I’ve spent a good part of the past month reviewing The Carter Center in depth. We found out about The Carter Center though referrals from an advisor and donor, and through the Gates Award for Global Health.

We chose to investigate The Carter Center further for four reasons:

1. Strong track record of success. The Carter Center has been credited with leading the global effort to eradicate guinea worm. In 1986, when Carter got involved, there were 3.5m annual cases of guinea worm. In 2008, there were fewer than 5,000. Guinea worm has been eliminated from 12 of the 18 countries that were once endemic. This chart shows the decline in cases from 1989-2007 (PDF). (More information about guinea worm and its symptoms is available on The Carter Center website.)
2. Strong program selection. Other Carter Center programs have strong evidence of effectiveness supporting them. The interventions they implement to control or eliminate neglected tropical disease including river blindness, trachoma, lymphatic filariasis, and schistosomiasis are recommended by the experts at the Disease Control Priorities Project.
3. Monitoring and evaluation. For its health programs, The Carter Center often monitors not only the number of drugs distributed in each region but disease prevalence directly. This monitoring isn’t evident for every single program or region, but it is far more consistent than any other complex organization we’ve seen before.
4. Transparency. All the information we’ve used to research The Carter Center is available publicly on their website. For example, the detailed program reports I mentioned above are available here. For an example of the type of monitoring conducted for its guinea worm program, see the latest monthly report linked here.

I still have some large, unanswered questions about The Carter Center, and we aren’t yet ready to recommend them.