Philanthropy's Success Stories

By Holden Karnofsky @ 2012-03-01T16:53 (+3)

This is a linkpost to https://www.openphilanthropy.org/blog/philanthropys-success-stories

Note: The Open Philanthropy Project was formerly known as GiveWell Labs. Before the launch of the Open Philanthropy Project Blog, this post appeared on the GiveWell Blog. Uses of “we” and “our” in the below post may refer to the Open Philanthropy Project or to GiveWell as an organization. Additional comments may be available at the original post.

The first item on the agenda for GiveWell Labs is to get the broadest possible view of philanthropy: its history (what’s gone well, what hasn’t) and its current state (what’s being funded and what isn’t).

On the history front, I’ve found very little of interest. Most books on philanthropy are how-to’s rather than histories, and most of the histories don’t appear to focus on listing specific cases where foundations had (or failed to have) impact. One exception is the Casebook for The Foundation: A Great American Secret, which lists and discusses “100 of the highest-achieving foundation initiatives” since 1900.

I thoroughly examined this volume, and collected some basic notes into a spreadsheet. My reflections follow. In brief, I felt there were some very strong cases here, particularly in the area of medical research, and I was surprised by philanthropy’s history of being active in shaping various graduate education programs. At the same time, I thought the Casebook’s history had important shortcomings - in particular, not putting successes in context along with failures - and I see a lot of room for improvement in the amount of information available about the history of philanthropic successes and failures.

Note that I am not well-informed about most of the cases discussed here and have relied on the Casebook for my information. The notes that follow are only loose impressions and are not backed by the sort of evidence that we usually seek (even for blog posts).

Philanthropy has some extremely impressive accomplishments. Among other things, foundations have been (in my view) reasonably credited for leading the way on building schools and hospitals in the rural Southern U.S., piloting the shoulder line on U.S. roads, successfully advocating for federal legislation in areas including health care for the homeless and nuclear deproliferation, the research that led to the Green Revolution, and many major advances in medical research (including the first combination drug therapy for AIDS and the development of the pap smear). There are many other projects that sound like they may have been impactful, but which the Casebook doesn’t give enough context on for me to have a strong view.

The most impressive cases (in my view) are mostly the earlier ones. Though the Casebook focuses on more recent philanthropy (78 of its 100 cases are post-1950), 9 of the 14 cases I found most impressive are pre-1950 (and a 10th is from 1952).

A possible explanation is that the space of doing good has become more crowded over time. For example, note that

• Total U.S. government health spending was 0.26% of GDP in 1902 and 0.92% of GDP in 1950; by contrast, in 2009, it was 7.06% of GDP (these figures are in the spreadsheet linked above), and even most developing countries spend 2%+ of GDP on in this area (source). In 1927, the Commonwealth Fund piloted a rural hospital program; there aren’t a lot of “philanthropic opportunities” that look like that today.
• Total U.S. government education spending was 1.07% of GDP in 1902 and 3.28% of GDP in 1950; by contrast, in 2009, it was 6.16% of GDP (these figures are in the spreadsheet linked above), and even most developing countries spend 3%+ of GDP on in this area (source). In 1902, the Rockefeller Foundation funded advocacy for providing public schools in the U.S. South; there aren’t a lot of “philanthropic opportunities” that look like that today.
• More context: The Department of Education was created in 1979, the National Science Foundation was created in 1950, and the National Institutes of Health began in 1930 (but have grown significantly since; in fact one of the “success stories” in the Casebook discusses the growth of the NIH budget from $2.4 million in 1945 to $5.5 billion in 1985).

The most impressive achievements (in my view) are concentrated in the sectors of research (particularly medical research) and health care. In part, these reflect the fact that achievements in these two fields tend to be unusually tangible. However, it’s worth noting that many of the cases discussed in the Casebook have had decades to show a tangible impact on policy and institutions.

Foundations have a long history of influencing the curricula of colleges and graduate schools. I was surprised by how many of the cases fell into this category (marked “graduate education” or “undergraduate education” in the spreadsheet linked above) because I rarely hear about it in the context of modern philanthropy. While in most cases the long-term impact of foundations’ work in this area remains unclear, they appear to have had a lot of highly tangible proximate success, i.e., they have succeeded in getting universities to follow the paths they’ve advocated for.

Some “philanthropic success stories” may have created institutions that have now outlived their purpose. For example, the National Merit Scholarship Corporation was created in 1955; at that time, “38 percent of students in the top 2 percent of intelligence quotients were not pursuing a college education” and the scholarships it offered may have been highly impactful. Today, my impression of National Merit Scholarships is that they are small compared to college tuition ($2500) and that they are fungible with need-based aid; they therefore don’t seem to impact people’s ability to attend college.

