People living in the poorest parts of the world often lack basic, cheap things that could help them a great deal. For example, they may suffer from infectious diseases that could be treated or prevented relatively straightforwardly, if the funding were available.
Helping people in the United States usually involves tackling extremely complex, poorly understood problems. Many popular approaches simply don't work. (See some examples we've identified here.) Many more approaches have simply never been investigated, beyond stories and anecdotes. (More here.)
The table below compares one of our top charities to two of the most promising U.S.-focused charities we have investigated.1
Cause | Organization | Cost | Impact |
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Global health | Malaria Consortium (seasonal malaria chemoprevention program) | $3,000-$5,000 per life saved (including transportation, administration, etc.) 2 | Improve health, save lives |
Early childhood care and education (U.S.) | Nurse-Family Partnership | $15,000 per child served3 | Increase academic performance and reduce criminal behavior |
US Education | KIPP | $9,000-$20,000 per student per year (including state funds)4 | Improve academic performance |
This is not to say that aid in low- and middle-income countries is easy or simple. Some activities are highly proven and cost-effective; others have very poor track records. As in the U.S., generating evidence of impact (not just stories) is essential. We publish what we've learned.
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- 1.
The full list of U.S. charities we have considered is here.
- 2.
Our estimate of the cost to save a life is based on our cost-effectiveness model.
You can read more about our approach to estimating cost-effectiveness and its role in our decisions about what to fund and recommend to donors here. Explicit cost-effectiveness estimates are a major, but not the only, input into our decision-making process. More on the principles we use in decision-making here.
We present cost-effectiveness estimates as a range rounded to the nearest thousand dollars on our Top Charities page. This reflects the degree of precision we believe our model can estimate, as well as the range of cost-effectiveness that charities are likely to achieve across the countries they work in. Charities' cost-effectiveness can vary widely by geography, depending on the underlying burden of disease and the costs of operating in a given country. GiveWell: Sources for Top Charities page
- 3.
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- On our 2010 page on Nurse-Family Partnership (NFP)'s program, we cite two estimates of the cost per child/family served:
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- $10,800, according to information from the NFP National Service Office.
- $11,200, according to the Coalition for Evidence-Based Policy.
- In November 2019, we searched for updated estimates of the cost per child/family of NFP's program. Our process:
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- Searching for "Nurse-Family Partnership" on the Social Programs That Work website and on the Campbell Collaboration website.
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- We identified these as helpful sources for critical discussions of program evaluations on our 2010 page on criteria for evaluating U.S. programs.
- We also searched for "Nurse-Family Partnership" in the Washington State Institute for Public Policy (WSIPP)'s database of benefit-cost analyses. We searched WSIPP based on our impression that its work is highly regarded. (This post from Pew Charitable Trusts informed our impression.)
- Searching NFP's website for cost per participant information.
- Searching for "Nurse-Family Partnership" on the Social Programs That Work website and on the Campbell Collaboration website.
- On this spreadsheet, we calculate three updated cost per participant estimates for NFP (all in 2019 USD):
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- $15,344, based on information from WSIPP. This estimate relies on information NFP reported to WSIPP as of January 2017:
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- "The annual per-participant cost estimate is based on average total cost per family in Washington State, provided by Siobhan Mahorter at the Nurse Family Partnership National Service Office, January 2017." WSIPP NFP benefit-cost analysis 2019
- $14,682, based on information from Social Programs That Work.
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- We have not seen the full details of Social Programs That Work's calculation. Our best guess is Social Programs That Work used cost information reported in papers of randomized controlled trials of NFP's program and adjusted the figures for inflation. From Social Programs That Work’s Evidence Summary for the Nurse Family Partnership:
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- “This summary of the evidence on NFP is based on a systematic search of the literature and
correspondence with leading researchers to identify all well-designed and implemented RCTs of NFP.” Pg 2. - “IV. Summary of the Program’s Benefits and Costs… All monetary amounts shown are in 2017 dollars.” Pg 13.
- “This summary of the evidence on NFP is based on a systematic search of the literature and
- We have not seen the full details of Social Programs That Work's calculation. Our best guess is Social Programs That Work used cost information reported in papers of randomized controlled trials of NFP's program and adjusted the figures for inflation. From Social Programs That Work’s Evidence Summary for the Nurse Family Partnership:
- $12,624, adjusting our 2010 estimate of $10,800 for inflation.
- $15,344, based on information from WSIPP. This estimate relies on information NFP reported to WSIPP as of January 2017:
- We did not find additional information on costs per participant in our searches of Campbell Collaboration or NFP's website.
- We primarily rely on WSIPP's estimate in the table above. It appears that WSIPP's estimate, using information sourced in 2017, is the most up-to-date source of information we have seen.
- One limitation of WSIPP's cost estimate is that it is based on the average cost of Nurse-Family Partnership in Washington State. (See spreadsheet linked above for more details.) We are uncertain whether costs in Washington are above or below Nurse-Family Partnership's average costs at a national level.
- On our 2010 page on Nurse-Family Partnership (NFP)'s program, we cite two estimates of the cost per child/family served:
- 4.
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- On our 2011 page on KIPP, we reported that KIPP's costs per student per year ranged from $7,500 to $17,000.
- In November 2019, we searched for updated information on KIPP's costs per student per year. Our process:
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- Searching for "KIPP" on the Social Programs that Work website and on the Campbell Collaboration website.
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- We identified these as helpful sources for critical discussions of program evaluations on our 2010 page on criteria for evaluating U.S. programs.
- We also searched for "KIPP" in the Washington State Institute for Public Policy (WSIPP)'s database of benefit-cost analyses. We searched WSIPP based on our impression that its work is highly regarded. (This post from Pew Charitable Trusts informed our impression.)
- Searching KIPP's website for cost per student information.
- Searching Google for "KIPP cost per student."
- Searching for "KIPP" on the Social Programs that Work website and on the Campbell Collaboration website.
- On this spreadsheet, we adjust our 2010 cost per student estimates for inflation: in 2019 USD, cost per student ranges from $9,000 to $20,000.
- Social Programs That Work reports that KIPP estimated its overall cost per student per year at $12,665 as of 2016, or $13,451 in 2019 USD. (See spreadsheet linked above for details.)
- Through our Google search for "KIPP cost per student" we also found cost per student estimates from the 2016-2017 school year for several KIPP schools listed on this spreadsheet (sourced from the website Public School Review). These spending per student estimates cover a broader range than our inflation-adjusted estimate: ~$4,000 to ~$57,000 per student per year.
- We have not vetted the information from Public School Review and we are uncertain what types of costs are included in its estimates, so we have reported our inflation-adjusted estimate of $9,000 to $20,000 per student per year in the table above. KIPP's estimate reported by Social Programs That Work (~$13,000) is roughly in the middle of this range.
- We did not find additional cost per student information in our searches of the WSIPP or Campbell Collaboration websites.