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Published: November 2020; Updated April 2021

Give effectively

Research hours

GiveWell has 15 full-time research staff. The names and roles of research staff can be found here.

Each research staff member contributes about 2,000 hours per year (46 weeks at 40 hours per week). We assume that one-quarter of their time is spent on non-research work, such as staff meetings. We thus roughly estimate that they collectively conduct more than 20,000 hours of research per year (15 staff multiplied by 2,000 hours per year multiplied by 75% of time on research).

Cost to save a life

Our estimate of the cost to save a life is based on our cost-effectiveness model. This model does not yet include estimates for New Incentives; you can find those in our cost-effectiveness model for New Incentives.

Impact estimates are updated annually (last updated: Nov. 2020). The range we share represents our estimate of the average cost-effectiveness of a donation to the top charity. The cost-effectiveness of any specific funding opportunity for each top charity may be above or below this range.

You can read more about our approach to estimating cost-effectiveness and its role in our decisions about what to fund and recommend to donors here. Explicit cost-effectiveness estimates are a major, but not the only, input into our decision-making process. More on the principles we use in decision-making here.

We present cost-effectiveness estimates as a range rounded to the nearest thousand dollars on our Top Charities page. This reflects the degree of precision we believe our model can estimate, as well as the range of cost-effectiveness that charities are likely to achieve across the countries they work in. Charities' cost-effectiveness can vary widely by geography, depending on the underlying burden of disease and the costs of operating in a given country.

Why is the cost to save a life so much higher than the cost per net/treatment?

We often get questions about why we estimate it costs $3,000 to $5,000 to save a life if, for example, it only costs approximately $5 to distribute a malaria net, or $7 to distribute antimalarial medicine, or $1 to provide a vitamin A supplement—the interventions we recommend to save lives. It's not intuitive!

Here, we'll briefly walk through why our estimate of the cost to save a life is higher than our estimate of the cost per treatment or item. We'll use the example of the Against Malaria Foundation (AMF), a GiveWell top charity.

AMF supports the distribution of insecticide-treated nets to prevent malaria. These nets are hung over sleeping spaces and block and kill malaria-carrying mosquitoes. We estimate that it costs about $5 to purchase and distribute one of these nets.1

Not every person who receives a net from an AMF-supported distribution would have otherwise died of malaria. This is why the cost per life saved is not $5.

In addition, although the nets are highly effective, the nets do not prevent malaria 100% of the time. They wear out over time, developing holes that reduce their effectiveness.2 In addition, mosquitoes have developed some resistance to the insecticide that the nets are treated with, also reducing the nets' effectiveness.3 In addition to factors related to the nets themselves, some people will choose not to use their nets, will not use them consistently, or may use them incorrectly (for example, leaving gaps between the net and their sleeping space).4 People can also be bitten by infected mosquitoes when they are not in bed.5 We adjust our estimate of nets' effectiveness against malaria to account for these factors.

We also incorporate the local malaria mortality rates where AMF works. While nets are distributed to people who are at risk of malaria, even without nets a fairly small portion of them would die due to the disease. Many would, by chance, avoid infection. Many who do get infected would survive the infection with treatment or without. We estimate the cost per life saved for each location based on the likelihood that a person who receives a net would have died from malaria without the net.6

In addition, we include whether we believe that other actors would distribute nets if AMF didn't, so that we can estimate AMF's true impact—and thus our best guess of the true impact of donations to AMF. 7

When we take these and many other factors into account, we come to our all-in estimate of the true cost to save a life by donating to AMF: $3,000 - $5,000.8You can see our full calculation here. It may sound high, but it's one of the most cost-effective programs we've ever found.

Medicine to prevent malaria

Impact of malaria

Estimates of annual malaria deaths vary from about 410,000 to 640,000.9 At least 90% of the malaria deaths reported by the World Health Organization (WHO) for 2019 were in sub-Saharan Africa, and children under five years old accounted for about two-thirds of malaria deaths globally.10

Presuming the proportion of children dying from malaria is approximately constant across countries, then about 60% of total malaria deaths were children under 5 years old in sub-Saharan Africa (90% of total malaria deaths in sub-Saharan Africa multiplied by 67% of total malaria deaths occurring in children under five).

