Aggregator

We began exploring opportunities to mitigate the effects of the COVID-19 (coronavirus) pandemic in March. We are excited to announce that we granted a total of $450,000 to support coronavirus-response projects run by Development Media International (DMI), IDinsight, and Yale professor Mushfiq Mobarak, respectively.

With our grant funding, we expect DMI to run or support mass media campaigns to promote essential health messages. We expect IDinsight and Professor Mobarak to support policymakers responding to the pandemic in low- and middle-income countries through data collection and analysis and by making recommendations.

Our goal at GiveWell is always to direct funding to maximize impact. This typically leads us to conduct thorough, monthslong investigations into potential grantees. However, in response to the coronavirus pandemic, we believe we can have more impact by acting quickly to prevent the spread of the disease—even if it means completing only relatively shallow grant investigations.

These three grants may save or improve lives as well as or better than our current top charities. Nevertheless, we are more uncertain about their potential impact, given our brief review. The $450,000 in grants is the full amount we’re comfortable directing to these opportunities at this time; we do not suggest additional donations beyond this amount today.

We remain very worried about the effects of the pandemic on non-coronavirus health programs as the global funding landscape shifts in response to coronavirus. The need for the programs operated by our top charities is already large and we are unsure if our top charities will receive less funding than usual in the coming year. We expect that our top charities will require significant additional resources to continue to carry out their programs.

Our recommendation to individual donors is thus unchanged: our top recommendation is to give to “Grants to recommended charities at GiveWell’s discretion,” which we will allocate quarterly among our recommended charities where we believe it will do the most good. For donors who prefer to give directly to a GiveWell top charity, we recommend Malaria Consortium’s seasonal malaria chemoprevention program. We do not expect to make coronavirus-specific recommendations for individual donors.

Why we made these three grants

Our process for identifying and assessing grant recipients

We focused our investigation on projects operating in low- and middle-income countries. After initial conversations, we believed the pandemic’s impacts would be more severe in these contexts than in high-income countries due to their already-overburdened health systems. Funding opportunities in low- and middle-income countries also seemed more likely to be equally or more cost-effective than our top charities, which work in the same contexts. This is an important point of comparison, as we expect that the coronavirus grant funding would have otherwise been given to our top charities.

We started with a broad look at potential opportunities to fund. GiveWell researchers spoke to around 30 people from our networks, such as staff at the Center for Global Development and the Abdul Latif Jameel Poverty Action Lab. We reached out to groups we had previously funded that we thought may be well positioned to contribute to coronavirus mitigation efforts we could support and asked about their plans and funding needs. We also received a number of inbound requests for funding.

We narrowed the list of potential grants based on the following:

• We ruled out opportunities that we did not believe we had the expertise to assess well and quickly.
  • We deprioritized programs that looked significantly different from the types we’ve historically investigated, such as scientific research and development. We didn’t think we could make good, quick decisions about where to give in a space that was very new to us. Investigating new types of programs may require developing novel analytical frameworks in which we wouldn’t expect to feel confident in a short timeframe.
  • We deprioritized organizations we didn’t know well. We believe that thoroughly assessing an organization’s strength requires a significant time investment. We didn’t think we could become sufficiently knowledgeable about the coronavirus pandemic and all potential projects to be in a position to evaluate organizations we knew very little about.
• Since thoroughly assessing a new organization was not compatible with our brief timeline for these grants, we prioritized organizations that we knew well and thought highly of.
• We considered the likelihood the grant would be very cost-effective, based on our experience assessing similar interventions. For example, we believe programs to assist government policymakers may offer strong returns on investment, based on our initial investigations into policy organizations.
• We considered whether the grant had a plausible theory of change. In other words, we considered whether we understood the case for how the grant would have an impact and if that case seemed reasonable.
• We considered the likelihood the grant work would be funded without our support.

This led us to DMI, IDinsight, and Professor Mobarak. We feel these represent excellent opportunities to support coronavirus efforts. We decided to make relatively small grants to fill particularly urgent funding gaps in each case because (a) we know less about these grants than we would following a typical GiveWell investigation and (b) we have some reservations about the possibility that these grants are displacing funding from other donors. In each case, we may decide to make larger grants at a later date.

How the grants will be used

Development Media International: $200,000 grant

Our grant will support DMI’s work to run or support mass media campaigns, mostly over the radio, to promote handwashing, social distancing, and cough etiquette (also called “respiratory hygiene”) in nine African countries. There’s a common-sense argument that in countries where extreme social distancing is difficult, low-cost interventions like cough etiquette are particularly important. In addition, DMI has been a GiveWell standout charity since 2014.

We are excited to support DMI because it is an organization we know well and think highly of, there’s a common-sense case for this work, and our very rough cost-effectiveness analysis of this work looks promising.

IDinsight: $150,000 grant

Our grant will enable IDinsight, a development consulting group we partner closely with, to provide additional assistance to governments with their coronavirus response and to increase the amount of data IDinsight can collect to inform that response. Working with governments to improve responses to the pandemic may be highly cost-effective and a plausible way to have a lot of impact. Please note the relationship disclosure in the footnote.1We hired Dr. Neil Buddy Shah, IDinsight’s Founding Partner and CEO, as GiveWell’s managing director. We expect him to start at GiveWell this summer. Buddy is currently employed at IDinsight and provided information about and input on this grant. 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] });

Professor Mushfiq Mobarak: $100,000 grant

Mushfiq Mobarak is an economics professor at Yale who we worked closely with in our assessment of former top charity Evidence Action’s No Lean Season. Our grant to Professor Mobarak will enable him to either (a) hire a new analyst to help respond to coronavirus-related policy requests from the Bangladesh government or (b) collect additional data to inform the Bangladesh government’s response to coronavirus. As with IDinsight, we think that assisting governments may be a particularly effective and cost-effective way to have impact. We have a very positive opinion of Professor Mobarak from our previous engagement with No Lean Season.

What’s next?

Our focus is finding the most cost-effective ways to help people. We may make additional grants to these organizations or others in response to the pandemic. We also plan to continue our work to understand the effects of the pandemic on our current top charities.

Notes   [ + ]

1. ↑ We hired Dr. Neil Buddy Shah, IDinsight’s Founding Partner and CEO, as GiveWell’s managing director. We expect him to start at GiveWell this summer. Buddy is currently employed at IDinsight and provided information about and input on this grant. 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 Three grants in response to the COVID-19 pandemic appeared first on The GiveWell Blog.

We hope everyone is staying well during these difficult times. We are publishing this blog post to provide a brief update on how the COVID-19 (coronavirus) pandemic impacts our plans.

We are looking into the impact of the pandemic on the organizations we support as well as opportunities to mitigate its effects. We are in the early stages of this work and will update you as we reach conclusions.

We don’t have a new recommendation for donors: our bottom line continues to be to donate to “Grants to recommended charities at GiveWell’s discretion,” which we allocate quarterly to the highest priority need we see.

Monitoring the organizations we support

We are monitoring how the coronavirus pandemic is impacting the organizations we support. We’re in the early stages of seeing the myriad ways in which the pandemic is expected to impact their programs in 2020, such as:

• Restrictions (mandated by government or self-imposed) on reaching program participants in their homes.
• School closures that affect school-based deworming programs.
• Reduced availability of government resources for organizations that typically rely on health ministries or government-run networks of health workers.
• Additional costs for protective equipment for staff.
• Challenges obtaining commodities for distribution.

The organizations we support are updating their program implementation plans in response to the coronavirus. One of our top charities, the Against Malaria Foundation, suspended the monitoring it typically conducts after distributing malaria nets for at least one month in Ghana, though it says its overall operations have been minimally impacted so far. Another top charity, GiveDirectly, paused door-to-door operations for its cash transfer program and has begun exploring a contactless operational model to prevent the spread of the virus.

We are working to get a complete picture of the effects of the coronavirus on the organizations we support so that we can update our assessment of their funding needs and expected impact. Overall, we expect low- and middle-income countries, in which our charities operate, to have greater funding needs for healthcare in 2020 due to the coronavirus.

Exploring opportunities to mitigate the effects

We are also exploring opportunities to mitigate the effects of the coronavirus pandemic. Consistent with our usual practice for assessing giving opportunities, we are prepared to make new grants or to work with partners to reallocate our funding if there appear to be more cost-effective uses than the program to which we’d otherwise direct funds. These opportunities could explicitly target the coronavirus and its broader health and economic effects or could respond to its impact on the funding landscape for global health and poverty alleviation.

We are unsure if we will find new cost-effective giving opportunities that haven’t received government or philanthropic funding. If we do, we will report on any grants or funding decisions we recommend as a result of our investigation.

We are open to the landscape of opportunities in 2020 looking different than we expected before the pandemic. That said, we expect a continued need for funding for the programs implemented by the organizations we support.

Continuing our work

Thanks to our donors’ generous support of GiveWell’s own operations—enabling us to pay our staff to conduct research, process donations, and keep the lights on—we remain in a solid financial position. We expect to fundraise to ensure we can continue our work over the long term, but we don’t expect the pandemic to have a direct effect on our ability to do our work. We remain dedicated to our mission of finding and recommending highly cost-effective giving opportunities, and we’ll keep you posted, as we always do, on our findings. In the meantime, please stay safe and be well.

