# The GiveWell Blog

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 info@givewell.org or to request a call with GiveWell staff if you have feedback or questions you’d prefer to discuss privately. We’ll try to respond promptly to questions or comments.

You can view previous open threads here.

• Greetings,

1. I was wondering, has Givewell considered notifying their donors on their email list when your top charities are having independent donation matching events so as to further maximize the impact of their contributions, not exclusively through Givewell? It seems like a wasted opportunity when those donation matching periods occur but people who would normally donate to those top charities through Givewell do not hear about them. I think you should consider helping your base be more engaged with those opportunities.

2. What insights for Givewell management did you extract from the donation matching campaign that Givewell set up for first time donors last year?

3. Why has Givewell not redesigned their payment processing page to give donors a convenient option to donate directly from their bank accounts instead of credit/debit card so as to save on processing fees? I know this is mentioned as an alternate option on the right side of the page and we are given information to do it ourselves. I just wonder why it was not already designed into the payment processing system that Givewell uses to make it more desirable to donors, which I assume they would be incentivized to do to save on card processing fees.

Thank you for your time and take care.

• Catherine (GiveWell) on March 29, 2021 at 6:27 pm said:

Hi Eddy,

1. We’re committed to providing counterfactual matching opportunities to our donors, to the best of our ability (we’ve written about this here). What that means is that we only want to promote matches where we’re confident the matching donor would not have otherwise given. We feel most confident in offering counterfactual matches through our own network, which is why we’ve focused on GiveWell matches for the time being. We may do more with our top charities going forward, but we haven’t prioritized this as a first step.

