In this discussion between GiveWell CEO and co-founder Elie Hassenfeld and Senior Program Officer Julie Faller, we provide snapshots of how US funding changes are affecting global health programs:

• Immediate program trade-offs: As funds are paused, country governments are having to choose between essential health services, including one country that said it would prioritize HIV treatment programs while indefinitely pausing HIV prevention programs.
• Supply chain breakdown: Essential supplies like ready-to-use therapeutic food for malnourished children have been stranded throughout the supply chain (in ports, warehouses, and transit) with no systems to track or distribute them, as the electronic logistics management systems were operated by now-dismissed US government contractors.
• Implementation capacity concerns: Widespread layoffs at implementing organizations raise questions about whether these groups can effectively deliver programs even if alternative funding becomes available.

The episode also offers a look at our initial response strategy, which has focused on:

• Addressing urgent gaps in high-impact program areas we’re familiar with, such as malaria prevention and malnutrition treatment
• Exploring flexible funding options such as forgivable loans or phased disbursements to help mitigate risks during this volatile period
• Preparing for longer-term needs that could arise due to sustained reductions in foreign assistance from the US and other donor countries

This episode was recorded on March 12, 2025 and represents our best understanding at that time.

Our first episode shared a broad overview of the impacts of US government aid cuts and GiveWell’s initial response. This time, GiveWell Program Officer Natalie Crispin joins CEO and co-founder Elie Hassenfeld to zoom in on a specific case, focusing on grants we’ve made to support urgent funding gaps for seasonal malaria chemoprevention (SMC). 

SMC is one of the most cost-effective programs we’ve found—GiveWell has historically funded around $60-80 million annually for Malaria Consortium’s SMC program, which is one of our Top Charities.  

Elie and Natalie discuss:

• How SMC campaigns work: SMC campaigns involve community health workers going door-to-door to deliver preventative malaria medicines to children under five in regions with highly seasonal malaria, particularly in Africa's Sahel region. These campaigns run during the rainy season (June-October) when malaria transmission is highest. The campaigns require pre-campaign preparation including training, supplies, and logistics planning, and staff to manage this work.
• The impact of USAID funding pauses on SMC campaigns: When USAID funding was paused in January 2025, organizations implementing SMC in many countries couldn't proceed with critical pre-campaign activities required before June campaign launches. While most medicine had been purchased, supplies, staff, and preparation activities like training were left unfunded, putting entire campaigns at risk.
• GiveWell’s response to keep SMC campaigns on track: Our research team quickly identified and filled approximately $3 million in critical funding gaps for pre-campaign activities across five countries. If these timely activities didn’t take place, the campaigns wouldn’t be prepared to run if funding returns by June. By maintaining the existing implementation ecosystem, campaigns can proceed with preparations as planned, preserving the potential for USAID funding to seamlessly resume and enable the distribution of these life-saving drugs.

GiveWell has so far directed approximately $15 million toward urgent needs caused by cuts to US foreign aid, focusing on highly cost-effective interventions at risk of near-term disruption. Our research team is continuing to investigate more than $100 million of potential grants to support similar needs across a wide range of impacted programs, including in areas like vaccines and malnutrition treatment.

Visit our USAID Funding Cuts webpage to learn more about our response and how you can help, and listen or subscribe to our podcast for the latest updates.

This episode was recorded on March 31, 2025 and represents our best understanding at that time.

The US government has historically spent approximately $12 billion to $15 billion annually in foreign assistance dedicated to global health. The funding cuts announced in the first few months of 2025 disrupted the global health landscape and created the possibility of enormous funding gaps that are still coming into focus. In response, GiveWell has approved around $18 million in grants to support urgent needs—but why has our research led us not to grant more funds yet?

In today’s episode, the third in our series examining the impact of these cuts, GiveWell CEO and co-founder Elie Hassenfeld is joined by Director of Research Teryn Mattox to explore this question. Building on our previous conversations about program disruptions and emergency responses, they dive into the nuanced reality of the current funding landscape and GiveWell’s evidence-based approach to grantmaking during uncertainty.

Elie and Teryn discuss:

• Increased need on the horizon: While current impacts haven’t been as severe as the 90% cuts that we initially feared, forecasts suggest that US global health aid may be cut by approximately 50% in fiscal year 2026. We anticipate the most significant funding gaps will likely emerge later. For example, a new fiscal year begins for the US government after September 2025, and the administration will have greater flexibility to enact reductions to global health spending it has discussed.
• Reinstatement of many critical programs: Many initially terminated contracts, particularly in high-impact areas that we know well like malaria programs, have been reinstated in the short term. A rough analysis suggests that more than 80% of malaria programming has been reinstated for the time being, including some of the most cost-effective programs we’ve identified, which has reduced the immediate need for emergency funding.
• Expanding our search for emerging opportunities: We think the shifts in US government funding have likely created new, highly cost-effective opportunities. We’re rapidly exploring new areas that have been hit hard by these funding cuts, such as integrated health programs (which deliver multiple services to communities) and family planning. While it takes time to get up to speed before we can make cost-effective grants in these new areas, we are aiming to move more quickly than is typical by leaning on learning over time versus building a high degree of confidence first.

GiveWell is actively identifying funding opportunities and recommending grants to help with urgent situations, but we are now primarily concerned with predicting and planning for likely significant cuts in the upcoming US government fiscal year, and with gathering the resources needed to respond. We’ve formed a “rapid response team” to quickly assess urgent funding gaps, and we are considering a “learn by giving” approach in promising new areas to build organizational knowledge while addressing immediate needs.

Visit our USAID Funding Cuts webpage to learn more about our response and how you can help, and listen or subscribe to our podcast for the latest updates.

This episode was recorded on April 15, 2025 and represents our best understanding at that time.

The US government has historically been a major funder of HIV/AIDS programs, providing around $5 to $6 billion annually through PEPFAR and other initiatives. With anticipated major reductions in US government foreign aid, including potential cuts of 20% to 50% to HIV/AIDS funding, GiveWell is assessing where new, cost-effective needs might emerge.

GiveWell aims to find programs where additional funding can have the greatest impact. While HIV/AIDS has not historically been a focus for GiveWell due to substantial US government support, the current funding cuts might lead to potential cost-effective opportunities within HIV/AIDS programming. In the latest episode in our podcast series, GiveWell CEO and co-founder Elie Hassenfeld speaks with Program Officer Alice Redfern about our initial exploration into HIV/AIDS programming.

Elie and Alice discuss:

• Prevention programs for high-risk populations: While HIV/AIDS treatment and mother-to-child prevention programs are likely to retain funding, prevention programs targeting other high-risk groups have already seen significant cuts and program cancellations. GiveWell is focused on finding cost-effective opportunities within HIV/AIDS programming, and prevention efforts targeting high-transmission populations offer the greatest potential to reduce overall infection rates.
• The challenge of finding cost-effective opportunities: Unlike GiveWell’s typical approach of broad coverage in a targeted geography (like distributing malaria nets to all children under five in high-burden areas), HIV prevention requires targeting high-risk populations to be cost-effective. This creates a complex “search problem” of identifying programs that efficiently reach these populations in areas with high transmission rates.
• Promising innovations on the horizon: The emergence of highly effective, long-acting injectables like Lenacapavir offers game-changing potential for HIV prevention. However, their future cost-effectiveness and feasibility at scale depend on factors like price and real-world delivery challenges, including uptake and practical implementation.

This work is a good example of our ongoing efforts to identify where donor funding can be most impactful, which is especially important in the wake of recent cuts to US foreign assistance. We are working quickly to respond to emerging needs, leaning on partners and existing research to help us navigate the complexities and uncertainties of the HIV/AIDS funding landscape.

