The disaster in Haiti - and the media coverage of it - pull at the emotions in a way that everyday suffering in the developing world does not. However, our rough calculations suggest that in fact, a donor can have a bigger impact for less money by funding top charities’ everyday activities to reduce unnecessary death and debilitation.

We estimate a “generous” cost-effectiveness figure for a donation to Haiti is by considering (a) the total amount given and (b) the total number of people affected by the disaster.

Total amount given: It’s hard to find definitive figures for the amount of money already donated to the relief efforts, but ReliefWeb provides what appears to be a reasonable lower-bound (i.e., conservative) estimate. As of January 27, ReliefWeb reports that $1.2 billion had been given or pledged to Haiti relief efforts. (See document A on ReliefWeb’s Haiti Earthquake: Appeals and Funding page.) Note that its numbers clearly do not include all charities or all revenue sources: for example, it lists only $2.8 million raised by Partners in Health, whereas the Chronicle of Philanthropy’s roundup - up as of two days ago but seemingly down at this writing - lists $40 million (and also includes many charities that don’t appear at all in Reliefweb’s stats.)

Number of people affected: Haitian authorities estimated that 1 million people were left homeless by the quake (according to ABC World News) and perhaps 3 million were “affected” (according to the Guardian). For the sake of our calculuation, we’ll assume a range of 1-3 million people affected.

Expenses per person affected: using the Reliefweb number (assuming that nothing is excluded from it and that no more money is forthcoming, both assumptions that clearly understate the funds) yields a current level of $395-$1,185 pledged or donated per person affected. (For some interesting context, we’ve seen estimates that the 2004 Indian Ocean Tsunami affected 2,000,000 people and donors gave approximately $14 billion — funding per person of $7,000.)

We estimate that our top-rated charities save a life for approximately that amount. While it’s clearly not possible to directly compare the impact of relief efforts to the impact of saving an individual’s life, our feeling is that saving an individual’s life is likely to have a significantly larger effect on that person than the future change likely to occur in the average life of a Haitian due to the relief efforts.

Reader Evan writes:

I’ve been thinking about how best to donate to Haiti, and I reviewed some of the materials on your website and found them pretty helpful and persuasive. So thank you! But then my law firm announced that it would match donations to the Red Cross or Doctors Without Borders. Given that, I think I have to donate to one of those orgs: even if my money would probably be better spent elsewhere, it’s hard to imagine that it would be more than twice as well spent. Do you disagree?

My intuition here is different than Evan’s. My guess would be that giving to one of our top-rated charities could easily accomplish more than twice as much good as supporting the efforts of the Red Cross or Doctors Without Borders in Haiti.

This guess is largely based on two factors:

1. The large divergence in relative cost-effectiveness of different programs (which can approach a factor of 1,000, not just a factor of 2) combined with the reasonable position that disaster relief is not among the most cost-effective avenues for charitable funds.
2. A back-of-the-envelope calculation for cost-effectiveness of efforts in Haiti which puts it well below the cost-effectiveness of our top charities.

In this post, I’ll look at the first factor. I’ll post more on the second issue in a future post.

Cost-effectiveness for different approaches to helping people varies widely

The most cost-effective programs are so much more impactful per dollar than other programs that a much smaller donation to a top program will likely help significantly more people. We’re careful about our use of cost-effectiveness figures, and the Disease Control Priorities Report’s (DCP) in particular (which we think constitute “best-case” scenarios rather than what a donor can expect from his donation), but we do think they give a reasonable basic sense of the differences between different kinds of programs.

Figures 2.2 and 2.3 on pages 41-2 of the DCP report provide cost-effectiveness estimates for many common programs charities run. (These are all presented using the $/DALY metric. For more information on what this is, see our overview for interpreting the DALY metric.) Some of the most cost-effective programs are deworming programs ($3/DALY), expanding immunization coverage ($7/DALY), and bednets to prevent malaria ($11/DALY).