2. We offered a $250 match for first-time donors who heard about us through podcast ads during the 2020 year-end giving season. Because donors had to indicate which podcast they heard about us on in order to be eligible for the match, the incentive helped us get better information about which podcasts were successful for us. The match seemed to have incentivized some listeners to donate, although it’s difficult to say what proportion of them wouldn’t have donated counterfactually (if we had just advertised and not offered a match). The match did seem to influence the sizes of donations to some extent. We saw some different trends in donation sizes between 2019 (when the matching amount was$1k) and 2020 (when the matching amount was $250), suggesting that the match amount was a strong motivator (when we offered$250 matches, we saw more $250 donations; when we offered$1k matches, we saw more $1k donations). 3. Thanks for letting us know about your preference to donate directly via bank transfer through our website. We haven’t heard much demand for this option from our donors and so this isn’t something we’ve considered adding. It’s helpful to know that this is something you’d be interested in! • Vasco Grilo on March 31, 2021 at 8:31 am said: Good afternoon, I am interested to know your thoughts on World Food Program’s ShareTheMeal App (https://innovation.wfp.org/project/sharethemeal). Kind regards, Vasco • Catherine (GiveWell) on March 31, 2021 at 9:52 am said: Hi Vasco, Thanks for your question! Rather than trying to rate as many organizations as possible, we focus on finding and recommending a small number of outstanding giving opportunities to help donors save or improve lives the most with their gifts. We look for organizations that are evidence-backed, cost-effective, transparent, and underfunded. You can learn more about what we look for on our criteria page. Though we consider many organizations as we search for outstanding giving opportunities, we do not aim to rate or review each of them, so unfortunately we generally cannot answer questions about specific opportunities, such as World Food Program’s ShareTheMeal App, that are not on our list of recommended organizations. You can learn more about what we do on this page and in our FAQ. Please let me know if you have any additional questions. • John f Smith on April 1, 2021 at 4:20 am said: Hi my name is John Smith I’m 57 years old I’m from Summerville Georgia I live in a mobile home where I rent the past winter I went without any heat my landlord after asking him on many occasions to install heaters in my mobile home refuse to do so and only told me to go to Walmart and buy me a portable heater and his wife Tara Wilson text me and told me to have my case manager from Lookout Mountain community service go buy me a portable heater instead of them putting one in meaning my landlord so what I would do is take the mattress for my bed and put on the floor in front of the stove and turn the stove on my dog and I would sleep their front of the stove keep warm at night during the day I wear my winter coat and make sure my dog was covered up pretty good he’s 14 years old I was trying to find a place to move to get away from this place but financially it was hard for me to do so and then what’s this virus going on not too many people wanted to rent. That’s not only problem around just trailer there’s several problems which I had to dress the landlord with and we never fixed after living in the cold like I did and he didn’t care my landlord Jackie Wilson I decided I would call the building inspector and have him come in during inspection inside and outside Allen mobile home which I invited him to do so. He found multiple code violations he told me that he probably wouldn’t need to condemn this trailer and wrote on the paper that he gave me it’s unlivable for human to be in here and living at this time building inspector has made numerous attempts to schedule times for my landlord to meet him here at my residence to talk to him and go over the code violations and where they were my landlord keeps making excuses whether he forgot that day or his wife’s in the hospital. I have a floor that’s leaning to one side light fixtures falling I couldn’t take a shower at all because the bathroom and that back here it was too cold so I do find myself to the front area to one room and take a bath in the sink in the the kitchen and wash up like right there. My landlord change the lease also I’m raise my rent and also made me responsible for any repair of any appliances that would happen I’ve checked with other renters of his and their lease does not say the same thing I feel that this landlord knowing that I’m a homosexual and a white man is prejudiced against me I never seen the landlord but maybe two times and that’s been from a distance I think he thinks that being gay and white rugs off cuz he won’t get very close to me at all he stands probably a house away from me talkin to me they’ll knock on the door and they’ll run to the driveway here’s my hand to God I seen it. I’m trying to take legal resources and do a civil lawsuit against the landlord for not having heat from me and my law he should have done that being prejudiced against me being homosexual because he has asked me questions about my sexual orientation before and me being on disability and have a handicap knowing this and he still did not put heat in here that’s absolutely disgusting that he would let somebody live like that and collects rent he calls himself a minister that’s not a church I would want to go to. So I’m out looking for places to live and what is my illness I’ve had two heart attacks I have post-traumatic stress syndrome from a home invasion where ice pistol whipped and beaten that occurred in Columbus Ohio severe depression HIV positive and I’m currently and congestive heart failure there’s anything that you can assist me with and help me wish I would appreciate it so very much how to hear from you very soon thank you John Smith • Selon Nerias on April 1, 2021 at 2:25 pm said: Is the content of the monthly update shared publicly anywhere? It’d make it easier to share them on social media, though I understand there’s a tradeoff between that and keeping them exclusive to make signing up for the email newsletter more appealing. • Catherine (GiveWell) on April 5, 2021 at 7:07 pm said: Hi John, Thank you for getting in touch with GiveWell. Unfortunately, we do not provide this type of support. I’m sorry not to be more helpful and we send you our best wishes during this difficult time. • Catherine (GiveWell) on April 5, 2021 at 7:08 pm said: Hi Selon, We don’t currently publish the newsletters on our website or via social media, but we’re considering doing so going forward, which will make them easier to share. Thanks for letting us know that you’d prefer this option! • David Nash on April 16, 2021 at 5:32 am said: I would second the comment by Selon. I would like to share the monthly update on why malaria is still being funded as I think it gives a good response to a question people do ask. At the moment the only way I can see of sharing that is via copy and pasting it, there isn’t a ‘view in browser’ option on the email. • ANGELO TOMEDI on April 25, 2021 at 8:42 am said: Recent reports suggest progress on a malaria vaccine, with 77% efficacy in an initial trial and larger trials planned. If confirmed in the larger trials, how might the launch of vaccination programs affect the cost-benefit analysis for AMF and SMC programs? • Ethan Kennerly on April 25, 2021 at 2:22 pm said: The news that Angelo relayed of a vaccine reaching 75% is uplifting! I have a historical question about the benefit of an AMF donation in 2010 versus the benefit of an AMF donation in 2020. I noticed that GiveWell revised their estimate for the cost of a life saved by AMF from about$1200 in 2010 to about 5000 in 2020. However, GiveWell has also revised the model of estimates between 2010 and 2020. Do you know of a rough estimate to convert the AMF cost of a life saved from 2010 to 2020 so that the two estimates could be comparable? Linked is a cell in a spreadsheet where I referred to GiveWell’s estimate in 2010. I ignorantly estimated a multiplier between 0% (optimistic) and 25% (pessimistic). Although that is my specific question, here is a presentation of the broader context for my inquiry: Which Helped More? Donating mosquito bednets in 2010 or 2020. By the way, it seems plausible that the real (inflation-adjusted) cost per life saved for mosquito bednets might be going up over a decade if the program were effective. For one naive model, a logarithmic model of marginal utility for each additional bednet would align with a diminishing marginal value of additional coverage. Since earlier bednet distribution may have prevented some worse cases, an increase in real cost per life saved would be a fact to celebrate. • Elizabeth Santorella on April 26, 2021 at 2:11 pm said: 1) I’m curious for more info on GiveWell’s 2019 decision to discontinue funding Charity Science Health. (https://www.givewell.org/research/incubation-grants/charity-science-exit-grant-july-2019) GiveWell’s preliminary 2017 cost-effectiveness analysis made CSH look fairly cost-effective, at about “7x cash.” That sounded good to me, so I was confused by the negativity of GiveWell’s exit grant writeup, which mentioned “high expected costs” and “lack of a strong quantitative case.” Is the issue that GiveWell has a very high bar, so “7x cash” is not good enough? Or is it that CSH was much worse than 7x cash, since it had trouble identifying a cost-effective way to collect phone numbers? (https://www.givewell.org/charities/charity-science/charity-science-health/july-2017-grant) (I understand that uncertainty and staffing changes were also factors in this decision.) I’m asking because I’m curious to understand how GiveWell thinks about evaluating incubated organizations. Incidentally, FYI, this intervention still seems very uncertain. One on hand, a 2019 meta-analysis found that “there was a statistically significant positive effect of text message reminders among LMICs”. (https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-019-1054-0) On the other hand, the quality of the evidence was deemed “low level,” and two pre-registered RCTs that were too recent to be included in the meta-analysis had disappointing results (Seth et. al. in 2018 and Kazi et. al. 2018). 2) Just out of curiosity, have you heard any updates on the mask trial? I’m excited for results! Thanks so much for all your hard work! • Catherine (GiveWell) on April 26, 2021 at 5:44 pm said: Hi Angelo, We’re excited to see the latest news on the malaria vaccine. We’re looking at the results and are in touch with malaria experts to discuss the implications of malaria vaccination for the programs we recommend (antimalarial nets and seasonal malaria chemoprevention) and whether there are or might be vaccine-related funding opportunities we should consider supporting. If this work updates our view on what to recommend, we will make our new recommendations public. We do not have reason to believe that we should change our approach today—the vaccine is being tested but not widely rolled out. We continue to enthusiastically recommend the Against Malaria Foundation and Malaria Consortium’s seasonal malaria chemoprevention program and believe it is crucial to maintain support for malaria prevention today, as malaria remains a major cause of mortality. Over 400,000 people died of malaria in 2019. • Alex Rosen on April 27, 2021 at 3:22 pm said: I wish GiveWell would say more about Covid. It’s the big elephant in the room of global health, and GiveWell barely mentions it. I would like to know if GiveWell has investigated Covid-related giving opportunities; and if not, why not? Like: from a naive view, Covid seems like by far the most pressing global health concern. So it makes me wonder why GiveWell has ignored it. Has GiveWell looked into it, and after analysis believes that its existing charities are still the better than Covid related giving? Or, has GiveWell decided not to dive into that? These seem like obvious questions that a giver would have, no? • Catherine (GiveWell) on April 28, 2021 at 10:48 am said: Hi Alex, I’m glad to share more about our work related to COVID-19. We made six grants in response to the COVID-19 pandemic. They’re discussed in detail on this page. We published a separate page on our2 million grant to study masks and COVID-19 and a blog post on the three initial grants we made in response to the COVID-19 pandemic.