The post The impact of COVID-19 on GiveWell’s plans appeared first on The GiveWell Blog.

We hope everyone is staying well during these difficult times. We are publishing this blog post to provide a brief update on how the COVID-19 (coronavirus) pandemic impacts our plans.

We are looking into the impact of the pandemic on the organizations we support as well as opportunities to mitigate its effects. We are in the early stages of this work and will update you as we reach conclusions.

We don’t have a new recommendation for donors: our bottom line continues to be to donate to “Grants to recommended charities at GiveWell’s discretion,” which we allocate quarterly to the highest priority need we see.

Monitoring the organizations we support

We are monitoring how the coronavirus pandemic is impacting the organizations we support. We’re in the early stages of seeing the myriad ways in which the pandemic is expected to impact their programs in 2020, such as:

• Restrictions (mandated by government or self-imposed) on reaching program participants in their homes.
• School closures that affect school-based deworming programs.
• Reduced availability of government resources for organizations that typically rely on health ministries or government-run networks of health workers.
• Additional costs for protective equipment for staff.
• Challenges obtaining commodities for distribution.

The organizations we support are updating their program implementation plans in response to the coronavirus. One of our top charities, the Against Malaria Foundation, suspended the monitoring it typically conducts after distributing malaria nets for at least one month in Ghana, though it says its overall operations have been minimally impacted so far. Another top charity, GiveDirectly, paused door-to-door operations for its cash transfer program and has begun exploring a contactless operational model to prevent the spread of the virus.

We are working to get a complete picture of the effects of the coronavirus on the organizations we support so that we can update our assessment of their funding needs and expected impact. Overall, we expect low- and middle-income countries, in which our charities operate, to have greater funding needs for healthcare in 2020 due to the coronavirus.

Exploring opportunities to mitigate the effects

We are also exploring opportunities to mitigate the effects of the coronavirus pandemic. Consistent with our usual practice for assessing giving opportunities, we are prepared to make new grants or to work with partners to reallocate our funding if there appear to be more cost-effective uses than the program to which we’d otherwise direct funds. These opportunities could explicitly target the coronavirus and its broader health and economic effects or could respond to its impact on the funding landscape for global health and poverty alleviation.

We are unsure if we will find new cost-effective giving opportunities that haven’t received government or philanthropic funding. If we do, we will report on any grants or funding decisions we recommend as a result of our investigation.

We are open to the landscape of opportunities in 2020 looking different than we expected before the pandemic. That said, we expect a continued need for funding for the programs implemented by the organizations we support.

Continuing our work

Thanks to our donors’ generous support of GiveWell’s own operations—enabling us to pay our staff to conduct research, process donations, and keep the lights on—we remain in a solid financial position. We expect to fundraise to ensure we can continue our work over the long term, but we don’t expect the pandemic to have a direct effect on our ability to do our work. We remain dedicated to our mission of finding and recommending highly cost-effective giving opportunities, and we’ll keep you posted, as we always do, on our findings. In the meantime, please stay safe and be well.

The post The impact of COVID-19 on GiveWell’s plans appeared first on The GiveWell Blog.

We recently allocated donations made from October through December 2019 to "Grants to recommended charities at GiveWell's discretion." We granted $11.9 million to Malaria Consortium's seasonal malaria chemoprevention program and $1.5 million to Helen Keller International's vitamin A supplementation program.

We allocate donations to "Grants to recommended charities at GiveWell's discretion" (discretionary funds) quarterly, according to where we see the highest-priority funding needs. Malaria Consortium's seasonal malaria chemoprevention (SMC) program and Helen Keller International (HKI)'s vitamin A supplementation (VAS) program had the top-priority needs among our top charities at the time we made this decision.

Malaria Consortium provides preventive anti-malarial medication to young children during the time of year when malaria transmission is highest. HKI supports provision of vitamin A supplements to young children, which reduces their risk of dying of infectious disease.[1] We estimate that the combined discretionary grants to these organizations will save 5,600 lives.[2]

In this post, we discuss:

• Our process for deciding where to allocate discretionary funds. (More)
  • We share updates on:
    • HKI's VAS program. (More)
    • Malaria Consortium's SMC program. (More)
    • SCI Foundation. (More)
  • We also discuss uncertainties in our decision. (More)
• Our bottom line for donors giving today. (More)

Read More

The post Allocation of discretionary funds from Q4 2019 appeared first on The GiveWell Blog.

We recently allocated donations made from October through December 2019 to "Grants to recommended charities at GiveWell's discretion." We granted $11.9 million to Malaria Consortium's seasonal malaria chemoprevention program and $1.5 million to Helen Keller International's vitamin A supplementation program.

We allocate donations to "Grants to recommended charities at GiveWell's discretion" (discretionary funds) quarterly, according to where we see the highest-priority funding needs. Malaria Consortium's seasonal malaria chemoprevention (SMC) program and Helen Keller International (HKI)'s vitamin A supplementation (VAS) program had the top-priority needs among our top charities at the time we made this decision.

Malaria Consortium provides preventive anti-malarial medication to young children during the time of year when malaria transmission is highest. HKI supports provision of vitamin A supplements to young children, which reduces their risk of dying of infectious disease.[1] We estimate that the combined discretionary grants to these organizations will save 5,600 lives.[2]

In this post, we discuss:

• Our process for deciding where to allocate discretionary funds. (More)
  • We share updates on:
    • HKI's VAS program. (More)
    • Malaria Consortium's SMC program. (More)
    • SCI Foundation. (More)
  • We also discuss uncertainties in our decision. (More)
• Our bottom line for donors giving today. (More)

Read More

The post Allocation of discretionary funds from Q4 2019 appeared first on The GiveWell Blog.

We recently allocated donations made from October through December 2019 to “Grants to recommended charities at GiveWell’s discretion.” We granted $11.9 million to Malaria Consortium’s seasonal malaria chemoprevention program and $1.5 million to Helen Keller International’s vitamin A supplementation program.

We allocate donations to “Grants to recommended charities at GiveWell’s discretion” (discretionary funds) quarterly, according to where we see the highest-priority funding needs. Malaria Consortium’s seasonal malaria chemoprevention (SMC) program and Helen Keller International (HKI)’s vitamin A supplementation (VAS) program had the top-priority needs among our top charities at the time we made this decision.

Malaria Consortium provides preventive anti-malarial medication to young children during the time of year when malaria transmission is highest. HKI supports provision of vitamin A supplements to young children, which reduces their risk of dying of infectious disease.[1] We estimate that the combined discretionary grants to these organizations will save 5,600 lives.[2]

In this post, we discuss:

• Our process for deciding where to allocate discretionary funds. (More)
  • We share updates on:
    • HKI’s VAS program. (More)
    • Malaria Consortium’s SMC program. (More)
    • SCI Foundation. (More)
  • We also discuss uncertainties in our decision. (More)
• Our bottom line for donors giving today. (More)

Our process for deciding where to allocate discretionary funds

GiveWell donors gave $13.4 million in discretionary funds in the fourth quarter of 2019. We decide how to allocate discretionary funds by reviewing which of our top charities’ unmet funding needs, or “funding gaps,” are the most cost-effective and time-sensitive.

In January 2020, we asked HKI, Malaria Consortium, and SCI Foundation (SCI) for updates on their funding needs. We asked HKI and Malaria Consortium because we estimated that their unfunded work was highly cost-effective relative to that of our other top charities.[3] We asked SCI for information because we had pledged to revisit its funding needs in early 2020 (details below). We did not request updated funding information from our other five top charities. We discuss below what we have learned this year about the funding gaps at HKI, Malaria Consortium, and SCI.

In addition to our proactive requests for more information, we have asked our top charities to inform us when they have new funding opportunities we should consider. We were not informed of any opportunities this quarter outside of the information we received from HKI, Malaria Consortium, and SCI.

HKI’s VAS program

In 2019, HKI told us that it did not expect Global Affairs Canada (GAC) to renew its support for VAS programs in Côte d’Ivoire and Kenya from 2020 onward. HKI confirmed in January 2020 that GAC had not renewed its funding.[4]

We consider HKI’s VAS program in Côte d’Ivoire to be highly cost-effective.[5] Our top priority for fourth-quarter discretionary funds is filling the $1.5 million funding gap left by GAC in Côte d’Ivoire from 2020 to 2022.[6]

Malaria Consortium’s SMC program

We incorporated the following information into our estimate of Malaria Consortium’s funding needs in January 2020: a $33.9 million grant we recommended in November 2019; the revenue Malaria Consortium raised through the end of 2019; and Malaria Consortium’s updated budgets for 2020 to 2022.

We estimate that Malaria Consortium can now effectively absorb approximately $36 million for SMC programs in 2022 in Burkina Faso, Chad, Nigeria, and Togo.[7] This $36 million funding gap has the highest estimated cost-effectiveness among our top charities’ funding gaps after HKI’s work in Côte d’Ivoire.[8] We allocated the remaining $11.9 million in fourth-quarter discretionary funds to Malaria Consortium’s SMC program as our second priority.

