The GiveWell Blog

Challenges of passive funding

(updated on: ) | by Holden

[Added August 27, 2014: GiveWell Labs is now known as the Open Philanthropy Project.]

Something I think about a lot is the spectrum from “passive funding” to “active funding.” By “passive funding,” I mean a dynamic in which the funder’s role is to review others’ proposals/ideas/arguments and pick which to fund, and by “active funding,” I mean a dynamic in which the funder’s role is to participate in – or lead – the development of a strategy, and find partners to “implement” it. Active funders, in other words, are participating at some level in “management” of partner organizations, whereas passive funders are merely choosing between plans that other nonprofits have already come up with.

My instinct is generally to try the most “passive” approach that’s feasible. Broadly speaking, it seems that a good partner organization will generally know their field and environment better than we do and therefore be best positioned to design strategy; in addition, I’d expect a project to go better when its implementer has fully bought into the plan as opposed to carrying out what the funder wants. However, (a) this philosophy seems to contrast heavily with how most existing major funders operate; (b) I’ve seen multiple reasons to believe the “active” approach may have more relative merits than we had originally anticipated. This post discusses our observations on this front, and the implications. Note that Good Ventures has played a major role in facilitating and participating in conversations with other major funders, which is where most of our learning on this front comes from.

Brief summary:

  • Major funders very frequently take a highly active approach to funding, in some cases going so far as to play a major role in creating partner organizations.
  • In the nonprofit world of today, it seems to us that funder interests are major drivers of which ideas that get proposed and fleshed out, and therefore, as a funder, it’s important to express interests rather than trying to be fully “passive.”
  • While we still wish to err on the side of being as “passive” as possible, we are recognizing the importance of clearly articulating our values/strategy, and also recognizing that an area can be underfunded even if we can’t easily find shovel-ready funding opportunities in it.

Major funders appear to be highly active
Since we launched GiveWell Labs, we’ve spent a fair amount of time talking to major funders. Unfortunately, in many cases we’ve been able to have these conversations only under condition of confidentiality, but we’ve posted notes from conversations when possible and we can share examples of patterns we’ve observed.

Perhaps the most vivid example of an “active” funder is the Bill and Melinda Gates Foundation, which we also perceive as one of the most generally impressive foundations we’ve interacted with.

  • The Gates Foundation has been integral in the creation of many of the organizations it has made major grants to, such as GAVI (which has received several of its largest grants), Alliance for a Green Revolution in Africa, Innovative Vector Control Consortium, Foundation for Innovative New Diagnostics, and PATH Malaria Vaccine Initiative.
  • On polio eradication, it describes itself as providing “technical and financial” (not just financial) resources.
  • In a conversation with Cynthia Lewis of the Gates Foundation’s Tobacco Initiative, Cynthia emphasized that much of the Foundation’s work is “hands-on,” and also stressed that when going into a new area it may be necessary for a grantmaker to “create” the partner organizations it needs to fulfill specific objectives. When we asked her how one might go about this, she gave an example of an anti-tobacco organization whose team had been largely recruited by a program officer at another foundation. (At the same time, she characterized much of her own work as providing more “hands-off” funding to particularly strong organizations, indicating that there’s a time and place for both styles of grantmaking.) We will soon be publishing conversation notes from another conversation on this specific topic, which will give many more examples of cases in which various foundations were instrumental in the creation of partner organizations.

Other examples of “active funding” can be seen in our notes from discussing drug policy with Open Society Foundation representatives and in CIFF’s description of its approach to funding. An Atlantic Philanthropies document on political philanthropy states, “Once a grantmaker decides to support an advocacy campaign, there are several options for how to manage advocacy-oriented funding. Determine early on whether there is 1) a grantee, or coalition of grantees, that is already actively involved in a campaign or can easily take leadership; 2) a third party group that should be contracted to act as the manager for a new campaign initiated by the funder(s); or 3) the campaign would best be managed directly by foundation staff. Each approach has its own benefits and risks depending upon the issue and the funder(s).” In all three cases, it is clear that foundation staff sometimes intend to restrict funds and/or manage projects quite actively rather than simply providing funding.