We also published updates on the impact of COVID-19 on the organizations we support and on our plans for 2020. We summarized our work on COVID-19 in 2020 in our year-end blog post with recommendations to donors. As we write in that post, we plan to follow needs that continue to emerge due to the pandemic, which may lead us to make additional recommendations in the future.

• Hello. I would love some thoughts on the new Malaria vaccine developments, and how it might or shouldn’t change funding allocation in the future.

• Catherine (GiveWell) on April 28, 2021 at 3:11 pm said:

Hi Oren! You can see my response on this topic above. I hope this helps!

• Catherine (GiveWell) on April 28, 2021 at 4:09 pm said:

Hi Ethan,

You’re absolutely right that our model has been updated significantly since 2010, such that it is not possible to directly compare the cost-effectiveness we calculated then with the cost-effectiveness we calculate today.

We have done a quick review of the historical cost-effectiveness for malaria nets between 2000 and 2020. Between 2010 and 2020, decreases in malaria mortality rates drove down nets’ cost-effectiveness, while decreases in the price of nets increased their cost-effectiveness. We have fairly low confidence in our assessment since this is based on a rough case study, but overall, we think that decreases in the price of nets might moderately outweigh the decreases in malaria mortality rates—so it’s probably a little more cost-effective to donate in 2020 than 2010.

• Catherine (GiveWell) on April 29, 2021 at 6:16 pm said:

Hi Elizabeth,

(1) Charity Science Health: Our estimate of Charity Science Health’s cost-effectiveness of 7x cash was extremely rough. We say in the write-up: “In our last published cost-effectiveness analysis of CSH,[*] we estimated that its program was roughly seven times as cost-effective as cash transfers (“7x cash” for short), which is moderately lower than our cost-effectiveness estimates for funding we have recently directed to our top charities. We estimate that our current top charities focused on the same outcome as CSH (averting deaths) have large remaining funding gaps at around 7x cash. Our cost-effectiveness model for CSH is also underdeveloped compared to our cost-effectiveness analyses for our top charities—even if our current estimate were higher, we would place limited weight on it when deciding whether to continue supporting CSH.”

So rather than seeing our top charities and Charity Science Health as comparable in cost-effectiveness, we would summarize our view as something like: “we’re really unsure how cost-effective the CSH program is, and it looks like it might be a bit less cost-effective than our top charities—given that, plus the high expected costs and lack of a strong qualitative case, we’ve decided not to continue supporting Charity Science Health.” I hope this helps clarify!