Visit our USAID Funding Cuts webpage to learn more about our response and how you can help, and listen or subscribe to our podcast for the latest updates.

This episode was recorded on May 30, 2025 and represents our best understanding at that time.

Cuts to US government foreign assistance have created unprecedented challenges for global health programs. Countries that have relied on this funding must now navigate substantial gaps and make difficult decisions about program priorities. 

In the fourth episode of GiveWell’s podcast series on these cuts, GiveWell CEO and co-founder Elie Hassenfeld speaks with Program Officer Dan Brown about grants to create technical support units (TSUs) in six African countries. These TSUs will provide support to the ministries of health in Burkina Faso, Democratic Republic of the Congo, Malawi, Nigeria, Uganda, and Zambia as they navigate funding transitions to maintain essential health services. The work is being led by the respective governments, and the support will be tailored to their individual priorities, as well as the work they have already done. 

Elie and Dan discuss:

• What are TSUs?: Technical support units are small teams of three to five people, typically nationals of the countries they serve, who work directly with ministries of health. They provide additional capacity to support governments’ planning and prioritization, making them particularly valuable as officials navigate decisions about health programs in response to US funding cuts.
• How do TSUs create impact?: TSUs help ministries assess funding gaps, identify cost-saving opportunities, analyze the cost-effectiveness of different programs, and develop strategies to secure additional funding sources. By creating in-depth analyses and evidence-based recommendations, TSUs enable ministries to make informed decisions quickly. 
• What’s unique about these grants?: These grants are a good illustration of how GiveWell is applying increased flexibility, speed, and risk tolerance to respond to urgent needs caused by recent cuts to US foreign assistance. Funded by our All Grants Fund, the grants also demonstrate how GiveWell has broadened its research scope beyond its Top Charities while maintaining its disciplined approach—comparing each new opportunity to established interventions, like malaria prevention or vitamin A supplementation, as part of its grantmaking decisions. 

GiveWell co-investigated and co-funded these grants with Open Philanthropy. The TSUs will be implemented by two international organizations with established relationships at the respective ministries—Clinton Health Access Initiative (CHAI) in five countries (Burkina Faso, Nigeria, Malawi, Uganda, and Zambia) and PATH in Democratic Republic of the Congo.

To date, GiveWell has committed around $23 million in grants in response to US funding cuts. Visit our USAID Funding Cuts webpage to learn more about our response and how you can help, and listen or subscribe to our podcast for the latest updates.

This episode was recorded on May 2, 2025 and represents our best understanding at that time.

In the face of potential major cuts to foreign aid, how can we anticipate the impact on global health and effectively direct resources to the areas of greatest need?

In this episode, GiveWell’s CEO and co-founder, Elie Hassenfeld, speaks with Principal Researcher Alex Cohen to discuss the forecasting work GiveWell has undertaken to better understand what the future of global health funding might look like. They explore the potential size of the funding gaps, which programs might be affected, and how GiveWell is preparing to respond in a new era for global health philanthropy.

Elie and Alex discuss:

• The scale of potential aid cuts: Informed by insights from professional forecasters, policy experts, and other partners, GiveWell anticipates a potential 50% cut in US global health funding and a 35% reduction in overall global health funding, creating a funding gap of approximately $20 billion annually. These estimates are highly uncertain, but they provide a directional view of what the funding landscape could look like.
• The impact on the most cost-effective programs: While some prioritization is expected to protect cost-effective programs, we estimate around $1.5 billion in cuts to programs that are 20x our benchmark or greater—in addition to another $1.5 billion in cuts to programs that are 10x to 20x our benchmark. This includes programs like malaria prevention, HIV treatment, and childhood vaccinations. 
• How GiveWell is preparing to respond: In response to these potential gaps, GiveWell is working to increase its research capacity to investigate new funding areas like HIV/AIDS, which have historically been well-funded. We’re also engaging with supporters to highlight the exceptional impact additional funding could have. 

While forecasting provides a valuable framework for planning, these estimates are highly uncertain, and the situation remains fluid. GiveWell is monitoring the funding landscape through regular check-ins with partners and experts, as we recognize that the impacts of the coming cuts will likely emerge gradually rather than all at once. Whatever the exact outcome, the scale of cuts we're forecasting will likely create significant new funding needs, and we will do all we can to find and fund them.

Visit our USAID Funding Cuts webpage to learn more about our response and how you can help, and listen or subscribe to our podcast for the latest updates.

This episode was recorded on June 11, 2025 and represents our best understanding at that time. 

GiveWell has long grappled with fundamental questions about how to value different positive impacts and make funding decisions across diverse programs. In particular, how much more valuable it is to save a life than to substantially improve it? And how can we prioritize between programs that achieve those outcomes in different measures when there’s no “right” answer to that question?

In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Senior Program Officer Julie Faller about why GiveWell is dedicating more capacity to researching livelihoods programs that aim to increase people's incomes. They discuss how we're building on existing work, searching for new cost-effective opportunities, and exploring more of the impactful programs we've long cared about.

Elie and Julie discuss:

• A new funding threshold: GiveWell uses a framework of “moral weights” to compare different outcomes across interventions, but they are a necessary tool and not an absolute truth. To account for this, we’re using a different cost-effectiveness threshold for our expanded livelihoods portfolio. This enables us to evaluate and fund programs that would appear as cost-effective as our standard recommendations to a donor who values income gains twice as much as our standard model.
• How we’re expanding our livelihoods work: GiveWell is hiring a dedicated Livelihoods Program Officer to lead a more focused search for impactful livelihoods programs. This increased capacity will allow us to develop a long-term livelihoods strategy, build an expert network, and collaborate directly with implementing organizations to find and co-create promising programs. 
• Some areas we plan to explore more deeply: Promising areas for investigation include programs that create positive economic “spillover” benefits for entire communities and community-driven development projects. We’ll also analyze results from our previously funded research on interventions like footbridges and eyeglasses to understand the potential impact these programs could have if scaled. 

Our new program officer will lead the search for livelihoods opportunities over the next year that meet our high bar for funding, and we plan to keep growing this research if it proves successful. We’re excited that this expansion of our research team will allow us to explore more of the impactful opportunities that we—and our donors—have long cared about.

Visit our All Grants Fund webpage to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on June 25, 2025 and represents our best understanding at that time. 

Malaria is the cause area where GiveWell has directed the most funding over our 18-year history. We’ve recommended over $1 billion to malaria programs, which we estimate will avert over 200,000 deaths, mostly in young children, through support for programs like Against Malaria Foundation’s insecticide-treated nets and Malaria Consortium’s seasonal malaria chemoprevention.

Despite significant progress against malaria in the past 25 years, malaria is still a leading cause of death globally for children under five. The current status of malaria prevention—and all the progress that’s been made—is now in a precarious position. Significant reductions in funding from key donors like the US President’s Malaria Initiative and the Global Fund are anticipated and threaten to create substantial new gaps in life-saving malaria programs.

In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Program Officer Alex Bowles and Senior Researcher Rosie Bettle about the impacts these funding cuts could have. They offer a timely look at the uncertainty of the funding landscape, the life-saving malaria programs that are most at risk, and how GiveWell is leveraging its expertise to respond to emerging needs.

Elie, Alex, and Rosie discuss:

• The impact of foreign aid funding cuts: Significant funding cuts for malaria are expected, potentially in the range of 20% to 30%. This has prompted the Global Fund to instruct recipient countries to prepare for cuts across its malaria programs, forcing countries to reorganize entire malaria campaigns in just two months—a process that normally takes a full year.
• Program prioritization decisions: Countries are facing difficult choices as a result of reduced funding and will have to cut some programs. Highly cost-effective malaria prevention programs are at a high risk of being deprioritized to ensure malaria treatment remains available for people who are already sick. This is concerning because these prevention tools, such as insecticide-treated net campaigns and seasonal malaria chemoprevention, have been a major driver in reducing malaria deaths.
• How we’re responding: GiveWell is working to identify and fund emerging needs created by the funding shortfalls. This includes an emergency grant to procure three million rapid diagnostic tests for Nigeria and cover a last-minute gap in supplies. We’re also investigating funding for the delivery costs of mosquito nets—costs previously covered by large donors like the Global Fund—to ensure that already-purchased nets reach the people who need them.

GiveWell has a long history of finding and funding highly cost-effective malaria programs. We’re working closely with our partners to understand the complexities of this new funding landscape, prepare for emerging cost-effective needs, and direct funding where our research shows it can have the greatest impact. 

Visit our Foreign Aid Funding Cuts webpage to learn more about our response and how you can help, and listen or subscribe to our podcast for the latest updates.

This episode was recorded on July 16, 2025 and represents our best understanding at that time.

As GiveWell’s research team grows, that increased capacity and expertise allows us to evaluate a wider range of programs to find the most cost-effective opportunities to help people. Over the past year and a half, we’ve been investigating a new research area—family planning services that help people decide whether and when to have children. 

Family planning programs have particularly complex challenges around targeting, logistics, and ensuring informed and voluntary choice. However, GiveWell's increasing research capacity now positions us to take on new and complex investigations like this. We’ve been reviewing evidence, consulting with experts, modeling the benefits of contraception, and conducting initial grant investigations, focusing on programs that aim to increase access to and use of modern contraception. This work is especially timely as anticipated cuts to foreign assistance could significantly reduce existing family planning support, creating substantial new funding gaps.

In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Senior Research Associate Dilhan Perera about the complexity of evaluating family planning programs. They explore the types of programs GiveWell is considering, the unique challenges this area presents, and key questions we’re working to answer.

Elie and Dilhan discuss:

• Types of family planning programs: GiveWell is investigating several approaches, including direct service delivery to underserved communities, programs that provide counseling, and supply chain interventions that work with health facilities to prevent stockouts of contraceptives.
• The complexity of evaluation: Unlike programs such as malaria prevention that target a well-defined population and try to maximize coverage, family planning programs must account for individual preferences and avoid coercing people into using contraception they don’t want. This requires more sophisticated monitoring systems to prevent coercion, which raises the overall cost and complexity of effective program delivery.
• Operational challenges and trade-offs: Programs must often choose between reaching the most underserved communities (which are often remote and expensive to reach) and working within existing health facilities. The challenges in either approach include making sure people are accurately informed about their family planning options and navigating supply chain issues like stockouts. 

We’re actively considering a handful of funding opportunities in family planning. Our goal is to make initial grants that will not only have a direct impact but also help us learn more about this type of intervention, helping us better compare these programs against other funding opportunities.

Visit our All Grants Fund webpage to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on June 24, 2025 and represents our best understanding at that time.

GiveWell’s ability to find and fund highly cost-effective health programs relies on a foundation of credible data. A key source of that data, the Demographic and Health Surveys (DHS), recently had its primary funding from USAID discontinued. This creates the potential of a significant challenge for GiveWell’s research—and for evidence-based grantmaking across the global health sector.

In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Senior Researcher Adam Salisbury to explore the implications of this funding gap. They discuss how the DHS program works, why it’s essential for informed decision-making, and how GiveWell is responding to the growing limitations of public health data.

Elie and Adam discuss:

• The surprising source of global health data: In many countries where GiveWell works, basic health metrics like child mortality rates aren’t comprehensively tracked in official registries. The DHS program fills this data gap by conducting vast, in-person surveys that ask women to recall their children’s birth and survival histories. This method provides the primary data for mortality estimates in low- and middle-income countries.
• Why good data is difficult to get: The DHS is resource-intensive, costing tens of millions of dollars per year to administer in-person, house-to-house surveys across more than 50 countries. Enumerators must travel to remote areas where unreliable internet and postal systems necessitate this approach. The logistical complexity and high cost are primary reasons the surveys in any given country often happen only once every five years.
• GiveWell’s approach to repairing data gaps: With USAID funding discontinued, GiveWell is considering whether to support these surveys directly, coordinating with other global health partners who share similar interests. GiveWell is also funding targeted data collection to address questions the DHS doesn’t cover, such as bed net durability or how people in low-income countries value consumption versus health gains.

The loss of funding for DHS creates a significant gap in global health infrastructure that affects decision-making across the sector. GiveWell is working with other global health organizations to explore sustainable solutions, while considering the trade-off between funding programs that help people now and funding research that guides future effective giving. 

Visit our All Grants Fund webpage to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on August 13, 2025 and represents our best understanding at that time.

Foreign aid funding cuts are reshaping the global health landscape, creating urgent funding gaps and forcing difficult prioritization decisions across health systems worldwide. To understand the real-world effects, it’s essential to hear from the organizations working on the front lines with government partners to navigate the funding crisis. The Clinton Health Access Initiative (CHAI) is a large global health nonprofit and an important GiveWell partner in this work.

In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with CHAI CEO Dr. Neil Buddy Shah about how the aid cuts are affecting vital health programs and what it takes to build a strategic response. They discuss the hidden complexities of the funding landscape, the difficult choices governments are being forced to make, and what this pivotal moment could mean for the future of global health.

Elie and Buddy discuss:

• The “gap identification” challenge: In many countries, a significant portion of the national health budget comes from foreign aid, and the funding cuts revealed a surprising vulnerability—many national health ministries don’t have a comprehensive map of who funds what within their own systems. The first step needed was a complex data-gathering exercise to identify where the gaps emerged.
• A strategic response to the crisis: CHAI is helping governments implement a three-pronged response. This includes (1) driving efficiencies to make existing funds go further, (2) reprioritizing budgets to protect the most essential services, and (3) advocating for increased domestic health funding.
• The long-term view: While the cuts are already causing significant drops in areas like HIV testing, the most severe health consequences are expected to hit in the coming years. The crisis represents a major shakeup of the funding and delivery system that has defined global health for 20 years, creating a critical opportunity to rethink what should come next.

The conversation reveals both the immediate crisis and long-term transformation occurring in global health. While governments are working to maintain some vital services through improved efficiency and reprioritization, these measures cannot compensate for the scale of funding reductions. GiveWell is working closely with partners like CHAI to understand the complexities of this new funding landscape and direct funding where our research shows it can have the greatest impact.

Visit our Foreign Aid Funding Cuts webpage to learn more about our response and how you can help, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on August 20, 2025 and represents our best understanding at that time. 

Our Beyond the Spreadsheets mini-series lets you ride along with our leadership team on their recent weeklong site visit to Malawi. Recorded daily during the trip, the series shares the behind-the-scenes experience of a GiveWell site visit through real-time reflections and clips of conversations. New episodes will be released weekly over the next month, and you can subscribe to be notified when each episode is published. 

At GiveWell, the vast majority of our work is desk-based research—analyzing evidence and modeling program outcomes. Site visits are a small part of what we do, but they add crucial on-the-ground context that raises important questions, challenges our assumptions, and makes our research stronger.

We had two main goals in visiting Malawi. First, we wanted to understand the effects of foreign aid cuts firsthand in a country that may be particularly hard hit. Second, we wanted to see livelihoods programs like GiveDirectly and Spark Microgrants in action, providing insight as we expand our focus on interventions that aim to increase people’s economic well-being.

On day one, the GiveWell team visited Zingwangwa Health Center and two villages that had recently received unconditional cash transfers through GiveDirectly.

Throughout the week, the team visited health clinics, schools, and local villages to speak with healthcare workers and community members who shared a glimpse into their lives. This new mini-series offers a candid, day-by-day account of our learning process and some of the new insights and questions that will inform our future research. We invite you to listen, subscribe, and follow along!

This episode was recorded on July 30, 2025 during GiveWell's site visit to Malawi and represents our best understanding at that time.

Our Beyond the Spreadsheets mini-series lets you ride along with our leadership team on their recent weeklong site visit to Malawi. Recorded daily during the trip, the series shares the behind-the-scenes experience of a GiveWell site visit through real-time reflections and clips of conversations. 

On day two, the GiveWell team met with district health officials to learn about the impact of foreign aid funding cuts and visited a local hospital to review health data. Listen to day one here. 

Throughout the week, the team visited health clinics, schools, and local villages to speak with healthcare workers and community members who shared a glimpse into their lives. This new mini-series offers a candid, day-by-day account of our learning process and some of the new insights and questions that will inform our future research. We invite you to listen, subscribe, and follow along!

This episode was recorded on July 31, 2025 during GiveWell's site visit to Malawi and represents our best understanding at that time.

Our Beyond the Spreadsheets mini-series lets you ride along with our leadership team on their recent weeklong site visit to Malawi. Recorded daily during the trip, the series shares the behind-the-scenes experience of a GiveWell site visit through real-time reflections and clips of conversations. 

On day three, the GiveWell team visited a rural health outpost where they met with health care workers to discuss the services they provide through village clinics and home visits—and the impact of foreign aid cuts on their work. Listen to day one and day two of the series here.

Throughout the week, the team visited health clinics, schools, and local villages to speak with healthcare workers and community members who shared a glimpse into their lives. This new mini-series offers a candid, day-by-day account of our learning process and some of the new insights and questions that will inform our future research. We invite you to listen, subscribe, and follow along!

This episode was recorded on August 1, 2025 during GiveWell's site visit to Malawi and represents our best understanding at that time.

Our Beyond the Spreadsheets mini-series lets you ride along with our leadership team on their recent weeklong site visit to Malawi. Recorded daily during the trip, the series shares the behind-the-scenes experience of a GiveWell site visit through real-time reflections and clips of conversations. 

On day four, the GiveWell team visited community projects funded by Spark Microgrants, including a maize mill and a sunflower oil mill, and spoke with residents about their impact. New to the series? Start with day one here. 

Throughout the week, the team visited health clinics, schools, and local villages to speak with healthcare workers and community members who shared a glimpse into their lives. This new mini-series offers a candid, day-by-day account of our learning process and some of the new insights and questions that will inform our future research. We invite you to listen, subscribe, and follow along!

This episode was recorded on August 2, 2025 during GiveWell's site visit to Malawi and represents our best understanding at that time.

Our Beyond the Spreadsheets mini-series lets you ride along with our leadership team on their recent weeklong site visit to Malawi. Recorded daily during the trip, the series shares the behind-the-scenes experience of a GiveWell site visit through real-time reflections and clips of conversations. 

On day five, the GiveWell team visited a school in Lilongwe, where they spoke with school representatives and families of students in a nearby urban settlement. On day six, the GiveWell team stopped at a major hospital in Lilongwe to hear from hospital staff and an implementing partner about the impact of foreign aid funding cuts. 

New to the series? Start with day one here. 

Throughout the week, the team visited health clinics, schools, and local villages to speak with healthcare workers and community members who shared a glimpse into their lives. This mini-series offers a candid, day-by-day account of our learning process and some of the new insights and questions that will inform our future research.

This episode was recorded on August 3 and 4, 2025 during GiveWell's site visit to Malawi and represents our best understanding at that time.

Despite significant progress over the past several decades, malaria remains a leading cause of death globally for children under five. This year’s cuts to foreign aid funding disrupted highly effective programs to prevent malaria, such as seasonal malaria chemoprevention (SMC).  

SMC provides antimalarial medication to children under the age of five during the rainy season when malaria transmission is highest, reducing their risk of dying from the disease. Malaria Consortium’s SMC program, which is one of the most cost-effective programs our researchers have identified, has been one of GiveWell’s Top Charities since 2016, and we’ve recommended more than $500 million in grants for the program since that time. 

SMC is only delivered during a specific period each year when malaria transmission is highest. The campaigns require careful planning and preparation on a specified timeline to ensure that the drugs are ready to distribute during that window. The funding freeze that started in January jeopardized 2025 SMC campaigns in several countries because of the disruption to funding for these time-sensitive pre-campaign activities. 

In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Program Officer Natalie Crispin about how GiveWell responded quickly and flexibly to ensure that SMC campaigns moved forward this year.

Elie and Natalie discuss:

• Planning for SMC campaigns: Prior to carrying out SMC campaigns, implementing organizations engage in an intensive and time-sensitive planning process to ensure that drug distributors are fully trained, the right quantity of preventive drugs is shipped to each community, and people are informed about upcoming campaigns.   
• GiveWell’s response to keep SMC campaigns on track: GiveWell considered funding for SMC in 11 countries where it had been funded by the US government, talked with stakeholders in 10, and ultimately provided funding guarantees for SMC planning activities in six countries. These grants ensured funding for pre-campaign activities if US government funds didn’t return—enabling implementing organizations to move forward with timely preparations while their funding was uncertain.
• Challenges, reflections, and lessons learned: While the work required for us to decide whether, when, and how to provide funding was more time-consuming than many of our grants, it strengthened our networks among SMC implementers and funders, and we believe our funding guarantees made a difference in ensuring that the campaigns were able to be carried out.

GiveWell has a long history of finding and funding highly cost-effective malaria programs. Our prior work on SMC enabled us to move quickly to protect lifesaving programs and keep campaigns on track until US government funding was restored. 

Visit our Foreign Aid Funding Cuts webpage to learn more about our response and how you can help, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on November 17, 2025 and represents our best understanding at that time.

On Thursday, December 4, 2025, GiveWell hosted a live webinar titled “Growing Needs, Shrinking Aid: Cost-Effective Action in a Year of Funding Cuts.” 

Major cuts to foreign aid this year created deep uncertainty for global health programs. In this live-recorded discussion, co-founder and CEO Elie Hassenfeld moderates a panel of GiveWell researchers to discuss the effects of these cuts and how GiveWell is leveraging its nearly two decades of experience in cost-effectiveness research and analysis to identify opportunities for exceptional donor impact.

The panelists—Rosie Bettle (Program Officer, Malaria), Alex Bowles (Program Officer, Malaria), Meika Ball (Senior Research Associate, New Areas), and Dilhan Perera (Senior Research Associate, New Areas)—answered questions selected live by attendees and shared their insights. They discussed the challenges of understanding the cuts’ impacts, how GiveWell adapted its grantmaking approach to fund time-sensitive opportunities, the trade-offs the research team had to make in the face of uncertainty, and new areas that might have cost-effective funding gaps. 

The conversation explores what the research team has learned so far, along with their predictions and uncertainties about the future. We expect needs to continue growing in the years ahead as the effects of current and future cuts accumulate. In this context of growing need, it’s increasingly important that resources are used as effectively as possible. 

Check out this blog post to learn more about our response to this year’s aid cuts, visit the All Grants Fund page to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on December 4, 2025 and represents our best understanding at that time.

This episode follows up on the November 26, 2025 episode of Planet Money, “Saving lives with fewer dollars,” which covered GiveWell’s evaluation of a grant to the Alliance for International Medical Action (ALIMA) to maintain primary healthcare, hospital services, and malnutrition treatment in two subdistricts of North Cameroon following unexpected aid cuts earlier this year. We recommend listening to the Planet Money episode first, as it provides important context. 

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Significant changes to foreign aid this year created challenges for implementing organizations—and for funders evaluating which programs to support with limited resources. The Planet Money team followed along as we assessed the effects of the cuts in real time, focusing on our evaluation of a potential grant to ALIMA to maintain nutrition and primary healthcare services in Cameroon. 

Following the announcement of the US government’s stop-work order and funding freeze in January, we created a rapid response research team and began assessing opportunities we thought were potentially highly cost effective. In March, we launched an investigation of the $1.9 million ALIMA grant, which we funded in June based on the team’s findings.

In this episode, GiveWell CEO and co-founder Elie Hassenfeld dives deeper into the grant investigation with Program Officers Rosie Bettle and Alice Redfern, discussing the timeline, modeling approach, and what ultimately led us to make the grant.

Elie, Rosie, and Alice discuss:

• The grant investigation timeline: GiveWell completed the investigation in about six weeks from start to finish. Typically, GiveWell grant investigations build on months or years of prior research. While we’ve researched and funded malnutrition programs in the past (including ALIMA’s programs), this program’s scope was wider—covering primary healthcare, disease surveillance, and hospital logistics.  
• How we adapted our modeling: As part of evaluating this grant, GiveWell attempted to estimate several parameters related to mortality, then used a series of simple models—rather than one comprehensive model—to estimate cost-effectiveness based on those parameters. These models, along with conversations with experts and other inputs, allowed the team to move quickly and respond to the urgent need. 
• An update on grant progress: With GiveWell’s funding, ALIMA’s program is now up and running again. The program has been adapted to incorporate mobile clinics, and ALIMA is on track to treat the number of children GiveWell expected. Based on a number of conversations, we believe that ALIMA’s programs are leading to increased care-seeking behavior. 

As GiveWell’s research team grows, that increased capacity and expertise allows us to evaluate a wider range of programs and adapt our approaches to better find the most cost-effective opportunities to help people. In this case, that growth enabled us to move quickly and navigate uncertainty to evaluate and fund ALIMA’s program.  

Visit our Foreign Aid Funding Cuts page to learn more about our response to this year’s aid cuts, visit the All Grants Fund page to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on December 3, 2025 and represents our best understanding at that time.

Global health programs faced major disruptions to their funding in 2025. Back in March, we published our first podcast episode to share a timely snapshot of the immediate impacts caused by the foreign aid freeze and GiveWell’s initial response strategy. It was unclear whether and when funding would resume, and what the medium and long-term implications would be for life-saving programs. 

Over the last year, GiveWell has drawn on almost two decades of cost-effectiveness research and analysis to assess the effects of this tumult in real time, identify gaps where funding could have exceptional impact, and prepare for future needs. We’ve made nearly $50 million in grants in direct response to funding cuts, as part of our expected total grantmaking of around $350 million for the year. 

In our final episode of the year, GiveWell CEO and co-founder Elie Hassenfeld and Director of Research Teryn Maddox follow-up on their first podcast conversation to look back at GiveWell’s response: Where did we succeed? What did we get wrong? Where could we have done better? How did our response evolve? And what might all of this mean for the world and our work in 2026? 

Elie and Teryn discuss:

• Strengthening partnerships for better decision-making: GiveWell first focused on addressing urgent gaps in familiar, high-impact program areas like malaria prevention, where our existing partnerships provided timely information about programs with imminent funding needs. We also built new relationships in areas previously well-funded by the US government, such as HIV prevention and treatment, where we’d done little prior grantmaking.
• The current state of aid and emerging needs in the new year: Some funding was reinstated for certain life-saving areas like malaria prevention, but other areas faced larger cuts and future funding levels remain uncertain. In addition, changes in how aid is structured have created further ongoing uncertainty. We anticipate that needs will continue to emerge in areas like HIV prevention—particularly for key populations that may be deprioritized—even as promising new interventions become available. 
• What we’ve learned and how we’re preparing for 2026: We discuss some of our successes—like funding guarantees that kept malaria prevention campaigns on track—and new modeling approaches we used. We’re drawing on lessons from that work and making learning grants in new areas, including HIV, family planning, and health systems strengthening, to position ourselves for potential future cuts. 

Read our blog post to learn more about our response to this year's aid cuts, visit the All Grants Fund page to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on December 16, 2025 and represents our best understanding at that time.

GiveWell has built its reputation on rigorous research—analyzing randomized controlled trials, building cost-effectiveness models, and reviewing monitoring data to identify cost‑effective ways to save and improve lives.

In an effort to supplement this desk research and make better decisions, we’ve been working to gather more information directly from the people who live and work in the countries where we fund programs.

In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Principal Researcher Alex Cohen about GiveWell’s work to gather local insights to check our assumptions and figure out what we might be missing.

Elie and Alex discuss:

• Testing key hypotheses about the data GiveWell relies on: We’re working to improve the inputs in our decision making. This includes checks on coverage data, more information about how programs work in practice, and assessing whether estimated program effects are plausible. These efforts have already identified discrepancies between coverage surveys and other areas for improvement.
• Addressing the limitations of global health data: GiveWell depends on credible data for its research, yet global health and development data is quite limited. For example, basic measurements like child mortality rates rely on household surveys conducted only every five years. We’re employing multiple approaches to address these limits: funding independent survey firms; conducting site visits; hiring local consultants; and strengthening networks with government officials, implementing organizations, and other funders.
• Balancing the trade-offs between local work and desk research: Desk research will continue to make up the vast majority of our work. We believe that complementing that research with additional information we gather from local sources could meaningfully improve our grantmaking. We expect to dedicate around 5% of our research team’s time and around 1% of our total grantmaking to these efforts, which we believe will have an outsized impact.

By prioritizing efforts to learn from people in the places where we fund programs, we hope to better understand how programs are being implemented, identify bottlenecks, and more. We believe that incorporating this information will improve our decision-making and our work to help people as much as we can. It provides checks on our primary models, increases confidence in our conclusions, and could highlight where we might be missing something important.

Visit our All Grants Fund page to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on December 23, 2025 and represents our best understanding at that time.

GiveWell is often thought of for its Top Charities, but over the last several years, we’ve been substantially broadening our work. We’ve developed new ways to identify potential grantees, funded research to fill gaps in our understanding, and explored new program areas where we believe cost-effective opportunities exist but other funders aren’t investing. This increased breadth isn’t a goal in itself—we’ve been laying the groundwork to deliver more impact, now and in the future.

In this episode GiveWell CEO and co-founder Elie Hassenfeld speaks with Senior Program Officer Julie Faller about how our research approach has evolved and what it means for the future of our grantmaking.

Elie and Julie discuss:

• Launching new approaches for finding grantees: In the past, we primarily found grantees through our existing networks. We’ve recently started running requests for proposals for programs like in-line chlorination (a water treatment program) and vaccine outreach, which has allowed us to learn about and fund organizations we hadn’t previously worked with. As our research team has grown, we’ve gained expertise and the ability to articulate a clearer perspective on the kinds of programs we believe are likely to be cost-effective.
• Using a grant portfolio approach to learn more: From the hundreds of proposals we received for in-line chlorination pilot programs, we funded a portfolio of pilots across a number of African countries. Because we funded a wide range of organizations working in varying contexts with diverse program models, we’ll learn a lot very quickly and be able to apply those lessons to future funding decisions. We’re incorporating intensive monitoring and evaluation, as well as technical assistance to increase the likelihood that the pilots succeed and to maximize what we learn.  
• Broadening our research funding: While GiveWell has funded research for many years, we’re now taking a broader view of the research questions and research designs we might support. For example, we recently funded a study to better understand how hemoglobin levels among anemic individuals are associated with particular health outcomes, which could improve global anemia guidelines and our funding decisions for iron fortification and supplementation programs.

This work reflects some of the outcomes of a shift several years in the making. By strategically growing and diversifying our research team, we’re building the capabilities needed to direct more donations to highly cost-effective programs and help more people in need. 

Visit our All Grants Fund page to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on January 13, 2026 and represents our best understanding at that time.

Seasonal malaria chemoprevention (SMC)—a program that provides preventive antimalarial medication to young children during the months when malaria is mostly likely to be transmitted—is one of the most cost-effective programs GiveWell has identified. Malaria Consortium’s SMC program has been one of our Top Charities since 2016, and we’ve recommended more than $500 million in grants to the program.

Most of our funding to date has supported programs in West Africa, where strong evidence gives us confidence in the effectiveness of the drug combination used. In eastern and southern Africa, malaria chemoprevention programs could potentially help many more children, but we have substantial uncertainties about drug effectiveness in that region.

In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Senior Researcher John Macke about the CHAMP trial, a randomized controlled trial of chemoprevention drugs we’re supporting in Malawi, and how it could shape our malaria grantmaking.

This research is one example of how GiveWell is building for the future: investing in research now that could substantially expand our ability to direct funding cost-effectively in the years ahead.

Elie and John discuss:

• Why eastern and southern Africa present different challenges: One of the drugs used in seasonal chemoprevention shows widespread resistance in the region, and existing trial evidence about the effectiveness of chemoprevention there has limitations. While we’ve supported SMC in parts of Uganda and Mozambique, we’ve been cautious about scaling up without stronger evidence on which drug combinations work and whether using certain drugs could increase resistance.
• What this trial will tell us: The trial will test three drugs alone and in different combinations across roughly 7,000 children in Malawi, making it the largest individually randomized trial of chemoprevention drugs ever conducted. We’ll learn about the efficacy of the two drugs currently used in SMC, as well as an additional drug that had previously shown resistance but might now be effective again. The trial will look at the effect of the drugs on both malaria infections and hospitalizations caused by malaria.
• How the results could affect our grantmaking: Depending on what we learn, this trial could open up more than $100 million in cost-effective funding opportunities for chemoprevention programs each year in eastern and southern Africa. The trial results will also provide a knowledge base for other funders and implementers to improve the cost-effectiveness of malaria programming. We expect initial results in mid- to late 2027, with the potential for resulting grants to provide medication to children in 2028-2029.

Visit our Top Charities Fund and All Grants Fund pages to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on January 22, 2026 and represents our best understanding at that time.

Vaccines are remarkably effective at preventing deadly diseases, and, while global needs for them are great, vaccines already receive substantial global funding. This creates a challenge: How do you identify opportunities where additional funding can meaningfully increase vaccination rates and save lives?

GiveWell has long recognized the potential for highly cost-effective vaccine programs. We started supporting vaccination programs in 2015 and have made over $200 million in vaccination-related grants to date. For example, New Incentives, one of our Top Charities, aims to increase routine childhood vaccinations in northern Nigeria by providing small cash incentives to caregivers who bring their children into clinics for vaccinations. 

Over the past several years, we’ve been growing our research team and laying the groundwork to expand the scope of our work and funding. 

In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Senior Program Officer Natalie Crispin, who leads GiveWell’s vaccination grantmaking. They discuss how our research approach has evolved and what it means for helping more children access life-saving vaccinations.

Elie and Natalie discuss:

• Moving from finding existing programs to targeting funding gaps: In the past, GiveWell primarily looked for specific, evidence-backed program types to support—such as conditional cash transfers that incentivize vaccination. Now, with a dedicated vaccines team, we ask a bigger question: What are the bottlenecks that prevent children from getting vaccinated and how can we address them? This shift has driven our funding in areas like vaccination outreach, where teams travel to remote communities to deliver vaccines.
• Building a grantmaking portfolio to maximize learning: GiveWell recently funded several vaccination outreach programs. For example, in DRC’s Kongo Central province, where vaccination coverage rates are low, we’re supporting planning vaccination sessions (e.g. timing, frequency, location) with better data, paying community health workers to track which children need vaccines, and funding motorbikes and fuel for vaccination teams to provide vaccination near communities who are far from health facilities. This year, we hope to fund a number of additional vaccination outreach and mobile vaccination programs in differing contexts. We expect this will provide the opportunity to learn quickly about what works and help us direct future funding accordingly.
• Expanding capacity through specialization: Over the past three years, GiveWell’s research team has doubled in size and its structure has changed. Today, nearly 60 researchers work on cause-specific teams, one of which focuses on vaccination. This specialization has enabled deeper relationships with vaccination implementers, funders, and government officials—relationships that have allowed us to surface new opportunities and better understand potential funding gaps. 

GiveWell’s vaccination grantmaking is a longstanding area of focus with growing diversity and impact. The deepening expertise and novel approaches of that dedicated team illustrate how the research team as a whole has evolved to pursue opportunities we wouldn’t have been able to just a few years ago. With greater capacity and specialization across health areas, we’re now better positioned to identify and direct donations to highly cost-effective programs that save and improve lives.

Visit our Top Charities Fund and All Grants Fund pages to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on February 10, 2026 and represents our best understanding at that time.

GiveWell aims to find and fund programs that will do the most good per dollar. To do this, we carefully evaluate potential grants before making them—assessing academic evidence, building cost-effectiveness models, and talking to people in the sector who know the program well. 

But our work doesn’t stop there. When a program we’ve supported nears the end of their funding, we also regularly evaluate its results to decide whether to continue our support. This typically involves gathering and analyzing extensive monitoring data. In most cases, the results are consistent with what we expected, and we renew the programs’ support. But sometimes we decide that, even if a program is doing a lot of good, it may not be having the impact we expected. In that case, we decide not to renew our support and instead direct those funds to where we think they’ll do much more good for people in need. 

In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Senior Program Officer Erin Crossett about the research that led GiveWell not to renew support for Evidence Action’s Dispensers for Safe Water—a program that installs chlorine dispensers at rural water points so that households can treat their drinking water and reduce waterborne disease—in Malawi and Uganda.

Elie and Erin discuss:

• How independent data revealed a significant gap in program reach: Early signals from a separate GiveWell-funded study and Evidence Action’s own internal review of the program in Kenya suggested chlorination rates were far lower than routine monitoring indicated. GiveWell then commissioned an independent survey in Uganda and Malawi to find out whether the same was true there. The survey found that only about a third as many people were using dispensers as previously estimated: roughly 2 million rather than 5 million. 
• Potential reasons for the data discrepancy: We believe that no single error drove the discrepancy. Instead, there were five or six contributing issues that together caused the differences in estimated usage. For example, chlorine was measured by matching a test result to a color wheel, which can be subjective and affected by lighting. This data was collected by Evidence Action’s own staff, which may have led them to interpret the color wheel results more favorably. 
• What GiveWell learned and its effect on future grantmaking: We believe that approving the initial grant in 2022 was the right decision, given what we knew at the time. We also think that we could have done better by, for example, investing earlier in independent verification. We now apply these lessons to our current grantmaking. For instance, our recent portfolio of safe water grants includes external surveys for all grants. 

