Our recommendations for giving in 2022

By GiveWell @ 2022-11-23T23:16 (+91)

This is a linkpost to https://blog.givewell.org/2022/11/23/giving-recommendations-2022/

Author: Miranda Kaplan, GiveWell Communications Associate

We wrote back in July that we expected to be funding-constrained this year. That remains true as we approach the end of the year, putting us in the unusual position of leaving impact on the table.

We've set a goal of raising $600 million in 2022, but our research team has identified $900 million in highly cost-effective funding gaps. That leaves $300 million in funding gaps unfilled. By donating this year, you can help us not only meet but exceed our goal—and say yes to more excellent opportunities to save and improve lives.

Additionally, our giving guidance for donors has changed this year. For the first time, our top recommendation is to give to our new All Grants Fund, which we allocate to any need that meets our cost-effectiveness bar. We think it's the best bet for donors who want to support the most promising opportunities we've found to help people, regardless of program or location. And it reflects our current views on how we can best meet our goal of maximizing global well-being—by taking advantage of every path to impact, whether that's funding top charities, seeding and scaling newer programs, or funding research. See "Our giving funds, and our top recommendation" for more on all three of our giving funds.

Why your support is so important

We rely heavily on numbers to think through our funding decisions. But it’s important to remind ourselves what those numbers represent.^[1] If we reach our goal of $600 million this year, we speculatively guess that that funding would save around 70,000 lives.^[2] That's approximately the population of Portland, Maine.^[3]

To make the image a little more specific: we also expect most of the lives saved will be those of very young children, under five years old.^[4] If they reach their fifth birthday, they'll have a much higher chance of surviving into adulthood.^[5] We think about 49,000 of the lives these donations are expected to save will be those of children under five^[6]—enough to fill more than 2,000 average US primary school classrooms.^[7]

But raising $600 million is not a given. We expect $350 million of our funding this year to come from Open Philanthropy, our single largest donor.^[8] The rest will come from our broader community of supporters (like you!), and our projections for this category of our fundraising are fairly uncertain.

What $600 million will enable

Last year, our research team had tremendous success in identifying new room for more funding,^[9] and those efforts have continued to bear fruit in 2022. We've found highly cost-effective funding opportunities in both the interventions implemented by our top charities—malaria prevention, incentives for vaccination, and vitamin A supplementation (VAS)—and newer-to-us areas, such as water treatment, iron fortification, and maternal syphilis screening and treatment.

Below are just a few examples of what the money we raise this year will likely fund:

$30.2 million to New Incentives for continued expansion of its program. New Incentives, a top charity since 2020, provides cash transfers to incentivize caregivers in northern Nigeria to get their infants vaccinated. Funding from GiveWell and others has enabled the program to grow rapidly over the past couple of years.^[10] Prior to this grant, New Incentives had raised funding to reach approximately 3.2 million children across northern Nigeria; we estimate that this grant will allow it to reach approximately 1.4 million additional children.^[11]
$2.4 million to r.i.c.e., a nonprofit that has partnered with the government of Uttar Pradesh, India, to continue operating the Project on Breastfeeding and Newborn Care. The project focuses on kangaroo mother care (KMC), and r.i.c.e. is exploring potential avenues to expand its scale. KMC supports caregivers to adopt best practices for low-birthweight infants, including skin-to-skin contact and early initiation of breastfeeding.^[12] Our best guess is that KMC reduces neonatal mortality in low-birthweight infants by 27% compared with conventional neonatal intensive care. We think the effect might be larger for low-birthweight infants who aren't getting other targeted care, such as those in the hospital where r.i.c.e. works.^[13]
$6.2 million to PATH to conduct a pilot of perennial malaria chemoprevention (PMC), formerly called intermittent preventive treatment in infants for malaria, in the Democratic Republic of the Congo (DRC). PMC provides antimalarial drugs to infants at routine vaccination visits to protect them from malaria.^[14] We believe PMC is potentially a very cost-effective way to prevent malaria deaths, but it isn't yet widely implemented.^[15] This grant for implementation research could help demonstrate feasibility and open up the possibility for PMC to be brought to scale in DRC, by GiveWell or another funder.
Around $40 million to Malaria Consortium for its seasonal malaria chemoprevention (SMC) program in Nigeria. SMC involves distributing preventive antimalarial drugs during peak malaria season to children living in places where malaria is highly seasonal.^[16] This grant will enable Malaria Consortium to continue delivering SMC to children in Nigerian states that have a high malaria burden, but no other large, dedicated sources of SMC funding.

What we could do with more

We're thrilled about the expected impact of the above grants, all of which we estimate are above our bar of 10 times as cost-effective as cash transfers. But if our donor community gives beyond our goal, we'd have no shortage of funding gaps to fill with those donations, too.