Limitations of a passive approach
When we first started work on GiveWell Labs, we contemplated a highly passive approach in which we would ask major charities – and major foundations – for the “best projects that aren’t already funded.” This approach seemed to face many obstacles. When speaking with major charities, we found that:

  • Some groups (such as GAVI and PATH) emphasized the need for unrestricted funds to respond to opportunities as they came up, rather than pointing to specific un-funded opportunities.
  • Other groups (such as GAIN and Micronutrient Initiative) listed many possible projects, at a very broad level, and asked us to direct them to the ones we were most interested in.
  • In all cases, it’s been a consistent fact that there are no existing detailed writeups on the ideas ready for us to review. Rather, it seems to consistently be the case that detailed writeups on potential projects are developed for (and in collaboration with) potential funders. (Every project proposal we’ve ever seen from a large organization has been for a specific funder).

When speaking with major funders, we were often presented with more specific project proposals, about which more written information was available. However, in these cases, it wasn’t always clear to us that the projects we were looking at needed more funding to go forward. In the case of the PSI project that Good Ventures co-funded with the Gates Foundation, we initially believed there was a concrete funding gap and later changed our view. In the case of the Wellcome Trust, it was made explicit to us that there are rarely specific projects that are outlined and ready to go but not funded.

Without detailed writeups, and without a good deal of context, it’s very difficult to assess a potential project. Asking for a detailed writeup would be, to some extent, indicating and committing interest in the potential project. Because of this dynamic, it’s very difficult to a purely “passive” funder: one needs a sense of which sorts of projects one is most interested in.

This may also help explain the shortcomings of the “maximally passive” approach we took in 2007. (See our July 2012 blog post discussing this.) We had hoped that many charities would fully make the case for their impact to us, and that we would simply choose the best case. But when writeups are usually done for – and in collaboration with – specific funders, this sort of approach isn’t possible, and it’s necessary to have an idea of one’s criteria in order to even decide what to evaluate.

Another approach to “passive” funding is to focus on smaller, startup-like nonprofits rather than large charities and foundations, as Ashoka does. However, even when seeking out groups like this, we see possible advantages to being active:

  • There are already multiple groups that take a systematic, “sector-agnostic” approach to funding smaller and more startup-like groups. (Ashoka, Draper Richards Kaplan, Echoing Green; Skoll Foundation at a later developmental stage.) We’re not sure whether we’d have substantial value-added over such groups if we focused on taking a similar approach.
  • We’ve seen multiple cases in which a funder’s “active” strategy was crucial in finding – or even creating – a “startup-like” nonprofit. Some of these involved interactions with other funders from which we have not produced public information, but we can discuss cases that involved us directly. These are intended to give examples of how one’s active strategy can be crucial in becoming aware of (or even contributing to the creation of) a “startup-like” nonprofit; we don’t intend these examples to be interpreted as groups we’re actively considering funding.
    • In one case, we spoke to a professor about the Cochrane Collaboration, and after he saw our post on meta-research, he asked whether we’d be interested in a proposal for the creation of a meta-research-oriented group. He explained to us that he had wanted to write up such a proposal for a long time, but had not done so previously, because he couldn’t identify any funders that would likely be interested.
    • Dario Amodei has also been influenced by our discussion of meta-research. As an academic himself, he has considered trying to get involved in improving the system of academia. Our interest in this area has helped give shape to his interests, and has played a role in the creation of Vannevar, a group of scientists dedicated to making scientific research more efficient, collaborative and productive. According to Dario, the knowledge that a funder might be interested in his collected observations on academia – even though the interest was very preliminary and did not come with any funding commitment – has spurred him to conceptualize, and follow through on, a strategy focused on producing the sort of information such a funder might find valuable.

