Published: November 2019
- Data and detailed methodology from surveys that they conduct to check whether their programs had the reach and impact they expected.
- Data on costs they and other partners incurred to deliver the program and numbers of people reached. More here.
- How much funding they have available and how they would use additional funding. More here.
We also conduct periodic visits to our top charities in the locations they work. In August, GiveWell staff visited Burkina Faso to see Malaria Consortium's seasonal malaria chemoprevention (SMC) program.
- 2019 updates on top charities
- Against Malaria Foundation (AMF)
- The END Fund's deworming program
- Evidence Action's Deworm the World Initiative
- Helen Keller International (HKI)'s vitamin A supplementation (VAS) program
- Malaria Consortium's seasonal malaria chemoprevention (SMC) program
- SCI Foundation (SCI)
- Sightsavers' deworming program
- 2019 updates on standout charities
- Development Media International (DMI)
- Evidence Action's Dispensers for Safe Water (DSW)
- Food Fortification Initiative (FFI)
- Georgetown University Initiative on Innovation, Development, and Evaluation (gui2de)—Zusha! Road Safety Campaign
- The Global Alliance for Improved Nutrition (GAIN)—Universal Salt Iodization (USI) program
- Iodine Global Network (IGN)
- Living Goods
- Sanku-Project Healthy Children (Sanku-PHC)
2019 updates on top charities
We summarize updates on our top charities' activities and other major updates to our top charity reviews below, excluding changes in cost-effectiveness and room for more funding. For a description of changes to our cost-effectiveness analyses, see our 2019 changelog. See this summary for updates on our top charities' room for more funding as of November 2019.
Against Malaria Foundation (AMF)
As of July 2019, AMF has distributed 38 million long-lasting insecticide-treated nets (LLINs) in eight countries. It has committed funding for 49 million LLINs for distributions expected to take place in 2019-2020. Since fiscal year 2012, it has spent $106.1 million, including $91.5 million on LLIN purchases.
We have reviewed post-distribution monitoring (PDMs) from each country where AMF has distributed LLINs. Because AMF conducts PDMs every nine months, we have not seen results from more recent distributions. As of July 2019, we had seen more limited results than expected from some of AMF's 2017 and 2018 distributions. The results we have seen are highly granular, providing household-level information on LLIN distribution and usage.
We have seen only brief methodological overviews, rather than detailed PDM reports, from AMF's newer countries of operation: Togo, Uganda, Zambia, and Papua New Guinea. Compared with monitoring reports from most top charities, we have a more limited understanding of how these surveys were conducted and thus greater uncertainty about how to interpret the results.
The END Fund's deworming program
We used information shared by the END Fund to update our overview of its spending on neglected tropical disease programs. 52% of the END Fund’s grants in 2017 and 29% of its grants in 2018 supported deworming specifically. See more details in this spreadsheet.
Evidence Action's Deworm the World Initiative
Deworm the World spent a total of $12.4 million in 2018, up from $10.2 million in 2017. Most of this funding supported programs in India and Kenya, followed by programs in Nigeria and Pakistan. We used 2018 cost data from India, Kenya, and Nigeria to update our cost per child dewormed analysis. Deworm the World's Nigeria program is the newest of the three countries, and this was the first year for which Deworm the World had cost and coverage survey data (from 2018) to allow for a full analysis of its cost per child dewormed in Nigeria. The resulting estimates were in line with previous estimates.
In the past, we have noted that the monitoring Deworm the World has conducted for its programs in India and Kenya stood out among top charity monitoring for its regularity (monitoring has been conducted for a very high percentage of deworming rounds) and strong methodology. This year, we focused our review on coverage surveys from its programs in Nigeria, from which we had previously seen less monitoring. We found the 2018 coverage surveys to be of similarly high quality to those we have seen from Kenya and India.
GiveDirectly provided $59.2 million in cash transfers to recipients in 2018. It launched a refugee program in Rwanda and continued scaling its refugee program in Uganda, which will be evaluated in a randomized controlled trial (RCT). See more details on this RCT and GiveDirectly's other experimentation work in this spreadsheet.
GiveDirectly is matching funding with USAID to deliver cash transfers and run studies on its impact. As part of its work with USAID, it published results from a cash benchmarking study it conducted in Rwanda, started distributing cash transfers in Liberia and Malawi, established an office in the Democratic Republic of the Congo (DRC), and signed an agreement for a new project in Morocco.
