Note: This page summarizes the rationale behind a GiveWell-recommended grant to Results for Development. Results for Development staff reviewed this page prior to publication.
Summary
In December 2022, GiveWell made a $1,006,445 grant to Results for Development (R4D). The grant was funded by unrestricted donations that had been re-designated by the GiveWell board for granting. R4D expects to use this funding to support an 18-month phase out period for the project. GiveWell previously recommended phase 1 and phase 2 grants for the program.
We recommended this grant in order to give R4D more time to assist the government of Tanzania in transitioning from external funding for amoxicillin dispersible tablets (amox DT), a pediatric pneumonia treatment. Progress in making this transition had been delayed by the Covid-19 pandemic and changes in the political landscape in Tanzania.
Published: January 2023
Table of Contents
Planned activities and budget
The grant will primarily fund R4D staff salaries as they continue to support the government of Tanzania:1
- $0.73 million for staff based in Tanzania
- $0.12 million for US-based staff
- $0.16 million for other costs
The case for the grant
Phase 2 of R4D’s program was initially planned to conclude with transition of financial and procurement activities for amox DT from R4D to the government in 2023. In 2021, R4D told us that, due to disruptions caused by the Covid-19 pandemic and changes in the political landscape in Tanzania, it expected to need additional funding beyond phase 2 of the program (2019-2023). Additional funding would be used to reach a point where it could be more confident that government systems would be ready to step in once it ceased providing funding for purchases of amox DT.
At our request, R4D provided several phase out plans with higher costs and more confidence in a successful transition and lower costs and lower confidence. We opted for an option that enables an 18-month phase out period (latter half of 2023 until the end of 2024), or about two years since we started discussing phase out plans with R4D. This is in line with what we aim for with top charities and other grant recipients: two years of funding runway at the time we tell the grantee that we do not plan to renew funding for the program.
We have aimed for two years of funding runway because, in our experience, grant recipients believe this is a reasonable timeframe for planning a smooth transition. Our guess is that this length of funding runway enables us to maintain strong relationships with partners and for those partners to maintain strong relationships with the governments they support and others they work with.
We decided not to consider funding maintenance of the program (i.e. continued R4D procurement of drugs and/or R4D technical assistance to the government without a set end date). Based on our past work and how the program had evolved, we guessed that the cost-effectiveness of maintaining the program was more likely below than above our cost-effectiveness bar. We considered creating a cost-effectiveness model that would give us more clarity on this question by incorporating results from phases 1 and 2 of the program and estimating the cost-effectiveness of maintaining the program over the next few years. Ultimately, we opted to prioritize other grant investigations with either higher likely cost-effectiveness or greater potential for scale, or both.
Risks and reservations
A larger grant may have enabled R4D to have more confidence that the government of Tanzania would be in a position to ensure consistent access to pediatric pneumonia treatment in health facilities. It is possible that a smaller grant would have allowed R4D to accomplish the most critical transition activities.
Plans for follow up
As this is a phase out grant, we have limited plans for follow up. We plan to have several conversations with R4D to learn more about how efforts to set up systems to maintain access to pediatric pneumonia treatment are progressing.
Our process
We have been speaking with R4D approximately once a quarter during the project. We have followed its progress at a high level through those conversations. In 2021 and 2022, we had several conversations about a phase out period and R4D shared this document detailing some options.
Sources
- 1
Budget details were redacted from this proposal document at R4D's request; R4D staff approved the budget summary that we provide here.