# Why Is It So Expensive to Save Lives?

Note added July 2022: The content of this page is based on impact estimates we produced in 2021. Some of the figures listed on this page may not exactly match those in the updated impact estimates we calculated in 2022. While some details about the specific example grant described below may no longer be completely accurate, the general ideas presented on this page remain true.

Published: December 2021; Last updated: September 2022

Our recommended charities produce outcomes that help save lives. These charities are the most cost-effective programs we’ve found at saving lives.

Because the initial outputs of these charities are so inexpensive (for example, it costs about \$5 to purchase and deliver an insecticide-treated net), many people are surprised at how expensive it is to save a life—about \$4,500 on average for funding we directed in 2020.1

We hope that this 2020 example helps illustrate the discrepancy in cost between the initial outputs and the cost to save a life. This example does not reflect what we estimate this program's cost to save a life will be in the future. We generally expect the cost to save a life to increase over time.

### The cost to save a life for one grant

Below we’ll explain our 2020 estimate for how \$4,500 could save a life in Guinea by funding a net distribution through the Against Malaria Foundation. These numbers are based on a \$7.2 million grant to AMF we funded in 2020. We estimate this grant will provide 1.6 million nets and save about 1,700 lives. We chose Guinea for this example because the cost-effectiveness of nets distributed there was close to the average cost-effectiveness of nets AMF distributed with grants from GiveWell’s Top Charities Fund (we updated the name of this fund in September 2022, more information here) and grants from Open Philanthropy in 2020.2

### What \$4,500 accomplished with AMF in Guinea3

Metric Explanation
Step One: 1,001
nets delivered
The cost of purchasing and delivering each net is about \$4.50,4 so \$4,500 in donations can purchase about 1,001 nets.5
Step Two: 795
nets are in use
Evidence suggests that not all purchased nets are actually put to use. Based on this evidence, we estimate that about 79% of delivered nets are used in practice. So about 795 are actually in use as a result of this donation.6
Step Three: 1,431
people are protected by nets
Nets are often used to cover multiple people. On average, each net covers 1.8 people, implying that 795 nets in use protect 1,431 people.7
Step Four: 12
of those people are expected to die every year of any cause
In order to estimate how many lives these nets might save, we first need to know how many people in this population would have died without the protection of the nets. The mortality rates and population demographics in Guinea suggest that about twelve out of 1,431 people would have died per year of any cause (including malaria).8
Step Five: 1.3
lives are saved by the net distribution
Based on the results of academic studies on the effectiveness of insecticide-treated nets, we estimate that this net distribution will reduce the number of deaths each year within this population from 12 to about 11.4. We multiply 0.6 deaths averted per year by 2.1, the average number of years nets provide coverage. In our initial estimate, this donation will avert 1.3 deaths.9
Step Six: 1.0
life is saved by this donation once we account for its effect on other funders
Donations can affect the behavior of other funders. In this case, we expect that this \$4,500 donation will cause other funders to shift some amount of their giving from net distributions to other programs. We account for that to give a true estimate of impact. Once we adjust for the impact of that reduced funding, we estimate that this donation will save one life.10 You can read more about how we account for the behavior of other funders here.