The GiveWell Blog

More than a Spoonful of Medicine

| by GiveWell Staff

What does it take to prevent malaria? Some of the programs GiveWell recommends might sound straightforward—for example, seasonal malaria chemoprevention (SMC) programs provide antimalarial drugs to young children—but the process of accomplishing this is not simple at all.

Below, we offer a post from Malaria Consortium that describes the many complex steps required to carry out an SMC campaign. See our reports for more information about the evidence for SMC and about Malaria Consortium’s SMC program.

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Some Things We’re Reading

(updated on: ) | by GiveWell Staff

Today we’re sharing a few quotes from pieces we’ve come across recently in our work—claims have not been vetted, and (of course) interest is not endorsement.

  • “The story of Ethiopian manufacturing—its rise, its faltering, and its potential for renewal—is an example, I believe, of where a little more empathy can lead to better economics.” (Oliver Kim, Global Developments)
  • “Every year, tuberculosis kills over a million people. Can a new vaccine turn the tide? For the last 100 years, we’ve only had one TB vaccine—and it leaves a lot to be desired.” (Jess Craig, Future Perfect)

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100 Miles of Monitoring

(updated on: ) | by GiveWell Staff

We’re crossposting a blog post by New Incentives, one of our grantee organizations and Top Charities. New Incentives promotes vaccination in Northern Nigeria by providing cash incentives to parents and caregivers. Recently, one of New Incentives’ field officers wrote about his experience collecting program data.

GiveWell asks all of our Top Charities to share detailed monitoring information, which we review to assess the quality of program implementation and the number of children reached. We also use this data as part of our cost-effectiveness analyses, which are the basis of our funding decisions.

We’re sharing this post to provide a firsthand account of how that monitoring data is collected. We recognize that individual stories about a program can be misleading, as they can often highlight the best examples rather than typical cases. Still, we hope Sanusi’s experience opens one small window into the efforts our Top Charities take to ensure high-quality implementation.

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Research Strategy: Water

(updated on: ) | by Erin Crossett

Water is a relatively new area of grantmaking for GiveWell, but we’re excited about its potential. Two billion people around the world lack access to clean drinking water, and unclean water is a major cause of illness and death, primarily through waterborne diseases such as diarrhea and cholera.

Within the water portfolio, we think about which specific programs in which specific places are likely to address these health burdens most cost-effectively, and what additional evidence we need to gather in order to make that determination.

In this blog post, we detail our current approach to our water portfolio, explore the areas we’re excited to investigate next, and share the work we’re doing this year to deepen our understanding of the sector. Through this work, we aim to make more highly cost-effective grants that bring clean water to many more people around the world.

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The fungibility question: How does GiveWell’s funding affect other funders?

| by Jeremy Rehwaldt

How do GiveWell’s funding decisions influence the actions of governments, funders, and other organizations? Answering this question is an important part of figuring out which global health programs are most cost-effective and thus which we should support. We’ve already written about two key factors in our cost-effectiveness estimates: the cost per person reached and the overall burden. But those are only part of the equation.

We also consider what others are likely to do in response to our choices. For example, does our funding displace money the local government had planned to allocate to the program? Or would our funding make other funders more excited to join us in making sure the program is implemented?

Wedding registries provide a loose analogy about how one person’s decision might influence another’s: If someone already bought the toaster on the list, you’re probably not going to buy the lucky couple another one. The money that great-aunt Sally spent on the toaster has displaced the funding you had planned to allocate to the toaster: this is what we call “fungibility.”

In contrast, if the spouses-to-be have signed up for flatware service for 12 and only 6 settings have been purchased, you might prioritize filling out the remainder of the set, to be sure that the couple doesn’t run out of spoons at their upcoming dinner parties. In that case, the guests who purchased the first 6 settings can “crowd in” funding from other guests: this is what we call “leverage.”

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Increasing impact by combining programs

(updated on: ) | by Jeremy Rehwaldt

The idea has obvious intuitive appeal: If you’re already sending community healthcare workers door-to-door in (say) remote parts of Sierra Leone to deliver routine childhood vaccines, why not have those healthcare workers deliver chlorine for disinfecting drinking water, or oral rehydration solution for treating dehydration from diarrhea?

After all, if you’re already spending money on the fixed costs of delivery, why not provide other programs at the same time? You’d be able to amortize the costs across multiple goods and offer additional benefits to the community. (If you’re getting groceries delivered, it’s more efficient to have one driver deliver your eggs and milk and vegetables all together than to have separate drivers going round delivering each one separately.)

GiveWell is very interested in these “layered interventions,” and we are excited to support them wherever they cross our cost-effectiveness threshold. But we’ve discovered it’s harder than you might think to find ways to combine programs effectively.

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