I think the above observations point to a potential disanalogy between the for-profit and nonprofit worlds. In the for-profit world, a business gets capital from investors but ultimately gets its revenue from customers (and if it can’t raise capital, it can often “bootstrap” to the point where it has something more impressive to show funders). In the nonprofit world, funders provide both the capital needed to get started and the ultimate verdict on whether a project succeeded. Thus, in the nonprofit world, it seems that the “what projects are people trying to start?” question and the “what projects do people think major funders will be interested in?” question are tightly integrated. Expressing clear interests (as we did with our meta-research post) can cause new opportunities to emerge; simply looking for “shovel-ready” projects may severely limit a funder’s options.

Another possibility that has occurred to me is that the role of “strategy development” may be structurally more common at foundations/grantors than at charities/grantees. Since foundations ultimately decide which strategies get funded, people who are oriented toward developing strategies may gravitate toward foundations.

Implications
In the nonprofit world of today, it seems to us that funder interests are major drivers of which ideas get proposed and fleshed out, and therefore, as a funder, it’s important to express interests rather than trying to be fully “passive.”

It’s possible, and perhaps desirable, that the nonprofit world of the future will work differently. If funders had greater commitments to transparency, and posted the proposals they chose not to fund, it’s possible that a database of “shovel-ready” proposals could emerge. We certainly intend to share the proposals we don’t fund, when possible, and to encourage others to do the same. But in the world as it exists, it seems important to recognize that articulating preferences and areas of interest is an important thing for a funder to do.

Partly for this reason, we’ve largely de-emphasized the kind of thinking we were doing in 2011 about “sector-agnostic” giving (looking across all issue areas for the most outstanding projects), in favor of the related idea of strategic cause selection. In strategically choosing causes, we want to place some weight on the criterion of room for more funding, and therefore we’d conceptually like to choose causes based partly on what projects are available to fund within them. However, we don’t believe that looking at the current set of “shovel-ready” projects is a reliable way to assess conceptual “room for more funding,” and we believe it may sometimes be fruitful and necessary to express interest in a cause despite not having a good sense of what projects are available within it. We will have to find other – and perhaps rougher – ways of estimating which causes are “overfunded” as opposed to “underfunded.”

Is the world getting better?

| by Elie

I recently spoke with Robin Hanson and he proposed that donors invest their money in order to give more in the future.

One question that came up was whether the world is improving such that opportunities to cost-effectively accomplish good are running out.

I think there’s a strong argument that this may be the case, at least when it comes to improving the health and opportunities of the world’s poorest. The following charts illustrate that child deaths have been falling dramatically and population growth has been slowing as incomes have risen. (In the charts, the trails show each country’s changes over time, from the first year noted in the bubble with the country’s name until the present day.)

The graphs below come from Gapminder.org. The charts below only show several countries for several indicators, but they’re broadly representative of what has happened. To see more, click through to Gapminder.

Child mortality has fallen dramatically since the 1960s as incomes have risen
Population growth has slowed as incomes have risen

GiveWell’s history of philanthropy/philanthropy journalism project

(updated on: ) | by Elie

Programs’ track records have always been a major input into our research process. For example, when assessing the case for distributing nets to prevent malaria, we’ve looked for information about the track record of similar programs.

As we begin to research other areas where philanthropy could play a role, we similarly want to learn from history about philanthropy’s track record. We’ve done some minimal work looking for literature, but what we’ve found was either not on the topic we’re most interested in (i.e., what has philanthropy accomplished?) or wasn’t at a sufficient level of depth to adequately answer the question “what role did philanthropy, as opposed to other factors, play in the outcome in question?” (For more, see our 2012 post on the best source we’ve found so far for this sort of information.)

Because we’ve struggled to find relevant literature, we’ve begun a project to investigate the possibility of funding someone to do a more thorough job of synthesizing what already exists – or to create better literature. We think it’s possible that we might seek to fund this type of work in the future. Such funding would be modest in size, at least to start, and would be thought of more as “costs of research” than as “top giving opportunities.” We would view this work, at least in the short term, as a potential way to increase our total “research capacity” by answering questions that we would otherwise try to answer internally.

