• Our “excess assets” policy specifies that once we surpass a certain level of unrestricted assets, we grant out the excess rather than continue to hold it ourselves. We reviewed our unrestricted asset holdings and projected revenue and expenses for 2018-2020 and concluded that we held $1.8 million more than was required to give us a stable, predictable financial situation (details of how this rule is applied are at the previous link). The Board voted to irrevocably restrict this amount to making grants to recommended charities. Note that we continue to need ongoing donor support for our operations. This decision incorporates our projections for future donations.
• In order to limit the risks of relying too heavily on any single source of revenue, we cap the amount of funding that we will use from one source to support our operating costs at 20% of our projected annual expenses. In early 2018, we received a donation of $2.1 million in unrestricted funds. Our operating expense budget for 2018 is $4.9 million. Therefore, the Board voted to retain $1.0 million to support operating costs in 2018 and irrevocably restrict $1.1 million to making grants to recommended charities.

The post Allocation of discretionary funds from Q2 2018 appeared first on The GiveWell Blog.

In April to June 2018, we received $1.2 million in funding for making grants at our discretion. In addition, GiveWell's Board of Directors voted to allocate $2.9 million in unrestricted funds to making grants to recommended charities. In this post we discuss:

• The decision to allocate the $4.1 million to the Against Malaria Foundation (AMF) (70 percent) and the Schistosomiasis Control Initiative (SCI) (30 percent).
• Our recommendation that donors give to GiveWell for granting to top charities at our discretion so that we can direct the funding to the top charity or charities with the most pressing funding need. For donors who prefer to give directly to our top charities, we continue to recommend giving 70 percent of your donation to AMF and 30 percent to SCI to maximize your impact.
• Why we have allocated unrestricted funds to making grants to recommended charities.

Read More

The post Allocation of discretionary funds from Q2 2018 appeared first on The GiveWell Blog.

In April to June 2018, we received $1.2 million in funding for making grants at our discretion. In addition, GiveWell's Board of Directors voted to allocate $2.9 million in unrestricted funds to making grants to recommended charities. In this post we discuss:

• The decision to allocate the $4.1 million to the Against Malaria Foundation (AMF) (70 percent) and the Schistosomiasis Control Initiative (SCI) (30 percent).
• Our recommendation that donors give to GiveWell for granting to top charities at our discretion so that we can direct the funding to the top charity or charities with the most pressing funding need. For donors who prefer to give directly to our top charities, we continue to recommend giving 70 percent of your donation to AMF and 30 percent to SCI to maximize your impact.
• Why we have allocated unrestricted funds to making grants to recommended charities.

Read More

The post Allocation of discretionary funds from Q2 2018 appeared first on The GiveWell Blog.

In April to June 2018, we received $1.2 million in funding for making grants at our discretion. In addition, GiveWell’s Board of Directors voted to allocate $2.9 million in unrestricted funds to making grants to recommended charities. In this post we discuss:

• The decision to allocate the $4.1 million to the Against Malaria Foundation (AMF) (70 percent) and the Schistosomiasis Control Initiative (SCI) (30 percent).
• Our recommendation that donors give to GiveWell for granting to top charities at our discretion so that we can direct the funding to the top charity or charities with the most pressing funding need. For donors who prefer to give directly to our top charities, we continue to recommend giving 70 percent of your donation to AMF and 30 percent to SCI to maximize your impact.
• Why we have allocated unrestricted funds to making grants to recommended charities.

Allocation of discretionary funds

The allocation of 70 percent of the funds to AMF and 30 percent to SCI follows the recommendation we have made, and continue to make, to donors. For more discussion on this allocation, see our blog post about allocating discretionary funds from the fourth quarter of 2017.

We ask each top charity to provide details of how they will use additional funding each year, as part of our process to update our “room for more funding” summary for each top charity. This year, we have asked for this information by the end of July. We also ask each of our top charities to let us know if they encounter unexpected funding gaps at other times of year. We have not learned of new funding gaps in the last quarter.

What is our recommendation to donors?

We continue to recommend that donors give to GiveWell for granting to top charities at our discretion so that we can direct the funding to the top charity or charities with the most pressing funding need. For donors who prefer to give directly to our top charities, we are continuing to recommend giving 70 percent of your donation to AMF and 30 percent to SCI to maximize your impact. The reasons for this recommendation are the same as in our Q4 2017 post on allocating discretionary funding.

We will complete a full analysis of our top charities’ funding gaps and cost-effectiveness by November and expect to update our recommendation to donors at that time.

Why we have allocated unrestricted funds to making grants to recommended charities

In June, GiveWell’s Board of Directors voted to allocate $2.9 million in unrestricted funds to making grants to recommended charities. We generally use unrestricted funds to support GiveWell’s operating costs. The decision was made to grant out some of the unrestricted funds we hold in accordance with two policies:

• Our “excess assets” policy specifies that once we surpass a certain level of unrestricted assets, we grant out the excess rather than continue to hold it ourselves. We reviewed our unrestricted asset holdings and projected revenue and expenses for 2018-2020 and concluded that we held $1.8 million more than was required to give us a stable, predictable financial situation (details of how this rule is applied are at the previous link). The Board voted to irrevocably restrict this amount to making grants to recommended charities. Note that we continue to need ongoing donor support for our operations. This decision incorporates our projections for future donations.
• In order to limit the risks of relying too heavily on any single source of revenue, we cap the amount of funding that we will use from one source to support our operating costs at 20% of our projected annual expenses. In early 2018, we received a donation of $2.1 million in unrestricted funds. Our operating expense budget for 2018 is $4.9 million. Therefore, the Board voted to retain $1.0 million to support operating costs in 2018 and irrevocably restrict $1.1 million to making grants to recommended charities.

The post Allocation of discretionary funds from Q2 2018 appeared first on The GiveWell Blog.

In April to June 2018, we received $1.2 million in funding for making grants at our discretion. In addition, GiveWell’s Board of Directors voted to allocate $2.9 million in unrestricted funds to making grants to recommended charities. In this post we discuss:

• The decision to allocate the $4.1 million to the Against Malaria Foundation (AMF) (70 percent) and the Schistosomiasis Control Initiative (SCI) (30 percent).
• Our recommendation that donors give to GiveWell for granting to top charities at our discretion so that we can direct the funding to the top charity or charities with the most pressing funding need. For donors who prefer to give directly to our top charities, we continue to recommend giving 70 percent of your donation to AMF and 30 percent to SCI to maximize your impact.
• Why we have allocated unrestricted funds to making grants to recommended charities.

Allocation of discretionary funds

The allocation of 70 percent of the funds to AMF and 30 percent to SCI follows the recommendation we have made, and continue to make, to donors. For more discussion on this allocation, see our blog post about allocating discretionary funds from the fourth quarter of 2017.

We ask each top charity to provide details of how they will use additional funding each year, as part of our process to update our “room for more funding” summary for each top charity. This year, we have asked for this information by the end of July. We also ask each of our top charities to let us know if they encounter unexpected funding gaps at other times of year. We have not learned of new funding gaps in the last quarter.

What is our recommendation to donors?

