2008-2009 update to 2007-2008 report on PIH
All of the content following this section comes from our 2007-2008 report on developing-world aid, which was published on 12/6/2007.
We intend to complete a full update on Partners in Health as part of our 2008-2009 report. In the meantime, we have conducted a preliminary scan of its publicly available information. As of 3/2/2009, we still endorse Partners in Health as one of the top international aid charities we have seen. We offer the following comments as updates on the 2007-2008 content.
Update on PIH's transparency: In 2007-2008, we recommended PIH for its straightforward, well-documented approach rather than for its transparency. Most of our information came from a document that has not been cleared by the funder for public release. We are still not able to locate this document in the public domain. We would like to see more detailed information about PIH's activities and outcomes.
Update on PIH's activities: based on page 32 of PIH's 2008 annual report (PDF), we believe that PIH's health programs in Haiti and Africa remain its largest and most rapidly expanding programs. Programs in Africa, in particular, appear to have grown their share of PIH's overall expenses. As these are the programs we focus on in our review, we feel that our review is still broadly representative of PIH's activities as a whole.
Update on PIH's effectiveness and cost-effectiveness: PIH still does not appear to publish information on how it monitors the quality of its care and its impact on patients. We urge caution in interpreting our cost-effectiveness estimate, as it involves many assumptions, but we do not wish to revise this estimate numerically.
Review of PIH: Summary from (2007-2008 report)
What they do: the PIH model is a combination of clinic-based care (hospitals and health centers) and community-based care (home visits and prevention campaigns) aiming to bring quality health care to extremely poor rural areas.
Does it work? PIH's model is straightforward, logical, and well-documented. We would bet that PIH significantly improves health care for regions with many health problems, and therefore saves lives.
What do you get for your dollar? Focusing on PIH's Rwanda program (the one we know the most about), our rough estimate has it saving lives for something in the neighborhood of $3500 each. As a health clinic PIH also provides many services that improve quality of life even if they don't save lives, though it is difficult for us to compare PIH to our other applicants on these terms (as our other applicants also provide additional benefits). More on the goal of this cause, and the terms of comparison, is here.
Where they rank: the other programs we've examined from our finalists appear more "cost-effective" to us, in terms of the cost per person saved from death (or extreme debilitation). That said, we have relatively high confidence in PIH as a whole (not just a single project); this, along with the concreteness and comprehensiveness of its model, makes us prefer it to all of our finalists other than PSI.