Some examples of projects we might consider include:

  • An annotated bibliography of what relevant materials already exist – materials written by academics and think tanks as well as materials available in foundation archives (e.g., the Rockefeller Archives house archival information from multiple foundations and make this information available to researchers).
  • Literature reviews of topics covered by existing literature.
  • A list of the 20 most important philanthropic “success stories” (policy changes, scientific/technical contributions, or other) of the last 25 years.
  • A list of 20 major philanthropic failures (e.g., cases in which philanthropists spent large amounts of money with disappointing results).
  • In-depth case studies of the above aiming to questions such as “What role did philanthropy play in this change?”, “What other, non-philanthropic factors played a major role?”, “Who (if anyone) was opposed to the change in question and how did they try to prevent it from occurring?” and “What was the social impact of this change?” These case studies could take the form of ~10,000-word “long-form journalism,” academic papers, or think-tank white papers.
  • We could also imagine supporting work that’s more focused on reporting on events as they develop. For example, we could fund a journalist to visit NGOs and report back, much in the way we’ve done on our site visits to our top charities. Or, we could support a journalist to report on the ongoing way in which philanthropists develop strategies and how those strategies play out.

We’re very early in our investigations. We still aren’t sure whether this work would be best suited to academics, think tanks, journalists, or someone else, and we have little idea of what scope (or how much funding) we will eventually find worthwhile. As always, we plan to be fully transparent with the results of this work, so the output of what we produce will be publicly available.

What we’ve done so far and plans for 2013

Thus far, I’ve spoken with about 15 people including journalists, academics, and people who have worked (or work) at think tanks. The conversations have generally been short and we haven’t produced notes from individual conversations. What we have taken away from these conversations is a broad consensus that (a) there isn’t much information of the type we’re looking for already available and (b) this is an interesting project that people would be excited to participate in. The book that’s been most frequently recommended to me as fitting what we’re looking for is Steven Teles’s The Rise of the Conservative Legal Movement.

The people I’ve spoken with (who gave me permission to put their names in this post) are:

While this project may become something much bigger, our goals for 2013 are to undertake several small projects (as a very rough benchmark, we’ve thought of potentially funding up to $250,000 this year) to see if we’re able to produce the type of information we’re looking for.

Deep value judgments and worldview characteristics

(updated on: ) | by Holden

One purpose of this blog is to be explicit about some of the deep value judgments and worldviews that underlie our analysis and recommendations. As we raise the priority of expanding our research into new causes, this seems like a good time to lay out some of the things we believe – and some of the things we’re unsure about – on topics that could be of fundamental importance for the question of where to give.

In general, the below statements broadly describe the values of the GiveWell staff who have final say over our research. There may be cases in which different individuals would give different levels of weight/confidence to the various statements than I have, but at a high level we expect these statements to be a reasonably good guide to the values underlying GiveWell’s research.

Values

We don’t believe it would be productive to try to produce a complete explicit characterization of the fundamental values that guide our giving recommendations, but we think it’s worth noting some things about them.

  • We are global humanitarians, believing that human lives have equal intrinsic value regardless of nationality, ethnicity, etc. We do believe there may be cases where helping some people will create more positive indirect effects than helping others (for example, I stated in 2009 that I preferred helping people in urban areas for this reason, though this represents my view and not necessarily the view of others at GiveWell). However, we do not agree with the principle that “giving begins at home”: we do not assign more moral importance to people in our communities and in our country than to others.
  • The primary things we value are reducing suffering and tragic death and improving humans’ control over their lives and self-actualization. We also place value on reducing animals’ suffering, though substantially less than on human suffering. We also place value on reducing animals’ suffering, though our guess is that the type of suffering animals experience is of a kind that we would not weigh as heavily as the type of suffering that humans experience. (We do not have clear consensus views on how to weigh these things against each other.) This bullet point edited for clarity on Sep. 5, 2013.
  • We do not put strong weight on “achievements” (artistic endeavors, space exploration, etc.) as ends in themselves, though these may contribute to the things we do value (details above). We also don’t put strong weight on things like “justice,” “equality,” “fairness,” etc. as ends in themselves (though again, these may contribute to the things we do value).
  • We are broadly consequentialist: we value actions according to their consequences.
  • We are operating broadly in an “expected value” framework; we are seeking to “accomplish as much good as possible in expectation,” not to “ensure that we do no harm” or “maximize the chance that we do some good.”

