We’re excited about the impact donors can have by supporting our All Grants Fund and our Top Charities Fund. For donors who want to support the programs we’re most confident in, we recommend the Top Charities Fund, which is allocated among our four top charities. For donors with a higher degree of trust in GiveWell and willingness to take on more risk, our top recommendation is the All Grants Fund, which goes to a wider range of opportunities and may have higher impact per dollar. Read more about the options for giving below. We estimate that donations to the programs we recommend can save a life for roughly $5,000 on average, or have similarly strong impact by increasing incomes or preventing suffering.
Why your support matters
We expect to find more outstanding giving opportunities than we can fully fund unless our community of supporters substantially increases its giving. Figures like $5,000 per life saved are rough estimates; while we spend thousands of hours on our cost-effectiveness analyses, they’re still inherently uncertain. But the bottom line is that we think donors have the opportunity to do a huge amount of good by supporting the programs we recommend.
For a concrete sense of what a donation can do, let’s focus briefly on seasonal malaria chemoprevention (SMC), which involves distributing preventive medication to young children. We’ve directed funding to Malaria Consortium to implement SMC in several countries, including Burkina Faso.
In Burkina Faso, community health promoters go from household to household across the country, every month during the rainy season (when malaria is most common). They give medicine to each child under the age of five, which involves mixing a medicated tablet into water and then spoon-feeding the medicine to infants and having young children drink it from a cup. They also give caregivers instructions to give additional preventive medicine over the next two days.
It costs roughly $6 to reach a child with a full season’s worth of SMC (though this figure doesn’t account for fungibility, which pushes our estimate of overall cost-effectiveness downward). If a child receives a full course of SMC, we estimate that they’re about five times less likely to get malaria during the rainy season (which is when roughly 70% of cases occur).
Imagine a village with 135 families in it, each with two kids under the age of five, for a total of 270 young children. In this village, imagine that every child is reached with a full course of SMC during the rainy season. Without SMC, we estimate that on average, 100 of those 270 young kids would test positive for malaria at any given point in time (though we think most of them would be asymptomatic). We estimate that SMC brings the overall prevalence of malaria down from 100 kids to only 40. For kids who would be symptomatic, this is the difference between feeling healthy and experiencing fever, aches, and other flu-like symptoms. And even more importantly: we estimate that SMC would protect one of these 270 young children from a fatal case of malaria.
What we’re excited to have recommended so far
This year, we’ve recommended grants to extend and expand programs we’ve supported for a while, like top charities, and we’ve also supported programs that are newer to us. With a decline in expected funding from Open Philanthropy, we’ve slowed our spending to match the funding we expect to raise going forward; we’ve focused more of our grantmaking on building for the future rather than funding large-scale opportunities this year. Below, we describe four selected grants from this year.
- $6.6 million to the Clinton Health Access Initiative (CHAI) to provide oral rehydration solution (ORS) and zinc for the treatment of diarrhea and to study the program’s effectiveness. We’ve been interested in funding ORS/zinc for a long time; it appears to be a low-cost way to prevent and treat dehydration caused by diarrhea. Previously, we hadn’t found the right opportunity to support it or to learn about our open questions. This grant will fund a randomized controlled trial studying the extent to which preemptively distributing free ORS/zinc directly to households increases usage by children under five, who are most at risk of death from diarrhea. This is the first program we’ve funded via the CHAI Incubator, a collaboration between GiveWell and CHAI designed to identify, assess, and scale highly cost-effective interventions.
- $12.6 million to New Incentives to extend and expand its promotion of infant immunization. New Incentives is one of our four top charities, which means it’s one of the giving opportunities we’re most confident in recommending to donors. With this funding, New Incentives is scaling up its work in northern Nigeria, where vaccination rates are particularly low and many children die of vaccine-preventable diseases. So far in 2023, New Incentives has enrolled over 1 million infants in its program.
