The GiveWell Blog

Update on the Schistosomiasis Control Initiative: Our current #2-ranked charity

Since GiveWell recommended the Schistosomiasis Control Initiative (SCI) in November 2011, SCI has received about $1.4 million in unrestricted funds ($500,000 of which we directly attribute to GiveWell’s recommendation), of which $1.1 million remains to be spent. We have spoken with and met with SCI to discuss its plans for using these funds.

Funds spent to date

  • SCI has made grants of $100,000 and $80,000 to Yemen and Senegal respectively for deworming drug delivery.
  • SCI has granted about $25,000 to Tanzania to treat 153,000 children in one region.
  • As part of discussions with the government about starting a national deworming program, SCI spent approximately $13,000 to support a conference on the deworming in Ethiopia.
  • SCI has spent about $99,000 of the unrestricted funding on various organizational expenses such as travel and one staff member’s salary.

Plans for funds raised due to GiveWell’s research

SCI is currently planning to fund the delivery of donated schistosomiasis drugs to 1.5 million children in two regions of Ethiopia, and support disease mapping in other parts of the country. SCI is currently waiting on a budget from Ethiopia, but we estimate this project will cost a few hundred thousand dollars. SCI has told us that it expects these treatments to be delivered by the end of 2012.

SCI has also committed $100,000 to fund treatment of adults in one district of Burundi.

SCI is exploring the possibility of supporting deworming programs in Zimbabwe and the Democratic Republic of Congo. In addition, it may use unrestricted funding to provide additional treatments in Tanzania and Malawi, which are primarily supported by a large grant from the British government.

Comparing current plans to past plans

In November 2011, SCI told us that it would primarily use additional funds to expand deworming programs in Mozambique, Malawi, and Senegal. Recently, SCI told us that these are no longer the countries it expects to focus on with the funds raised through GiveWell. What has changed:

  • SCI told us that it raised sufficient funding from other sources to support the Senegal program and that it never intended to expand the program beyond paying for delivery of drugs that were already available from the World Health Organization. We had been under the impression that SCI would expand this program further if it raised the money to do so, but it appears that we had a miscommunication with SCI on this point.
  • In 2010, SCI received funding from the British government to support deworming programs in 8 countries, including Mozambique and Malawi. SCI recently decided that programs planned for two of the countries weren’t feasible, and shifted the money it expected to spend in these two countries to the Mozambique program.
  • There may be other changes that we are not including here. We are not confident in our understanding of why SCI changed its plans.

Comments on SCI’s plans

First, SCI expects to spend almost all of the funds it has received due to GiveWell’s recommendation for a single round of treatment (save 15% of the funds, which it will hold for future treatments). Because multiple deworming treatments appear necessary for long-term impact (though the evidence on how many treatments are needed is thin), we are concerned that spending nearly all the funds now, could reduce SCI’s expected impact.

Second, our position is that treating children accounts for the majority of impacts from deworming. We are not confident in the impact of treating adults in Burundi.


  • Alan Fenwick on April 20, 2012 at 12:21 am said:

    I am sorry if we never communicated why treating adults in Burundi was deemed necessary. It is because we have found a small area in Burundi where adults are infected and a recent paper by Charles King and colleagues has shown that people with schistosomiasis (adults or children) need treating because of the chronic effect on their organs – Thus while treating children protects them from future illness, treating adults is still very beneficial. We are in the business of reducing suffering and therefore we are prepared to be flexible with our resources and treat anyone who needs treatment. Indeed flexibility is our guiding principle which is why we sometimes change plans as different resources and requests hit our desk. Alan

  • Tom Ash on April 20, 2012 at 2:38 am said:

    It’s great to have such detailed updates on where our SCI money is going – including Alan’s comment (direct responses are always illuminating). I’m also appreciating SCI’s newsletters, which contain some substantial information on programs alongside fundraising news and suchlike.

  • Caroline Fiennes on April 23, 2012 at 7:06 am said:

    So you still recommend giving SCI unrestricted money?

  • Alexander on April 23, 2012 at 12:11 pm said:

    Caroline: SCI continues to be our #2 overall recommended charity, and we still recommend unrestricted donations. We didn’t mean to call that into question.

  • Jason K on May 3, 2012 at 7:04 am said:

    Hi GiveWell,
    Would it be possible to get a response from SCI regarding the single-round expenditure of 85% of their funds? Perhaps their donation projections allow them to operate in this fashion, but I was wondering if there was any continuing dialogue to confirm this?

    On a side note, it is really refreshing to see an organization like yours be honest about miscommunications and other imperfections. It gives me the confidence to trust your recommendations.

  • Alan Fenwick on May 3, 2012 at 2:20 pm said:

    Thank you Jason for this question.
    We will use a high percentage of Givewells donor funds in the year they are given because I believe that donations from Givewell donors should be used for the purpose we advertised, to treat children and those at risk. If you have donated on this recommendation from Givewell you want your money to be used – not sat in SCI’s bank account. Our premise is that we have a good model and that by treating children in more and more countries we will in fact attract more funding, – success brings success. If Givewell decide to change their recommendation in 2012 we will lose one of our income sources so yes we are taking a risk, but if that happens we will use our other sources to comsolidate rather than expand our coverage further. Infected children need treatment and we want to accelerate coverage rather than be cautious. However as I have often said we have a flexible policy and so will watch the income rate closely. Alan Fenwick

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