We've identified another $300 million in cost-effective opportunities (at least 6 times as cost-effective as cash transfers) that we'd be excited to consider funding. Programs in this category include Evidence Action's in-line chlorination program in Kenya, Nutrition International's support for vitamin A supplementation (VAS) in Angola, and Malaria Consortium's SMC program in countries that haven't yet delivered SMC at large scale. We very roughly estimate that funding this additional work could result in more than 30,000 additional lives saved.^[17]

Our giving funds, and our top recommendation

GiveWell has three distinct giving funds. Which fund you choose to support depends largely on how much you value confidence and established track record in a program, and how much you trust GiveWell to direct funding where it's most needed.

All Grants Fund (top recommendation)

Our All Grants Fund, which is allocated to any grant that meets our cost-effectiveness bar, is our top recommendation for most donors. It allows donors to contribute to the most impactful grant opportunities we've identified, regardless of program or location. Supporting the All Grants Fund is an especially good fit for donors who have a high level of trust in GiveWell and are open to some calculated risk, but also want their donation to support programs (as opposed to GiveWell's operations). You can find examples of the types of grants that could be funded by the All Grants Fund here.

Other options

Top Charities Fund

The Top Charities Fund is allocated to the highest-priority funding gaps among our top charities only. It's a good fit for donors who trust GiveWell's approach to identifying excellent programs, but want to restrict their gifts to those that warrant our highest degree of confidence, in accordance with our top charity criteria. Our current top charities are:

Against Malaria Foundation, which supports campaigns to distribute long-lasting insecticide-treated nets (LLINs) to protect against malaria
Helen Keller International's vitamin A supplementation (VAS) program, which provides VAS to children under five to reduce their risk of infection and death
Malaria Consortium's seasonal malaria chemoprevention (SMC) program, which provides antimalarial drugs to children under five
New Incentives, which provides conditional cash transfers to caregivers who get their children vaccinated

Unrestricted Fund

Our Unrestricted Fund can be spent on any GiveWell priority, including our own operating expenses (such as staff salaries, website maintenance, and other routine costs).

If we raise more funding than we need for our operating costs, we will grant out the excess. Because of this, donors needn't worry that GiveWell's operating budget will ever be overfunded.^[18]

The Unrestricted Fund is the best fit for a donor who's excited about GiveWell's work and wants to fund the activities, such as research, recruitment, and fundraising, that fuel our success.

You can learn more about all of our giving funds here. If you'd like to donate directly to one of our top charities, you can find a list of links here. Read more about all options for supporting recommended programs here.

What we're asking from donors

The generosity of donors to GiveWell and our recommended charities since our founding will be responsible for transformative change. We expect that funding directed by GiveWell from our inception to the end of 2022 will save at least 200,000 lives,^[19] an achievement we can all be incredibly proud of. Still, the very cost-effective funding gaps we're likely to leave unfilled this year illustrate that a significant need remains.

If you're an impact-focused donor, we ask that you give what you can this year to help reduce the gap—with the knowledge that you'll be contributing toward exceptionally cost-effective work. We're grateful for your support of effective programs!