Helen Keller International (HKI)'s vitamin A supplementation (VAS) program
In 2018, HKI spent $3 million on VAS mass distribution campaigns, primarily in Guinea, Burkina Faso, Mali, and Côte d'Ivoire. In this spreadsheet, we summarize distribution methods and additional interventions delivered in these countries.
Last year, we used several sources to form a best guess of the prevalence of vitamin A deficiency (VAD) among preschool-aged children in countries where HKI works or plans to work. This year, we used data from the Institute for Health Metrics and Evaluation's Global Burden of Disease project to estimate that VAD prevalence in these countries is around 31% on average, which is higher than our estimate last year of 20%.
Last year, we had seen one coverage survey each from Mali and Burkina Faso. We have now seen coverage surveys representing around 60% of HKI's total spending on VAS mass campaigns in 2018, with at least one survey from each of HKI's primary countries of operation.
Malaria Consortium's seasonal malaria chemoprevention (SMC) program
In 2018, Malaria Consortium used primarily GiveWell-directed funds ($15 million) to target approximately 3.9 million children in Burkina Faso, Chad, and Nigeria with SMC. It shared information with us on its 2018 spending on these programs. Malaria Consortium planned to use GiveWell-directed funds to continue these programs, targeting 5.7 million children in 2019.
In 2017 and 2018, Malaria Consortium made major changes to its monitoring methodology, most notably to the frequency and sampling procedures of its coverage surveys, which measure the proportion of targeted children who were reached with SMC. This year, we reviewed post-cycle surveys (conducted after each of the first three cycles of SMC) and post-round surveys (conducted after all four cycles) from each country where Malaria Consortium used GiveWell-directed funds in 2018.
In 2017, post-cycle and post-round surveys yielded highly similar results, which suggested that respondents' ability to accurately recall whether children had been treated did not deteriorate over the course of the four-month round. In 2018, the results were generally similar in post-cycle and post-round surveys, though with larger differences than in 2017. The difference was largest in Nigeria, where Malaria Consortium attributed inconsistent post-cycle and post-round results to methodological issues in post-cycle surveys.
SCI Foundation (SCI)
Until 2019, SCI was housed within Imperial College London, a university. As of June 2019, it was in the process of separating its operations from the university. We updated our overview of SCI’s spending by country with information from 2018.
SCI has conducted studies to monitor a non-representative sample of about 55% of the treatments it funded from 2014-2017 (updated from 50% in our 2018 review) across roughly 90% of the countries in which it has worked. We reviewed the results and methodology of new coverage surveys (which measure the percentage of targeted individuals who actually received treatment) and impact surveys (which measure infection rates over time) that we received this year. Some of these recent surveys have methodological limitations, including non-random selection of districts, that limit our confidence in their results.
As of November 2019, we consider SCI to have no identified funding gaps. SCI is seeking additional information on whether funding gaps exist in a set of countries for which SCI will receive funding from DFID to treat neglected tropical diseases. We may increase our assessment of SCI's room for more funding in the next six months as a result. We and SCI plan to have further conversations in 2020 about whether SCI has a funding gap after it has sufficient information to project funding needs and availability in Ethiopia, Malawi, Sudan, Tanzania, and Uganda.
Sightsavers' deworming program
In 2018 and 2019, Sightsavers used GiveWell-directed funds to continue its deworming programs in the DRC, Guinea, Guinea-Bissau, and several states in Nigeria and to expand its work to Cameroon and an additional state in Nigeria. Previously, our cost per child treated estimates relied heavily on projected information; this year, our cost per child dewormed analysis for Sightsavers relied on data on costs incurred and treatments delivered during its 2017 and 2018 financial years. The resulting estimate ($0.91) is not substantially different from last year's estimate ($0.95).
Of the several locations where Sightsavers used GiveWell-directed funds to support deworming programs scheduled for 2018, we have seen a coverage survey from one location, Cameroon. Most of the distributions scheduled for 2018 did not take place until 2019, which is why we have seen limited monitoring thus far. As of August 2019, coverage surveys were planned or in progress in the other locations. If completed, these surveys will cover 91% of Sightsavers' spending of GiveWell-directed funds to date. We expect to review reports from these surveys when they are available.
2019 updates on standout charities
In addition to our top charities, we recognize standout charities—organizations that support programs that may be extremely cost-effective and are evidence-backed but whose impact we have less confidence in than we do for our top charities.
We don’t follow standout charities as closely as we do our top charities. We generally have one or two calls per year with representatives from each group and publish notes on our conversations. We provide brief updates on these charities below.