There are many questions that we do not have internal consensus on, or are individually unsure of the answers to, such as

  • How should one value increasing empowerment vs. reducing suffering vs. averting deaths?
  • How should one value animal suffering in comparison to human suffering helping animals in comparison to helping humans? This line edited for clarity on Sep. 5, 2013.
  • Is it better to bring someone’s quality of life from “extremely poor” to “poor” or from “good” to “extremely good?”
  • Is creating a new life a good thing? Can it be a bad thing? How “desirable” or “undesirable” must the life be for its creation to count as a good/bad thing? Should we value “allowing future lives to exist that would never come into existence otherwise” similarly to “lives saved?”
  • Is it better to save the life of a five-year-old or fifteen-year-old?

We don’t believe it is practically possible to come to confident views on these sorts of questions. We also aren’t convinced it is necessary. We haven’t encountered situations in which further thought on these questions would be likely to dramatically change our giving recommendations. When we have noticed a dependency, we’ve highlighted it and encouraged donors to draw their own conclusions.

Worldview

We view the questions in the previous section as being largely “fundamental,” in that empirical inquiry seems unlikely to shift one’s views on them. By contrast, this section discusses views we have that largely come down to empirical beliefs about the world, but are very wide-ranging in their consequences (and thus in their predictions).

There are two broad worldview characteristics that seem, so far, to lie at the heart of many of our disagreements with others who have similar values.

1. We are relatively skeptical. When a claim is made that a giving opportunity can have high impact, our default reaction is to doubt the claim, even when we don’t immediately see a specific reason to do so. We believe (based partly on our experiences investigating charities) that most claims become less impressive on further scrutiny (and the more impressive they appear initially, the steeper the adjustment that happens on further scrutiny). As a result, we tend to believe that we will accomplish more good by recommending giving opportunities we understand relatively well than by recommending giving opportunities that we understand poorly and look more impressive from a distance.

We have written about this aspect of our worldview previously, and have done some rudimentary work on formalizing its consequences:

  • A Conflict of Bayesian Priors? lays out the basic fact that we have a skeptical prior (by default, we expect that a strong claim will not hold up to scrutiny).
  • Why We Can’t Take Expected-Value Estimates Literally does some basic formalization of this aspect of worldview and explores some of the consequences, defending our general preference for giving where we have strong evidence that donations can do a lot of good rather than where we have weak evidence that donations can do far more good. It also explains why we put only limited weight on formal, explicit calculations of “expected lives saved” and similar metrics.
  • Maximizing cost-effectiveness via critical inquiry expands on this framework, laying out how it can be vital to understand a giving opportunity “from multiple angles.”
  • We will likely post more in the future on this topic.

2. We believe that further economic development, and general human empowerment, is likely to be substantially net positive, and that it is likely to lead to improvement on many dimensions in unexpected ways. This is a view we haven’t written about before, and it has strong implications for what causes to investigate. While we see great value in directly helping the poorest of the poor, we’re also open to the viewpoint that contributing to general economic development may have substantial benefits for the poorest of the poor (and for the rest of the world). And while we are open to arguments that particular issues (such as climate change) are particularly important to the future of humanity, we also believe that by default, we should expect contributions to economic development and human empowerment to be positive for the future of humanity; we don’t feel that one must necessarily choose between improving lives in the short and long term. (This view is part of why we put more weight on helping humans than on helping animals.)

Because of this view, we are open to outstanding giving opportunities across a wide variety of causes; we aren’t convinced that the best opportunities must be in developing-world aid, or mitigation of global catastrophic risks, or any other particular area. Even if a particular problem is, in some sense, the “most important,” it may be possible to accomplish more good by working in another cause where there is better room for more funding. We will discuss this view more in a future post.