Notes

The estimates in this section are extremely rough and shouldn't be taken to represent our literal expectations. We provide them to give an illustration of the approximate scale of the impact we think this funding will have in the world. Where possible, we've given conservative estimates. ↩︎
- We roughly estimate that about $350 million of that $600 million total would go toward programs whose primary benefit is saving lives. We've calculated this estimate by summing up the expected value of very cost-effective life-saving grant opportunities (total amount in dollars represented by the grant, multiplied by the percent likelihood of recommending the grant) that we've identified this year, across both our top charities and other programs. These numbers aren't public yet because many of the grant investigations are still ongoing. The likelihood of our recommending a grant that we're still investigating, as well as the total amount of the grant in some cases, is often very uncertain.
- We're using an extremely rough estimate of $5,000 to save a life on average. $5,000 is our rounded average cost per life saved for 2021 grants to top charities; see source spreadsheet calculations here. This average is calculated using the subset of grants to top charities that were funded by Top Charities Fund donations, Open Philanthropy, GiveWell unrestricted funding that our board approved for regranting, or other organizations that accept donations on our behalf (e.g., effective altruism groups outside the U.S.). It doesn't include donations made directly to our top charities based on our recommendation, or donations we accepted on behalf of and regranted to individual top charities. GiveWell also directed other grants to life-saving programs outside our top charities in 2021; the cost per life saved for these grants is not factored into the $5,000 estimate.
- $350,000,000/$5,000 = 70,000.
↩︎
Estimated population on July 1, 2021: 68,313. US Census, "QuickFacts: Portland city, Maine" ↩︎
Three out of four of our top charities—Malaria Consortium's SMC program, New Incentives, and Helen Keller International's VAS program—directly target children under five. Against Malaria Foundation supports distribution of insecticide-treated nets to households to prevent malaria, without specifically targeting children; however, because malaria deaths are concentrated in children under five, the largest benefit we model from AMF's program is a reduction in under-five mortality. Generally, because the moral weights that we use to help us evaluate the impact of a potential grant heavily favor averting the death of a child under five, grants recommended by GiveWell often support programs whose benefit lies primarily in reducing child mortality. ↩︎
See this chart from Our World in Data, "Child and Infant Mortality." Globally, in 2017, more than three times as many children died under the age of five than died in the next three age groups combined (5-9 years, 10-14 years, and 15-19 years). ↩︎
We estimate here that about 70% of the lives we expect to be saved by the funds we direct to our top charities will be those of children under five. We calculated this percentage by first finding the average under-five deaths as a percentage of all deaths we'd expect to avert with a hypothetical donation to each of our top charities. See the results here. As a conservative proxy for the average proportion of under-five deaths across all top charities, we chose the estimate for the top charity with the lowest proportion (New Incentives, 66%) and rounded it up to 70%. We then multiplied this number by 70,000. These calculations are extremely rough, as they do not take into account the proportion of our total funding that we expect to be directed to each top charity this year, among other factors. ↩︎
- National Center for Education Statistics, National Teacher and Principal Survey, "Average class size in public schools, by class type and state: 2017–18", see column "Average class size for teachers in self-contained classes"
- 49,000/20.9 = 2,344.
↩︎
"Last year, we recommended $300 million of grants to GiveWell’s evidence-backed, cost-effective recommendations in global health and development, up from $100 million the year before. We recently decided that our total allocation for this year will be $350 million." Open Philanthropy, "Update on our planned allocation to GiveWell’s recommended charities in 2022," July 5, 2022 ↩︎
"Our key accomplishment this year was identifying a significantly larger amount of cost-effective room for more funding than previously. We expect that we’ll increase our total room for more funding from $200 million in 2020 to $450 million in 2021." GiveWell blog, "Our recommendations for giving in 2021," November 2021. We ended up exceeding this forecast, and directed around $518 million to cost-effective programs in 2021 (see p. 6 of GiveWell Metrics Report — 2021 Annual Review). ↩︎
See the charts titled "Expanding our reach" and "Growth" on New Incentives' Impact page. ↩︎
In an unpublished financial forecasts document, New Incentives has shared that it raised enough in its last funding cycle to cover 3,181,800 infants by the end of 2022. It projects that the $30.2 million grant GiveWell has recommended would allow it to cover an additional 1,355,698 infants by mid-2023, for a total of 4,537,498 infants. ↩︎
"Kangaroo mother care (KMC) is intended as a low-cost alternative to conventional neonatal intensive care for low birth weight infants during their stay at a healthcare facility and primarily involves keeping infants warm through skin-to-skin contact with their mothers. KMC can also include exclusive breastfeeding and relaxing the criteria for discharge from the facility in order to reduce length of hospitalization, though these components of KMC are not implemented consistently in studies on KMC…. There is some evidence that KMC may lead to reductions in neonatal mortality and morbidity for LBW infants." GiveWell, "Kangaroo Mother Care," 2021. ↩︎
This estimate draws from our analysis of the cost-effectiveness of the grant to r.i.c.e., which isn't yet published. ↩︎
- "Intermittent preventive treatment for infants (IPTi) is the provision of preventive antimalarial medicine to infants at routine vaccination visits." GiveWell, "Intermittent Preventive Treatment in Infants (IPTi) for Malaria," 2022.
- "WHO has updated it recommendations for 3 key malaria prevention strategies: seasonal malaria chemoprevention (SMC), perennial malaria chemoprevention (PMC – previously known as intermittent preventive treatment in infants, or IPTi) and intermittent preventive treatment of malaria in pregnancy (IPTp)." WHO, "Updated WHO recommendations for malaria chemoprevention among children and pregnant women," June 3, 2022
↩︎
- "Our preliminary estimate suggested that IPTi may be around 18 times as cost-effective as cash transfers, which is above the range of cost-effectiveness of programs we would consider funding. However, this estimate is quite rough, given our uncertainties about program costs, feasibility of implementation at scale, and the counterfactual impact of funding we might direct to IPTi." GiveWell blog, "IPTi for malaria: a promising intervention with likely room to scale," January 31, 2022.
- "However, our research has identified only one country, Sierra Leone, that has integrated IPTi into its routine national health care practice…. With only one country having adopted IPTi, there are currently no charities and no philanthropic funding that we know of supporting its implementation at significant scale." GiveWell blog, "IPTi for malaria: a promising intervention with likely room to scale," January 31, 2022.
↩︎
"Seasonal malaria chemoprevention (SMC) involves giving children under the age of 5 full malaria treatment courses intermittently during the malaria season." GiveWell, "Seasonal Malaria Chemoprevention," 2018. ↩︎
This figure relies on internal calculations using the expected funding gap for each program divided by our roughly estimated cost per life saved for each grant opportunity, to get a rough expected number of lives saved by each hypothetical grant. ↩︎
We have an excess assets policy as well as a "single donor cap," which specifies that we can't get more than 20% of our operating budget from a single donor, in order to avoid overreliance on one source of funding. ↩︎
See our calculations here. We estimate that GiveWell-directed donations to our current top charities (Against Malaria Foundation, Helen Keller International's vitamin A supplementation program, Malaria Consortium's seasonal malaria chemoprevention program, and New Incentives) between 2009 and 2021 can be expected to collectively save around 159,000 lives. We estimate lives saved via GiveWell-directed donations to these four programs in 2021 alone at around 57,000 lives. Naively assuming that we'll direct an equivalent or greater amount of donations to these programs in 2022, we believe that sometime this year we'll have influenced enough funding to eventually save 200,000 lives. (Our rough guess is that funding we direct in 2022, to both top charities and other programs, will actually result in more than 57,000 lives saved; see the "Why your support is so important" section of the blog post.) ↩︎