(2) Mask RCT: The mask trial is being run in two stages. The first stage involves collecting information on how successfully a series of mask distribution and promotion strategies increased consistent mask wearing. The second stage involves collecting data on rates of COVID-19 to understand the extent to which mask wearing reduces the spread of COVID-19.

The first stage is complete, resulting in a 29 percentage point increase in mask-wearing (in line with our expectations). Excitingly, the authors are working with government and non-government implementers in several states in India, provinces in Pakistan, and in Bangladesh to apply lessons learned from the first stage and implement in large-scale the specific strategies that were successful in Bangladesh.

Collection of data for the second stage is still underway; it was somewhat delayed past our initial timelines due to it taking longer than expected to receive government approval to run the trial.

• Maxwell Pietsch on May 14, 2021 at 11:28 am said:

I have money that is earmarked for a later purchase (car and house) so it cannot be donated, and was wondering if there’s a more altruistic way to use it than just letting it sit in my bank account. My first thought was micro loans but reading about microfinance organizations here: https://www.givewell.org/international/economic-empowerment/microfinance I am not optimistic this would be very helpful. Do you have any suggestions for the question of, ‘how best to *lend* money in order to have a positive impact?’ Much appreciate any thoughts.

• Catherine (GiveWell) on May 14, 2021 at 3:20 pm said:

Hi Maxwell,

Thanks for your question! We deprioritized our work on microfinance after 2011 because we found that the evidence of impact wasn’t as positive or as strong as it is for the other programs we’re prioritizing. Our page about microfinance, which you linked, has more information on our views. In 2011, we recommended the Small Enterprise Foundation, but we haven’t kept up to date on its progress in recent years. Given this shift in our research priorities, unfortunately I don’t have any recommendations for you.

• Hello,
Really appreciated GiveWell’s work on Covid during 2020, and of course all their usual great work. With vaccinations now well underway in the rich world, I wanted to ask if GiveWell has any updates on that specific aspect, particularly Gavi/COVAX as an effective giving opportunity. It looks like the last GiveWell review of Gavi was in 2018 (https://www.givewell.org/print/international/charities/Gavi) and concluded no clear funding gaps, but given the current situation it seems worth a refresh? (Sorry if I missed anything.)

A very rough, back-of-the-envelope estimate suggests it could be competitive with your top charities. The US paid Pfizer $20/dose for their vaccine. It would cost about$160 million at that price to fully vaccinate 100% of a country like Sierra Leone (population 8 million). If we put the case fatality rate (probably conservatively) at ~1%, suppose (conservatively) that herd immunity occurs around 50% and that the country would eventually (over the next several years) reach herd immunity via infections, that means ~40k deaths without vaccines. If we could get the vaccines in arms right away at $20 each, those lives would be saved at$4000 each, in the same ballpark as the AMF and Malaria Consortium.

Obviously there are a lot of assumptions here. Probably the weakest ones are that the bottleneck for COVAX is funding rather than physical production constraints, that the vaccines would never otherwise arrive without GiveWell’s help (rich governments, other charities are indeed already donating), and that there’s no additional cost to actually perform vaccinations. Sierra Leone might also be a slower transmission environment depending on various factors: policies (e.g. border controls), population age, time spent outside, etc. On the other hand, this assumes paying full rich country prices for the most expensive vaccine, and there’s at least some reporting that Gavi faces a \$6 billion funding gap (https://www.kff.org/coronavirus-covid-19/issue-brief/covax-and-the-united-states/). It also omits positive spillover effects to other countries, and we’ve seen in India how quickly fortunes can turn in developing countries.

If there is a near-term funding gap and money now instead of later could speed up production/distribution to break up transmission chains sooner, the case for funding this vs GiveWell’s malaria charities seems at least plausible. I’d be really interested to hear GiveWell’s thoughts on this.

Thanks!
Ben

• Catherine (GiveWell) on May 27, 2021 at 11:07 am said:

Hi Ben,

Thanks for your kind words. The short answer is that, while simple cost-effectiveness estimates make vaccines seem comparable with our top charities, the funging concerns and delivery costs you mention, and a few other factors (e.g. younger populations in many low- and middle-income countries reducing the infection fatality rate) mean that we think it’s unlikely that deeper investigation of the COVAX opportunity would have led us to conclude that it would have been more cost-effective than our top charities.

Within our COVID-19 grantmaking, our initial research led us to focus on two types of opportunities: (1) high-leverage opportunities that could influence funding (such as the Innovations for Poverty Action mask study) and (2) making small, quick grants to partners that we were well-positioned to assess quickly (partners we had worked with before: IDinsight, Development Media International, and Y-RISE). We haven’t assessed the COVAX opportunity in depth and so don’t have specifics to share about your estimate, I’m afraid!