SCI Foundation

We wrote in November 2019 that SCI had not, at that time, identified opportunities to effectively absorb additional funding. We moved it to a new, separate category off of our top charities list: “Top Charities without capacity to use new donations effectively at this time.”

We also decided to wait until 2020 to consider whether to make an “incentive grant” to support SCI’s work.[9] Subject to charities’ ability to use additional funding, we recommend annual “incentive grants” to each of our top charities to reward them for engaging in our intensive review process.[10] We were not confident in late 2019 that SCI could use additional funding.

SCI recently shared new information about funding gaps in the countries where it works. We now believe SCI can likely absorb additional funding (though we are uncertain about its total funding needs) and plan to recommend that it receive a standard $2.5 million incentive grant. We also moved SCI from the “Top Charities without capacity to use new donations effectively at this time” category to the regular top charities list.

We decided not to make SCI’s incentive grant out of our fourth-quarter discretionary funding. We recently received an $8 million donation that is partially restricted to GiveWell’s “top life improving nonprofit/s,” of which SCI is one. We estimate that our top charities that focus on programs to reduce mortality, such as HKI’s VAS program and Malaria Consortium’s SMC program, have more cost-effective funding gaps at this time, and we prefer to save our non-restricted discretionary funding for them.

Uncertainties in our decision

HKI’s VAS program

We don’t know whether, in the absence of a GiveWell grant to HKI, VAS campaigns in the districts formerly funded by GAC would be skipped or if HKI would reallocate other available funding to support these campaigns. Reallocation of HKI’s available funding would make its funding gap in Côte d’Ivoire less time-sensitive but would leave funding gaps for other work in a year or two. These new gaps would be our top priority to fill due to their high cost-effectiveness.

We haven’t resolved this question because we believe our discretionary grant to HKI will support the most cost-effective unfunded work we are aware of, regardless of time-sensitivity.

Malaria Consortium’s SMC program

We believe that our estimate of Malaria Consortium’s funding gap represents the maximum amount it can absorb effectively for its SMC program ($36 million). GiveWell donors’ $11.9 million discretionary grant will close some of this gap.

It is possible that other funders will also step in to fill some of this gap. In particular, we believe that one funder that supported SMC coverage in part of Burkina Faso in 2020 may choose to extend its support through 2022; this would decrease Malaria Consortium’s room for more funding by around $8 million. Even if this occurs, Malaria Consortium would still have a significant unfilled gap ($16.1 million) for its work in 2022.[11]

We thus expect that donations to Malaria Consortium today will support its work in 2022, which we generally expect to be highly cost-effective.

Our bottom line for donors giving today

We continue to recommend that donors give to “Grants to recommended charities at GiveWell’s discretion.” We direct these funds where we believe they can be used most effectively.

For donors who wish to give to a specific charity, we recommend Malaria Consortium’s SMC program, as we believe it continues to have a highly cost-effective and large unfilled funding gap after receiving GiveWell discretionary funding.

Footnotes

Footnotes for this post may be found here.

The post Allocation of discretionary funds from Q4 2019 appeared first on The GiveWell Blog.

We recently allocated donations made from October through December 2019 to “Grants to recommended charities at GiveWell’s discretion.” We granted $11.9 million to Malaria Consortium’s seasonal malaria chemoprevention program and $1.5 million to Helen Keller International’s vitamin A supplementation program.

We allocate donations to “Grants to recommended charities at GiveWell’s discretion” (discretionary funds) quarterly, according to where we see the highest-priority funding needs. Malaria Consortium’s seasonal malaria chemoprevention (SMC) program and Helen Keller International (HKI)’s vitamin A supplementation (VAS) program had the top-priority needs among our top charities at the time we made this decision.

Malaria Consortium provides preventive anti-malarial medication to young children during the time of year when malaria transmission is highest. HKI supports provision of vitamin A supplements to young children, which reduces their risk of dying of infectious disease.[1] We estimate that the combined discretionary grants to these organizations will save 5,600 lives.[2]

In this post, we discuss:

• Our process for deciding where to allocate discretionary funds. (More)
  • We share updates on:
    • HKI’s VAS program. (More)
    • Malaria Consortium’s SMC program. (More)
    • SCI Foundation. (More)
  • We also discuss uncertainties in our decision. (More)
• Our bottom line for donors giving today. (More)

Our process for deciding where to allocate discretionary funds

GiveWell donors gave $13.4 million in discretionary funds in the fourth quarter of 2019. We decide how to allocate discretionary funds by reviewing which of our top charities’ unmet funding needs, or “funding gaps,” are the most cost-effective and time-sensitive.

In January 2020, we asked HKI, Malaria Consortium, and SCI Foundation (SCI) for updates on their funding needs. We asked HKI and Malaria Consortium because we estimated that their unfunded work was highly cost-effective relative to that of our other top charities.[3] We asked SCI for information because we had pledged to revisit its funding needs in early 2020 (details below). We did not request updated funding information from our other five top charities. We discuss below what we have learned this year about the funding gaps at HKI, Malaria Consortium, and SCI.

In addition to our proactive requests for more information, we have asked our top charities to inform us when they have new funding opportunities we should consider. We were not informed of any opportunities this quarter outside of the information we received from HKI, Malaria Consortium, and SCI.

HKI’s VAS program

In 2019, HKI told us that it did not expect Global Affairs Canada (GAC) to renew its support for VAS programs in Côte d’Ivoire and Kenya from 2020 onward. HKI confirmed in January 2020 that GAC had not renewed its funding.[4]

We consider HKI’s VAS program in Côte d’Ivoire to be highly cost-effective.[5] Our top priority for fourth-quarter discretionary funds is filling the $1.5 million funding gap left by GAC in Côte d’Ivoire from 2020 to 2022.[6]

Malaria Consortium’s SMC program

We incorporated the following information into our estimate of Malaria Consortium’s funding needs in January 2020: a $33.9 million grant we recommended in November 2019; the revenue Malaria Consortium raised through the end of 2019; and Malaria Consortium’s updated budgets for 2020 to 2022.

We estimate that Malaria Consortium can now effectively absorb approximately $36 million for SMC programs in 2022 in Burkina Faso, Chad, Nigeria, and Togo.[7] This $36 million funding gap has the highest estimated cost-effectiveness among our top charities’ funding gaps after HKI’s work in Côte d’Ivoire.[8] We allocated the remaining $11.9 million in fourth-quarter discretionary funds to Malaria Consortium’s SMC program as our second priority.

SCI Foundation

We wrote in November 2019 that SCI had not, at that time, identified opportunities to effectively absorb additional funding. We moved it to a new, separate category off of our top charities list: “Top Charities without capacity to use new donations effectively at this time.”

We also decided to wait until 2020 to consider whether to make an “incentive grant” to support SCI’s work.[9] Subject to charities’ ability to use additional funding, we recommend annual “incentive grants” to each of our top charities to reward them for engaging in our intensive review process.[10] We were not confident in late 2019 that SCI could use additional funding.

SCI recently shared new information about funding gaps in the countries where it works. We now believe SCI can likely absorb additional funding (though we are uncertain about its total funding needs) and plan to recommend that it receive a standard $2.5 million incentive grant. We also moved SCI from the “Top Charities without capacity to use new donations effectively at this time” category to the regular top charities list.

We decided not to make SCI’s incentive grant out of our fourth-quarter discretionary funding. We recently received an $8 million donation that is partially restricted to GiveWell’s “top life improving nonprofit/s,” of which SCI is one. We estimate that our top charities that focus on programs to reduce mortality, such as HKI’s VAS program and Malaria Consortium’s SMC program, have more cost-effective funding gaps at this time, and we prefer to save our non-restricted discretionary funding for them.

Uncertainties in our decision

HKI’s VAS program

We don’t know whether, in the absence of a GiveWell grant to HKI, VAS campaigns in the districts formerly funded by GAC would be skipped or if HKI would reallocate other available funding to support these campaigns. Reallocation of HKI’s available funding would make its funding gap in Côte d’Ivoire less time-sensitive but would leave funding gaps for other work in a year or two. These new gaps would be our top priority to fill due to their high cost-effectiveness.

We haven’t resolved this question because we believe our discretionary grant to HKI will support the most cost-effective unfunded work we are aware of, regardless of time-sensitivity.

Malaria Consortium’s SMC program

We believe that our estimate of Malaria Consortium’s funding gap represents the maximum amount it can absorb effectively for its SMC program ($36 million). GiveWell donors’ $11.9 million discretionary grant will close some of this gap.

It is possible that other funders will also step in to fill some of this gap. In particular, we believe that one funder that supported SMC coverage in part of Burkina Faso in 2020 may choose to extend its support through 2022; this would decrease Malaria Consortium’s room for more funding by around $8 million. Even if this occurs, Malaria Consortium would still have a significant unfilled gap ($16.1 million) for its work in 2022.[11]

We thus expect that donations to Malaria Consortium today will support its work in 2022, which we generally expect to be highly cost-effective.

Our bottom line for donors giving today

We continue to recommend that donors give to “Grants to recommended charities at GiveWell’s discretion.” We direct these funds where we believe they can be used most effectively.