- $5.8 million to MiracleFeet to scale up treatment for clubfoot and monitor its program. MiracleFeet’s program is different from most of the programs we fund because it involves treating a physical disability rather than implementing a preventive health program. We currently estimate that this program is close to our cost-effectiveness threshold, and we hope that we’ll learn more and update our views as a result of this work with MiracleFeet.
- $7.3 million to Evidence Action to explore opportunities to expand water chlorination and improve its effectiveness. This funding is intended to support Evidence Action to improve its safe water interventions and scope opportunities to expand to new settings. Evidence Action is also conducting pilots in three states in India; the goal is to explore the feasibility of different chlorination programs and partner with the government to deliver chlorination effectively.
What more donations will enable
With more funding, we can support more programs over the next few years. We research a variety of programs and estimate the cost-effectiveness of each, which varies by both program and location.
We set our cost-effectiveness threshold such that we expect to be able to fully fund all the opportunities above a given level of cost-effectiveness. Currently, we generally fund opportunities that we believe are at least 10 times as cost-effective as unconditional cash transfers to people living in poverty (i.e., “10x cash“). But there’s nothing magical about the 10x cash threshold. We’d be very excited to recommend programs that are 6x cash, for example, if we had enough funding—a program that’s 6x cash might save a life for less than $15,000.
See below for a stylized representation of our cost-effectiveness threshold, with details in this footnote.
If we had a very weak Giving Season this year and expected donations to continue lagging, we might have to raise our cost-effectiveness threshold to something like 12x cash and fund fewer programs going forward. In contrast, with exceptionally strong growth in donations we might be able to use a bar of 8x cash, expanding the set of opportunities we can fund.
Funding we receive this Giving Season could support a variety of programs at top charities and in areas that are newer to us; we’re still in the process of researching those opportunities. A few examples of programs that we might support include:
Iron fortification. When people consume iron-fortified wheat or rice, they’re less likely to be iron deficient and anemic. In areas where iron deficiency is very common, we think fortification leads to cognitive benefits that also increase income and consumption.
Malnutrition treatment. Children experiencing malnutrition are at higher risk of mortality. Severe acute malnutrition can be treated with ready-to-use therapeutic food and antibiotics. We wrote about malnutrition in 2021 and have continued to refine our analysis of malnutrition programs since then.
Seasonal malaria chemoprevention (SMC). As discussed above, this program involves distributing preventive antimalarial medication to young children. We’ve directed about $400 million to Malaria Consortium for SMC throughout GiveWell’s history.
Vitamin A supplementation. Vitamin A deficiency prevents the immune system from functioning well, increasing the risk of death from infectious diseases. Twice-annual supplementation campaigns like Helen Keller International’s reduce that risk.
How you can contribute
All Grants Fund
Our All Grants Fund is our top recommendation for donors who have a high level of trust in GiveWell and are open to programs that might be riskier than top charities. It allows donors to contribute to the most impactful grant opportunities we’ve identified, regardless of program or location. When you give to the All Grants Fund, your donation might go to support research or scoping opportunities rather than straightforward delivery of programs. You can find examples of the types of grants that could be funded by the All Grants Fund here.
Top Charities Fund and specific top charities
If you want to give to the programs we have the highest confidence in, we recommend giving to the Top Charities Fund. The Top Charities Fund is allocated to the highest-priority funding gaps among our top charities only. Because it’s more restricted, the Top Charities Fund may go to opportunities with lower expected value than the All Grants Fund; this would happen if our top charities become less funding-constrained than the rest of our portfolio, though so far we think the expected impact has been similar across the two funds. You can also give to a specific top charity of your choosing.
If you’re open to supporting both GiveWell’s operating expenses and our recommended programs, we recommend our Unrestricted Fund. If we raise more unrestricted funding than we need for our operating costs, we will grant out the excess. This is a great fit for donors who are excited about GiveWell’s work and trust us to prioritize between our operations and our recommended programs.
You can read more about all options for making a donation here.
Our community of donors will determine what we’re able to fund in the future. By giving to any of the options above, you’ll be supporting high-impact, evidence-backed programs. We’re grateful for your contributions!