The GiveWell Blog

Mega-charities

(updated on: ) | by Holden

We haven’t written much about mega-charities: extremely large international charities (budgets of $250+ million per year) carrying out a very wide range of activities, and commonly recognized as household names. We’re thinking of groups like UNICEF, Oxfam, Mercy Corps, Catholic Relief Services, Save the Children, World Vision, and CARE.

The main reason we haven’t written much about these groups is that we still know very little about them. They tend to publish a great deal of web content aimed at fundraising, but very little of interest for impact-oriented donors. On the occasions when we’ve engaged with these groups, we’ve come away with the feeling that they engage in a wide variety of activities, and we can’t get a concrete sense of (a) the specifics of the activities; (b) the organization-wide track record; (c) likely uses of additional funding. (We wrote in 2007 about our inability to put together bird’s-eye views of their activities).

Below are general impressions from our limited information on, and interactions with, these groups. Note that in preparing this post, we examined the websites of the 7 organizations named in the first paragraph, looking for whatever information we could find on specific projects (as opposed to broad characterizations of activities), results (technical writeups, not narratives), and financial information (any budget breakdown by project or program type, or revenue source – we tabulated our findings in this spreadsheet).

The risks of giving

(updated on: ) | by Holden

Elie recently highlighted his doubts about our top charities, and a commenter responded:

Of course one ultimately never knows how much good a charity or any given donation will do. Bednets might end up saving the life of child who grows up to be the next Nelson Mandela – or the next Saddam Hussein. Everything we do is a gamble, but I’d like to make the best ones I can. These two charities look like good gambles.

I agree completely, but I’m still glad Elie emphasized these risks. Because in one specific way, supporting our top charities is riskier than supporting any other charity: if something goes wrong with one of our top charities, it will come out promptly and publicly.

Guest post from Cari Tuna

(updated on: ) | by Guest

Cari Tuna is a member of GiveWell’s board of directors and president of Good Ventures, a foundation in the San Francisco Bay Area which she created with her partner Dustin Moskovitz earlier this year. Previously, Cari was a reporter for the Wall Street Journal.

Today, I’m writing to share that Good Ventures is donating $500,000 to the Against Malaria Foundation and $250,000 to the Schistosomiasis Control Initiative–GiveWell’s #1 and #2 charity recommendations this giving season, respectively. Over the coming months, Good Ventures also plans to donate to the six nonprofits that GiveWell recently named “standout organizations”: GiveDirectly, Innovations for Poverty Action, KIPP Houston, Nyaya Health, Pratham and the Small Enterprise Foundation.

I first learned about GiveWell about a year ago while preparing to transition from reporting to working in philanthropy full time. I read about the organization in Peter Singer’s The Life You Can Save and, around the same time, met co-founder Holden Karnofsky through a mutual friend. Right away, I was struck by the rigor of GiveWell’s research, its commitment to transparency and the volume of thoughtful commentary about the nonprofit sector it already had produced in just three years.

In April 2011, I joined GiveWell’s board. Since then, I’ve been increasingly impressed by the co-founders’ dedication to their work, humility about what they know and what they don’t, and ability to adapt the GiveWell model as they learn.

As a new foundation, Good Ventures’ top priorities are 1) to learn how to do as much good as possible with the resources at our disposal and 2) to become a great resource for other people who care about improving our world. We plan to make a number of carefully selected grants over the coming years in order to learn about promising solutions to the world’s most formidable problems. Over time, we hope our work contributes to significant, sustained reductions in poverty and improvements in quality of life for disadvantaged people around the world.

To that end, we see huge potential in encouraging greater effectiveness and transparency across the social sector, in particular by helping to foster a culture in which individual donors demand evidence of impact from the nonprofits they support.

One simple idea–that all donors should be at least as thoughtful about our philanthropic investments as we are about our financial investments–has transformed the way I think about giving. If you’re reading GiveWell’s blog, this probably isn’t news to you. But it might be news to your friends, parents, siblings, children or coworkers. So this giving season, please spread the word, and let’s transform the culture around giving, one heart and mind at a time.

Note: While Good Ventures does not accept unsolicited requests for funding, we do consider all of GiveWell’s recommended charities–and not just its #1 recommendation–for substantial grants.

Please don’t give me a goat for the holidays

(updated on: ) | by Holden

There’s no question that “giving a goat” has caught on, as a way of getting people to support charity – rather than consumer goods – for the holidays.