We continue to recommend that donors give to GiveWell for granting to top charities at our discretion so that we can direct the funding to the top charity or charities with the most pressing funding need. For donors who prefer to give directly to our top charities, we are continuing to recommend giving 70 percent of your donation to AMF and 30 percent to SCI to maximize your impact. The reasons for this recommendation are the same as in our Q4 2017 post on allocating discretionary funding.

We will complete a full analysis of our top charities’ funding gaps and cost-effectiveness by November and expect to update our recommendation to donors at that time.

Why we have allocated unrestricted funds to making grants to recommended charities

In June, GiveWell’s Board of Directors voted to allocate $2.9 million in unrestricted funds to making grants to recommended charities. We generally use unrestricted funds to support GiveWell’s operating costs. The decision was made to grant out some of the unrestricted funds we hold in accordance with two policies:

• Our “excess assets” policy specifies that once we surpass a certain level of unrestricted assets, we grant out the excess rather than continue to hold it ourselves. We reviewed our unrestricted asset holdings and projected revenue and expenses for 2018-2020 and concluded that we held $1.8 million more than was required to give us a stable, predictable financial situation (details of how this rule is applied are at the previous link). The Board voted to irrevocably restrict this amount to making grants to recommended charities. Note that we continue to need ongoing donor support for our operations. This decision incorporates our projections for future donations.
• In order to limit the risks of relying too heavily on any single source of revenue, we cap the amount of funding that we will use from one source to support our operating costs at 20% of our projected annual expenses. In early 2018, we received a donation of $2.1 million in unrestricted funds. Our operating expense budget for 2018 is $4.9 million. Therefore, the Board voted to retain $1.0 million to support operating costs in 2018 and irrevocably restrict $1.1 million to making grants to recommended charities.

The post Allocation of discretionary funds from Q2 2018 appeared first on The GiveWell Blog.

Summary

We recently completed a small project to determine whether using subnational baseline malaria mortality estimates would make a difference to our estimates of the cost-effectiveness of two of our top charities, the Against Malaria Foundation and Malaria Consortium. We ultimately decided not to include these adjustments because they added complexity to our models and would require frequent updating, while only making a small difference (a 3-4% improvement) to our bottom line.

Though this post is on a fairly narrow topic, we believe this example illustrates the principles we use to make decisions about what to include in our cost-effectiveness model.

Background

Two of our top charities—the Against Malaria Foundation (AMF) and Malaria Consortium’s seasonal malaria chemoprevention program—implement programs to prevent malaria, a leading killer of people in low- and middle-income countries.

One of the core reasons we recommend AMF and Malaria Consortium is their cost-effectiveness: how much impact they have (e.g., cases of malaria prevented, malaria deaths averted) with the funds they receive. Our estimates of charities’ cost-effectiveness isn’t just helpful to us in determining which charities should be GiveWell top charities; we also rely on these estimates to guide our decisions about how to allocate funding between our top charities.

Our cost-effectiveness estimates for AMF and Malaria Consortium use country-wide data on malaria mortality and malaria incidence in the places that both organizations work.1In both cases, we rely on reports by Cochrane, an organization that produces systematic reviews and other synthesized research to inform decision-makers. For AMF, we use a decline in all-cause mortality, because the Cochrane review of anti-malarial bed net distributions reports the effect in terms of a reduction in all-cause mortality. For Malaria Consortium, we use a decline in malaria mortality (proxied by a decline in malaria incidence), as the Cochrane review of seasonal malaria chemoprevention reports the effect in terms of a reduction in malaria incidence, but not all-cause mortality. See our cost-effectiveness analysis for more details. jQuery("#footnote_plugin_tooltip_1").tooltip({ tip: "#footnote_plugin_tooltip_text_1", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] }); However, neither organization serves a whole country—rather, they operate in sub-national regions—so the use of country-level estimates could cause us to either underestimate or overestimate their cost-effectiveness. If, for example, these programs are focused in the areas of the country with the highest malaria burden, using the average burden for the country would lead us to underestimate their cost-effectiveness. So, we completed a project to determine how much of an impact using subnational estimates would have, to consider whether we ought to incorporate this information into our cost-effectiveness analysis.

How we estimated the impact of subnational malaria incidence

AMF distributes insecticide-treated nets to prevent malaria; Malaria Consortium’s seasonal malaria chemoprevention (SMC) program provides preventive anti-malarial drugs. We used estimates of subnational malaria incidence from the Malaria Atlas Project (MAP) to see if regions covered by nets or eligible for SMC had higher or lower incidence than the average in the country in which they are located.2We assume that the regional distribution of malaria incidence is a reasonable proxy for the regional distribution of malaria mortality. jQuery("#footnote_plugin_tooltip_2").tooltip({ tip: "#footnote_plugin_tooltip_text_2", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

We focused on all areas covered by nets or eligible for SMC (rather than those covered by our top charities, specifically) for two reasons:

1. Our understanding is that when our top charities contribute resources to a country’s net distribution or SMC programs, the marginal region covered by these additional resources is not necessarily the same as the region to which these resources are assigned (because these resources are fungible with other resources within the national programs).3A limitation of this analysis is it does not account for the possibility that AMF and Malaria Consortium are causing locations that are higher priority or lower priority than the average location already covered by nets or eligible for SMC to be covered on the margin. We do not explicitly include estimates of the marginal region funded in our cost-effectiveness analysis because we often have limited information about which regions would be covered with marginal additional funds. jQuery("#footnote_plugin_tooltip_3").tooltip({ tip: "#footnote_plugin_tooltip_text_3", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });
2. Our aim is to estimate the cost-effectiveness of funds donated to these organizations in the future. The subnational region where AMF has worked in the past has not historically been a good indicator of the region where it will work in future.

Results for net distributions in countries where AMF works

We looked at geographical variation in malaria incidence in countries where AMF works, weighting each region by the number of nets it currently receives.4We assume that where nets have been delivered in the past is a good proxy for where new nets will be delivered in the future. The data and calculations are in this spreadsheet. jQuery("#footnote_plugin_tooltip_4").tooltip({ tip: "#footnote_plugin_tooltip_text_4", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

The average net delivered in the countries in which AMF works is hung in an area with 0-9% higher malaria incidence than the average in that country, and the weighted average adjustment to AMF’s cost-effectiveness would be 3% (in other words, AMF becomes 3% more cost-effective if we incorporate subnational estimates).5See Cell J114. We did not include Papua New Guinea (where AMF funds some nets) in this analysis, as MAP only covers countries in Africa. jQuery("#footnote_plugin_tooltip_5").tooltip({ tip: "#footnote_plugin_tooltip_text_5", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

Country Adjustment Zambia +9% Uganda +4% Ghana +4% Democratic Republic of the Congo +1% Togo +1% Malawi +0% Results for SMC in countries where Malaria Consortium works

We looked at six countries comprising >95% of Malaria Consortium’s SMC spending and compared malaria incidence in districts eligible for SMC with the country-wide average.6“The suitability of an area for SMC is determined by the seasonal pattern of rainfall, malaria transmission and the burden of malaria. SMC is recommended for deployment in areas: (i) where more than 60% of the annual incidence of malaria occurs within 4 months (ii) where there are measures of disease burden consistent with a high burden of malaria in children (incidence ≥ 10 cases of malaria among every 100 children during the transmission season) (iii) where SP and AQ [the drugs used to treat children] retain their antimalarial efficacy.” WHO SMC field guide (2013), Pg 8. jQuery("#footnote_plugin_tooltip_6").tooltip({ tip: "#footnote_plugin_tooltip_text_6", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });7The data and calculations are in this spreadsheet. jQuery("#footnote_plugin_tooltip_7").tooltip({ tip: "#footnote_plugin_tooltip_text_7", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

