The GiveWell Blog

Clarifying the role of different partners

(updated on: ) | by Elie

One major question we’ve struggled to answer is: how do the different NGOs, local governments, and international global health partnerships work together to implement a given program?

For example, take mass drug administration of ivermectin to reduce onchocerciasis, one of our favorite programs. In Uganda, the African Programme for Onchocerciasis Control (APOC) works out of the World Health Organization (WHO). The Ugandan Ministry of Health is also involved. So are two nonprofits, The Carter Center and SightSavers International. What role does each play?

Steven Kasolo, the program officer responsible for SightSavers’ onchocerciasis program in Uganda, kindly agreed to speak with us on Tuesday morning. A summary (paraphrased highlights, not verbatim) follows. To us the key points to note are that:

  • Program implementation is ultimately being done exclusively by (district-level) government officials.
  • APOC, The Carter Center, and Sight Savers International provide funding and in some cases help with reporting, but do not have significant staff on the ground.
  • Funds flow from APOC and the nonprofits to the district-level government officials. The funds are kept in separate accounts and come with separate reporting requirements, but otherwise are largely fungible (according to Steven). From a donor perspective, it doesn’t seem to matter much which of the three donation-accepting organizations (APOC, SightSavers, The Carter Center) the funds flow through, given that they’re funding this project.

Elie: What role does SSI [Sight Savers International] play in Uganda’s onchocerciasis program?

Steven: SSI has two roles. One is to help with the evaluation; the other is to actually fund the program. In Uganda, The Carter Center and SSI each contribute 25% of the total budget for onchocerciasis. TCC and SSI are responsible for different districts. The government contributes the rest. Right now, APOC (African Programme for Onchocerciasis Control) doesn’t fund Uganda’s programs.

Elie: When APOC was funding Uganda’s programs, how did that work?

Steven: The Ministry of Health [MoH] applies to APOC and APOC sends funds to the Ministry of Health. MoH sends money to districts and it’s all government employees that implement and document the program. Government employees send activities reports and budgets to me. I also make site visits to local villages (where the programs are being implemented). Then, I send reports on to the MoH and the MoH would send them to APOC.

Elie: Where, specifically, do SSI funds go when you fund an onchocerciasis program?

Steven: We send funds straight to the district. Funds are managed by government employees in the district. These are the same people who receive funds from the MoH. The actual treatments are distributed using unpaid, community volunteers, following the CDTI process.

New, promising charity: The Stop TB Partnership

(updated on: ) | by Elie

As part of our current work on developing-world aid, we’ve completed a preliminary report on The Stop TB Partnership. We still have more work to do, but want to share what we’ve learned thus far. Here’s what’s available:

KIPP and self-selection

(updated on: ) | by Holden

The Knowledge is Power Program is one of our current recommended charities, but I think that Sarah Mosle’s critique in Slate is very much worth keeping in mind.

Mosle writes:

While KIPP does have outreach efforts to broaden its applicant pool, only the most determined parents are likely to respond to … sign KIPP’s demanding contract. This dedication suggests a higher value on education within these families, and thus kids better able or willing to learn. And the weakest students, not surprisingly, get disproportionately winnowed. In KIPP’s schools in the San Francisco Bay Area, for example, the worst-performing kids have dropped out (or been expelled) in greater numbers in the higher grades; the result has been to inflate the schools’ grade-to-grade improvement.

We agree that the superior performance of KIPP’s students can’t be taken fully at face value, because they may not be a truly representative set of disadvantage students. Our analysis concludes that KIPP most likely is making a difference for the students that it serves, despite these concerns (and Mosle thinks so as well).

However, just because KIPP is making a difference for the students it serves doesn’t mean its model can be fully generalized to close the achievement gap. For one thing, it isn’t clear how many teachers can be found that are at the caliber KIPP aims for. For another, KIPP appears to be aimed at a particular kind of student. I think Mosle’s closing concern is right on target:

But since the biggest debate about KIPP, on both the ideological left and right, is whether or not its methods can work for all disadvantaged children (instead of just a handful of self-selecting families), why wouldn’t it—and its financial, ideological, and media backers—have a strong interest in answering this question once and for all by taking on an entire urban area or even, for that matter, a single neighborhood as, say, Geoffrey Canada has tried to do in Harlem with his Harlem’s Children’s Zone?

There’s something perversely evasive about KIPP’s opening up just one school in Dallas, one school in Albany, N.Y., one school in Oakland, Calif., one school in Charlotte, N.C., one school in Nashville, Tenn., and so on—as if the program recognizes that its best chance at success is to be the exception rather than the rule in any city where it operates.

I believe anyone pointing to KIPP as “the path to closing the achievement gap” is being far too optimistic, although KIPP is a promising way to improve outcomes for the individuals it serves.

Additional GiveWell materials related to KIPP:

  • The summary of our review of KIPP is available here with a link to our full-length review.
  • Our overview of programs aiming to increase equality of opportunity is available here.
  • We’ve blogged about KIPP here and here.

Mistargeted microfinance?

(updated on: ) | by Holden

There are many studies attempting to gauge microloans’ impact on borrowers, but most suffer from the problem of selection bias: by comparing participants and non-participants, they may be picking up other differences between these groups (for example, people who participate in microloan programs may be wealthier to begin with, so a study showing that they have higher incomes does not really show that microloans help).

One of the better-known attempts to avoid this problem was a 1997 study that attempted to take advantage of a “landholding requirement”: a program that allowed people to borrow only if they held less than a half-acre of land. This study is one of the few empirically encouraging studies of microloan programs, as we discuss here, although there was some dispute over whether the landholding requirement was strictly enforced.

