We ask you, as a donor, to turn down some great pitches – “Your interest-free loan will help this person escape poverty forever,” “You can give a cow to a poor family for Christmas,” etc. – and give instead to charities that aren’t terribly good at storytelling. Why?

It comes down to this. We think that most of those stories are just that – stories. (For more, see our summary of recent posts on “big-name” charities, which we feel are representative of the full set of charities we’ve reviewed.) But if you give to one of our top charities, you really can save (or dramatically change) a human life.

It hasn’t been easy to find charities that we can honestly say this about. That’s what our process is built around and where most of our energy goes. This week we’ve blogged about the best we’ve found, VillageReach and Stop Tuberculosis Partnership. There is plenty of room for doubt even with them, but overall we think there is a strong case - even for the skeptic - that your donation to them can save a life.

What do we mean when we say “save a life?”

By “you can save a life,” we don’t mean anything as simple, concrete, or easy to grasp as the stories charities usually tell.

• Your gift can’t literally be linked to an individual. It will help an organization that, all things considered, is achieving a lot of impact for what it spends.
• If you must know what “your” dollars are doing, it’s likely that they’ll be sitting in reserves to ensure financial stability, or enabling a slightly larger travel budget for evaluators, or something similarly unexciting.
• It’s even highly possible that your donations will be wasted, and that the charity you give to – even the best you can find – will fail. We don’t think there are true guarantees in aid.
• Even if these charities are succeeding, it’s very likely that your donation won’t ultimately result in the charity doing anything differently. It’s pretty hard to think about how $1000, by itself, could really change anything about Stop TB Partnership’s plans for next year.
• Yet donations add up. 50-100 of these donations could mean a significantly larger grant, more people getting tuberculosis treatment … and that could mean families staying intact instead of being struck by sudden death.

The truth is that it takes a lot of abstraction and analytical thinking to really think about how your donation saves a life. The life you can save is an “expected” life (”expected” in the sense of probabilistic expected value) - it isn’t a person we can point to or show you a picture of. More than with typical charities, you have to use your imagination. But more than with typical charities, your impact is real.

With opportunity comes responsibility

In The Life You Can Save (which prominently features GiveWell and which we have reviewed), Peter Singer writes:

By donating a relatively small amount of money, you could save a child’s life … we all spend money on things we don’t really need, whether on drinks, meals out, clothing, movies, concerts, vacations, new cars, or house renovation. Is it possible that by choosing to spend your money on such things rather than contributing to an aid agency, you are leaving a child to die, a child you could have saved? (pg 5)

Our corollary: is it possible that you are leaving a child to die when you choose to donate to a charity with a “feel-good” story rather than a charity with a great case for real impact?

It is true that, as our critics often point out, a charity can be impactful without being demonstrably impactful. But when one charity proves itself and another leaves you guessing, it seems clear to us which one offers the “better bet” – and more “expected lives saved” – given the information available. When you have the option of giving to an outstanding charity that demonstrably can save a life, how do you justify giving to a charity whose true impact is essentially a big question mark?

I’ll leave this blog’s last words for 2009 to Natalie, a relatively recent GiveWell hire (she has been working full-time on research since July).

Sometimes I’m almost tempted to give to a charity I know less about. I’ve been over VillageReach and I’ve seen how complex the situation is and how many questions there are. If I gave to some charity I know nothing about, I could just think about the story they tell and feel good and not have these nagging doubts. But I’m not going to do that – in the end it’s more important to me that I really make a difference.

One person who’s more critical of charity than we are or than David Hunter is is the economist Robin Hanson. He has stated that “charity isn’t about helping” and spelled out this view somewhat in a post about the founder of Rite Aid:

when folks like Alex spend their later years trying to “do good” with the millions they were paid for actually doing good, they usually end up pissing it away. We already have too much medicine and academia, because such things are mainly wasteful signals. We didn’t need and shouldn’t be thankful for more hospital wings or lecture halls. Imagine how much more good could have been done instead via millions spent trying to make more innovative products or organizations.

Of course most innovations attempts fail, and that wouldn’t have looked so good for Mr. Grass. I’m sure those hospital wings and lecture halls came with grand ceremonies attended by folks in his social circle, saying what a great guy he was. And I expect people in his social circle are more likely than most to actually use those hospital wings and lecture halls; he was showing loyalty to his clan by buying such things.

But when I think of all the good that could be done by philanthropists who actually wanted more to do good than to look good, it makes me sad. At it doesn’t make me sympathetic toward the tax deductions and other social support our society offers for these wasteful signals.

Prof. Hanson tends to imply that charitable giving should be essentially ignored in favor of pro-poor causes like allowing more immigration.

What response can the nonprofit sector marshal to arguments like this? I must say that, in fact, much of the nonprofit sector fits incredibly better into Prof. Hanson’s view of charity as “wasteful signaling” than into the traditional view of charity as helping.