The average region eligible for SMC in countries where Malaria Consortium works has -2% to 17% higher malaria incidence than the average in that country. The weighted average adjustment to Malaria Consortium’s cost-effectiveness would be 4%.8See Cell C126. jQuery("#footnote_plugin_tooltip_8").tooltip({ tip: "#footnote_plugin_tooltip_text_8", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

Country Adjustment Commentary Guinea +17% Conakry, the capital, is ineligible for SMC and has low incidence. Nigeria +12% SMC appears to be targeted in the north, where malaria incidence is slightly higher. Niger +2% The majority of the population is either covered or planned to be covered from 2019. Burkina Faso 0% All districts are eligible. Mali 0% All districts are eligible. Chad -2% The four regions with very low malaria incidence (Borkou, Tibesti, Ennedi Est and Ouest) aren’t eligible for SMC, but are sparsely populated. What we concluded

We decided not to include these adjustments in our cost-effectiveness analysis because they increased complexity, without substantially affecting the bottom line.

When we decide whether to include adjustments in our model in general, we use a framework that first takes our best guess of the likely effect size and then rates each of the remaining question on a three-point scale.

Score9We use these scores as a qualitative guide to help us think through what to include in our cost-effectiveness analysis. You can see the rubric we use to assign scores in this spreadsheet. jQuery("#footnote_plugin_tooltip_9").tooltip({ tip: "#footnote_plugin_tooltip_text_9", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] }); Commentary Best guess of effect size 3-4% Can it be objectively justified? 3/3 While we have not investigated the MAP data in detail, we would guess that after further investigation, we would conclude it provides a reasonable approximation of subnational malaria incidence.10You can read more about MAP’s methodology in this paper. jQuery("#footnote_plugin_tooltip_10").tooltip({ tip: "#footnote_plugin_tooltip_text_10", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] }); How easily can it be modelled? 3/3 The methodology is clear and simple. Is it consistent with our other cost-effectiveness analyses? 2/3 We could include subnational adjustments for both of our top charities that implement malaria-prevention programs, but we believe it is unlikely there would be sufficient data to do the same for prevalence of worms or vitamin A deficiency (the focus of five of our other seven top charities).

Even though these adjustments can be objectively justified and are fairly easy to model, the bottom-line difference they make to our cost-effectiveness estimates is insufficient to warrant the (moderate) increase in the complexity of our models. These adjustments would also introduce an inconsistency between our methodologies for top charities. As a result, we are not planning to incorporate subnational adjustments at this time.

When would we revisit this conclusion?

We will revisit using subnational malaria mortality estimates if AMF or Malaria Consortium start working in countries where it would make a large difference to the bottom line. We would include subnational adjustments if AMF contributed nets in any of these countries: Djibouti (+500% adjustment), South Africa (+259%), and Swaziland (+126%), where malaria is endemic in some parts of the country but not others. We would also consider subnational adjustments if AMF contributed nets in Namibia (+25%), Kenya (+23%), Madagascar (+14%), or Rwanda (+10%).11The data and calculations are in this spreadsheet. jQuery("#footnote_plugin_tooltip_11").tooltip({ tip: "#footnote_plugin_tooltip_text_11", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

We will investigate whether subnational adjustments would make a substantial difference if Malaria Consortium enters additional countries; at this time, we do not have details on which regions are eligible for SMC in countries in which Malaria Consortium is not currently operating.12We have not yet prioritized getting details on which regions are eligible for SMC in countries in which Malaria Consortium does not currently work, as this would likely impose a substantial time cost on Malaria Consortium. jQuery("#footnote_plugin_tooltip_12").tooltip({ tip: "#footnote_plugin_tooltip_text_12", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

You can read the internal emails discussing our decision process here.

Notes   [ + ]

1. ↑ In both cases, we rely on reports by Cochrane, an organization that produces systematic reviews and other synthesized research to inform decision-makers. For AMF, we use a decline in all-cause mortality, because the Cochrane review of anti-malarial bed net distributions reports the effect in terms of a reduction in all-cause mortality. For Malaria Consortium, we use a decline in malaria mortality (proxied by a decline in malaria incidence), as the Cochrane review of seasonal malaria chemoprevention reports the effect in terms of a reduction in malaria incidence, but not all-cause mortality. See our cost-effectiveness analysis for more details. 2. ↑ We assume that the regional distribution of malaria incidence is a reasonable proxy for the regional distribution of malaria mortality. 3. ↑ A limitation of this analysis is it does not account for the possibility that AMF and Malaria Consortium are causing locations that are higher priority or lower priority than the average location already covered by nets or eligible for SMC to be covered on the margin. We do not explicitly include estimates of the marginal region funded in our cost-effectiveness analysis because we often have limited information about which regions would be covered with marginal additional funds. 4. ↑ We assume that where nets have been delivered in the past is a good proxy for where new nets will be delivered in the future. The data and calculations are in this spreadsheet. 5. ↑ See Cell J114. We did not include Papua New Guinea (where AMF funds some nets) in this analysis, as MAP only covers countries in Africa. 6. ↑ “The suitability of an area for SMC is determined by the seasonal pattern of rainfall, malaria transmission and the burden of malaria. SMC is recommended for deployment in areas: (i) where more than 60% of the annual incidence of malaria occurs within 4 months (ii) where there are measures of disease burden consistent with a high burden of malaria in children (incidence ≥ 10 cases of malaria among every 100 children during the transmission season) (iii) where SP and AQ [the drugs used to treat children] retain their antimalarial efficacy.” WHO SMC field guide (2013), Pg 8. 7, 11. ↑ The data and calculations are in this spreadsheet. 8. ↑ See Cell C126. 9. ↑ We use these scores as a qualitative guide to help us think through what to include in our cost-effectiveness analysis. You can see the rubric we use to assign scores in this spreadsheet. 10. ↑ You can read more about MAP’s methodology in this paper. 12. ↑ We have not yet prioritized getting details on which regions are eligible for SMC in countries in which Malaria Consortium does not currently work, as this would likely impose a substantial time cost on Malaria Consortium. function footnote_expand_reference_container() { jQuery("#footnote_references_container").show(); jQuery("#footnote_reference_container_collapse_button").text("-"); } function footnote_collapse_reference_container() { jQuery("#footnote_references_container").hide(); jQuery("#footnote_reference_container_collapse_button").text("+"); } function footnote_expand_collapse_reference_container() { if (jQuery("#footnote_references_container").is(":hidden")) { footnote_expand_reference_container(); } else { footnote_collapse_reference_container(); } } function footnote_moveToAnchor(p_str_TargetID) { footnote_expand_reference_container(); var l_obj_Target = jQuery("#" + p_str_TargetID); if(l_obj_Target.length) { jQuery('html, body').animate({ scrollTop: l_obj_Target.offset().top - window.innerHeight/2 }, 1000); } }

The post Why we don’t use subnational malaria mortality estimates in our cost-effectiveness models appeared first on The GiveWell Blog.