Cost of providing medicine to prevent malaria

We estimate that seasonal malaria chemoprevention delivered by Malaria Consortium costs $6.59 per child.

Nets to prevent malaria

Cost of providing nets

We estimate that nets delivered by Against Malaria Foundation cost $4.95 each.

Supplements to prevent vitamin A deficiency

Impact of vitamin A deficiency

The Institute for Health Metrics and Evaluation's Global Burden of Disease project estimates that vitamin A deficiency increases the risk of diarrhea, measles, and lower respiratory tract infections.11 In 2017, an estimated 233,000 global deaths were linked to this increased risk.12

Cost of providing vitamin A supplementation

We estimate that vitamin A supplementation delivered by Helen Keller International costs $1.10 per child.

Cash incentives for routine childhood vaccines

Impact of vaccine-preventable diseases

Worldwide, at least 15% infants did not receive all recommended childhood vaccines.13 In Nigeria, where New Incentives operates, 43% of infants did not receive all recommended vaccines.14

Cost of providing vaccine incentives

We estimate that, on average, the total cost to immunize one child through New Incentives' program is $47.

Treatments for parasitic worm infections (deworming)

Impact of parasitic worms

Many types of parasitic worms infect human beings, causing illnesses including schistosomiasis and soil-transmitted helminthiasis. Hundreds of millions of people have these infections.15

Cost of deworming

The median cost per person dewormed per year by our four deworming top charities as of 2019 is $0.97; thus, $100 would cover deworming efforts for approximately 100 children.

Impact of deworming

Some studies indicate that reducing worm infection loads during childhood can have a significant later impact on income during adulthood. There is a possibility that deworming children has a subtle, lasting impact on their development and thus on their ability to be productive and successful throughout life. However, there is less research on the developmental impacts of deworming than on the interventions of our other top charities, so we are more uncertain about it. Our estimate of the impact of deworming—a cumulative $1,076 in additional earnings over the course of 100 children's lives—accounts for this uncertainty.

Income of those receiving deworming treatment

Our four top deworming charities work in the following countries: India, Kenya, Pakistan, Nigeria, Ethiopia, Malawi, Mozambique, Democratic Republic of Congo, Madagascar, Tanzania, Côte d'Ivoire, Zambia, Liberia, Guinea, Guinea-Bissau, Cameroon, Angola, Rwanda, and Zimbabwe.16 According to the World Bank's PovcalNet data, the median per capita consumption per year across the geographic areas supported by our four top deworming charities is $706.

Cash transfers for extreme poverty

Global incomes

According to Our World in Data’s analysis of the World Bank’s PovcalNet data, about 62% of the world’s population in 2017 had per capita consumption of $10 per day or less ($3,650 per year or less).17

Efficiency of GiveDirectly

Cash grants make up 83% of GiveDirectly’s all-time expenses.

Sources

Document Source
GBD 2017 Risk Factor Collaborators, 2018 Source (archive)
GiveWell's non-verbatim summary of a conversation with the Institute for Health Metrics and Evaluation, April 5, 2019 Source
Institute for Health Metrics and Evaluation, Global Burden of Disease, GBD Compare, Global malaria deaths Source (archive)
Institute for Health Metrics and Evaluation, Global Burden of Disease, GBD Results tool, Global parasitic worm infection prevalence Source (archive)
Ochomo et al. 2013 Source
Our World in Data, Global vaccination coverage, Nigeria, 2019 Source (archive)
Our World in Data, Global vaccination coverage, World, 2019 Source (archive)
Rosen and Ortiz-Ospina, 2019 Source (archive)
UNICEF, "Immunization," 2020 Source (archive)
United Nations Development Programme, "About sub-Saharan Africa" Source (archive)
WHO, World Malaria Report 2020 Source (archive)