Why we recommend so few charities

(updated on: ) | by Holden

This post seeks to address a common misconception about our work, and will in the future be linked from an FAQ.

We often encounter confusion around the fact that we recommend so few charities. Some take this as a statement that “very few charities are accomplishing good,” but this is very much an incorrect interpretation. We recommend few charities by design, because we see ourselves as a “finder of great giving opportunities” rather than a “charity evaluator.” In other words, we’re not seeking to classify large numbers of charities as “good” or “bad”; our mission is solely to identify, and thoroughly investigate, the best.

The upshot is that the charities we don’t recommend may be doing great work, and our lack of recommendation shouldn’t be taken as evidence to the contrary. However, our top charities are the ones that we believe best fit our criteria: evidence-backed, cost-effective, and capable of effectively using more funding.

We take this approach because

  • Thoroughly understanding even one charity is a great deal of work. We’ve put hundreds of hours into each of our current top charities. Our investigations include thoroughly reviewing the research behind charities’ programs, researching possible concerns about these programs, extensive back-and-forth with charities to gain full understanding of their processes and past and future uses of funds, multi-day site visits to charities’ operations in the field, and ongoing updates, as well as extremely time-intensive cost-effectiveness analysis (estimating how much good is accomplished per dollar spent). (For example, see this 2011 blog post about our due diligence on former #1 charity VillageReach; since then our process has intensified significantly).
  • Thoroughly understanding our top charities makes a substantial difference to our donors. One of the ways in which our money moved has increased is that donors have given higher percentages of their income to our top charities over time, as their confidence in our recommendations has grown. As evidenced by the public discussions we’ve had, donors tend to have many questions about our top charities and to value the work we put into being thorough.
  • Thoroughly understanding a charity is harder when the charity is less outstanding. Our top charities are characterized by partly by qualities that make them easy to understand: extreme transparency (which makes it relatively easy to communicate with them, understand them, and write about them) as well as strong relevant evidence bases (which make it relatively easy to answer key questions).By contrast, the experiences we’ve had attempting thorough reviews of less outstanding charities have frequently involved time-consuming confusion over answers to key questions and contentious, and time-consuming discussions about what is appropriate for us to publish.

    Note that establishing that a charity is failing would be even more difficult than establishing that a charity is succeeding. The latter is difficult because even well-done studies generally have many complexities and shortcomings. The former is more difficult because there is generally little data available (even if it exists it is unlikely to be made available to us).

  • Thoroughly reviewing less outstanding charities – while more difficult than reviewing top charities – would be far less benefit to our mission. We have written about this issue previously. In the past, we’ve tried recommending larger numbers of charities, with lower confidence; these efforts have included recommendations in popular causes such as microfinance and U.S. equality of opportunity. But we’ve seen the vast majority of dollars go to the charities that win our highest recommendations, and the lower-tier recommendations have attracted relatively little in the way of donations.It may be true that, all else equal, having more recommended charities raises our total money moved. It may be true that if we could comprehensively review all major charities, giving them a definitive positive or negative rating, our product would have more appeal. But these activities would take more resources than we have (or, in the case of the latter, more resources than we believe we could ever realistically have). The return on investment of reviewing less outstanding charities is far inferior to the return of focusing on the best giving opportunities.
  • We need all the capacity we have for the goal of finding the best giving opportunities possible. As discussed previously, we are currently trying to increase the time we spend trying to explore giving opportunities outside of our traditional criteria. Doing so while maintaining confidence in our current charity recommendations takes all the capacity we have. And if we had more capacity, we would try to improve the speed and quality of our efforts to identify even more outstanding giving opportunities, long before we tried to review less outstanding charities.

Our process is built around having maximal confidence in our recommendations for how to do as much good as possible with one’s giving. This goal is distinct from the goal of reviewing and/or recommending large numbers of charities, and trying harder to accomplish the latter would detract from our success at the former.