kokotajlod @ 2022-11-24T00:11 (+7)

Thanks for posting this! GiveWell was a big part of how I got involved with EA back in the day & I'm glad you are still going strong.

Off the top of your head, how would your recommendations change if you only cared about the next 5 years? (alternatively, if you had roughly a 10%/year discount rate) This may influence my donation.

GiveWell @ 2022-12-02T22:06 (+6)

Hi, kokotajlod,

Thank you for following our work; we're happy to have been a part of your journey! Apologies for the delay in responding here.

I'm not sure if by "your recommendations," you mean GiveWell's top charities, or our advice in the above post on giving to the All Grants Fund. It'd be pretty challenging to answer your question if it's about the All Grants Fund, since that money can go to any grant that meets our bar. We expect that a lot of All Grants Fund donations will support grants to top charities, but they could also support other programs, and there could be wide variation in how much of these programs' impact will occur in the next five years.

In our cost-effectiveness analysis for each of our top charities (AMF, Helen Keller's VAS program, Malaria Consortium's SMC program, and New Incentives), we count both deaths averted and future expected earnings from development effects as benefits. Our discount rate of 4% in our cost-effectiveness analyses applies to future expected earnings—if we raised the discount rate to 10%, it would reduce our estimate of these benefits across all four top charities. We don't expect that this would result in changes to our overall top charity recommendations, but it may have a greater impact on our estimated cost-effectiveness of some funding gaps than others, due to variance in the proportion of total benefits coming from development effects.

Steeply discounting future benefits would also make deworming look less cost-effective, since we expect the benefits of deworming to materialize only after treated children become adults.

I hope that's somewhat helpful!

Best,

Miranda

kokotajlod @ 2022-12-03T21:43 (+2)

Great, thank you!

MichaelStJules @ 2022-11-24T18:33 (+6)

It may be worth considering StrongMinds, since I don't think its cost-effectiveness depends nearly as much on the beneficiaries living much longer. I don't know about how long the delay is between donation and intervention, though. See these posts and others discussed in them:

https://forum.effectivealtruism.org/posts/uY5SwjHTXgTaWC85f/don-t-give-well-give-wellbys-hli-s-2022-charity

https://founderspledge.com/stories/mental-health-report-summary

Tristan Cook @ 2022-11-24T00:36 (+5)

In this recent post from Oscar Delaney they got the following result (sadly doesn't go up to 10%, and in the linked spreadsheet the numbers seem hardcoded)

Top three are Hellen Keller International (0.122), Sightsavers (0.095), AMF (0.062)

Peter Wildeford @ 2022-11-24T00:17 (+3)

Exciting!

I got a little confused by some of the numbers - is it $600M at 10x cash and an additional $300M at 6x cash? Or is it $900M at 10x cash and an additional $300M at 6x cash?

GiveWell @ 2022-11-29T01:05 (+4)

Hi, Peter! It's roughly the former - $600M at 10x cash (or higher) and an additional $300M in opportunities that are 6-9x cash.

Tom Tseng @ 2022-12-04T16:32 (+2)

How does GiveWell's All Grants Fund compare to EA Funds's Global Health and Development Fund? My understanding is that both funds are looking primarily at global health interventions and have a greater tolerance for risk than GiveWell's Top Charities Fund. Are there major differences between the funds?

GiveWell @ 2022-12-06T01:34 (+3)

Hi, Tom,

Thanks for your question! There really isn't a tremendous difference between the two in terms of purpose—both are allocated to global health and development opportunities, either among GiveWell's top charities or to other programs that are high-expected-value. The EA Global Health and Development Fund preceded the All Grants Fund, which we launched in August of this year.

Best,

Miranda