I certainly don’t need an iPad or a new TV, and I encourage friends and family to make donations in my name rather than sending me gifts. However, I’d rather not get a “goat” because:

  • I’d have unanswered questions about the effects this gift might have. Will the person who receives the goat be well-suited to receive it? Will they mistreat the goat? Will the goat produce enough to justify their investment in it? Will the local community perceive unfairness in who is chosen to receive the goat?We’ve found livestock-gift programs to be among the more poorly documented developing-world aid programs out there. We have little sense of whether and when these concerns apply.
  • The model of giving out goats fundamentally doesn’t make much sense to me. We wrote in 2009 that giving out livestock seems to have the same challenges as giving out cash, plus additional challenges. This isn’t to say that it’s never a good idea. But supporting a model with such fundamental questions would make me uneasy unless I saw those questions being addressed in an intelligent, context-specific way. (Note that there is a charity giving out cash.)
  • It’s not really a goat anyway. See our 2009 discussion of donor illusions: chances are, the fine print says you’re really just giving a donation to the charity, not any specific goat. Matching your dollars with a specific goat doesn’t (in our view) really make sense logistically, so we’re glad that it isn’t actually happening.
  • I think there are much better ways to help people with donations. This is the most important point for me. Maybe “giving a goat” really does help people – but I don’t believe it helps them as much as possible given our other options. GiveWell’s top charities carry out proven, cost-effective interventions; they have strong track records; they have better transparency and accountability than any livestock-focused programs I know of. They can generate incredible value for your money, such as saving a life for $2000 or keeping someone worm-free throughout childhood for $5. Those are our best evidence-based estimates (the details are all online), not marketing pitches.
  • Giving a goat means supporting the best story for donors, not the best solution for the people I want to help. If you agree that there are better ways to help people than “give a goat,” you should be worried about the message you send when you opt for the latter. To me, the whole point of “giving to charity for the holidays” is to take the focus off of our own wants and put it on helping people who have much more fundamental needs. This goal is cheapened if we support any charities other than the best we can find.

We like the idea of giving to charity in someone’s name as a gift for the holidays. We’ve recently made this possible for our top charities. We just think these gifts should be made to the best charities possible.

My favorite cause for individual donors: Global health and nutrition

(updated on: ) | by Holden

My favorite cause used to be U.S. equality of opportunity. But over the years since we started GiveWell, I’ve become more and more convinced that the best giving opportunities for individual donors lie in the area of global health and nutrition.

Fundamentally, this area stands out because it involves a lot of interventions that have measurable, demonstrable, quantifiable benefits, yet also haven’t been funded to reach everyone who can benefit from them. (See our list.) It’s the only aid area I know of fitting this description. This has made charities working in this area a good fit for our criteria.

One might retort that this just shows our criteria to have the problem of focusing on what can be measured, rather than on what’s best, but I would disagree. I think that there are good reasons to believe that the cause of global health and nutrition really does contain the best – and not just the most easily understood – giving opportunities.

  • Global health and nutrition interventions have the most impressive track record in international aid, with the possible exception of funding scientific research. I believe (though we are still investigating this) that the same holds for aid in general. To some extent this may be an artifact of how measurable the goals are, but it’s still a point in this cause’s favor.
  • Global health and nutrition interventions are incredibly cheap on a per-person basis. We don’t have “cost per life saved” type figures for any programs outside of health, largely because the effects of these programs aren’t well-known enough. But consider that
  • Health and nutrition programs are particularly good at having clear goals and accountability, leading to learning over time. Because benefits can be quantified and predicted, targets can be set, and adjustments can be made when they’re not met. We’ve been placing more emphasis on the criterion of accountability, i.e., the likelihood that giving will lead to learning. Health and nutrition interventions stand out in terms of the likelihood that giving will lead to learning.
  • Room for more funding is relatively easy to gauge in the area of health and nutrition. We believe that one of the thorniest issues that a donor has to contend with is that of room for more funding. In an area like funding scientific research (which otherwise has much to recommend it as a charitable cause), it’s particularly hard to answer the question, “How does the value of the next study on the priority list – the one that no one else has funded and that my funding will make possible – compare to the value of the average study overall?” This isn’t nearly as much of an issue when delivering global health and nutrition interventions; the expected benefits of running an additional project tend to be easier to quantify.
  • Health and nutrition are fundamental to quality of life. In my view, the value of additional education – or additional income – depends a lot on the context, but health and nutrition are fundamental and universal needs. In addition, with economic empowerment or education interventions, I tend to worry about the difficulty of distinguishing “zero-sum benefits” (helping some people at the expense of others) from “positive-sum benefits” – a well-intentioned business training or education program could end up simply transferring power/wealth from some people in a community to others, and this could be very difficult to distinguish from actually improving these people’s productivity. I feel this is much less of a concern when it comes to health and nutrition.

What problems are best suited to having money thrown at them?

I’m not arguing that health and nutrition are the most important issues in the world. There are many changes in the world that I’d like to see and that I believe are worth fighting for. There are many fantastic uses of money outside the sector of global health and nutrition; many involve taking risks on building institutions and producing public goods. But when thinking about how individual donors can do good, my mind jumps to the easiest ways to have impact without having special insight – the problems that are most likely to be solved by “throwing money at them.” When this is the goal, being able to measure, demonstrate and quantify one’s impact is enormously helpful.

According to our analysis, ~$5 can buy a bednet or 10 years of deworming – either of which will have a substantial, quantifiable, definite impact on quality of life. That can empower a person who is better positioned than you are to address many of their other problems. I believe that for a donor interested in making the world better just by writing a check, this sort of value-for-money may not be available in any other cause.