For donors who wish to give to a specific charity, we recommend Malaria Consortium’s SMC program, as we believe it continues to have a highly cost-effective and large unfilled funding gap after receiving GiveWell discretionary funding.

Footnotes

Footnotes for this post may be found here.

The post Allocation of discretionary funds from Q4 2019 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 December 2019 open thread here.

The post March 2020 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 December 2019 open thread here.

The post March 2020 open thread appeared first on The GiveWell Blog.

We see an early indication that GiveWell continued its trajectory of robust donor growth last year. The total value of donations processed by GiveWell increased 30% in 2019.[1]

We're sharing this data now because we believe it is an informative early update about our growth last year. However, GiveWell-processed donations don't tell the full story of our impact. Many donors who rely on our research give via our partner organizations or directly to our top charities. Their gifts account for the majority of donations due to our work and are not processed by GiveWell. Information about these gifts is time-consuming to gather and has usually led us to release our metrics data many months after the end of the year. We plan to release a complete 2019 metrics report and assessment of our impact, including donations not processed by GiveWell, later this year.

Here's what we know so far, based on the nearly complete information we have about donations we processed:

• We processed $54.1 million in donations in 2019. Sixty-five percent of this amount was restricted to our recommended charities and 35% was unrestricted, which we may use to support GiveWell's operations.
• Support from donors giving $10,000 to $100,000 comprised the largest proportion of our growth (35%).[2]
• Returning donors who gave more than last year made up 75% of our growth in funds donated (excluding anonymous donations).[3]
• We believe that the majority of our growth was organic and would have occurred without any outreach and marketing efforts from GiveWell, although we can attribute some to specific outreach and marketing initiatives.[4]

We're encouraged by this growth and excited to write about it. We also discuss below some ways that GiveWell-processed donations could be a misleading indicator of our overall impact.

Read More

The post How did we do in 2019? A preliminary look at our growth. appeared first on The GiveWell Blog.

We see an early indication that GiveWell continued its trajectory of robust donor growth last year. The total value of donations processed by GiveWell increased 30% in 2019.[1]

We’re sharing this data now because we believe it is an informative early update about our growth last year. However, GiveWell-processed donations don’t tell the full story of our impact. Many donors who rely on our research give via our partner organizations or directly to our top charities. Their gifts account for the majority of donations due to our work and are not processed by GiveWell. Information about these gifts is time-consuming to gather and has usually led us to release our metrics data many months after the end of the year. We plan to release a complete 2019 metrics report and assessment of our impact, including donations not processed by GiveWell, later this year.

Here’s what we know so far, based on the nearly complete information we have about donations we processed:

• We processed $54.1 million in donations in 2019. Sixty-five percent of this amount was restricted to our recommended charities and 35% was unrestricted, which we may use to support GiveWell’s operations.
• Support from donors giving $10,000 to $100,000 comprised the largest proportion of our growth (35%).[2]
• Returning donors who gave more than last year made up 75% of our growth in funds donated (excluding anonymous donations).[3]
• We believe that the majority of our growth was organic and would have occurred without any outreach and marketing efforts from GiveWell, although we can attribute some to specific outreach and marketing initiatives.[4]

We’re encouraged by this growth and excited to write about it. We also discuss below some ways that GiveWell-processed donations could be a misleading indicator of our overall impact.

Summary

This post covers the following topics:

• About GiveWell-processed donations (More)
• Donations we processed in 2019
  • Restricted donations by donor size (More)
  • Unrestricted donations by donor size (More)
  • New donors and returning donors (More)
• Ways in which these data are incomplete (More)
• Additional information: Where did donors give? (More)

About GiveWell-processed donations

This is our first time releasing information on GiveWell-processed donations as a standalone post.

It is very time-consuming to gather and analyze information from the many disparate sources through which GiveWell donors can support GiveWell and our recommended charities.[5] We have generally shared reports on donations due to our work quite late in the year as a result.[6]

We do have nearly complete information at this point of the year on GiveWell-processed donations in 2019. We’re experimenting with sharing this information as an early look at our impact.

What is included in GiveWell-processed donations?

The $54.1 million only includes donations that we processed ourselves, such as gifts that were made by credit card on our website, bank transfers to GiveWell’s account, checks made out to GiveWell, and other options listed here.[7] It includes both restricted and unrestricted donations:

• Restricted: A donor tells us to use the gift for one or more of our top charities or for “Grants to recommended charities at GiveWell’s discretion,” which we allocate quarterly to the recommended charity or charities with the most pressing needs.
• Unrestricted: A donor does not place any restrictions on the donation. We may use the donation for GiveWell’s operations or grant it to charities.

The $54.1 million does not include gifts that were made directly to our recommended charities or via our partner organizations.[8] Additional ways in which GiveWell-processed donations may not tell the full story of our impact are discussed below.

Our impact: donations we processed

Restricted donations: by donor size

We saw strong growth in 2019 in restricted donations across donor size categories under $1 million.[9] Most donors making restricted donations of $1 million or more give directly to our top charities and not through GiveWell; we discuss this in greater detail below.

Note: Anonymous donations are only tracked in the penultimate row and are not reflected in the other size category totals.[10]

Note: This table excludes all anonymous donors.

Unrestricted donations: by donor size

The largest absolute growth (just over $1 million) and relative growth (69%) in unrestricted donations was from donors giving between $100,000 and $1 million. We explain the slight decline in unrestricted donations from donors giving more than $1 million in the following footnote.[11]

Note: Anonymous donations are only tracked in the penultimate row and are not reflected in the other size category totals.

The total number of non-anonymous donors providing unrestricted gifts increased by 22%, with the strongest relative growth (34%) in the number of donors giving between $1,000 and $10,000.

Note: This table excludes all anonymous donors.

New donors and returning donors

Returning donors increasing their donations drove approximately 75% of our growth in funds donated, excluding anonymous donations. Funds from new donors increased more than 40% over the previous year and accounted for approximately 25% of our total growth in non-anonymous funds donated.

Note: This chart shows total donations by new and returning donors, as well as from anonymous donors who cannot be included in either category, as a percentage of all donations (restricted and unrestricted).

How GiveWell-processed donations don’t tell the full story

While we see GiveWell-processed donations as an early indicator of strong growth, we have significant uncertainty about the final picture of our influence in 2019.

Donors giving over $1 million have tended to donate directly to our recommended charities rather than through GiveWell, and so are not well-represented in GiveWell-processed donations.[12] They have also accounted for a large proportion of our impact each year as major contributors to our recommended charities. This group made up roughly one-third of our money moved to recommended charities in 2018, excluding donations from Open Philanthropy.[13] Our best guess is that growth among donors giving under $1 million is related to growth among donors giving over $1 million—if more donors are giving to GiveWell in general, we think it’s likely that additional larger donors will find our work. However, we’re unsure of the extent to which 2019 donors who gave under $1 million are predictive of the 2019 donors who gave over $1 million directly to our recommended charities.

Another way in which GiveWell-processed donations could fail to predict our overall growth is if donors shifted how they gave in 2019. If a greater proportion of donors chose to give through GiveWell in 2019, extrapolating from the proportion of GiveWell-processed donations in previous years to our total impact in 2019 would be overly optimistic. Although we don’t expect this to be the case, we won’t know for sure until we see the complete data from 2019.

Additional information: Where did donors give in 2019?

Restricted gifts accounted for $35 million of the $54.1 million we processed last year. Donors allocated 64% of restricted dollars in 2019 to “Grants to recommended charities at GiveWell’s discretion,” which was (and is) our top recommendation for GiveWell donors.

The remainder of the $54.1 million ($19.1 million) was unrestricted. We typically use unrestricted funding for our operations, though some of these funds will likely be granted to charities.[14]

Footnotes

Footnotes for this post may be found here.

—
Devin Jacob co-authored this post.

The post How did we do in 2019? A preliminary look at our growth. appeared first on The GiveWell Blog.

We see an early indication that GiveWell continued its trajectory of robust donor growth last year. The total value of donations processed by GiveWell increased 30% in 2019.[1]

We’re sharing this data now because we believe it is an informative early update about our growth last year. However, GiveWell-processed donations don’t tell the full story of our impact. Many donors who rely on our research give via our partner organizations or directly to our top charities. Their gifts account for the majority of donations due to our work and are not processed by GiveWell. Information about these gifts is time-consuming to gather and has usually led us to release our metrics data many months after the end of the year. We plan to release a complete 2019 metrics report and assessment of our impact, including donations not processed by GiveWell, later this year.

Here’s what we know so far, based on the nearly complete information we have about donations we processed:

• We processed $54.1 million in donations in 2019. Sixty-five percent of this amount was restricted to our recommended charities and 35% was unrestricted, which we may use to support GiveWell’s operations.
• Support from donors giving $10,000 to $100,000 comprised the largest proportion of our growth (35%).[2]
• Returning donors who gave more than last year made up 75% of our growth in funds donated (excluding anonymous donations).[3]
• We believe that the majority of our growth was organic and would have occurred without any outreach and marketing efforts from GiveWell, although we can attribute some to specific outreach and marketing initiatives.[4]

We’re encouraged by this growth and excited to write about it. We also discuss below some ways that GiveWell-processed donations could be a misleading indicator of our overall impact.