Summary

We recently completed a small project to determine whether using subnational baseline malaria mortality estimates would make a difference to our estimates of the cost-effectiveness of two of our top charities, the Against Malaria Foundation and Malaria Consortium. We ultimately decided not to include these adjustments because they added complexity to our models and would require frequent updating, while only making a small difference (a 3-4% improvement) to our bottom line.

Though this post is on a fairly narrow topic, we believe this example illustrates the principles we use to make decisions about what to include in our cost-effectiveness model.

Background

Two of our top charities—the Against Malaria Foundation (AMF) and Malaria Consortium’s seasonal malaria chemoprevention program—implement programs to prevent malaria, a leading killer of people in low- and middle-income countries.

One of the core reasons we recommend AMF and Malaria Consortium is their cost-effectiveness: how much impact they have (e.g., cases of malaria prevented, malaria deaths averted) with the funds they receive. Our estimates of charities’ cost-effectiveness isn’t just helpful to us in determining which charities should be GiveWell top charities; we also rely on these estimates to guide our decisions about how to allocate funding between our top charities.

Our cost-effectiveness estimates for AMF and Malaria Consortium use country-wide data on malaria mortality and malaria incidence in the places that both organizations work.1In both cases, we rely on reports by Cochrane, an organization that produces systematic reviews and other synthesized research to inform decision-makers. For AMF, we use a decline in all-cause mortality, because the Cochrane review of anti-malarial bed net distributions reports the effect in terms of a reduction in all-cause mortality. For Malaria Consortium, we use a decline in malaria mortality (proxied by a decline in malaria incidence), as the Cochrane review of seasonal malaria chemoprevention reports the effect in terms of a reduction in malaria incidence, but not all-cause mortality. See our cost-effectiveness analysis for more details. jQuery("#footnote_plugin_tooltip_1").tooltip({ tip: "#footnote_plugin_tooltip_text_1", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] }); However, neither organization serves a whole country—rather, they operate in sub-national regions—so the use of country-level estimates could cause us to either underestimate or overestimate their cost-effectiveness. If, for example, these programs are focused in the areas of the country with the highest malaria burden, using the average burden for the country would lead us to underestimate their cost-effectiveness. So, we completed a project to determine how much of an impact using subnational estimates would have, to consider whether we ought to incorporate this information into our cost-effectiveness analysis.

How we estimated the impact of subnational malaria incidence

AMF distributes insecticide-treated nets to prevent malaria; Malaria Consortium’s seasonal malaria chemoprevention (SMC) program provides preventive anti-malarial drugs. We used estimates of subnational malaria incidence from the Malaria Atlas Project (MAP) to see if regions covered by nets or eligible for SMC had higher or lower incidence than the average in the country in which they are located.2We assume that the regional distribution of malaria incidence is a reasonable proxy for the regional distribution of malaria mortality. jQuery("#footnote_plugin_tooltip_2").tooltip({ tip: "#footnote_plugin_tooltip_text_2", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

We focused on all areas covered by nets or eligible for SMC (rather than those covered by our top charities, specifically) for two reasons:

1. Our understanding is that when our top charities contribute resources to a country’s net distribution or SMC programs, the marginal region covered by these additional resources is not necessarily the same as the region to which these resources are assigned (because these resources are fungible with other resources within the national programs).3A limitation of this analysis is it does not account for the possibility that AMF and Malaria Consortium are causing locations that are higher priority or lower priority than the average location already covered by nets or eligible for SMC to be covered on the margin. We do not explicitly include estimates of the marginal region funded in our cost-effectiveness analysis because we often have limited information about which regions would be covered with marginal additional funds. jQuery("#footnote_plugin_tooltip_3").tooltip({ tip: "#footnote_plugin_tooltip_text_3", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });
2. Our aim is to estimate the cost-effectiveness of funds donated to these organizations in the future. The subnational region where AMF has worked in the past has not historically been a good indicator of the region where it will work in future.

Results for net distributions in countries where AMF works

We looked at geographical variation in malaria incidence in countries where AMF works, weighting each region by the number of nets it currently receives.4We assume that where nets have been delivered in the past is a good proxy for where new nets will be delivered in the future. The data and calculations are in this spreadsheet. jQuery("#footnote_plugin_tooltip_4").tooltip({ tip: "#footnote_plugin_tooltip_text_4", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

The average net delivered in the countries in which AMF works is hung in an area with 0-9% higher malaria incidence than the average in that country, and the weighted average adjustment to AMF’s cost-effectiveness would be 3% (in other words, AMF becomes 3% more cost-effective if we incorporate subnational estimates).5See Cell J114. We did not include Papua New Guinea (where AMF funds some nets) in this analysis, as MAP only covers countries in Africa. jQuery("#footnote_plugin_tooltip_5").tooltip({ tip: "#footnote_plugin_tooltip_text_5", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

Country Adjustment Zambia +9% Uganda +4% Ghana +4% Democratic Republic of the Congo +1% Togo +1% Malawi +0% Results for SMC in countries where Malaria Consortium works

We looked at six countries comprising >95% of Malaria Consortium’s SMC spending and compared malaria incidence in districts eligible for SMC with the country-wide average.6“The suitability of an area for SMC is determined by the seasonal pattern of rainfall, malaria transmission and the burden of malaria. SMC is recommended for deployment in areas: (i) where more than 60% of the annual incidence of malaria occurs within 4 months (ii) where there are measures of disease burden consistent with a high burden of malaria in children (incidence ≥ 10 cases of malaria among every 100 children during the transmission season) (iii) where SP and AQ [the drugs used to treat children] retain their antimalarial efficacy.” WHO SMC field guide (2013), Pg 8. jQuery("#footnote_plugin_tooltip_6").tooltip({ tip: "#footnote_plugin_tooltip_text_6", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });7The data and calculations are in this spreadsheet. jQuery("#footnote_plugin_tooltip_7").tooltip({ tip: "#footnote_plugin_tooltip_text_7", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

The average region eligible for SMC in countries where Malaria Consortium works has -2% to 17% higher malaria incidence than the average in that country. The weighted average adjustment to Malaria Consortium’s cost-effectiveness would be 4%.8See Cell C126. jQuery("#footnote_plugin_tooltip_8").tooltip({ tip: "#footnote_plugin_tooltip_text_8", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

Country Adjustment Commentary Guinea +17% Conakry, the capital, is ineligible for SMC and has low incidence. Nigeria +12% SMC appears to be targeted in the north, where malaria incidence is slightly higher. Niger +2% The majority of the population is either covered or planned to be covered from 2019. Burkina Faso 0% All districts are eligible. Mali 0% All districts are eligible. Chad -2% The four regions with very low malaria incidence (Borkou, Tibesti, Ennedi Est and Ouest) aren’t eligible for SMC, but are sparsely populated. What we concluded

We decided not to include these adjustments in our cost-effectiveness analysis because they increased complexity, without substantially affecting the bottom line.

When we decide whether to include adjustments in our model in general, we use a framework that first takes our best guess of the likely effect size and then rates each of the remaining question on a three-point scale.