I see impressive choices of causes and organizations; I don’t see impressive “tactics,” i.e., choices of projects or theories of change. This may simply be a reflection of the Casebook’s choice of approach and focus. There are many cases in which I found myself agreeing with the Casebook that a foundation had chosen an important and overlooked problem to put its money toward, but few (if any) cases where its strategy within the sector seemed particularly intricate, clever, noteworthy or crucial to its success. The spreadsheet above categorizes grants both by “sector” and by “type of grantmaking”; there is a surprising (to me) amount of variety when it comes to the former, and not as much when it comes to the latter.

My intuition is that the choice of sector is the most important choice a funder makes.

Two particular approaches - “blue-ribbon panels” and pilots for government programs - were common in early philanthropy, but have recently been more rare (at least among success stories). Regarding the former: the Casebook gives the impression that in some early cases, a foundation was the first/only agent to commission a “blue-ribbon panel” to produce a report on, e.g., medical or legal education, and that the report was eagerly awaited and garnered instant attention. Today, my impression is that it is very common for foundations to produce these sorts of reports, but that getting people to pay attention to them is more of an uphill battle.

Strong patterns emerge when one asks, “Why was philanthropy needed here - why didn’t beneficiaries create change for themselves?” We’ve written previously that there are many mechanisms for helping people other than philanthropy. In Column J, I tried to summarize the relevant properties of a project’s “constituency” (the people who stood to benefit from it) with an eye toward explaining why this constituency didn’t address (or wasn’t perceived to have addressed) its own needs, leading to a (perceived) need for philanthropy. I found that the following situations were common:

• Many projects’ primary constituencies were disadvantaged people (18 cases) or the environment (8 cases); it is easy to see why these constituencies wouldn’t create change for themselves.
• Many projects were focused on funding research for public consumption (24 cases) or on funding/improving education (27 cases). In theory, there are incentives for people to work on improving their own education (or their children’s) and there are incentives to do research; but in practice the connection between investment and reward may be weak enough that these links often break. (Research is also a global public good: when it is disseminated publicly, most of the benefits of the research cannot be captured by those who paid for it. Note that there are other kinds of public goods, such as parks, that seem less of a fit for large-scale philanthropy since they can be supported by community- or government-level philanthropy.)
• 2 projects focused on educating the general public on health; 1 advocated for increased government support for public radio; 3 focused on facilitating coordination between nations (e.g., nuclear deproliferation); 2 couldn’t be categorized because the projects were too general in scope.
• The remaining projects present, in my view, the most puzzling cases in terms of this question. There were 6 cases in which philanthropic funding led to the creation of organizations or movements that eventually came to be supported directly by their customers or communities (such as Blue Cross Blue Shield and Grameen Bank); there were 8 cases in which philanthropy focused on improving the general efficacy of government services. These were cases in which philanthropists may have found (or believed they had found) that other actors were fulfilling their roles suboptimally.

The Casebook has major biases and limitations, and there could be many impressive cases that it does not reveal (either by not covering them or by not discussing them convincingly enough).

• It often makes a thin case, or no case, for the big-picture impact of a foundation’s work. Chapter 71, on the Annie E. Casey Foundation’s collection and publication of data on well-being of U.S. children, is a particularly vivid example of this: it seems a case for impact might be possible to make but the book makes no attempt to do so.
• It seems overly eager to ascribe positive impact to a foundation’s work, and to overlook possible negative/offsetting impact. For example, in Chapter 24, it implicitly credits the Rockefeller Foundation’s work on studying population for subsequent slowing of population growth (the latter has many other, and I believe stronger, candidates for explanation).
• It seems very focused on large foundations (in Chapter 40, only the Edna McConnell Clark Foundation appears in the chapter headline, even though three other foundations are given credit for being the earlier seed funding for the project discussed).
• It also seems to place a heavy emphasis on “innovative work” rather than on results (for example, Chapter 92 emphasizes the dramatic change and unusual approach the Edna McConnell Clark Foundation took in funding the Nurse-Family Partnership, Harlem Children’s Zone, and Youth Villages, but does not discuss the evidence - which I independently believe to be reasonably strong by the standards of U.S. social programs - that these programs have been impactful).

The Casebook is the best resource I’ve found for getting a sense of the history of philanthropy, but its usefulness is severely limited by the lack of “failure stories” and the lack of dissenting perspectives. Which of these cases are widely/consensually believed to have had strong impact, and which are simply admired by the Casebook’s authors? How many failures accompanied the listed successes for each foundation, for each sector? Without this information, it’s not possible to get a real sense of “what’s worked and what hasn’t” in philanthropy.

I don’t think the Casebook authors can be blamed for this situation. The larger issue is that foundations publish very little of substance on the case for their work’s impact (or lack thereof). We don’t want to go into GiveWell Labs with so little historical context, but unfortunately it looks like we will have to. Hopefully, future philanthropists will be more easily able to learn from our work.