As we've developed and grown our research team over the past several years, we’ve become increasingly able to support additional data collection, analyze and learn from our grants, and reallocate resources to the most cost-effective global health and development needs we find. 

Getting things right requires both honest self-assessment and grantee partners willing to open themselves to scrutiny, and we are grateful for Evidence Action’s partnership in identifying the discrepancy in usage rates. Evidence Action is now reducing its footprint in Uganda and Kenya, and winding down the program in Malawi, with a 24-month transition to help support communities and turn over operations to the governments where possible. 

Dispensers for Safe Water is still a program that helps people, and our grant provided clean water to millions. GiveWell’s decision not to renew reflects our mission to direct donor funds to where they will do the most good—not to fund everything that does good. We are continuing to support chlorine dispensers in contexts where we believe they will be highly cost-effective. For instance, we are currently considering a grant to Evidence Action to pilot variations of the program in northern Nigeria, where disease burden is much higher than the countries where we had been funding the program—and therefore the impact per dollar might pass our high bar for funding. 

Visit our All Grants Fund page to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on February 20, 2026 and represents our best understanding at that time.

GiveWell’s primary focus has always been researching, identifying, and directing donations to programs we believe will do the most good. When GiveWell first started, we approached this by looking for organizations that were already delivering highly cost-effective, evidence-backed programs and directing funding to those programs. Over time, we were able to focus further upstream by first identifying highly cost-effective programs and then supporting the development of organizations to deliver them. 

We’ve been able to take an even more expansive view as our research team doubled in size over the last several years. In addition to our core grantmaking, we’re now funding an increased number of grants designed to provide information that we think will help us direct more funding to highly cost-effective programs in the future. This includes things like generating research about program effectiveness, scoping new promising programs, and piloting program variations.  

GiveWell has long made some grants aimed at improving our knowledge base, but this work has now grown substantially and become more systematic. In 2025, GiveWell made 18 grants, totaling approximately $39 million, that were aimed specifically at getting more information to improve future funding decisions. In our latest podcast episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Program Director Julie Faller about these “value of information” grants.

Elie and Julie discuss:

• Testing variations on cash transfers to improve cost-effectiveness: Following an initial scoping grant, GiveWell recently funded GiveDirectly to pilot three program variations aimed at increasing the economic impact of its flagship program, which provides unconditional cash transfers to very poor households. Each pilot tests a different approach to increasing impact: one provides grants to local businesses ahead of a cash transfer rollout, another targets transfers to the poorest young adults, and the third pairs transfers with footbridge construction to help remote communities access markets and services. Through these pilots, we expect to learn more about the feasibility and potential cost-effectiveness of the program variations, potentially leading to opportunities to help people in need even more.  
• Testing a delivery model for diarrhea treatment: Oral rehydration solution—an inexpensive, effective treatment for diarrhea-related dehydration—is used by far fewer children than could benefit from it. To explore whether door-to-door delivery could increase uptake, GiveWell funded a large randomized controlled trial with the Clinton Health Access Initiative in Bauchi, Nigeria. Initial results are promising, indicating that 3,000 community distributors were able to reach about 80% of households with young children—and that ORS usage increased as a result. GiveWell is now considering whether to fund this model at scale, potentially with multiple implementers.
• Collecting better data on a nutrition program in India: GiveWell has supported Fortify Health, which works to address widespread anemia in India by partnering with flour millers to fortify wheat flour with iron. GiveWell recently funded a household survey in six Indian cities to better understand how much fortified flour people are actually consuming, and who in the household is eating it. The survey provided more information about several parameters that, taken together, allowed us to resolve some uncertainty about the program’s cost-effectiveness. We used what we learned to inform our decision to renew funding for the program.  

These examples reflect a longer-term shift at GiveWell—from an organization that primarily evaluated existing programs to one that increasingly generates the evidence needed to improve its grantmaking and fund more impactful programs in the future.

Visit our All Grants Fund page to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on March 13, 2026 and represents our best understanding at that time.

Vitamin A supplementation is one of the programs GiveWell has supported the longest, and we’re currently funding it in many African countries. The program has an unusually strong evidence base for reducing child mortality, with multiple randomized controlled trials. Yet, as is the case for most global health programs, the evidence for vitamin A supplementation has complex, unresolved questions, such as how well findings from decades-old trials apply today and the extent to which existing research has been influenced by publication bias. As GiveWell’s research team has grown over the last several years, we have expanded our capacity to carefully research these questions. 

In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Senior Researcher Stephan Guyenet about the evidence base for vitamin A supplementation, the complications in applying that evidence to our funding decisions, and how GiveWell has improved our cost-effectiveness estimates for the program.

Elie and Stephan discuss:

• The evidence base for vitamin A supplementation: Evidence from rigorous trials shows that vitamin A supplementation can significantly reduce child mortality. However, most of these trials were conducted 30 to 40 years ago, when infectious disease rates and vitamin A deficiency were more prevalent, and a more recent large trial in India found a much smaller effect. As a result, we worked to resolve our uncertainties about the effect of vitamin A supplementation in the contexts where we’re supporting it today. 
• How GiveWell worked through the complications: To address our questions about the existing evidence, we engaged in further research. This included an analysis focused on the specific diseases for which vitamin A supplementation reduces mortality, a novel dosing-frequency analysis conducted in consultation with an outside statistician, and an assessment of possible publication bias. 
• What all of this means for grantmaking: While the trials report that vitamin A supplementation reduces the risk of death by 19% on average in children 6 to 59 months old, we estimate that the impact in the modern settings we model is smaller: a 1% to 11% lower risk of death. Nevertheless, we still think vitamin A supplementation can be highly cost-effective. Using our updated cost-effectiveness analysis, we estimate our most recent grant for vitamin A supplementation to Helen Keller Intl is 25 times more cost-effective than our benchmark. This change reflects our more precise, location-specific analyses that allows us to direct funding to places where vitamin A supplementation is likely to be the most cost-effective. 

GiveWell continues to scrutinize the programs we fund, including those we have supported for years. In this case, years of rigorous research have largely held up the case for vitamin A supplementation. We will continue to review the program, funding new research to address remaining uncertainties and exploring whether a new randomized trial might be feasible. By doing so, we’ll continue to increase our confidence and refine our funding decisions to target the most cost-effective locations and do the most good we can with donors’ funds.

Visit our All Grants Fund page to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on March 25, 2026 and represents our best understanding at that time.

Clubfoot, a congenital condition where children are born with one or both feet twisted inward, affects roughly one in 800 newborns globally. Most of those cases are in low- and middle-income countries, where only about 20% of children with clubfoot receive treatment. 

While most donations to GiveWell are directed to programs that reduce child mortality, our growing research capacity over the last several years has expanded what we’re able to evaluate and fund. One outcome of that work is that we’re better able to direct donations to highly cost-effective programs addressing disabling conditions, like clubfoot, and meaningfully improve quality of life.    

In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Program Officer Meika Ball about GiveWell’s grant to MiracleFeet, an organization that expands access to clubfoot treatment. Their conversation walks through MiracleFeet’s program, how we estimated its cost-effectiveness, and Meika’s recent site visit to see the program in action in Côte d’Ivoire.

