Published: March 2021
Note: This page summarizes the rationale behind a GiveWell Incubation Grant to Vital Strategies. Vital Strategies staff reviewed this page prior to publication.
Summary
In January 2021, Vital Strategies received a GiveWell Incubation Grant of $100,000 to support its work convening a consortium of organizations to develop a $5-10 million proposal to work on advocacy and technical assistance for alcohol policy in low- and middle-income countries. Vital Strategies plans to use part of this funding to engage a consultant to help it develop the proposal, and to allocate the remaining funding among other members of the consortium.
Table of Contents
The intervention
GiveWell has been exploring potentially promising giving opportunities within public health regulation.1 As part of this work, we've identified alcohol policy as an area with a large disease burden that may have cost-effective regulatory solutions.
There is a broad evidence base to support a set of interventions targeting the adverse health and social impacts of alcohol consumption, including alcohol taxes, restricting alcohol marketing, restricting alcohol availability, and policies to reduce drunk driving.2 We have not yet reviewed that evidence base in depth.
Institute for Health Metrics and Evaluation (IHME) estimates that the number of deaths caused by alcohol is 27% as large as the number caused by tobacco in low-, lower-middle-, and upper-middle-income countries.3 However, alcohol policy currently receives little philanthropic attention (we estimate less than $5 million annually;4 for comparison, IHME estimates that tobacco control received between $60 and $90 million in funding each year from 2015 to 2019).5
The organization
We think Vital Strategies is well-positioned to lead this consortium for several reasons:
- Vital Strategies has played a similar role in noncommunicable disease and injury prevention programs funded by Bloomberg Philanthropies.6
- Vital Strategies appears to be well-networked with other organizations working on alcohol control.7
- We have a positive impression of Vital Strategies, based in part on conversations we've had with Bloomberg Philanthropies (Vital Strategies' major funder).8
Plans for follow-up
Once we see the consortium's proposal, we plan to investigate whether to recommend further funding to support the work in the proposal.
Internal forecasts
For this grant, we are recording the following forecast:
| Confidence | Prediction | By time |
|---|---|---|
| 80% | We make a grant of over $1 million to Vital Strategies | End of 2021 |
Sources
- 1
See the "Prioritizing within public health regulation" section of this blog post.
- 2
See, for instance, the World Health Organization (WHO)'s SAFER alcohol control initiative, which aims to:
- "Strengthen restrictions on alcohol availability.
- Advance and enforce drink driving countermeasures.
- Facilitate access to screening, brief interventions, and treatment.
- Enforce bans or comprehensive restrictions on alcohol advertising, sponsorship, and promotion.
- Raise prices on alcohol through excise taxes and pricing policies."
Our high level view that at least some of these policies have a strong evidence base was informed by (i) Alcohol: No Ordinary Commodity (Babor et al. 2010), and (ii) David Roodman's replication review of the evidence base for alcohol taxes (Roodman 2015).
- 3
According to IHME data, alcohol use was responsible for 1.9 million deaths in low-, lower-middle-, and upper-middle-income countries in 2019; see IHME, Global Burden of Disease, GBD Results Tool, Alcohol use risk, deaths, low-, lower-middle, and upper-middle-income countries, 2019 (accessed March 5, 2021). Tobacco was responsible for 6.9 million deaths in low-, lower-middle, and upper-middle-income countries in 2019; see IHME, Global Burden of Disease, GBD Results Tool, Tobacco use risk, deaths, low-, lower-middle-, and upper-middle-income countries, 2019 (accessed March 5, 2021).
- 4
We base this estimate on conversations with experts. See, for instance:
- "Ahead of the call, Ms. Sperkova sent GiveWell an interconnected map of
organizations involved with alcohol control: https://files.givewell.org/files/DWDA%202009/Interventions/Alcohol_poli…."GiveWell's non-verbatim summary of a conversation with Kristina Sperkova, April 4, 2019, p. 1. The map includes estimates of annual budgets for the main organizations involved.
- GiveWell's non-verbatim summary of a conversation with Øystein Bakke, March 21, 2019
We also guess that there may be some additional funding from smaller sources not discussed in those conversations.
- "Ahead of the call, Ms. Sperkova sent GiveWell an interconnected map of
- 5
See IHME, Viz Hub, Flows of global health financing, 2019 (accessed March 4, 2021). The slider at the bottom of the page can be used to view funding in different years, while the dropdown menu in the upper right can be used to select data on tobacco only.
- 6
- "Vital Strategies is an implementing partner of the Bloomberg Philanthropies Initiative for Global Road Safety, a consortium carrying out proven road safety interventions in 10 cities and five countries around the world with a total investment of $259 million from Bloomberg Philanthropies…. our coordination team serves as the main liaison with the mayors’ offices, which involves: coordinating initiative partners; building institutional capacity and coordination mechanisms among city agencies; administering grants; building sustainability by developing long-term road safety strategies and institutionalizing best practices; and co-managing over 70 consultants embedded in government offices in the 10 cities, working on infrastructure, enforcement, communication and surveillance." Vital Strategies, Capability statement 2019, p. 20
- "Program: Tobacco Control…. Funder: Bloomberg Philanthropies…. In the 11 low- and middle-income countries with the largest populations and the highest rates of smoking, we design strategic tobacco control plans in partnership with WHO, the CDC, the World Bank and others." Vital Strategies, Capability statement 2019, p. 21
- "Based in part on the experience and success of the Bloomberg Initiative to Reduce Tobacco Use, Vital Strategies believes there are a number of key components for successful public health policy reform that could be useful for guiding work on alcohol policy. For country-level policy change, these components include:
- Technical assistance to Ministries of Health and Finance on the implementation of tax policy, marketing restrictions, availability regulation, drink driving prevention, and clinical services.
- Strengthening of civil society organizations to increase advocacy for governments to make the necessary reforms.
- Public communications focused on both a) framing the issue as a public health issue in order to increase the likelihood of policy action by governments, and b) engaging in strategic advocacy and communication to cause policy and behavior change.
- Strong data monitoring data to document progress."
GiveWell's non-verbatim summary of a conversation with Vital Strategies, May 22, 2019, p. 3
- 7
This impression is based on several conversations with Vital Strategies and other groups, for which we do not have published notes.
- 8
We do not plan to publish notes from these conversations.