Summary

This post covers the following topics:

• About GiveWell-processed donations (More)
• Donations we processed in 2019
  • Restricted donations by donor size (More)
  • Unrestricted donations by donor size (More)
  • New donors and returning donors (More)
• Ways in which these data are incomplete (More)
• Additional information: Where did donors give? (More)

About GiveWell-processed donations

This is our first time releasing information on GiveWell-processed donations as a standalone post.

It is very time-consuming to gather and analyze information from the many disparate sources through which GiveWell donors can support GiveWell and our recommended charities.[5] We have generally shared reports on donations due to our work quite late in the year as a result.[6]

We do have nearly complete information at this point of the year on GiveWell-processed donations in 2019. We’re experimenting with sharing this information as an early look at our impact.

What is included in GiveWell-processed donations?

The $54.1 million only includes donations that we processed ourselves, such as gifts that were made by credit card on our website, bank transfers to GiveWell’s account, checks made out to GiveWell, and other options listed here.[7] It includes both restricted and unrestricted donations:

• Restricted: A donor tells us to use the gift for one or more of our top charities or for “Grants to recommended charities at GiveWell’s discretion,” which we allocate quarterly to the recommended charity or charities with the most pressing needs.
• Unrestricted: A donor does not place any restrictions on the donation. We may use the donation for GiveWell’s operations or grant it to charities.

The $54.1 million does not include gifts that were made directly to our recommended charities or via our partner organizations.[8] Additional ways in which GiveWell-processed donations may not tell the full story of our impact are discussed below.

Our impact: donations we processed

Restricted donations: by donor size

We saw strong growth in 2019 in restricted donations across donor size categories under $1 million.[9] Most donors making restricted donations of $1 million or more give directly to our top charities and not through GiveWell; we discuss this in greater detail below.

Note: Anonymous donations are only tracked in the penultimate row and are not reflected in the other size category totals.[10]

Note: This table excludes all anonymous donors.

Unrestricted donations: by donor size

The largest absolute growth (just over $1 million) and relative growth (69%) in unrestricted donations was from donors giving between $100,000 and $1 million. We explain the slight decline in unrestricted donations from donors giving more than $1 million in the following footnote.[11]

Note: Anonymous donations are only tracked in the penultimate row and are not reflected in the other size category totals.

The total number of non-anonymous donors providing unrestricted gifts increased by 22%, with the strongest relative growth (34%) in the number of donors giving between $1,000 and $10,000.

Note: This table excludes all anonymous donors.

New donors and returning donors

Returning donors increasing their donations drove approximately 75% of our growth in funds donated, excluding anonymous donations. Funds from new donors increased more than 40% over the previous year and accounted for approximately 25% of our total growth in non-anonymous funds donated.

Note: This chart shows total donations by new and returning donors, as well as from anonymous donors who cannot be included in either category, as a percentage of all donations (restricted and unrestricted).

How GiveWell-processed donations don’t tell the full story

While we see GiveWell-processed donations as an early indicator of strong growth, we have significant uncertainty about the final picture of our influence in 2019.

Donors giving over $1 million have tended to donate directly to our recommended charities rather than through GiveWell, and so are not well-represented in GiveWell-processed donations.[12] They have also accounted for a large proportion of our impact each year as major contributors to our recommended charities. This group made up roughly one-third of our money moved to recommended charities in 2018, excluding donations from Open Philanthropy.[13] Our best guess is that growth among donors giving under $1 million is related to growth among donors giving over $1 million—if more donors are giving to GiveWell in general, we think it’s likely that additional larger donors will find our work. However, we’re unsure of the extent to which 2019 donors who gave under $1 million are predictive of the 2019 donors who gave over $1 million directly to our recommended charities.

Another way in which GiveWell-processed donations could fail to predict our overall growth is if donors shifted how they gave in 2019. If a greater proportion of donors chose to give through GiveWell in 2019, extrapolating from the proportion of GiveWell-processed donations in previous years to our total impact in 2019 would be overly optimistic. Although we don’t expect this to be the case, we won’t know for sure until we see the complete data from 2019.

Additional information: Where did donors give in 2019?

Restricted gifts accounted for $35 million of the $54.1 million we processed last year. Donors allocated 64% of restricted dollars in 2019 to “Grants to recommended charities at GiveWell’s discretion,” which was (and is) our top recommendation for GiveWell donors.

The remainder of the $54.1 million ($19.1 million) was unrestricted. We typically use unrestricted funding for our operations, though some of these funds will likely be granted to charities.[14]

Footnotes

Footnotes for this post may be found here.

—
Devin Jacob co-authored this post.

The post How did we do in 2019? A preliminary look at our growth. appeared first on The GiveWell Blog.

I’m very excited to announce that Dr. Neil Buddy Shah is joining GiveWell as Managing Director starting this summer.

We’re beyond thrilled that Buddy, a leader in the global health and development space, has chosen to be part of our team at this exciting time. We have significantly expanded our research focus over the past few years to identify high-impact giving opportunities beyond our current top charities list. In addition to working with me to set our strategy generally, a core component of Buddy’s work will be pushing our research and funding expansion forward by leading GiveWell’s efforts to learn from and contribute to the broader international development community.

He is exceptionally qualified to do so. Buddy has spent the last eight years as Founding Partner and CEO of IDinsight, a group GiveWell has worked closely with and supported through our Incubation Grants program. We’re confident that IDinsight will continue to do great work over the coming years.

Buddy is now heading the leadership transition process at IDinsight. He expects to join GiveWell around July. Welcome to the team!

About Buddy

Buddy’s impressive biography speaks to his commitment to and accomplishments in the global development sector. In addition to co-founding and leading IDinsight, a nearly 200-person organization dedicated to using data to improve international development programs and funding, he helped conceptualize and launch many of IDinsight’s contributions to the sector, including “decision-focused evaluations,” “embedded learning partnerships,” machine learning applications, and IDinsight’s large-scale, tech-enabled rural data collection infrastructure, “Data on Demand.”

Buddy has designed and co-led IDinsight engagements across Asia and Africa, working as a trusted advisor to senior leaders within national government ministries, multilaterals, foundations, and NGOs. He split his time between Cambodia, India, and Uganda while launching IDinsight’s first projects.

Before co-founding IDinsight, Buddy worked in the World Bank’s Governance and Public Sector Reform Unit and at MIT’s Abdul Latif Jameel Poverty Action Lab (J-PAL). He holds an AB in economics from Harvard, an MD from Albert Einstein College of Medicine, and an MPA in International Development from Harvard Kennedy School. Buddy is a term member of the Council on Foreign Relations and serves as visiting faculty in Harvard Kennedy School’s Executive Education program.

Buddy’s role

Buddy will work closely with me to set GiveWell’s high-level strategy: our goals and plans for achieving them. I expect that his success in founding, growing, and running a large non-profit will make him an excellent partner in this work. I have no plans to fundamentally change my role at GiveWell; Buddy will provide additional capacity and insights.

Another significant part of Buddy’s role will be engaging with the international development community. Although we have engaged regularly with the community over the past 12+ years, we haven’t made it a strategic priority to learn from and contribute to the community’s conversation about doing as much good as possible and to fund opportunities in support of that goal—until now.

Buddy plans to meet with leaders at development institutions, write op-eds and articles to raise our profile and share our findings, speak at key conferences, and identify opportunities to co-fund grants with others in this space. We believe this engagement will increase the impact of our work in a number of ways, including by:

• Learning from the community. How can we improve our methodology? Which programs, charities, and grants should we evaluate?
• Increasing the reach of our findings and methodology by proactively sharing with a community of people dedicated to poverty alleviation and global health.
• Uncovering promising funding opportunities in global health and development and leading GiveWell’s grantmaking process to support them.
• Raising our profile so that we can connect with great job candidates who will increase our impact.

We’re excited about all we expect Buddy to accomplish at GiveWell and look forward to having him on the team.

The post Introducing our new Managing Director: Dr. Neil Buddy Shah appeared first on The GiveWell Blog.

I’m very excited to announce that Dr. Neil Buddy Shah is joining GiveWell as Managing Director starting this summer.

We’re beyond thrilled that Buddy, a leader in the global health and development space, has chosen to be part of our team at this exciting time. We have significantly expanded our research focus over the past few years to identify high-impact giving opportunities beyond our current top charities list. In addition to working with me to set our strategy generally, a core component of Buddy’s work will be pushing our research and funding expansion forward by leading GiveWell’s efforts to learn from and contribute to the broader international development community.

He is exceptionally qualified to do so. Buddy has spent the last eight years as Founding Partner and CEO of IDinsight, a group GiveWell has worked closely with and supported through our Incubation Grants program. We’re confident that IDinsight will continue to do great work over the coming years.

Buddy is now heading the leadership transition process at IDinsight. He expects to join GiveWell around July. Welcome to the team!