Score9We use these scores as a qualitative guide to help us think through what to include in our cost-effectiveness analysis. You can see the rubric we use to assign scores in this spreadsheet. jQuery("#footnote_plugin_tooltip_9").tooltip({ tip: "#footnote_plugin_tooltip_text_9", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] }); Commentary Best guess of effect size 3-4% Can it be objectively justified? 3/3 While we have not investigated the MAP data in detail, we would guess that after further investigation, we would conclude it provides a reasonable approximation of subnational malaria incidence.10You can read more about MAP’s methodology in this paper. jQuery("#footnote_plugin_tooltip_10").tooltip({ tip: "#footnote_plugin_tooltip_text_10", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] }); How easily can it be modelled? 3/3 The methodology is clear and simple. Is it consistent with our other cost-effectiveness analyses? 2/3 We could include subnational adjustments for both of our top charities that implement malaria-prevention programs, but we believe it is unlikely there would be sufficient data to do the same for prevalence of worms or vitamin A deficiency (the focus of five of our other seven top charities).

Even though these adjustments can be objectively justified and are fairly easy to model, the bottom-line difference they make to our cost-effectiveness estimates is insufficient to warrant the (moderate) increase in the complexity of our models. These adjustments would also introduce an inconsistency between our methodologies for top charities. As a result, we are not planning to incorporate subnational adjustments at this time.

When would we revisit this conclusion?

We will revisit using subnational malaria mortality estimates if AMF or Malaria Consortium start working in countries where it would make a large difference to the bottom line. We would include subnational adjustments if AMF contributed nets in any of these countries: Djibouti (+500% adjustment), South Africa (+259%), and Swaziland (+126%), where malaria is endemic in some parts of the country but not others. We would also consider subnational adjustments if AMF contributed nets in Namibia (+25%), Kenya (+23%), Madagascar (+14%), or Rwanda (+10%).11The data and calculations are in this spreadsheet. jQuery("#footnote_plugin_tooltip_11").tooltip({ tip: "#footnote_plugin_tooltip_text_11", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

We will investigate whether subnational adjustments would make a substantial difference if Malaria Consortium enters additional countries; at this time, we do not have details on which regions are eligible for SMC in countries in which Malaria Consortium is not currently operating.12We have not yet prioritized getting details on which regions are eligible for SMC in countries in which Malaria Consortium does not currently work, as this would likely impose a substantial time cost on Malaria Consortium. jQuery("#footnote_plugin_tooltip_12").tooltip({ tip: "#footnote_plugin_tooltip_text_12", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

You can read the internal emails discussing our decision process here.

Notes   [ + ]

1. ↑ In both cases, we rely on reports by Cochrane, an organization that produces systematic reviews and other synthesized research to inform decision-makers. For AMF, we use a decline in all-cause mortality, because the Cochrane review of anti-malarial bed net distributions reports the effect in terms of a reduction in all-cause mortality. For Malaria Consortium, we use a decline in malaria mortality (proxied by a decline in malaria incidence), as the Cochrane review of seasonal malaria chemoprevention reports the effect in terms of a reduction in malaria incidence, but not all-cause mortality. See our cost-effectiveness analysis for more details. 2. ↑ We assume that the regional distribution of malaria incidence is a reasonable proxy for the regional distribution of malaria mortality. 3. ↑ A limitation of this analysis is it does not account for the possibility that AMF and Malaria Consortium are causing locations that are higher priority or lower priority than the average location already covered by nets or eligible for SMC to be covered on the margin. We do not explicitly include estimates of the marginal region funded in our cost-effectiveness analysis because we often have limited information about which regions would be covered with marginal additional funds. 4. ↑ We assume that where nets have been delivered in the past is a good proxy for where new nets will be delivered in the future. The data and calculations are in this spreadsheet. 5. ↑ See Cell J114. We did not include Papua New Guinea (where AMF funds some nets) in this analysis, as MAP only covers countries in Africa. 6. ↑ “The suitability of an area for SMC is determined by the seasonal pattern of rainfall, malaria transmission and the burden of malaria. SMC is recommended for deployment in areas: (i) where more than 60% of the annual incidence of malaria occurs within 4 months (ii) where there are measures of disease burden consistent with a high burden of malaria in children (incidence ≥ 10 cases of malaria among every 100 children during the transmission season) (iii) where SP and AQ [the drugs used to treat children] retain their antimalarial efficacy.” WHO SMC field guide (2013), Pg 8. 7, 11. ↑ The data and calculations are in this spreadsheet. 8. ↑ See Cell C126. 9. ↑ We use these scores as a qualitative guide to help us think through what to include in our cost-effectiveness analysis. You can see the rubric we use to assign scores in this spreadsheet. 10. ↑ You can read more about MAP’s methodology in this paper. 12. ↑ We have not yet prioritized getting details on which regions are eligible for SMC in countries in which Malaria Consortium does not currently work, as this would likely impose a substantial time cost on Malaria Consortium. function footnote_expand_reference_container() { jQuery("#footnote_references_container").show(); jQuery("#footnote_reference_container_collapse_button").text("-"); } function footnote_collapse_reference_container() { jQuery("#footnote_references_container").hide(); jQuery("#footnote_reference_container_collapse_button").text("+"); } function footnote_expand_collapse_reference_container() { if (jQuery("#footnote_references_container").is(":hidden")) { footnote_expand_reference_container(); } else { footnote_collapse_reference_container(); } } function footnote_moveToAnchor(p_str_TargetID) { footnote_expand_reference_container(); var l_obj_Target = jQuery("#" + p_str_TargetID); if(l_obj_Target.length) { jQuery('html, body').animate({ scrollTop: l_obj_Target.offset().top - window.innerHeight/2 }, 1000); } }

The post Why we don’t use subnational malaria mortality estimates in our cost-effectiveness models appeared first on The GiveWell Blog.

Summary

We recently completed a small project to determine whether using subnational baseline malaria mortality estimates would make a difference to our estimates of the cost-effectiveness of two of our top charities, the Against Malaria Foundation and Malaria Consortium. We ultimately decided not to include these adjustments because they added complexity to our models and would require frequent updating, while only making a small difference (a 3-4% improvement) to our bottom line.

Though this post is on a fairly narrow topic, we believe this example illustrates the principles we use to make decisions about what to include in our cost-effectiveness model.

Background

Two of our top charities—the Against Malaria Foundation (AMF) and Malaria Consortium’s seasonal malaria chemoprevention program—implement programs to prevent malaria, a leading killer of people in low- and middle-income countries.

One of the core reasons we recommend AMF and Malaria Consortium is their cost-effectiveness: how much impact they have (e.g., cases of malaria prevented, malaria deaths averted) with the funds they receive. Our estimates of charities’ cost-effectiveness isn’t just helpful to us in determining which charities should be GiveWell top charities; we also rely on these estimates to guide our decisions about how to allocate funding between our top charities.