New analysis by the Center for Global Development’s David Roodman shows that even though the microfinance program attempted to target people with less land, in fact people with more land borrowed significantly more. I agree with Roodman’s general conclusion:

This is not necessarily bad: serving richer clients with larger loans may make it more economical to reach poorer people in the same villages–an example of cross-subsidization. And someone whose main asset is an acre or two or riceland in rural Bangladesh is hardly rich by western standards–and might even make better use of the credit. Still, the “mistargeting” of landed families contradicts the public image of microfinance in Bangladesh as targeting the poorest, and probably needs to be better understood.

Additional GiveWell materials related to microfinance:

  • Our full review of the evidence for microfinance programs is available here
  • We first blogged about microfinance here and here.
  • Those blog posts rely heavily on a white paper published by the Grameen Foundation, available here (PDF).

Can the Green Revolution be repeated in Africa?

(updated on: ) | by Holden

In his Annual Letter, Bill Gates describes the “Green Revolution”:

Almost every country that has become wealthy started with a huge increase in farming productivity. Chart 4 shows the increase in output per acre for various grains, including wheat, corn, and rice, in the United States, India, China, and Africa since 1961. This dramatic increase in output—more than three times—is often called the Green Revolution.

The Green Revolution, and the Rockefeller Foundation’s role in the research that enabled it, is frequently cited as one of philanthropy’s great success stories(1) and a huge contributor to enormous reductions in poverty.(2) Yet as Gates continues, “Africa jumps out as the only case where this [revolution] has not taken place.” Why?

To Gates, the answer appears to come down to insufficient investment:

African countries have widely varying climate conditions, and there hasn’t been the same investment in creating the seeds that fit those conditions. Because agriculture is an essential part of economic growth for most African countries, we are working with others to fund a “Green Revolution for Africa” and other areas that could benefit from this kind of investment.

Gates gives the impression that bringing the Green Revolution in Africa is mostly a matter of repeating what’s worked elsewhere, which would make it an excellent fit for our priorities. But from the rough analysis we’ve done, it appears that there has been at least as much effort to bring about a Green Revolution in Africa as elsewhere, and the obstacles in this area are specific and significant.

CGIAR funding

The Consultative Group on International Agricultural Research appears to have been the main vehicle for philanthropic funding of relevant research.(3) Using data from its website, we put together the chart below showing how much has been spent at its centers in (sub-Saharan) Africa as opposed to its other centers. The proportion was consistently been between 25% and 30% from 1972-2003:(4)

For context, sub-Saharan Africa accounted for 20-30% of the world’s extremely poor in 2003, up from 14-19% in 1990.(5) It certainly seems from this rough cut that funding for relevant research in Africa was in line with funding for relevant research in the rest of the world.

Norman Borlaug

Norman Borlaug is often credited with (and won the 1970 Nobel Peace Prize for) a leading role in the research that made the Green Revolution possible.(6) The transcript of a 2006 Center for Global Development event implies the following about his relative efforts in different areas:

  • He started working in Mexico in 1944 (pg 4); “By the late 1950s the cooperative program had made such a contribution to Mexico’s food production that … Borlaug had succeeded in working himself out of a job” (page 3).
  • He entered India in 1967, and within 10 years India had gone from threats of famine to self-sufficiency (page 3; see also the account of the Green Revolution given by the Library of Congress’s Country Studies/Area Handbook Series).
  • He has been working on bringing similar benefits to Africa since 1985 (pages 6-7) – far longer than he worked in either Mexico or India.

Comparable efforts; disappointing results

There are many factors that may make a Green Revolution in Africa difficult or impossible to bring about, including:(7)

  • Agricultural prices have fallen drastically (in real terms) since the original Green Revolution. The benefits to increased crop production may therefore not be as great.
  • Africa’s environment, with its high disease burden and difficult climate, presents special – and possibly greater – challenges compared to other environments.
  • Much of Africa has low population density and extremely weak infrastructure (including railroads, irrigation and electricity).
  • African governments are not providing the sorts of subsidies that Asian governments used to encourage agricultural output.

None of this means that bringing the Green Revolution to Africa is necessarily impossible, or that aiming funding at this goal is necessarily futile. But it’s important to recognize that this goal is a formidable challenge for which no strong precedent exists.

The prospect of an African Green Revolution is extremely appealing, but we don’t feel that this sort of investment can ultimately be counted as “proven and scalable,” and we don’t feel it’s as well-suited for individual donors as many health interventions (which are both proven and likely repeatable, and have simply not been funded enough to reach full coverage – more on this in a future post).

(1) See, for example:

(2) “The green revolution, which accelerated growth from the 1960s, beginning in India and Indonesia, was a major factor reducing poverty in Asia, as documented by numerous studies (see, for example, Rosegrant and Hazell 2000; Timmer 2002; Lipton 2004; Datt and Ravallion 1998a, 1998b). ” From “Agriculture, Rural Development, and Pro-poor growth” (World Bank 2005) pg 15.

(3) Based on a reading of the Rockefeller Foundation’s history (note 1 gives two examples of the Rockefeller Foundation’s being credited with a primary role in the Green Revolution).

(4) Data, sources, and calculations available here (XLS).

(5) Based on the proportion of people living on $1/day or less and $2/day or less, as reported on page 60 of the World Bank’s 2007 Global Economic Prospects report.

(6) See Borlaug’s Nobel Peace Prize bio and the opening statements/summary of the Center for Global Development’s event on “The Prospects of Bringing a Green Revolution to Africa”.

(7)Sources: