Published: November 2018
- 2018 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 program
- Malaria Consortium's seasonal malaria chemoprevention program
- Schistosomiasis Control Initiative (SCI)
- Sightsavers' deworming program
- 2018 updates on standout charities
- Development Media International (DMI)
- Evidence Action's Dispensers for Safe Water
- 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
- Project Healthy Children (PHC)/Sanku
2018 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 2018 changelog. See our top charity reviews for updates on our top charities' room for more funding as of November 2018.
Against Malaria Foundation (AMF)
Between November 2017 and November 2018, AMF signed new agreements for the distribution of 26 million LLINs (which will cost AMF at least $46 million in total) in Ghana, Malawi, DRC, Guinea, and Papua New Guinea (AMF lists signed distribution agreements on its website here).
In 2017, AMF funded distributions costing $48 million in four countries which it had not previously supported (Uganda, Papua New Guinea, Togo, and Zambia). We originally expected to see post-distribution surveys from these new countries in 2018, but due to the timing of some of these distributions, a shift in AMF's process from conducting its first survey six months after the distribution to nine months after the distribution, as well as some delays in sharing information with us, we have not yet seen survey results from any of the 2017 distributions (as of November 2018).
We continued to be concerned in 2018 that AMF was limited by lack of staff capacity. AMF increased its staff since 2016, but has remained a very small organization with seven main team members. We believe constraints in staff capacity contributed to several cases in 2018 in which AMF did not share information or was delayed in sharing information that we requested.
GiveWell commissioned an ongoing project with IDinsight to better understand the survey methods AMF has used in several countries and to provide suggestions for how AMF might improve its monitoring processes. IDinsight shared its report with recommendations for the implementation of AMF's post-distribution monitoring in April 2018 (available here). We do not yet know whether or how AMF will adopt these recommendations.
The END Fund's deworming program
In 2018, the END Fund sent us additional coverage surveys, which monitor what proportion of targeted children were reached by deworming programs. At the end of 2017, we had seen such coverage surveys from 35 percent of the END Fund's deworming portfolio. As of November 2018, we had seen surveys from 69 percent of the END Fund's deworming portfolio. We believe that these surveys are of more variable quality than the monitoring we have seen from the other top charities that work on deworming.
Evidence Action's Deworm the World Initiative
Deworm the World has worked for several years in India and Kenya and more recently expanded to Nigeria (starting in 2016). In India and Kenya, Deworm the World's monitoring processes have included both visiting schools on the day deworming is scheduled to record whether deworming is happening and whether key procedures are followed, as well as visiting a different sample of schools a short time after deworming day to interview teachers and students about whether deworming occurred. We learned this year that in Nigeria, Deworm the World has conducted day-of monitoring but has not conducted post-deworming day monitoring. Deworm the World told us that it expects to conduct post-deworming day monitoring in Nigeria in future years.
Deworm the World reports that work to help start a deworming program in Pakistan is on track. The first deworming treatments may be delivered in late 2018 or in early 2019.
GiveDirectly grew substantially in 2018. It spent $29 million in 2017 and expected to spend $74 million in 2018. It scaled-up a project to provide cash transfers to refugees and the communities that host them in Uganda (our brief summary here) and released early results on its blog here. It secured matching funding commitments to expand to three new countries, Liberia, Malawi and DRC, as part of projects to partner with a major funder to benchmark its grant-making against cash transfers.
Helen Keller International (HKI)'s vitamin A supplementation program
We added HKI to our list of top charities in November 2017. In 2018, with funding received as a result of our recommendation, HKI supported vitamin A supplementation (VAS) mass distribution campaigns in Guinea, Mali, Burkina Faso, and Côte d'Ivoire.
HKI conducts door-to-door surveys following VAS mass distribution campaigns to estimate what percentage of the program's targeted population (preschool-aged children) received vitamin A supplements. We received results from coverage surveys in three of the four countries HKI supported; the surveys found moderately positive results. We have not yet seen full reports on the methodologies of these coverage surveys (as of November 2018).
Malaria Consortium's seasonal malaria chemoprevention program
On GiveWell's recommendation, Good Ventures made a grant of $27.9 million to Malaria Consortium's seasonal malaria chemoprevention program in December 2017. With the end of its large grant from UNITAID for SMC in 2017, Malaria Consortium is using these funds, and other GiveWell-directed funding, to maintain SMC programs in Burkina Faso, Chad, and Nigeria in 2018 and 2019.
We learned more about the quality of the data that Malaria Consortium collects to monitor the effectiveness of its SMC programs in 2018. We now have more confidence in the results of its coverage surveys, which monitor what proportion of targeted children were reached with SMC, in part because the surveys conducted monthly after each SMC cycle and those conducted at the end of the 4-month round of SMC found consistent results.
Schistosomiasis Control Initiative (SCI)
We are not aware of major changes to SCI's programs in 2018.
As in the past, SCI shared monitoring of deworming coverage levels for a portion of its programs with us; there continue to be several SCI-supported countries for which we have not seen monitoring results.
We noted last year that we had some concerns about SCI's plans to allocate all available funding to its 2017-2018 budget year and not hold a portion of this funding to ensure programs could be sustained in the next budget year. SCI has since changed its strategy and is holding more funding for sustaining programs than it has in the past.
Sightsavers' deworming program
Before this year, we had only seen limited monitoring from Sightsavers' past work on deworming programs. We have now seen coverage surveys, used to determine whether its programs have reached a large proportion of children targeted, covering 80% of the work that it has conducted with GiveWell-directed funds to date. These studies have generally found positive results.
2018 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 for which we have less confidence in their impact than we do for our top charities.
We’ve added one organization to the standout list in 2018: Georgetown University Initiative on Innovation, Development, and Evaluation (gui2de)'s Zusha! Road Safety Campaign.
We don’t follow standout organizations 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 is conducting an RCT of its family planning radio campaign in Burkina Faso, which is scheduled to conclude in December 2018. It is planning work on early childhood development in Burkina Faso and child survival in Mozambique.
In March 2018, the Lancet published results from the RCT of the child survival radio campaign that DMI conducted in Burkina Faso in 2012-2015. In July 2018, the British Medical Journal published two follow-up papers on this RCT: a model of the effect of DMI's program on child mortality using diagnostic data from health centers and a cost-effectiveness study.
It is our understanding that DMI will be constrained by funding in 2019.
Notes from our 2018 conversation with DMI are here.
Evidence Action's Dispensers for Safe Water
In 2017 and 2018, Dispensers for Safe Water (DSW) prioritized maintaining its existing dispensers and maintaining high adoption rates (i.e., the proportion of households in communities with a DSW chlorine dispenser that use it to chlorinate their water). DSW estimated in 2018 that its dispensers reach approximately four million people.
DSW told us in 2018 that it expects to be constrained by funding over the next few years.
Notes from our 2018 conversation with DSW are here.
Food Fortification Initiative (FFI)
In 2017 and 2018, FFI continued its work providing technical assistance for food fortification programs in the state of Haryana in India, the Solomon Islands, Mongolia, and Malaysia. It also organized stakeholders for three technical workshops in Africa.
FFI told us that it could scale-up its technical assistance work if it had additional funding.
Notes from our 2018 conversation with FFI are here.
Georgetown University Initiative on Innovation, Development, and Evaluation (gui2de)—Zusha! Road Safety Campaign
Road accidents are a leading cause of death and injury globally, and the problem is particularly pronounced in low- and middle-income countries. Zusha! is a campaign intended to reduce road accidents—it supports distribution of stickers to public service vehicles encouraging passengers to speak up and urge drivers to drive more safely. There is reasonably strong evidence from two randomized controlled trials (RCTs) conducted in Kenya that Zusha! decreases road accidents. However, our best guess of Zusha!'s effectiveness is lower than the estimated effects from the RCTs. Our analysis suggests that Zusha!'s cost-effectiveness is in a similar range of cost-effectiveness as unconditional cash transfer programs. Our review of Zusha! is here.
The Global Alliance for Improved Nutrition (GAIN)—Universal Salt Iodization (USI) program
GAIN's recent USI work has included research (e.g., co-designing a study measuring the impact of iodized salt on iodine status for pregnant women and infants), engagement in salt iodization policy at the regional level in East Africa (mostly supported with GiveWell-directed funding), and projects in Mozambique, Tanzania, Ethiopia, Nigeria, and Bangladesh.
GAIN has told us that it could provide additional support for salt iodization in Nigeria, Egypt, and India if it had additional funding.
Notes from our 2018 conversation with GAIN are here.
Iodine Global Network (IGN)
IGN's recent work has focused on international coordination work (e.g., facilitating a review of the feasibility of salt double-fortified with iodine and iron) and technical assistance for salt iodization in Tanzania, Mozambique, Sudan, Angola, Burundi, China, North Korea, Israel, Lebanon, and Madagascar.
IGN told us that it could use additional funding to increase its support for its current countries of operation and for expansion to new countries.
Notes from our 2018 conversation with IGN are here.
Living Goods has scaled-up its core work supporting community health workers (CHWs) who sell health and household goods door-to-door in Uganda and Kenya; in 2018, it expected its programs to reach eight million people in the two countries, compared to six million in 2017. Living Goods has also increased its focus on advocacy efforts in Uganda and Kenya, increased its support of nutrition-related services, expanded the number of family planning products it offers, and plans to begin distributing HIV self-testing products.
Living Goods is scaling up its program and could scale up more quickly with additional funding.
Notes from our 2018 conversation with Living Goods are here.
Project Healthy Children (PHC)/Sanku
PHC has recently focused on scaling up its Sanku project, which equips small millers with a machine that enables them to fortify their flour with micronutrients; we have not done as much formal analysis of Sanku as of PHC's earlier work on advocacy and technical assistance to countries to implement fortification. Most of its work on Sanku to date has been in Tanzania.
PHC/Sanku expects to be constrained by funding in the future.
Notes from our 2018 conversation with PHC/Sanku are here.