• Donors often prefer to “give local.” This makes no sense if you’re trying to help those in need (if you have a lot of disposable income, chances are your community is one of the ones that needs your help the least) but lots of sense if donating is primarily about impressing your acquaintances.
• Foundations generally try to exist in perpetuity, which makes no sense if they’re trying to maximize good accomplished but makes lots of sense if they’re all about their funder’s legacy.
• Donors and charities tend to deny the basic concept of triage. This makes no sense if you’re trying to help people; lots of sense if you’re using charity as a way to signal that you find certain causes important.
• Even analytical hedge fund types seem much more interested in basing their giving on social events than on information.
• And as we’ve argued at length, charities fundamentally behave as though they’re serving donors, not clients.

Perhaps ironically, if you want a good response to Prof. Hanson’s view, I can’t think of a better place to turn than GiveWell’s top-rated charities. We have done the legwork to identify charities that can convincingly demonstrate positive impact. No matter what one thinks of the sector as a whole, they can’t argue that there are no good charitable options - charities that really will use your money to help people - except by engaging with the specifics of these charities’ strong evidence.

Valid observations that the sector is broken - or not designed around helping people - are no longer an excuse not to give.

Because our Bayesian prior is so skeptical, we end up with charities that you can be confident in, almost no matter where you’re coming from.

GiveWell spends a lot of time on the question, “Should I give to charity A or charity B?”

One of the things that has surprised us about the world of charity is how many people insist on answering, “Both” or “You can’t/shouldn’t be asking that question.” To them, all that matters is whether a charity does some good, not how much good it does or how it compares to other options.

One statement of the idea comes from none other than the Jeffrey-Sachs led WHO Commission on Macroeconomics and Health (footnote 24):

Many have asked the Commission what to do if the donor money is not made available—in essence, how to triage with less money. We are asked to prioritize millions of readily preventable deaths per year, since we have already narrowed our focus to a small number of conditions that have an enormous social burden and that have low-cost interventions that are at least partially effective. Not only is this kind of triaging ethically and politically beyond our capacity, but it is also exceedingly hard to do in sensible way. Those who hope for a simple answer, for example to focus on the cheap interventions (immunizations) while putting off the expensive interventions (higher-cost prevention programs and antiretroviral therapy needed to fight AIDS) to a later date, misjudge the practical choices we face. The AIDS pandemic will destroy African economic development unless controlled; to fight measles but not AIDS will not begin to meet Africa’s human and economic needs. It would be wrong to go to the other extreme as well, and let the legitimate need to fight AIDS end up starving the cheaper interventions, so we advocate both. Moreover, the infrastructure developed to fight AIDS will support the infrastructure needed to fight measles, especially if strengthening such complementarities is explicitly built into the AIDS control effort. It is vastly more fruitful to design and finance a comprehensive program that addresses many critical health needs than to pick and choose the apparently inexpensive items.

More examples of this mentality can be seen in recent comments to our blog by John, Yael and Steve.

Our response to these comments is simple. Most donors have a certain amount they are willing to give, and that amount is less than enough to fully fund even one of the world’s underfunded humanitarian initiatives.

We don’t believe that any problem that people suffer from should be ignored or trivialized. We do believe that individual donors must choose which to address, and that they should be factoring in questions like “What evidence is there that my money can even do anything to address this problem?” and “How cost-effectively can I create change by giving my money here?”

In their personal and business lives, people constantly make tradeoffs on a limited budget. Imagine if a salesman tried to argue, “How can you choose between this car and that one? They’re both wonderful cars and each would make the other more useful. You should buy them both!”

Yet in the world of charity, the basic and undeniable idea of triage is constantly denied.

From the recent discussion on Tactical Philanthropy:

As philanthropists/donors/funders, we spend so much time thinking about how to maximize social benefit through our activities, that often we lose sight of the personal benefits that we experience from these endeavors.

We disagree. Consider the current state of the nonprofit sector.

• We have practically no information about charities’ effects on the people they serve.
• Donor misinformation is rampant. Failure to disclose basic facts sets off no one’s alarm bells even coming from the world’s biggest charities.
• Charities aggressively expand programs with great stories but questionable track records. (Three examples recently posted here: Village Phone, agriculture aid and microfinance).
• Programs with the catchiest stories get funded over the ones most likely to actually help people (more on this in the future, but for now see water vs. handwashing).
• Donors who actually want to help people as much as they can are so underserved, and so frustrated, that they do things like quitting their jobs to spend their time digging up information and giving to the Gates Foundation, which asks them not to give to it.

Bottom line: giving today is all about the giver. The sector revolves around telling donors great stories, while charities’ actual impact is unexamined and essentially irrelevant.

We do believe that the benefits of giving for the giver are important, particularly from a fundraising perspective, but we think the current level of attention to them is out of control.

I was glad to read of a new $110 million initiative for insecticide-treated bednet distribution, which we find one of the better-established ways to spend money to improve lives.

But what does this mean for you if you’ve been giving to a malaria charity? Do independent bednet distributions now run the risk of being redundant with the new one? Has USAID provided enough funding that your donation is no longer as needed?

Unfortunately, we have no way of answering this question. While there are some attempts to coordinate government aid, we know of no one asking questions like “How much total room is there for funding distribution of bednets? How can we make sure that all the malaria organizations are on the same page? How can we track the extent to which individual donations are still needed?”

If donors focused on how to have real impact (as opposed to, say, fictions about where “their” money goes), such a question would be extremely important to them.