Organizations supporting and delivering public health and poverty alleviation programs have been impacted by the COVID-19 pandemic in many ways. Here, we provide a brief look at how some of the groups we’ve supported are responding to the pandemic.
We share an example of a charity that continues to implement its health program, with modifications for social distancing and safety; charities that have paused their programs, but continue supporting their staff; and a charity that is allocating funding to pandemic-response efforts.
This is neither a comprehensive update nor a static one. The situation is evolving rapidly. We will share a more complete update on what the pandemic means for our top charities and their funding needs closer to the end of the year. We continue to recommend that donors give to “Grants to recommended charities at GiveWell’s discretion,” which we allocate among our recommended charities where we see the greatest need.
What follows is a snapshot of what’s happening now.
Examples of how charities are responding
A charity that is continuing its program, but with modifications: Malaria Consortium’s seasonal malaria chemoprevention program
Seasonal malaria chemoprevention (SMC) is the delivery of anti-malarial medication to children under age five during the time of year when malaria transmission is highest. The World Health Organization (WHO) recommends that programs to prevent malaria, including SMC, continue during the pandemic.
Malaria Consortium is a GiveWell top charity that supports SMC campaigns (primarily door-to-door) in the Sahel region of Africa. We expect Malaria Consortium’s next SMC distributions to take place during the upcoming July-to-October rainy season.
GiveWell-directed funding to Malaria Consortium’s SMC program is flexible. We don’t restrict its use to specific activities. That means Malaria Consortium can use GiveWell-directed funds to quickly adapt its distribution model to prevent the spread of COVID-19.
Malaria Consortium will aim to provide personal protective equipment, including masks and gloves, to its community SMC distributors. It also plans to provide alcohol-based hand sanitizers, disinfecting wipes, soap, bio-waste bags, and additional T-shirts and hijabs. Malaria Consortium has instructed community distributors to maintain two meters of distance in their interactions and to share information on how to prevent COVID-19 while visiting each household.
Image from Malaria Consortium’s visual aid for community distributors. SPAQ (sulfadoxine-pyrimethamine and amodiaquine) is medication to prevent malaria.
Overall, Malaria Consortium expects slightly higher costs for its campaigns as a result of these changes. We expect these additional costs to amount to a modest increase in the cost per child treated. In our projections of Malaria Consortium’s 2020 spending, we use an assumption of 20% higher costs due to program modifications. This reduces our estimate of the cost-effectiveness of past donations to Malaria Consortium that are now being used for the 2020 SMC campaigns. Even with that adjustment, we still consider these past donations to be highly cost-effective, given our assessment of Malaria Consortium’s cost-effectiveness overall.
We expect that donations made to Malaria Consortium today will support its SMC campaigns in 2022, at which point we hope that these additional measures are no longer necessary. Our estimate of the cost-effectiveness of donations made to Malaria Consortium today thus remains high at $2,000 to $3,000 per death averted.
Charities that are pausing programs and retaining staff: organizations that treat parasitic worm infections (deworming)
Added December 2020: While deworming programs were paused at the time this post was published (July 16, 2020), the World Health Organization updated its guidance shortly thereafter to advise considering the costs and benefits to decide whether to do neglected tropical disease mass drug administrations (including deworming) during COVID-19 (source, p. 1; archive). As of December 2020, we understand that all of our deworming top charities have resumed either undertaking deworming distributions or planning for upcoming distributions.
Our top charities list includes four organizations that support deworming programs: Evidence Action’s Deworm the World Initiative, SCI Foundation, Sightsavers, and the END Fund. The WHO has recommended pausing deworming programs to mitigate the spread of COVID-19. Our top charities are not distributing deworming treatments at this time.
As with Malaria Consortium, the donations we’ve directed to the deworming organizations we recommend have been allocated flexibly, so they may support operations as well as delivery of deworming treatments. We understand that our top charities plan to retain most staff using this and other funding. Maintaining stability in uncertain times benefits staff. It will also enable a quick and smooth transition back to providing deworming treatments once campaigns restart, as hiring and training new staff can be difficult and time-consuming.
We’re unclear how long the pause will last and thus how disruptive it will be. The hope is that it will be short-lived.
Deworming is done on an annual basis in many locations, or at most twice per year. Many rounds of deworming are scheduled for later in the year and so have not yet been missed. It’s possible that in many of these cases, deworming will take place as scheduled.
If the pause persists beyond the end of the year, it will impact our estimated cost-effectiveness of deworming. We estimate that the maintenance of staff costs in the absence of program implementation during a 12-month interruption of deworming would lead to a roughly 10-25% decrease in the cost-effectiveness for our deworming top charities over three years (our typical deworming funding period). This estimate relies upon a number of simplifying assumptions and judgment calls; more information is in the following footnote. We believe that deworming would remain a cost-effective intervention overall.
A charity that is allocating funds to respond to COVID-19: Abdul Latif Jameel Poverty Action Lab’s Innovation in Government Initiative
In December 2018, we recommended a grant of $1 million to the Innovation in Government Initiative (IGI), a grantmaking entity within the Abdul Latif Jameel Poverty Action Lab (J-PAL) focused on scaling evidence-based policies in collaboration with low- and middle-income country governments. This grant was part of a new area of our work to explore approaches to improve government policies. Our grant supported IGI’s general operations and two requests for proposals (RFPs). The RFPs sought proposals primarily for technical assistance to governments to scale up evidence-based policies.
In March 2020, IGI reached out to us about allocating approximately $150,000 of the remaining funding from the GiveWell-directed grant to COVID-19 response. Specifically, IGI was interested in funding off-cycle, rapid-response grants to mitigate the impact of COVID-19 in low- and middle-income countries by supporting technical assistance and analysis for governments to inform COVID-19 policy responses in areas like health and social protection. This goal is in line with the original grant purpose, and we approved. A list of COVID-19 projects IGI has funded so far can be found here.
A broader list
This update highlights the importance of allocating funding flexibly so that grantees can respond to unforeseen events. But it doesn’t address all of the work our top charities and other groups we support are doing in response to the pandemic. GiveWell standout charity Development Media International is supporting public health broadcasts to promote behaviors to mitigate the spread of the pandemic. We’ve provided grant funding to expand this work. GiveDirectly has launched COVID-19 cash transfer programs in the United States, Kenya, and Uganda, and it plans to expand its COVID-19 response into five more countries. [July 22 update: GiveDirectly informed us that it is now also running COVID-19 response programs in Liberia, Malawi, and Rwanda.]
Other charities we support have adjusted their operations in large and small ways. We plan to share a more detailed look at the pandemic’s impact on charities we support later in the year.
Sources and footnotes for this post may be found here.