Some of the least cost-effective (but common among charities) programs are improved water and sanitation to prevent diarrhea ($4,185/DALY), some types of maternal and neonatal care packages ($1,060/DALY), and Antiretroviral therapy to treat HIV/AIDS ($922/DALY).

These examples are not meant to demonstrate that the less cost-effective programs are necessarily less worthy, but they do illustrate that the impact per dollar a donor can expect from his gift can easily vary by 2-3 orders of magnitude, even under assumptions that programs are essentially being carried out as intended. Of course, if some programs are poorly executed or simply ineffective, the difference can be much larger still.

With that context, when choosing which charity to support, I wouldn’t trade much confidence-in-an-organization to merely double the size of my donation.

As we’ve discussed before, with limited information we’d tentatively guess that disaster relief funds are closer to the less-cost-effective end of the range rather than the most-cost-effective end. With that in mind, I’d guess that a gift to VillageReach or Stop TB could easily accomplish more than twice as muc good as a gift supporting the Red Cross or Doctors without Borders in Haiti.

The above is very general and though relevant, not at all specific to the situation in Haiti. In a future post, I’ll post more on some specifics regarding Haiti and why I think it offers further support to the notion that donors can accomplish more good by giving to our top charities, even if they give less.

Two other small notes

There are a couple other factors that contribute (though in a relatively small way) to my conclusion here:

• It doesn’t seem appropriate to consider causing one’s company to give a donation to be equivalent to doubling one’s cost-effectiveness. The firm may have taken matching funds from a pool already allocated to charitable giving, or the partners may have given the funds to charities themselves. Even if the funds wouldn’t otherwise go to charity, the firm likely has another motive for giving, which should lead you to consider how this program differs from other embedded giving programs, which we think are of dubious additional value.
• Giving to a charity because it has demonstrated effectiveness has the additional benefit of signaling to other charities that effectiveness matters to donors. A core belief of ours at GiveWell is that rewarding charities for effectiveness in changing lives will incentivize other charities to improve their programs to compete for those donor funds. Proactive giving (i.e., trying to choose the best charity available) furthers this dynamic; passive giving (choosing from a predefined list) hampers it. It’s also quite possible that in a very direct sense telling your company that you’ve chosen to give in this way could influence them to adjust their own giving towards more considered and effective charities.

Update: see our official page on Haiti earthquake relief, which consolidates advice from us and a few other sources we have high opinions of.

Reader Brigid writes:

“I would love to hear any thoughts you have on contributions in light of the crisis in Haiti. My sense is that now of all times is when people give significantly without due diligence into a charity’s impact and that donor have more illusions than generally (i.e., My gift is going directly to a hurt Haitian). It seems inevitable the news piece several months after the event when donors are surprised/angry to learn their gifts were not used as they believed they were.

Is there any way for an average donor to help the crisis in Haiti right now? Is there a way to “capture” the generosity that these events inspire while still focusing on impact? Specifically to GiveWell: would your team consider focusing quick efforts on analyzing charities that are addressing the crisis in Haiti (i.e. would you shift your mission at this moment)? Or, would you say: despite the current crisis in Haiti, any contribution an individual donor wants to make will still impact more people if, for example, given to fighting tuberculosis through Stop TB Partnership.”

A few notes:

• Unfortunately, “disaster relief” is not an area we’ve researched. When we’ve (very briefly) looked into the cause of “disaster relief” in the past, we haven’t found substantive, well-supported, specific recommendations for where to give. More at two posts from May 2008, following the cyclone in Burma:
  • Cyclone Relief: Recommendation and Questions
  • Emergency Assistance for Donors
• According to the Disease Control Priorities Project, emergency aid is one of the worst uses of donations, despite being one of the most emotionally compelling. For more, see our post on the cost-effectiveness of disaster-focused aid.
• Our intuition then, as it is now, is that the most effective way to help those in need is to give to effective organizations. A few of our recommended organizations have a presence in Haiti:
  • The Stop TB Partnership provides tuberculosis drugs in Haiti.
  • Population Services International has worked in Haiti since 1989.
  • Partners in Health’s flagship clinic is located in Haiti.