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Comments
Have you looked in detail at any birth control initiatives?
I would have thought that, at least in theory, the cost benefit in terms of freedom of choice and poverty alleviation relative to the cost of the drugs that this would have the potential to be a competitive cause area.
Given you don’t have any in your top charities I expect this intuition is wrong, but I’d be interested to know why.
Hi Jamie,
Thanks for your question! We are actively considering funding programs that increase access to modern contraception in low- and middle-income countries. This may include programs that deliver family planning services and contraceptives to communities with limited existing access, or mass media campaigns that try to address misconceptions about contraceptives.
As you likely know, GiveWell relies heavily on cost-effectiveness analyses to decide which programs we recommend funding to. In order to assess the relative cost-effectiveness of family planning programs, we need to estimate the value created by increasing contraceptive uptake so that we can compare the benefits created by funding family planning to the benefits created by funding other programs.
Our initial estimate is that programs counterfactually providing a year of modern contraception (that is, contraception usage that wouldn’t otherwise occur for a woman in a low- or middle-income country who wants it) for less than $20 would meet our cost-effectiveness threshold. However, we’re highly uncertain about this because it requires difficult judgment calls and several empirical uncertainties. Given our uncertainty, we’ll also consider programs above this cost as we explore family planning programs.
Our Top Charities Fund supports our Top Charities, programs that we’ve estimated to be very cost-effective and in which we have a high degree of certainty according to our criteria. Because family planning is a funding area with high uncertainty, potential grants would come from our other giving funds. We’re planning to publish our initial report on valuing contraception in the next month.
great, thanks for getting back
What is a recent estimate of the marginal cost per marginal life saved for the Top Charities Fund?
For that recent period of the Too Charities Fund, what is an estimate of the odds or probability that one marginal USD would save a marginal life?
Suppose marginal cost per marginal life saved of 6000 USD.
Is 1:6000 approximately the odds of one more USD to save one more life?
If not, what is a tip for quickly estimating reasonable odds of one more USD donated?
Hi Ethan,
Thanks for this question! Our current estimate for the marginal cost per life saved through the Top Charities Fund is approximately $8,000, but this is sensitive to inputs like what fraction of the benefits are lives saved (versus increased later-life income or reduced morbidity, for example), the ages of the people whose lives are saved, and the possibility of funging. Because of these variables, the actual cost might range from roughly $5,000 to $10,000 while still meeting our 8x cost-effectiveness threshold for Top Charities grants.
When we estimate a marginal cost of $8,000 per life saved, this translates roughly to a probability of 1:8,000 that one additional dollar saves one additional life. For quickly estimating the odds of one more dollar saving another life, simply take the reciprocal of the cost-effectiveness figure. So if our cost per life saved is $8,000, then the probability is roughly 1/8,000 (or 0.000125).
However, this doesn’t mean that the chance for each dollar to save a life is exactly 1 in 8,000. Rather, it means each dollar contributes a small fraction (1/8,000) toward saving lives in expectation. If we roughly model this mathematically (using a Poisson distribution), the probability that donating $1 saves at least one life is approximately 0.000125. But if you donate the full $8,000, the probability of saving at least one life is about 63% (not 100%), with some chance you might save multiple lives, averaging out to one life saved in expectation.
The clear and simple arithmetic perfectly reassured a casual estimate.
Respectfully, I suggest that there are some very significant [other] ways to factor in “how much money it cost to save a life.” As a volunteer I have been educated over the last 20 yrs. on how this can be done.
One [way] I rarely hear elaborated on is the very real “social/emotional” health connections related to “life saving.”
The well-being of a person, as it regards their social/emotional health, can [often] result in saving their life (through a life-impacting benefit), once developed through a means compatible with educating said person. That cost could be as low as $185 for such an intervention (with the certainty that each child will be fully engaged). Over a 10 year period that amount drops considerably, regardless where that child gains this added life-benefit (e.g., $18.50, depending on what calculation is used to determine “life saving”). Imagine, how many people/children would use the same mosquito net…the cost to save lives drops considerably due to more [net] usage by a greater number of people. You can see, measurements can be used in a variety of well-meaning ways.
Through philanthropy, we can establish early methods that address social/emotional health (e.g., Preschoolers: 90% of their brains are developed by their 5th year) as a viable “life saving” method that delivers true dividends to the persons and communities.
I’d love to share some work/research history on this subject matter, and anyone should feel free to make contact.
Thank you.
Hi Jay,
Thanks for your comment! At GiveWell, we aim to identify and fund programs that have the greatest impact on global well-being, with a strong emphasis on evidence and cost-effectiveness. Much of our funding supports health programs, especially those that reduce child mortality from infectious diseases, because these interventions often have robust, generalizable evidence and measurable impact.
Many of the programs we fund, particularly those targeting child health, also offer indirect benefits such as increased income or improved long-term well-being. Our cost-effectiveness models incorporate a range of factors to estimate the cost per life saved. For example, in evaluating mosquito net programs, we account for usage rates, net durability, shared use, and more.
While we focus primarily on physical health interventions, we have evaluated some programs that focus on social and emotional health (e.g., StrongMinds), and we’ve made grants to support livelihood and education programs such as One Acre Fund and Malengo.
Like you, we think it’s possible that early childhood education may offer lasting benefits, potentially by increasing educational attainment, enhancing cognitive or socio-emotional skills, or improving children’s readiness for school. However, there is limited empirical evidence of its long-term economic impacts, so to date GiveWell has not directed significant funding towards these programs.
In 2024, we recommended a grant to the International Initiative for Impact Evaluation (known as 3ie) to assess the feasibility of a long-term follow-up to a randomized controlled trial (RCT) of a low-cost preschool program in Mozambique. If feasible, this could begin to fill the evidence gap, building on the initial RCT’s findings, which showed promising short-term effects on cognitive development and on primary school enrollment rates.