Our cost-effectiveness estimates for AMF and Malaria Consortium use country-wide data on malaria mortality and malaria incidence in the places that both organizations work.1In both cases, we rely on reports by Cochrane, an organization that produces systematic reviews and other synthesized research to inform decision-makers. For AMF, we use a decline in all-cause mortality, because the Cochrane review of anti-malarial bed net distributions reports the effect in terms of a reduction in all-cause mortality. For Malaria Consortium, we use a decline in malaria mortality (proxied by a decline in malaria incidence), as the Cochrane review of seasonal malaria chemoprevention reports the effect in terms of a reduction in malaria incidence, but not all-cause mortality. See our cost-effectiveness analysis for more details. jQuery("#footnote_plugin_tooltip_1").tooltip({ tip: "#footnote_plugin_tooltip_text_1", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] }); However, neither organization serves a whole country—rather, they operate in sub-national regions—so the use of country-level estimates could cause us to either underestimate or overestimate their cost-effectiveness. If, for example, these programs are focused in the areas of the country with the highest malaria burden, using the average burden for the country would lead us to underestimate their cost-effectiveness. So, we completed a project to determine how much of an impact using subnational estimates would have, to consider whether we ought to incorporate this information into our cost-effectiveness analysis.

How we estimated the impact of subnational malaria incidence

AMF distributes insecticide-treated nets to prevent malaria; Malaria Consortium’s seasonal malaria chemoprevention (SMC) program provides preventive anti-malarial drugs. We used estimates of subnational malaria incidence from the Malaria Atlas Project (MAP) to see if regions covered by nets or eligible for SMC had higher or lower incidence than the average in the country in which they are located.2We assume that the regional distribution of malaria incidence is a reasonable proxy for the regional distribution of malaria mortality. jQuery("#footnote_plugin_tooltip_2").tooltip({ tip: "#footnote_plugin_tooltip_text_2", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

We focused on all areas covered by nets or eligible for SMC (rather than those covered by our top charities, specifically) for two reasons:

1. Our understanding is that when our top charities contribute resources to a country’s net distribution or SMC programs, the marginal region covered by these additional resources is not necessarily the same as the region to which these resources are assigned (because these resources are fungible with other resources within the national programs).3A limitation of this analysis is it does not account for the possibility that AMF and Malaria Consortium are causing locations that are higher priority or lower priority than the average location already covered by nets or eligible for SMC to be covered on the margin. We do not explicitly include estimates of the marginal region funded in our cost-effectiveness analysis because we often have limited information about which regions would be covered with marginal additional funds. jQuery("#footnote_plugin_tooltip_3").tooltip({ tip: "#footnote_plugin_tooltip_text_3", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });
2. Our aim is to estimate the cost-effectiveness of funds donated to these organizations in the future. The subnational region where AMF has worked in the past has not historically been a good indicator of the region where it will work in future.

Results for net distributions in countries where AMF works

We looked at geographical variation in malaria incidence in countries where AMF works, weighting each region by the number of nets it currently receives.4We assume that where nets have been delivered in the past is a good proxy for where new nets will be delivered in the future. The data and calculations are in this spreadsheet. jQuery("#footnote_plugin_tooltip_4").tooltip({ tip: "#footnote_plugin_tooltip_text_4", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

The average net delivered in the countries in which AMF works is hung in an area with 0-9% higher malaria incidence than the average in that country, and the weighted average adjustment to AMF’s cost-effectiveness would be 3% (in other words, AMF becomes 3% more cost-effective if we incorporate subnational estimates).5See Cell J114. We did not include Papua New Guinea (where AMF funds some nets) in this analysis, as MAP only covers countries in Africa. jQuery("#footnote_plugin_tooltip_5").tooltip({ tip: "#footnote_plugin_tooltip_text_5", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

Country Adjustment Zambia +9% Uganda +4% Ghana +4% Democratic Republic of the Congo +1% Togo +1% Malawi +0% Results for SMC in countries where Malaria Consortium works

We looked at six countries comprising >95% of Malaria Consortium’s SMC spending and compared malaria incidence in districts eligible for SMC with the country-wide average.6“The suitability of an area for SMC is determined by the seasonal pattern of rainfall, malaria transmission and the burden of malaria. SMC is recommended for deployment in areas: (i) where more than 60% of the annual incidence of malaria occurs within 4 months (ii) where there are measures of disease burden consistent with a high burden of malaria in children (incidence ≥ 10 cases of malaria among every 100 children during the transmission season) (iii) where SP and AQ [the drugs used to treat children] retain their antimalarial efficacy.” WHO SMC field guide (2013), Pg 8. jQuery("#footnote_plugin_tooltip_6").tooltip({ tip: "#footnote_plugin_tooltip_text_6", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });7The data and calculations are in this spreadsheet. jQuery("#footnote_plugin_tooltip_7").tooltip({ tip: "#footnote_plugin_tooltip_text_7", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

The average region eligible for SMC in countries where Malaria Consortium works has -2% to 17% higher malaria incidence than the average in that country. The weighted average adjustment to Malaria Consortium’s cost-effectiveness would be 4%.8See Cell C126. jQuery("#footnote_plugin_tooltip_8").tooltip({ tip: "#footnote_plugin_tooltip_text_8", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

Country Adjustment Commentary Guinea +17% Conakry, the capital, is ineligible for SMC and has low incidence. Nigeria +12% SMC appears to be targeted in the north, where malaria incidence is slightly higher. Niger +2% The majority of the population is either covered or planned to be covered from 2019. Burkina Faso 0% All districts are eligible. Mali 0% All districts are eligible. Chad -2% The four regions with very low malaria incidence (Borkou, Tibesti, Ennedi Est and Ouest) aren’t eligible for SMC, but are sparsely populated. What we concluded

We decided not to include these adjustments in our cost-effectiveness analysis because they increased complexity, without substantially affecting the bottom line.

When we decide whether to include adjustments in our model in general, we use a framework that first takes our best guess of the likely effect size and then rates each of the remaining question on a three-point scale.

Score9We use these scores as a qualitative guide to help us think through what to include in our cost-effectiveness analysis. You can see the rubric we use to assign scores in this spreadsheet. jQuery("#footnote_plugin_tooltip_9").tooltip({ tip: "#footnote_plugin_tooltip_text_9", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] }); Commentary Best guess of effect size 3-4% Can it be objectively justified? 3/3 While we have not investigated the MAP data in detail, we would guess that after further investigation, we would conclude it provides a reasonable approximation of subnational malaria incidence.10You can read more about MAP’s methodology in this paper. jQuery("#footnote_plugin_tooltip_10").tooltip({ tip: "#footnote_plugin_tooltip_text_10", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] }); How easily can it be modelled? 3/3 The methodology is clear and simple. Is it consistent with our other cost-effectiveness analyses? 2/3 We could include subnational adjustments for both of our top charities that implement malaria-prevention programs, but we believe it is unlikely there would be sufficient data to do the same for prevalence of worms or vitamin A deficiency (the focus of five of our other seven top charities).

Even though these adjustments can be objectively justified and are fairly easy to model, the bottom-line difference they make to our cost-effectiveness estimates is insufficient to warrant the (moderate) increase in the complexity of our models. These adjustments would also introduce an inconsistency between our methodologies for top charities. As a result, we are not planning to incorporate subnational adjustments at this time.

When would we revisit this conclusion?