Trying (and failing) to find more funding gaps for delivering proven cost-effective interventions

(updated on: ) | by Holden

There are interventions that we believe are – or may be (pending a literature review) – very well supported by evidence, that we’ve been unable to find charities focused on. In 2012, we put a significant amount of effort into trying to find ways donors could pay for further delivery of these interventions, even if it required working with a large organization (such as UNICEF or GAVI) rather than with a small charity dedicated to the intervention in question. Good Ventures played a major role in these investigations and was particularly helpful in getting engagement from these larger organizations.

The bulk of our efforts focused on immunizations – which we consider to have the strongest evidence base of any intervention we know of – and micronutrient supplementation (particularly salt iodization and vitamin A supplementation, which we perceive as the most evidence-supported micronutrient interventions; writeups on these interventions are forthcoming).

Despite substantial effort, we did not find any such giving opportunities. The basic pattern we saw was that:

  • Government and multilateral funders provide substantial funding for these interventions.
  • It often appears that the greatest obstacle to universal coverage is a logistical bottleneck rather than a simple lack of funding for more direct execution.
  • We asked persistently for areas where more funding was needed to do more direct delivery. In many cases, we were told that there were opportunities, but then (a) these opportunities became funded by others while we were investigating them, or (b) we tried to follow up on these opportunities and ultimately were met with unresponsiveness, and/or concluded that funding was not the primary bottleneck to progress in these cases.

Overall, this pattern of observations fits a model in which the most proven, cost-effective interventions are often already being appropriately funded by the international community (though not in every single case; LLIN distribution is the clearest exception we’ve found).

Unfortunately, many of the details of our investigations cannot be shared, because the organizations we worked with sometimes shared information only under condition of confidentiality. What we can share is the following:

  • Immunizations. Our immunization landscape writeup shares most of what we’ve learned about immunization funding. In brief, it appears that developing-world governments fund much of the basic costs of routine immunization, while GAVI provides substantial support for routine immunizations, newer more expensive vaccines, and campaigns (additional opportunities for children to receive a few key vaccines, as a way to reach children missed by the routine vaccination system and to provide additional doses to increase immunity to the targeted diseases). GAVI exceeded its fundraising target for 2011-2015 as of June 2011 (with much of the funding coming from developed-world governments, as seen on page 4 of this PDF) and is currently raising funds for 2016 and beyond (as discussed in this conversation (DOC)). We looked into several other organizations, speaking with UNICEF, the World Health Organization, and several campaign-focused organizations, and in no cases found the sorts of funding opportunities we were looking for.
  • Salt iodization. We investigated two apparent funding opportunities in depth: (a) a project with GAIN in Ethiopia, in which we concluded that the key issue to be resolved was not one of funding (more detail at the link), and (b) the possibility of funding in Eastern Europe (which a conversation with UNICEF highlighted to us), which we investigated but have not produced publicly available information on.
  • Vitamin A supplementation. It appears to us that the Canadian government is a major funder of vitamin A supplementation (for example, it recently granted ~$150 million for this purpose), and that UNICEF is a major supporter/implementer (see this link). We spoke with UNICEF and others in an attempt to find areas where more funding was needed to directly deliver more vitamin A supplementation, and were unable to identify such funding opportunities. The details are mostly confidential, with the exception of an initial conversation with UNICEF.
  • Other programs. Our 2012 efforts also included looking into the evidence behind zinc supplementation (both therapeutic and non-therapeutic), which had been highlighted to us as an area with large funding gaps by the Micronutrient Initiative. We concluded that the evidence case and likely cost-effectiveness were inferior to those of our top charities’ interventions.

For the time being, we’ve provisionally concluded that

  • The path of trying to fund the most proven interventions, when we can’t find charities that focus on them, doesn’t appear promising in the short term. This is partly because a lack of charities focusing on an intervention may be correlated with a lack of room for more funding to deliver the intervention directly; it is also because we’ve found it very difficult to work with and learn from large diverse organizations. We do expect to return to this path at some point, but we don’t expect to make it a major priority over the coming year.
  • In general, it appears that the most proven interventions do attract substantial funding from governments and others. There are some funding gaps (the best example being bednets); but overall, it appears that the most proven, cost-effective interventions are often already being appropriately funded by the international community.