Dissenting opinions on our top charities

(updated on: ) | by Elie

We feel very good about recommending that donors give to our top charities, and they’re where all GiveWell staff are – happily and confidently – giving our personal donations this year.

That said, we’re skeptical by nature, and internally, we keep thinking about and discussing the ways in which our top charities might not work out: i.e., the scenarios/circumstances in which giving to these charities doesn’t accomplish what we expect or our views change substantially in the next year about what donations to these charities accomplish.

If I were going to write the equivalent of a “dissenting opinion” for our top charities, it would be based on the issues below.

AMF: insecticide-treated net distributions

Our #1-ranked organization is the Against Malaria Foundation (AMF). Our recommendation relies on the fact that there have been numerous randomized controlled trials (RCTs, i.e., high-quality studies) tying net distributions to reductions in childhood mortality, but there’s a question of external validity for these RCTs. Is it reasonable to assume that net distributions of the type AMF carries out will have the same sort of effects they’ve had in the studies? There are a couple of reasons to question whether they will.

In our analysis of the RCTs, we found one trial where researchers conducted random spot checks to people’s houses at 5 in the morning to make sure that nets were being used. In another case, researchers, themselves, installed the nets in participants’ homes. In general, we had the impression that researchers were working hard to make sure that nets were used as intended. While AMF’s distributions (and large-scale distributions in general) involve some measures for community education and monitoring of usage, we don’t think they’re comparable to what was done in the RCTs.

For nets to be effective, people need to use them appropriately and consistently. It’s not hard to imagine someone receiving a net one day, but over time not consistently using it well.

The best available data seems to indicate that on a large scale, people use their nets relatively consistently – in line with the usage rates seen in the RCTs (which did not, themselves, reach 100% usage). But the best available data isn’t as robust as we’d like it to be, particularly when it comes to the distinction between “reported usage” and “actual usage” (our best attempts to adjust for this indicate that it is not a major issue, but we aren’t working off much information).

Another way in which large-scale net distributions could fail to live up to the small-scale studies has to do with malaria transmission dynamics. It’s possible that mosquito populations and transmission dynamics have changed in the several years since the last small-scale study was done; it’s possible that the studies were done in areas that were unusually well-suited to seeing big drops in malaria come from nets; it’s even possible that widespread use of nets could lead to increasing resistance in mosquito populations over time. We haven’t seen any strong reasons to believe that any of these things are the case; in particular, we don’t believe that data on transmission dynamics is strong enough for the small-scale studies to have picked out particularly favorable settings. But it’s a definite point of uncertainty.

One point of reassurance here: as we observed previously, the malaria control community spends a huge amount of money on distributing nets. So if one of these concerns ends up being a huge problem, finding out about it (as we hope AMF will) could be hugely beneficial in and of itself, by helping the malaria community better execute distributions and/or better allocate resources.

SCI: deworming

Our evidence review of deworming concludes that there isn’t a particularly strong case that deworming has a significant impact on individuals’ life outcomes. The evidence boils down to (a) two well-respected but far-from-ironclad research papers on the long-term effects of deworming and (b) a large degree of evidence that deworming has a consistent (but limited) impact on haemoglobin levels (which are measured to determine anemia). Our positive view of deworming stems from the fact that although there is limited evidence of quality-of-life significance, the intervention is so cheap that it is likely to be a relatively good buy and may be a great buy.

Our view of deworming is highly susceptible to change based on evidence. A single pre-registered, large-sample RCT that did not find significant impacts on development for dewormed children would significantly adjust our view about the likely impacts of deworming. Combing through the data of one of the existing papers on deworming – which we plan to do in 2012 – could easily adjust our view of the intervention. In addition, despite the fact that SCI’s evidence of impact is as strong as we’ve ever seen in a charity, we still have our doubts about it.

Given this situation, it’s not hard to picture a world in which our view shifts substantially by the end of next year.

Both organizations

Both AMF and SCI partner with governments and NGOs to implement their prorgrams. This means that neither is in complete control of their activities and they could run into problems caused by, among other things, (a) lack of funding for the components of their programs that they don’t directly fund (more on this in Holden’s recent post about charitable leverage) or (b) governments changing their minds about working with each. Note that SCI has already had one program (in Zambia) where results have been quite disappointing and data remains thin.

Difficulty in dealing with partners is a significant risk in aid, and one we’ve learned about this past year from some of the challenges VillageReach is facing in its scaleup in Mozambique.

Putting the dissents in context

The above concerns are very real, but they’re much smaller than the concerns we have for any other charity in existence.

Some seem to believe that concerns ought to be hidden from donors, to encourage them to give. This may make sense for many donors. When dealing with our own audience, we feel much better asking you to give with eyes wide open: recognize that there are no guarantees, but that the things your money can accomplish – in terms of improving others’ lives – are incredible. We think that’s more than enough reason to give without regret.