About Buddy

Buddy’s impressive biography speaks to his commitment to and accomplishments in the global development sector. In addition to co-founding and leading IDinsight, a nearly 200-person organization dedicated to using data to improve international development programs and funding, he helped conceptualize and launch many of IDinsight’s contributions to the sector, including “decision-focused evaluations,” “embedded learning partnerships,” machine learning applications, and IDinsight’s large-scale, tech-enabled rural data collection infrastructure, “Data on Demand.”

Buddy has designed and co-led IDinsight engagements across Asia and Africa, working as a trusted advisor to senior leaders within national government ministries, multilaterals, foundations, and NGOs. He split his time between Cambodia, India, and Uganda while launching IDinsight’s first projects.

Before co-founding IDinsight, Buddy worked in the World Bank’s Governance and Public Sector Reform Unit and at MIT’s Abdul Latif Jameel Poverty Action Lab (J-PAL). He holds an AB in economics from Harvard, an MD from Albert Einstein College of Medicine, and an MPA in International Development from Harvard Kennedy School. Buddy is a term member of the Council on Foreign Relations and serves as visiting faculty in Harvard Kennedy School’s Executive Education program.

Buddy’s role

Buddy will work closely with me to set GiveWell’s high-level strategy: our goals and plans for achieving them. I expect that his success in founding, growing, and running a large non-profit will make him an excellent partner in this work. I have no plans to fundamentally change my role at GiveWell; Buddy will provide additional capacity and insights.

Another significant part of Buddy’s role will be engaging with the international development community. Although we have engaged regularly with the community over the past 12+ years, we haven’t made it a strategic priority to learn from and contribute to the community’s conversation about doing as much good as possible and to fund opportunities in support of that goal—until now.

Buddy plans to meet with leaders at development institutions, write op-eds and articles to raise our profile and share our findings, speak at key conferences, and identify opportunities to co-fund grants with others in this space. We believe this engagement will increase the impact of our work in a number of ways, including by:

• Learning from the community. How can we improve our methodology? Which programs, charities, and grants should we evaluate?
• Increasing the reach of our findings and methodology by proactively sharing with a community of people dedicated to poverty alleviation and global health.
• Uncovering promising funding opportunities in global health and development and leading GiveWell’s grantmaking process to support them.
• Raising our profile so that we can connect with great job candidates who will increase our impact.

We’re excited about all we expect Buddy to accomplish at GiveWell and look forward to having him on the team.

The post Introducing our new Managing Director: Dr. Neil Buddy Shah appeared first on The GiveWell Blog.

Charity evaluation is rarely straightforward. Many factors, within a charity's control or outside of it, can influence the impact a charity has.

This blog post will highlight a case that illustrates how thinking through these factors can lead to surprising information that changes our understanding of a charity's impact.

Summary

GiveWell recommended a grant to Results for Development (R4D) in May 2016 for its recently-launched program to increase access to pneumonia treatments for children in Tanzania. We thought this program was promising enough to potentially join our short list of GiveWell top charities once we had more information on its impact.

Expanded access to treatments is a factor in reducing child mortality from pneumonia, but not the only factor. We ultimately want to know not just whether more pneumonia treatments are available in Tanzania, but whether fewer children die of pneumonia as a result of R4D's work. We expect the program to best achieve this impact if pneumonia patients visit health clinics with treatments in stock and are diagnosed and treated correctly.

We learned as we followed R4D's work that there was limited information available on the accuracy of clinicians' pneumonia diagnoses. We initially guessed that clinicians were diagnosing pneumonia accurately around 80 percent of the time. R4D collected data on diagnostic accuracy and we learned that the rate of accurate pneumonia diagnosis was actually 18 percent. This caused our estimate of the program's impact to fall, though it remains in the range that we look for in potential top charities.

This finding highlights why it's important to think through all of the factors along the path from a charity’s activities to its ultimate impact; if we had just considered whether more treatments were available, we would have missed this part of the story. We're excited to continue following R4D's work because of the role it has played in collecting this information to date and our expectation that it will continue collecting information that allows us to estimate its impact on the availability of pneumonia treatments across Tanzania. We expect to consider R4D as a potential future top charity.

In this post, we discuss:

• The background for GiveWell's grant to R4D (More)
• Our plans for assessing the impact of R4D's program (More)
• Approaches to measuring R4D’s impact (More)
• Lessons from this work (More)

Read More

The post Why it’s important to think through all of the factors that influence a charity’s impact appeared first on The GiveWell Blog.

Charity evaluation is rarely straightforward. Many factors, within a charity’s control or outside of it, can influence the impact a charity has.

This blog post will highlight a case that illustrates how thinking through these factors can lead to surprising information that changes our understanding of a charity’s impact.

Summary

GiveWell recommended a grant to Results for Development (R4D) in May 2016 for its recently-launched program to increase access to pneumonia treatments for children in Tanzania. We thought this program was promising enough to potentially join our short list of GiveWell top charities once we had more information on its impact.

Expanded access to treatments is a factor in reducing child mortality from pneumonia, but not the only factor. We ultimately want to know not just whether more pneumonia treatments are available in Tanzania, but whether fewer children die of pneumonia as a result of R4D’s work. We expect the program to best achieve this impact if pneumonia patients visit health clinics with treatments in stock and are diagnosed and treated correctly.

We learned as we followed R4D’s work that there was limited information available on the accuracy of clinicians’ pneumonia diagnoses. We initially guessed that clinicians were diagnosing pneumonia accurately around 80 percent of the time. R4D collected data on diagnostic accuracy and we learned that the rate of accurate pneumonia diagnosis was actually 18 percent. This caused our estimate of the program’s impact to fall, though it remains in the range that we look for in potential top charities.

This finding highlights why it’s important to think through all of the factors along the path from a charity’s activities to its ultimate impact; if we had just considered whether more treatments were available, we would have missed this part of the story. We’re excited to continue following R4D’s work because of the role it has played in collecting this information to date and our expectation that it will continue collecting information that allows us to estimate its impact on the availability of pneumonia treatments across Tanzania. We expect to consider R4D as a potential future top charity.

In this post, we discuss:

• The background for GiveWell’s grant to R4D (More)
• Our plans for assessing the impact of R4D’s program (More)
• Approaches to measuring R4D’s impact (More)
• Lessons from this work (More)

Grant background

Pneumonia is a leading cause of children’s death worldwide.[1] R4D approached us in 2015 and told us that Tanzania did not have sufficient funding to maintain an adequate supply of pneumonia treatments in the country’s public sector health system.[2] R4D was interested in providing market-shaping technical assistance and catalytic, time-limited funding for pneumonia drug supplies, with the goal of improving the availability of drugs in order to avert more deaths.[3]

We recommended a GiveWell Incubation Grant in May 2016 of $6.4 million to support the first phase of R4D’s scale-up of pneumonia treatments in Tanzania. We thought R4D might meet our top charity criteria once we had more information with which to assess its impact.[4]

How will we know if R4D is reducing deaths from pneumonia?

Funding the purchase of additional pneumonia treatments would seem a simple solution to the inadequate supply of the drugs. But to truly assess the impact of the program on reducing child mortality from pneumonia, we wanted to understand:[5]

1. Would R4D increase the availability of pneumonia treatments?
2. Would clinicians diagnose pneumonia accurately? (We initially estimated 80 percent accuracy in diagnoses in the public and private sectors.[6])
3. Would clinicians prescribe pneumonia treatments to people who needed them?

The second and third questions relate to factors outside of the scope of R4D’s program, which aimed to increase the availability of treatments. However, they play an important role in R4D’s success in reducing deaths from pneumonia.

We were surprised by how difficult it was to answer the second and third questions. There did not appear to be existing data from Tanzania on pneumonia diagnosis and treatment and it was challenging to design effective ways to measure them.

Gathering information

A common story we hear is that many charities do not conduct surveys to verify whether they’re reaching program participants and having the hoped-for impact because:

• donors don’t want to pay for monitoring; or
• charities don’t want to implement monitoring: it’s time-consuming, expensive, and not clearly in demand from donors.

Neither was true in this case. We were interested in funding measurement of the rates of accurate diagnosis and treatment. R4D was interested not only in implementing the measurement, but in taking the lead on developing creative ways to tackle questions about the program’s impact. The latter is rare in our experience. When we have asked charities how they monitor their work, we have often been told that the charity simply knows its program works.

