The GiveWell Blog

September 2017 open thread

Our goal with hosting quarterly open threads is to give blog readers an opportunity to publicly raise comments or questions about GiveWell or related topics (in the comments section below). As always, you’re also welcome to email us at or to request a call with GiveWell staff if you have feedback or questions you’d… Read More

Update on GiveWell’s intervention research in 2017

One of our major goals for 2017 is “intervention prioritization,” our work to assess a large number of programs (interventions) as potential GiveWell priority programs we’d be interested in recommending charities working on.


This post will provide a brief overview of our intervention work this year, focusing on the interim and full intervention reports we’ve published in 2017.

Programs we plan to continue investigating:

Programs we decided not to prioritize additional research on:

Deciding whether to recommend fistula management charities

We’ve long been interested in fistula surgery as a potential GiveWell priority program. However, as with other surgery charities, we have struggled to identify an organization that meets GiveWell’s criteria. Now, we’re working with a group called IDinsight and are excited that we may be able to consider a fistula surgery organization as a potential GiveWell top charity.

Our longstanding interest in interventions to treat fistula can be attributed in part to the popular narrative presented about fistula–the condition, which is often associated with social ostracization–appears to cause a significant amount of suffering, and seems to be treatable. We’re not sure how representative the popular narrative is, but as donors, it has contributed to our continued interest in better understanding this intervention, along with the feeling that surgery charities in general may offer low-cost, life-changing impacts.


This post will discuss:

  • Fistula management, including surgery, as an intervention.
  • Our open questions and uncertainty around fistula management programs, particularly their costs.
  • Our plans to partner with IDinsight to help answer some of our questions about fistula management.

Are GiveWell’s top charities the best option for every donor?

We’re sometimes asked whether we think GiveWell’s top charities are the “best,” in some absolute sense of the word, or whether we’d ever advise that a donor give to an opportunity outside of our recommendations. This post aims to clarify how GiveWell thinks about different giving options and their suitability for different types of donors.

We believe that GiveWell’s top charities offer donors an outstanding opportunity to do a lot of good and are the best option for most donors. However, some donors—those with a very high degree of trust in a particular individual or organization to make this decision, donors with lots of time (in excess of 50 hours per year, and likely more) to consider their giving decision, or donors whose values point strongly toward a particular cause outside of the ones GiveWell covers—may find opportunities to have a greater impact per dollar than GiveWell’s top charities. Note that we think these characteristics are likely to be necessary, but not sufficient, for finding these types of opportunities; we still expect good giving to be hard, and spending, for example, 50 hours per year on research isn’t necessarily going to yield better opportunities.

In this post, we describe relevant considerations for donors in greater detail.

How GiveWell uses cost-effectiveness analyses

Our cost-effectiveness analysis plays a critical role in the recommendations we make to donors. For example, as a direct result of our cost-effectiveness calculations, we place a higher priority on filling funding gaps at the charities we recommend that work on deworming programs and distributing malaria nets than we do directing funding to GiveDirectly, a GiveWell top charity that distributes direct cash transfers. We believe that GiveDirectly is the strongest organization we’ve ever seen, but according to our analysis, cash transfers are less cost-effective in terms of impact per dollar donated than deworming treatments and malaria nets.

Accordingly, cost-effectiveness analysis is a major part of GiveWell’s research process. We dedicate a large part of a full-time staff member (Christian Smith)’s capacity to this work and others involved with GiveWell research spend a considerable amount of time engaging with our cost-effectiveness model throughout the year. We consider this analysis a key part of our output and publish our model online so that anyone can check our calculations, enter their own inputs, and see if they agree with our approach and outputs.

This post will provide some basic information about how our cost-effectiveness analyses inform our charity recommendations.

Allocation of discretionary funds and new recommendation for donors

Since we released our 2016 recommendations in November, we have received about $4.9 million in funding for making grants at our discretion. We noted at the time that we would use these funds to fill the next highest priority funding gaps among our top charities. We have now reassessed the funding gaps for our top charities and plan to allocate $4.4 million to the Against Malaria Foundation (AMF) and $0.5 million of the funding we received for granting to the Deworm the World Initiative.

Our updated recommendation for donors

We have also updated our bottom line recommendation for donors seeking to follow our recommended allocation. We now recommend that donors give 100% of their donation to AMF, which will continue to have a pressing need for funding after the grant from GiveWell’s discretionary funds and after accounting for expected fundraising.

This is an update on the recommendation we made in November 2016 of giving 75% to AMF and 25% to the Schistosomiasis Control Initiative (SCI). We will update this recommendation again in November, and may do so sooner if we have new information that affects where we think additional donations would have the greatest impact.

We continue to recommend all seven of our current recommended charities as top charities and think all offer outstanding opportunities for donors to accomplish significant good with their donations. We have not completed any updates on our standout charities, and that list remains the same.