We will revisit using subnational malaria mortality estimates if AMF or Malaria Consortium start working in countries where it would make a large difference to the bottom line. We would include subnational adjustments if AMF contributed nets in any of these countries: Djibouti (+500% adjustment), South Africa (+259%), and Swaziland (+126%), where malaria is endemic in some parts of the country but not others. We would also consider subnational adjustments if AMF contributed nets in Namibia (+25%), Kenya (+23%), Madagascar (+14%), or Rwanda (+10%).11The data and calculations are in this spreadsheet. jQuery("#footnote_plugin_tooltip_11").tooltip({ tip: "#footnote_plugin_tooltip_text_11", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

We will investigate whether subnational adjustments would make a substantial difference if Malaria Consortium enters additional countries; at this time, we do not have details on which regions are eligible for SMC in countries in which Malaria Consortium is not currently operating.12We have not yet prioritized getting details on which regions are eligible for SMC in countries in which Malaria Consortium does not currently work, as this would likely impose a substantial time cost on Malaria Consortium. jQuery("#footnote_plugin_tooltip_12").tooltip({ tip: "#footnote_plugin_tooltip_text_12", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });

You can read the internal emails discussing our decision process here.

Notes   [ + ]

1. ↑ In both cases, we rely on reports by Cochrane, an organization that produces systematic reviews and other synthesized research to inform decision-makers. For AMF, we use a decline in all-cause mortality, because the Cochrane review of anti-malarial bed net distributions reports the effect in terms of a reduction in all-cause mortality. For Malaria Consortium, we use a decline in malaria mortality (proxied by a decline in malaria incidence), as the Cochrane review of seasonal malaria chemoprevention reports the effect in terms of a reduction in malaria incidence, but not all-cause mortality. See our cost-effectiveness analysis for more details. 2. ↑ We assume that the regional distribution of malaria incidence is a reasonable proxy for the regional distribution of malaria mortality. 3. ↑ A limitation of this analysis is it does not account for the possibility that AMF and Malaria Consortium are causing locations that are higher priority or lower priority than the average location already covered by nets or eligible for SMC to be covered on the margin. We do not explicitly include estimates of the marginal region funded in our cost-effectiveness analysis because we often have limited information about which regions would be covered with marginal additional funds. 4. ↑ We assume that where nets have been delivered in the past is a good proxy for where new nets will be delivered in the future. The data and calculations are in this spreadsheet. 5. ↑ See Cell J114. We did not include Papua New Guinea (where AMF funds some nets) in this analysis, as MAP only covers countries in Africa. 6. ↑ “The suitability of an area for SMC is determined by the seasonal pattern of rainfall, malaria transmission and the burden of malaria. SMC is recommended for deployment in areas: (i) where more than 60% of the annual incidence of malaria occurs within 4 months (ii) where there are measures of disease burden consistent with a high burden of malaria in children (incidence ≥ 10 cases of malaria among every 100 children during the transmission season) (iii) where SP and AQ [the drugs used to treat children] retain their antimalarial efficacy.” WHO SMC field guide (2013), Pg 8. 7, 11. ↑ The data and calculations are in this spreadsheet. 8. ↑ See Cell C126. 9. ↑ We use these scores as a qualitative guide to help us think through what to include in our cost-effectiveness analysis. You can see the rubric we use to assign scores in this spreadsheet. 10. ↑ You can read more about MAP’s methodology in this paper. 12. ↑ We have not yet prioritized getting details on which regions are eligible for SMC in countries in which Malaria Consortium does not currently work, as this would likely impose a substantial time cost on Malaria Consortium. function footnote_expand_reference_container() { jQuery("#footnote_references_container").show(); jQuery("#footnote_reference_container_collapse_button").text("-"); } function footnote_collapse_reference_container() { jQuery("#footnote_references_container").hide(); jQuery("#footnote_reference_container_collapse_button").text("+"); } function footnote_expand_collapse_reference_container() { if (jQuery("#footnote_references_container").is(":hidden")) { footnote_expand_reference_container(); } else { footnote_collapse_reference_container(); } } function footnote_moveToAnchor(p_str_TargetID) { footnote_expand_reference_container(); var l_obj_Target = jQuery("#" + p_str_TargetID); if(l_obj_Target.length) { jQuery('html, body').animate({ scrollTop: l_obj_Target.offset().top - window.innerHeight/2 }, 1000); } }

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GiveWell is dedicated to finding outstanding giving opportunities and publishing the full details of our analysis. In addition to evaluations of other charities, we publish substantial evaluation of our own work. This post lays out highlights from our 2017 metrics report, which reviews what we know about how our research impacted donors. Please note:

• We report on “metrics years” that run from February through January; for example, our 2017 data cover February 1, 2017 through January 31, 2018.
• We differentiate between our traditional charity recommendations and the work of the Open Philanthropy Project, which became a separate organization in 2017 and whose work we exclude from this report.
• More context on the relationships between GiveWell, Good Ventures, and the Open Philanthropy Project can be found here.

Summary of influence: In 2017, GiveWell influenced charitable giving in several ways. The following table summarizes our understanding of this influence.

Headline money moved: In 2017, we tracked $117.5 million in money moved to our recommended charities. Our money moved only includes donations that we are confident were influenced by our recommendations.

Money moved by charity: Our nine top charities received the majority of our money moved. Our seven standout charities received a total of $1.8 million.

Money moved by size of donor: In 2017, the number of donors and amount donated increased across each donor size category, with the notable exception of donations from donors giving $1,000,000 or more. In 2017, 90% of our money moved (excluding Good Ventures) came from 20% of our donors, who gave $1,000 or more.

Donor retention: The total number of donors who gave to our recommended charities or to GiveWell unrestricted increased about 29% year-over-year to 23,049 in 2017. This included 14,653 donors who gave for the first time. Among all donors who gave in the previous year, about 42% gave again in 2017, up from about 35% who gave again in 2016.

Our retention was stronger among donors who gave larger amounts or who first gave to our recommendations prior to 2015. Of larger donors (those who gave $10,000 or more in either of the last two years), about 73% who gave in 2016 gave again in 2017.

GiveWell’s expenses: GiveWell’s total operating expenses in 2017 were $4.6 million. Our expenses decreased from about $5.5 million in 2016 due to the Open Philanthropy Project becoming a separate organization in June 2017. We estimate that 67% of our total expenses ($3.1 million) supported our traditional top charity work and about 33% supported the Open Philanthropy Project. In 2016, we estimated that expenses for our traditional top charity work were about $2.0 million.

Donations supporting GiveWell’s operations: GiveWell raised $5.7 million in unrestricted funding (which we use to support our operations) in 2017, compared to $5.6 million in 2016. Our major institutional supporters and the six largest individual donors contributed about 49% of GiveWell’s operational funding in 2017.

Web traffic: The number of unique visitors to our website remained flat in 2017 compared to 2016 (when excluding visitors driven by AdWords, Google’s online advertising product).

For more detail, see our full metrics report (PDF).

The post GiveWell’s money moved and web traffic in 2017 appeared first on The GiveWell Blog.

GiveWell is dedicated to finding outstanding giving opportunities and publishing the full details of our analysis. In addition to evaluations of other charities, we publish substantial evaluation of our own work. This post lays out highlights from our 2017 metrics report, which reviews what we know about how our research impacted donors. Please note:

• We report on “metrics years” that run from February through January; for example, our 2017 data cover February 1, 2017 through January 31, 2018.
• We differentiate between our traditional charity recommendations and the work of the Open Philanthropy Project, which became a separate organization in 2017 and whose work we exclude from this report.
• More context on the relationships between GiveWell, Good Ventures, and the Open Philanthropy Project can be found here.