Initial plans

R4D initially planned to use health clinic records to see whether pneumonia treatments were increasing due to its program and whether those treatments were correctly prescribed.[7] However, R4D found in an initial investigation that these records were incomplete and thus did not indicate whether the intended impact was occurring.[8]

R4D considered and decided against a number of other means of assessing whether children who had pneumonia received treatment, such as video-recording clinicians (which was rejected due to anticipated challenges in obtaining consent for patients), surveying patients outside of health clinics (which was rejected due to its cost and anticipated challenges with patient recall), and conducting a high-quality study focused on child mortality (which was rejected due to the high cost of running a sufficiently large study).[9]

Eventual solution

R4D next partnered with IDinsight, another GiveWell Incubation Grant recipient, to develop a new approach to gathering this information.[10] Working with IDinsight, the government of Tanzania, and the Tanzanian national medical school, R4D used lung ultrasounds, which directly tested whether patients with respiratory symptoms had pneumonia, to measure the accuracy rate for clinicians’ pneumonia diagnoses—a neat solution.[11]

The lung ultrasound information yielded surprising results. The rates of accurate pneumonia diagnosis were quite low. Only 18 percent of children with pneumonia confirmed by lung ultrasound were correctly diagnosed.[12]

Getting the full picture

Even that, however, didn’t tell the full story. If we had just looked at diagnostic rates and assumed that incorrect diagnosis leads to incorrect prescription of treatment, then we would have missed another important element of the story: many children who were not diagnosed with pneumonia were still prescribed the right drug to treat pneumonia. When they had the pneumonia treatment in stock, clinicians prescribed it in 46 percent of cases in which they had incorrectly diagnosed a child as having something other than pneumonia. We are unsure why.[13]

Our estimate of the cost-effectiveness of R4D’s pneumonia program fell by 27 percent when we updated it to reflect this new information.[14]

A broader question

The importance of looking for factors that influence impact across a charity’s causal chain, whether under the charity’s control or not, is not unique to pneumonia, nor Tanzania, nor R4D. For example, when we try to understand whether GiveWell top charity Against Malaria Foundation‘s work to prevent malaria by supplying insecticide-treated nets results in fewer people dying of malaria, we think through all the parts of the process that could fail. We aim to do this for our other top charities, as well.

Our estimate of R4D’s pneumonia program’s cost-effectiveness remains in the range that we look for in potential top charities and we’re excited to continue following its work.[15] But without the new information on diagnostic accuracy, we, R4D, and the government of Tanzania might have gotten an incorrect picture of its impact.

We made another grant to R4D in January 2019 to support the second phase of the pneumonia treatment program. We forecast a 40 percent chance that R4D (as a whole) or one of its specific programs (like pneumonia treatment) is a top charity by December 2023.[16] As we move forward, we plan to continue to ask ourselves all of the ways this grant might have more or less impact, as we did before, and as we do in all cases.

Sources

Sources for this post may be found here.

The post Why it’s important to think through all of the factors that influence a charity’s impact appeared first on The GiveWell Blog.

Charity evaluation is rarely straightforward. Many factors, within a charity’s control or outside of it, can influence the impact a charity has.

This blog post will highlight a case that illustrates how thinking through these factors can lead to surprising information that changes our understanding of a charity’s impact.

Summary

GiveWell recommended a grant to Results for Development (R4D) in May 2016 for its recently-launched program to increase access to pneumonia treatments for children in Tanzania. We thought this program was promising enough to potentially join our short list of GiveWell top charities once we had more information on its impact.

Expanded access to treatments is a factor in reducing child mortality from pneumonia, but not the only factor. We ultimately want to know not just whether more pneumonia treatments are available in Tanzania, but whether fewer children die of pneumonia as a result of R4D’s work. We expect the program to best achieve this impact if pneumonia patients visit health clinics with treatments in stock and are diagnosed and treated correctly.

We learned as we followed R4D’s work that there was limited information available on the accuracy of clinicians’ pneumonia diagnoses. We initially guessed that clinicians were diagnosing pneumonia accurately around 80 percent of the time. R4D collected data on diagnostic accuracy and we learned that the rate of accurate pneumonia diagnosis was actually 18 percent. This caused our estimate of the program’s impact to fall, though it remains in the range that we look for in potential top charities.

This finding highlights why it’s important to think through all of the factors along the path from a charity’s activities to its ultimate impact; if we had just considered whether more treatments were available, we would have missed this part of the story. We’re excited to continue following R4D’s work because of the role it has played in collecting this information to date and our expectation that it will continue collecting information that allows us to estimate its impact on the availability of pneumonia treatments across Tanzania. We expect to consider R4D as a potential future top charity.

In this post, we discuss:

• The background for GiveWell’s grant to R4D (More)
• Our plans for assessing the impact of R4D’s program (More)
• Approaches to measuring R4D’s impact (More)
• Lessons from this work (More)

Grant background

Pneumonia is a leading cause of children’s death worldwide.[1] R4D approached us in 2015 and told us that Tanzania did not have sufficient funding to maintain an adequate supply of pneumonia treatments in the country’s public sector health system.[2] R4D was interested in providing market-shaping technical assistance and catalytic, time-limited funding for pneumonia drug supplies, with the goal of improving the availability of drugs in order to avert more deaths.[3]

We recommended a GiveWell Incubation Grant in May 2016 of $6.4 million to support the first phase of R4D’s scale-up of pneumonia treatments in Tanzania. We thought R4D might meet our top charity criteria once we had more information with which to assess its impact.[4]

How will we know if R4D is reducing deaths from pneumonia?

Funding the purchase of additional pneumonia treatments would seem a simple solution to the inadequate supply of the drugs. But to truly assess the impact of the program on reducing child mortality from pneumonia, we wanted to understand:[5]

1. Would R4D increase the availability of pneumonia treatments?
2. Would clinicians diagnose pneumonia accurately? (We initially estimated 80 percent accuracy in diagnoses in the public and private sectors.[6])
3. Would clinicians prescribe pneumonia treatments to people who needed them?

The second and third questions relate to factors outside of the scope of R4D’s program, which aimed to increase the availability of treatments. However, they play an important role in R4D’s success in reducing deaths from pneumonia.

We were surprised by how difficult it was to answer the second and third questions. There did not appear to be existing data from Tanzania on pneumonia diagnosis and treatment and it was challenging to design effective ways to measure them.

Gathering information

A common story we hear is that many charities do not conduct surveys to verify whether they’re reaching program participants and having the hoped-for impact because:

• donors don’t want to pay for monitoring; or
• charities don’t want to implement monitoring: it’s time-consuming, expensive, and not clearly in demand from donors.

Neither was true in this case. We were interested in funding measurement of the rates of accurate diagnosis and treatment. R4D was interested not only in implementing the measurement, but in taking the lead on developing creative ways to tackle questions about the program’s impact. The latter is rare in our experience. When we have asked charities how they monitor their work, we have often been told that the charity simply knows its program works.

Initial plans

R4D initially planned to use health clinic records to see whether pneumonia treatments were increasing due to its program and whether those treatments were correctly prescribed.[7] However, R4D found in an initial investigation that these records were incomplete and thus did not indicate whether the intended impact was occurring.[8]

R4D considered and decided against a number of other means of assessing whether children who had pneumonia received treatment, such as video-recording clinicians (which was rejected due to anticipated challenges in obtaining consent for patients), surveying patients outside of health clinics (which was rejected due to its cost and anticipated challenges with patient recall), and conducting a high-quality study focused on child mortality (which was rejected due to the high cost of running a sufficiently large study).[9]

Eventual solution

R4D next partnered with IDinsight, another GiveWell Incubation Grant recipient, to develop a new approach to gathering this information.[10] Working with IDinsight, the government of Tanzania, and the Tanzanian national medical school, R4D used lung ultrasounds, which directly tested whether patients with respiratory symptoms had pneumonia, to measure the accuracy rate for clinicians’ pneumonia diagnoses—a neat solution.[11]

The lung ultrasound information yielded surprising results. The rates of accurate pneumonia diagnosis were quite low. Only 18 percent of children with pneumonia confirmed by lung ultrasound were correctly diagnosed.[12]

Getting the full picture

Even that, however, didn’t tell the full story. If we had just looked at diagnostic rates and assumed that incorrect diagnosis leads to incorrect prescription of treatment, then we would have missed another important element of the story: many children who were not diagnosed with pneumonia were still prescribed the right drug to treat pneumonia. When they had the pneumonia treatment in stock, clinicians prescribed it in 46 percent of cases in which they had incorrectly diagnosed a child as having something other than pneumonia. We are unsure why.[13]

Our estimate of the cost-effectiveness of R4D’s pneumonia program fell by 27 percent when we updated it to reflect this new information.[14]

A broader question

The importance of looking for factors that influence impact across a charity’s causal chain, whether under the charity’s control or not, is not unique to pneumonia, nor Tanzania, nor R4D. For example, when we try to understand whether GiveWell top charity Against Malaria Foundation‘s work to prevent malaria by supplying insecticide-treated nets results in fewer people dying of malaria, we think through all the parts of the process that could fail. We aim to do this for our other top charities, as well.

Our estimate of R4D’s pneumonia program’s cost-effectiveness remains in the range that we look for in potential top charities and we’re excited to continue following its work.[15] But without the new information on diagnostic accuracy, we, R4D, and the government of Tanzania might have gotten an incorrect picture of its impact.

We made another grant to R4D in January 2019 to support the second phase of the pneumonia treatment program. We forecast a 40 percent chance that R4D (as a whole) or one of its specific programs (like pneumonia treatment) is a top charity by December 2023.[16] As we move forward, we plan to continue to ask ourselves all of the ways this grant might have more or less impact, as we did before, and as we do in all cases.

Sources

Sources for this post may be found here.

The post Why it’s important to think through all of the factors that influence a charity’s impact appeared first on The GiveWell Blog.

Although our list of top charities is short (just eight excellent organizations), we’re always on the lookout for other groups to add. Fistula Foundation is one of the charities we’re planning to prioritize highly for further evaluation. Donating to Fistula Foundation is not yet one of our recommendations—as it’s still under active investigation—but we’re excited to share an update on our work so far and next steps.