Development Media International (DMI)
DMI’s recent work includes a child survival campaign in Mozambique and a nutritional messaging campaign in Tanzania. It recently received funding for a malaria-specific child survival campaign in Burkina Faso and family planning campaigns in seven countries across East and Southern Africa.
In Burkina Faso, DMI completed an RCT on its family planning campaign (the results have not yet been published) and recently received funding to conduct an RCT on an early childhood development campaign.
DMI would use additional funding to support its child survival campaigns and to expand to new countries.
Notes from our 2019 conversation with DMI are here.
Evidence Action's Dispensers for Safe Water (DSW)
DSW has continued to maintain and refill its network of chlorine dispensers at community water points in Kenya, Uganda, and Malawi. Recently, it has focused on promoting the use of dispensers among those using targeted water points. It has not installed new dispensers in several years, due to lack of funding for expansion.
We completed a site visit of DSW's programs in Kenya and Uganda in October 2019 as part of a more in-depth review of DSW that we anticipate completing in 2020. We plan to publish notes from the site visit shortly. Further information about DSW's current work and room for more funding is forthcoming.
Food Fortification Initiative (FFI)
Recently, FFI has provided technical assistance to fortification programs in Ethiopia, the Solomon Islands, Sri Lanka, Mongolia, one state in India, and several countries in the Southern African Development Community. It plans to begin working in Egypt and aims to expand its work to Central Asia.
FFI would use additional funding to continue its support of African countries, scale its program across India, and expand to new countries.
Notes from our 2019 conversation with FFI are here.
Georgetown University Initiative on Innovation, Development, and Evaluation (gui2de)—Zusha! Road Safety Campaign
Zusha! is continuing its operations in Kenya, where it distributes stickers and supports a lottery to reward drivers who correctly display the stickers. It has not distributed additional stickers since December 2018 but plans to distribute stickers to 30,000 vehicles in Kenya in late 2019. Following the completion of its RCTs in Tanzania and Uganda, Zusha! ceased operations in both countries.
Zusha! uses GiveWell-directed funding as its core source of funding and expects to be constrained by funding in 2020.
Notes from our 2019 conversation with Zusha! are here.
The Global Alliance for Improved Nutrition (GAIN)—Universal Salt Iodization (USI) program
In the past year, GAIN supported USI in several countries, primarily by helping countries procure and distribute potassium iodate, build capacity for quality assurance and quality control, and develop national legislation. It was also involved in regional-level work in Africa and in two research projects, a study on double-fortified salt in India and a meta-analysis on the impact of large-scale food fortification.
GAIN would use additional funding to increase support for its current countries of operation and to provide technical assistance in new countries.
Notes from our 2019 conversation with GAIN are here.
Iodine Global Network (IGN)
Recently, IGN has worked on developing program guidance for national governments that focuses on iodization of salt used in processed foods and condiments. It has also incorporated advocacy for reduced salt consumption into its program guidance, communications, and monitoring. IGN continues to provide technical assistance for salt iodization in several countries and to partner with other fortification organizations.
IGN would use additional funding to conduct additional technical assistance and advocacy work in countries where iodine deficiency is highly prevalent.
Notes from our 2019 conversation with IGN are here.
Living Goods runs networks of community health promoters in Kenya and Uganda. Its activities in the past year have involved updating or experimenting with this model in several ways, including by scaling an expanded family planning package and piloting the use of results-based financing. In some places, it has contracted with governments to provide government-funded community health programs.
The impact of Living Goods’ program on under-5 mortality has been studied in one RCT; a second RCT is ongoing, with endline evaluation expected to occur in spring 2020.
Living Goods would use additional funding to expand its work to new countries.
Notes from our 2019 conversation with Living Goods are here.
Sanku-Project Healthy Children (Sanku-PHC)
Sanku-PHC provides small-scale mills with micronutrient premix and machines that fortify flour with this premix. In the past year, Sanku-PHC’s main priority was expanding its reach in Tanzania. It currently reaches an estimated 2 million people with fortified flour and expects to reach 3-4 million people by the end of 2020. Sanku-PHC is also involved in a number of other projects, including a partnership with the World Food Programme to provide fortified flour to 300,000 Burundian and Congolese refugees.
Sanku-PHC would use additional funding to scale its program in Tanzania and potentially expand into a new country in 2020 or 2021.
Notes from our 2019 conversation with Sanku-PHC are here.