Summary of influence: In 2017, GiveWell influenced charitable giving in several ways. The following table summarizes our understanding of this influence.

Headline money moved: In 2017, we tracked $117.5 million in money moved to our recommended charities. Our money moved only includes donations that we are confident were influenced by our recommendations.

Money moved by charity: Our nine top charities received the majority of our money moved. Our seven standout charities received a total of $1.8 million.

Money moved by size of donor: In 2017, the number of donors and amount donated increased across each donor size category, with the notable exception of donations from donors giving $1,000,000 or more. In 2017, 90% of our money moved (excluding Good Ventures) came from 20% of our donors, who gave $1,000 or more.

Donor retention: The total number of donors who gave to our recommended charities or to GiveWell unrestricted increased about 29% year-over-year to 23,049 in 2017. This included 14,653 donors who gave for the first time. Among all donors who gave in the previous year, about 42% gave again in 2017, up from about 35% who gave again in 2016.

Our retention was stronger among donors who gave larger amounts or who first gave to our recommendations prior to 2015. Of larger donors (those who gave $10,000 or more in either of the last two years), about 73% who gave in 2016 gave again in 2017.

GiveWell’s expenses: GiveWell’s total operating expenses in 2017 were $4.6 million. Our expenses decreased from about $5.5 million in 2016 due to the Open Philanthropy Project becoming a separate organization in June 2017. We estimate that 67% of our total expenses ($3.1 million) supported our traditional top charity work and about 33% supported the Open Philanthropy Project. In 2016, we estimated that expenses for our traditional top charity work were about $2.0 million.

Donations supporting GiveWell’s operations: GiveWell raised $5.7 million in unrestricted funding (which we use to support our operations) in 2017, compared to $5.6 million in 2016. Our major institutional supporters and the six largest individual donors contributed about 49% of GiveWell’s operational funding in 2017.

Web traffic: The number of unique visitors to our website remained flat in 2017 compared to 2016 (when excluding visitors driven by AdWords, Google’s online advertising product).

For more detail, see our full metrics report (PDF).

The post GiveWell’s money moved and web traffic in 2017 appeared first on The GiveWell Blog.

GiveWell is dedicated to finding outstanding giving opportunities and publishing the full details of our analysis. In addition to evaluations of other charities, we publish substantial evaluation of our own work. This post lays out highlights from our 2017 metrics report, which reviews what we know about how our research impacted donors. Please note:

• We report on “metrics years” that run from February through January; for example, our 2017 data cover February 1, 2017 through January 31, 2018.
• We differentiate between our traditional charity recommendations and the work of the Open Philanthropy Project, which became a separate organization in 2017 and whose work we exclude from this report.
• More context on the relationships between GiveWell, Good Ventures, and the Open Philanthropy Project can be found here.

Summary of influence: In 2017, GiveWell influenced charitable giving in several ways. The following table summarizes our understanding of this influence.

Headline money moved: In 2017, we tracked $117.5 million in money moved to our recommended charities. Our money moved only includes donations that we are confident were influenced by our recommendations.

Money moved by charity: Our nine top charities received the majority of our money moved. Our seven standout charities received a total of $1.8 million.

Money moved by size of donor: In 2017, the number of donors and amount donated increased across each donor size category, with the notable exception of donations from donors giving $1,000,000 or more. In 2017, 90% of our money moved (excluding Good Ventures) came from 20% of our donors, who gave $1,000 or more.

Donor retention: The total number of donors who gave to our recommended charities or to GiveWell unrestricted increased about 29% year-over-year to 23,049 in 2017. This included 14,653 donors who gave for the first time. Among all donors who gave in the previous year, about 42% gave again in 2017, up from about 35% who gave again in 2016.

Our retention was stronger among donors who gave larger amounts or who first gave to our recommendations prior to 2015. Of larger donors (those who gave $10,000 or more in either of the last two years), about 73% who gave in 2016 gave again in 2017.

GiveWell’s expenses: GiveWell’s total operating expenses in 2017 were $4.6 million. Our expenses decreased from about $5.5 million in 2016 due to the Open Philanthropy Project becoming a separate organization in June 2017. We estimate that 67% of our total expenses ($3.1 million) supported our traditional top charity work and about 33% supported the Open Philanthropy Project. In 2016, we estimated that expenses for our traditional top charity work were about $2.0 million.

Donations supporting GiveWell’s operations: GiveWell raised $5.7 million in unrestricted funding (which we use to support our operations) in 2017, compared to $5.6 million in 2016. Our major institutional supporters and the six largest individual donors contributed about 49% of GiveWell’s operational funding in 2017.

Web traffic: The number of unique visitors to our website remained flat in 2017 compared to 2016 (when excluding visitors driven by AdWords, Google’s online advertising product).

For more detail, see our full metrics report (PDF).

The post GiveWell’s money moved and web traffic in 2017 appeared first on The GiveWell Blog.

We’ve added the Georgetown University Initiative on Innovation, Development, and Evaluation (gui2de)'s Zusha! Road Safety Campaign (from here on, "Zusha!") as a standout charity; see our full review here. Standout charities do not meet all of our criteria to be a GiveWell top charity, but we believe they stand out from the vast majority of organizations we have considered. See more information about our standout charities here.

Read More

The post Announcing Zusha! as a standout charity appeared first on The GiveWell Blog.

We’ve added the Georgetown University Initiative on Innovation, Development, and Evaluation gui2de‘s Zusha! Road Safety Campaign (from here on, “Zusha!”) as a standout charity; see our full review here. Standout charities do not meet all of our criteria to be a GiveWell top charity, but we believe they stand out from the vast majority of organizations we have considered. See more information about our standout charities here.

Zusha! is a campaign intended to reduce road accidents. Zusha! supports distribution of stickers to public service vehicles encouraging passengers to speak up and urge drivers to drive more safely. We provided a GiveWell Incubation Grant to Zusha! in January 2017 and discussed it in a February 2017 blog post.

For more information, see our full review. Interested donors can give to Zusha! by clicking “Donate” on that page.

The post Announcing Zusha! as a standout charity appeared first on The GiveWell Blog.

We’ve added the Georgetown University Initiative on Innovation, Development, and Evaluation gui2de‘s Zusha! Road Safety Campaign (from here on, “Zusha!”) as a standout charity; see our full review here. Standout charities do not meet all of our criteria to be a GiveWell top charity, but we believe they stand out from the vast majority of organizations we have considered. See more information about our standout charities here.

Zusha! is a campaign intended to reduce road accidents. Zusha! supports distribution of stickers to public service vehicles encouraging passengers to speak up and urge drivers to drive more safely. We provided a GiveWell Incubation Grant to Zusha! in January 2017 and discussed it in a February 2017 blog post.

For more information, see our full review. Interested donors can give to Zusha! by clicking “Donate” on that page.

The post Announcing Zusha! as a standout charity appeared first on The GiveWell Blog.

Our goal with hosting quarterly open threads is to give blog readers an opportunity to publicly raise comments or questions about GiveWell or related topics (in the comments section below). As always, you’re also welcome to email us at info@givewell.org or to request a call with GiveWell staff if you have feedback or questions you’d prefer to discuss privately. We’ll try to respond promptly to questions or comments.

You can view our March 2018 open thread here.

The post June 2018 open thread appeared first on The GiveWell Blog.