Living with fistula

An obstetric fistula is an abnormal opening between the vagina and the bladder or rectum, which causes leakage of urine and/or feces through the vagina.[1] This type of fistula[2] is typically caused by a prolonged obstructed labor in which the fetus presses on the mother’s pubic bone and cuts off blood flow to the tissue nearby.[3]

Living with fistula may cause harm in many ways: physically, through skin conditions and constipation; economically, as it may be hard to get or keep a job, due to odor; and socially, as fistula is associated with divorce and isolation, also due to the odor.[4] Describing a fistula patient’s experience in 2016, New York Times columnist Nicholas Kristof referred to people with fistulas as “modern-day lepers.”[5]

Surgery may be used to repair fistulas in many cases.[6] Fistula Foundation supports fistula repair surgeries and a variety of activities to increase the number of fistula patients who receive treatment.[7]

GiveWell and Fistula Foundation

We first reviewed Fistula Foundation as a potential top charity in 2011, two years after it expanded its mission to treat fistula globally.[8] We decided that it did not then meet our strict top charity requirements due to our uncertainty about the success of surgeries and our lack of confidence in the degree to which Fistula Foundation’s support caused surgeries to take place that otherwise would not have.[9]

Our charity review process evolved over the years that followed. We began placing more emphasis on completing independent evidence reviews for promising programs as a first step in our research process, before looking at individual charities implementing the most promising programs that we identify: our “priority programs.”

As part of our work to complete more evidence reviews, we looked into surgery to repair obstetric fistula in 2017. We estimated that fistula surgery was potentially in the range of cost-effectiveness of our priority programs, although we had major open questions about the cost of surgery and patients’ long-term outcomes.[10] Despite these questions, we felt that fistula surgery met our criteria to be named a priority program and we continued our work to better understand it.

We partnered with a group called IDinsight through GiveWell’s Incubation Grants program to improve our understanding of the cost of fistula surgery. This was particularly challenging for us to estimate due to our uncertainty over (a) the cost to reach potential patients, who may be in remote areas and socially disconnected, and (b) the costs and impact of training surgeons and providing equipment (typical activities conducted by fistula management charities) on the long-term success of the surgeries.[11] Though we were interested in fistula management charities broadly, IDinsight identified Fistula Foundation as a promising group and produced an estimate of Fistula Foundation’s cost per surgery in Kenya, including outreach and indirect costs such as training.[12]

Our evidence review and work with IDinsight led us to revisit Fistula Foundation as a potential top charity. We made a $100,000 participation grant to Fistula Foundation after publishing an interim review of its work.[13]

Top charity contender

We consider Fistula Foundation a top charity contender. Our next steps are to determine which evidence will help us understand the effect Fistula Foundation’s programs have had on the number of surgeries performed, which is a key input into our understanding of its cost-effectiveness, and to review recent studies on the impact of fistula surgery at one to two years post-surgery.

Our open questions and next steps

Open questions

We plan to prioritize several key questions as we continue our review of Fistula Foundation. We want to better understand:[14]

• the role Fistula Foundation plays in supporting additional surgeries;
• the long-term outcomes of surgeries supported by Fistula Foundation;
• the counterfactual impact of Fistula Foundation (i.e. the degree to which it is increasing the number of fistula surgeries performed, relative to what would have occurred in its absence); and
• the opportunity costs of fistula surgery (e.g. what the doctors who treat fistulas would have done in the absence of this program).

Next steps

We’re unsure when we will complete our review. The timing will depend on our overall research capacity as well as how we prioritize Fistula Foundation alongside review of other potential top charities. We very roughly estimate that there’s a 30% chance we will review Fistula Foundation in 2020.

We’re still in the process of vetting Fistula Foundation and have more confidence in our current list of top charities. We’re excited to continue learning about the work of this promising organization in the future.

Sources

Sources for this post may be found here.

The post Update on our work on Fistula Foundation appeared first on The GiveWell Blog.

Although our list of top charities is short (just eight excellent organizations), we’re always on the lookout for other groups to add. Fistula Foundation is one of the charities we’re planning to prioritize highly for further evaluation. Donating to Fistula Foundation is not yet one of our recommendations—as it’s still under active investigation—but we’re excited to share an update on our work so far and next steps.

Living with fistula

An obstetric fistula is an abnormal opening between the vagina and the bladder or rectum, which causes leakage of urine and/or feces through the vagina.[1] This type of fistula[2] is typically caused by a prolonged obstructed labor in which the fetus presses on the mother’s pubic bone and cuts off blood flow to the tissue nearby.[3]

Living with fistula may cause harm in many ways: physically, through skin conditions and constipation; economically, as it may be hard to get or keep a job, due to odor; and socially, as fistula is associated with divorce and isolation, also due to the odor.[4] Describing a fistula patient’s experience in 2016, New York Times columnist Nicholas Kristof referred to people with fistulas as “modern-day lepers.”[5]

Surgery may be used to repair fistulas in many cases.[6] Fistula Foundation supports fistula repair surgeries and a variety of activities to increase the number of fistula patients who receive treatment.[7]

GiveWell and Fistula Foundation

We first reviewed Fistula Foundation as a potential top charity in 2011, two years after it expanded its mission to treat fistula globally.[8] We decided that it did not then meet our strict top charity requirements due to our uncertainty about the success of surgeries and our lack of confidence in the degree to which Fistula Foundation’s support caused surgeries to take place that otherwise would not have.[9]

Our charity review process evolved over the years that followed. We began placing more emphasis on completing independent evidence reviews for promising programs as a first step in our research process, before looking at individual charities implementing the most promising programs that we identify: our “priority programs.”

As part of our work to complete more evidence reviews, we looked into surgery to repair obstetric fistula in 2017. We estimated that fistula surgery was potentially in the range of cost-effectiveness of our priority programs, although we had major open questions about the cost of surgery and patients’ long-term outcomes.[10] Despite these questions, we felt that fistula surgery met our criteria to be named a priority program and we continued our work to better understand it.

We partnered with a group called IDinsight through GiveWell’s Incubation Grants program to improve our understanding of the cost of fistula surgery. This was particularly challenging for us to estimate due to our uncertainty over (a) the cost to reach potential patients, who may be in remote areas and socially disconnected, and (b) the costs and impact of training surgeons and providing equipment (typical activities conducted by fistula management charities) on the long-term success of the surgeries.[11] Though we were interested in fistula management charities broadly, IDinsight identified Fistula Foundation as a promising group and produced an estimate of Fistula Foundation’s cost per surgery in Kenya, including outreach and indirect costs such as training.[12]

Our evidence review and work with IDinsight led us to revisit Fistula Foundation as a potential top charity. We made a $100,000 participation grant to Fistula Foundation after publishing an interim review of its work.[13]

Top charity contender

We consider Fistula Foundation a top charity contender. Our next steps are to determine which evidence will help us understand the effect Fistula Foundation’s programs have had on the number of surgeries performed, which is a key input into our understanding of its cost-effectiveness, and to review recent studies on the impact of fistula surgery at one to two years post-surgery.

Our open questions and next steps

Open questions

We plan to prioritize several key questions as we continue our review of Fistula Foundation. We want to better understand:[14]

• the role Fistula Foundation plays in supporting additional surgeries;
• the long-term outcomes of surgeries supported by Fistula Foundation;
• the counterfactual impact of Fistula Foundation (i.e. the degree to which it is increasing the number of fistula surgeries performed, relative to what would have occurred in its absence); and
• the opportunity costs of fistula surgery (e.g. what the doctors who treat fistulas would have done in the absence of this program).

Next steps

We’re unsure when we will complete our review. The timing will depend on our overall research capacity as well as how we prioritize Fistula Foundation alongside review of other potential top charities. We very roughly estimate that there’s a 30% chance we will review Fistula Foundation in 2020.

We’re still in the process of vetting Fistula Foundation and have more confidence in our current list of top charities. We’re excited to continue learning about the work of this promising organization in the future.

Sources

Sources for this post may be found here.

The post Update on our work on Fistula Foundation appeared first on The GiveWell Blog.

In the third quarter of 2019, donors gave a combined $2.6 million to GiveWell for granting to recommended charities at our discretion. We greatly appreciate this support, which enables us to direct funding where we believe it can be used most impactfully. We grant this funding to one or more of our top charities each quarter.

We decided to allocate all $2.6 million to Helen Keller International's (HKI) vitamin A supplementation (VAS) program. HKI is a GiveWell top charity that supports provision of vitamin A supplements to young children, reducing their likelihood of dying from infectious disease. It does so by providing technical assistance, engaging in advocacy, and contributing funding to government-run VAS programs in sub-Saharan Africa. We based our decision on our estimate of the high cost-effectiveness of the work HKI expects to conduct with this funding.

We provide an updated recommendation for donors below.

Summary

In this post, we discuss:

• what HKI will do with this funding. (More)
• our process for deciding where to allocate funds. (More)
• our bottom line for donors giving today. (More)

Read More

The post Allocation of discretionary funds from Q3 2019 appeared first on The GiveWell Blog.