Elie and Meika discuss:

• How MiracleFeet supports clubfoot treatment: Clubfoot is treated using the Ponseti method, which involves casts to correct the foot’s position, a small surgical procedure, and a period of bracing. MiracleFeet supports this treatment by partnering with local health facilities, training healthcare workers, educating local communities about clubfoot, providing treatment materials, and working with Ministries of Health. Because of this support, treatment is provided at no cost to patients or their caregivers. GiveWell-funded independent surveys in Côte d’Ivoire and Chad indicated that very few children with clubfoot were being treated before the program, and hundreds have been enrolled since the program’s launch.
• What we learned from a recent site visit: Two GiveWell staff members recently traveled to Côte d’Ivoire to visit health facilities and see children being treated through MiracleFeet’s program. We spoke with a range of stakeholders, including healthcare workers, implementing partners, representatives from the Ministry of Health, caregivers of children receiving treatment, and disability advocates. Seeing the program in action increased our confidence that it is leading more children with clubfoot to receive treatment and is having an important impact on their lives. We also saw early signs of the program being integrated into national health systems, such as clubfoot being added to a maternal child health booklet that parents and midwives review after a child is born. 
• What makes this grant different: Most of GiveWell’s grantmaking focuses on preventing child deaths from widespread conditions like malaria or diarrhea. Clubfoot is a relatively rare condition that causes disability, not death. The treatment costs more per child than many other programs we fund, such as distributing vitamin A supplements or malaria nets, and requires sustained caregiver adherence over several years. To assess this grant opportunity, GiveWell applied moral weights, or subjective valuations, for the impact of clubfoot so it could be compared with other programs’ outcomes. We also made a separate grant to support monitoring and evaluation of the program to assess how much MiracleFeet’s support increases the number of children receiving appropriate and effective treatment. 

Our ability to evaluate, fund, and monitor a program like MiracleFeet’s is possible because of years of investment in our research team. This program exemplifies how our growing capacity is enabling us to expand our search for cost-effective opportunities where donors can do exceptional good.

Visit our All Grants Fund page to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on March 30, 2026 and represents our best understanding at that time.

GiveWell’s research doesn’t end once we’ve made a grant. We evaluate a subset of completed grants, comparing what we thought would happen to what actually took place, then try to use what we learn to improve our future funding decisions. Over the past year, we’ve formalized and expanded this work, publishing comprehensive “lookbacks” for select grants.

A recent lookback on grants GiveWell made to fund insecticide-treated net distributions supported by the Against Malaria Foundation (AMF) in the Democratic Republic of Congo (DRC) illustrates the growing capacity of GiveWell’s research team. We drew on multiple independent data sources, funded qualitative interviews to gather more information, and conducted a novel empirical analysis to deepen our confidence.

In this episode, based on a conversation originally aired on GiveWell’s internal podcast for staff, GiveWell’s co-founder and CEO Elie Hassenfeld provides additional context while GiveWell’s Chief Research and Program Officer Teryn Mattox dives deep into the details with Program Director Alex Cohen and Researcher Steven Brownstone, examining how we conducted the lookback, what we found, and how what we learned may shape our future nets grantmaking. 

Elie, Teryn, Alex, and Steven discuss:

• A more expansive and rigorous approach to evaluating past grants. This lookback draws on three independent quantitative sources—AMF’s monitoring data, a recent Demographic and Health Survey (DHS) conducted in the DRC, and an original survey commissioned by GiveWell—alongside qualitative research involving in-depth interviews with people involved in DRC’s net distribution system, from health zone administrators to village focus groups. 
• Conducting a novel mortality analysis using DHS microdata. Because net campaigns roll out on staggered schedules across DRC’s provinces, we were able to use the timing of children’s births relative to the date of local net campaigns as a natural experiment. We compared mortality risk for children based on when they were born, and thus the length of time they had protection from a net, and found that the net campaigns reduced the risk of death by around a quarter. That finding provides additional support for the mortality effect estimate we use in our cost-effectiveness models.
• What qualitative research revealed. Interviewers asked people across five provinces in DRC whether households received nets and whether households were using nets—and in cases where they either didn’t receive nets or weren’t using them, why not. Although we heard some anecdotes of misuse or diversion of nets, the data suggested overall that the nets are highly valued by the communities receiving them. 
• How durability data could inform campaign design. Our analysis of DHS data confirmed earlier research indicating that nets in DRC degrade before they are replaced through new distributions. As a result, it’s possible that changes in DRC like more frequent campaigns or increased support of routine net distribution through other channels may increase protection. 

If you’re interested in learning more about grant lookbacks like this one—and how they’re improving our research and shaping our future funding decisions—we invite you to join our next webinar on June 9. Alex Cohen, who was featured in this episode, and Program Director Julie Faller will walk through our lookback process, what we’re learning, and how we’re applying those lessons to help more people. Learn more and register here.

This episode was recorded on April 22, 2026 and represents our best understanding at that time.
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Glossary

Because the conversation in this episode first aired as part of GiveWell’s internal podcast for staff, there are a number of names, acronyms, and other terms that are not explained. To make it easier to follow along, we’ve provided a glossary below. 

• all-cause mortality. All-cause mortality measures the total number of deaths from any cause in a specific group of people over a specific period of time. 
• AMF. The Against Malaria Foundation, one of GiveWell’s Top Charities, collaborates with national malaria programs and other partner organizations in low- and middle-income countries to distribute insecticide-treated nets. 
• CEA. We build cost-effectiveness analyses to assess how much good can be achieved by giving money to a certain program. 
• Cox proportional hazards model. The Cox proportional hazards model is used to estimate how much different factors, such as time since an insecticide-treated net campaign, speed up or slow down the time to death. It assigns each factor a “hazard ratio,” which is a multiplier of the baseline risk of dying: a hazard ratio of 2 for smoking means that smokers face double the risk of death at any given moment compared to nonsmokers, all else equal. 
• DHS. Demographic and Health Surveys are vast, in-person surveys that ask women to recall their children’s birth and survival histories. This method provides the primary data for mortality estimates in low- and middle-income countries.
• funging. What we call “funging” (from fungibility) refers to the effect of crowding out funding that would have otherwise come from other sources.  
• insecticide-treated nets. These nets have been treated with insecticide to deter and kill the mosquitoes that transmit malaria. Distributing insecticide-treated nets, which are then hung over sleeping spaces, can be a cost-effective way of preventing malaria.
• lookbacks. Lookbacks are reviews of past grants published on the GiveWell website that assess how well they’ve met our initial estimates and what we can learn from them.
• Marakuja. Marakuja Kivu Research is a nonprofit organization in DRC that we have contracted with to conduct quantitative and qualitative surveys. 
• M&E. GiveWell asks organizations that we fund to share detailed monitoring and evaluation data on their programs to assess the quality of program implementation and whether it is reaching recipients as intended. 
• net durability. Insecticide-treated nets decay over time, both through loss of insecticide and physical wear.
• nets team. In internal conversations, this is what we sometimes call our vector control team (see below for definition).  
• OnFrontiers. OnFrontiers is a company that sets up interviews with subject matter experts around the world.  
• PDM....

Anemia, which is commonly caused by iron deficiency, can cause fatigue, cognitive impairment, and complications during pregnancy—and it affects roughly a quarter of the world’s population. Over the last decade, GiveWell has directed nearly $50 million to programs to address this health issue. 

Because of the large number of people affected and the low cost to provide people with iron, we are evaluating additional iron fortification and supplementation programs to potentially increase our grantmaking in this area. At the same time, it has been difficult to determine exactly how much providing people with additional iron improves their lives. GiveWell’s growing research capacity is allowing us to study the programs we’ve funded and to support new research, then to use what we learn to continue improving our funding decisions.

In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Researcher Andrew Martin about GiveWell’s work on iron: why the evidence is more complicated than it might seem, what we’ve learned from years of funding iron programs, and what’s ahead.

Elie and Andrew discuss:

• The evidence for iron: Anemia is a significant problem, but it can be hard to determine the exact magnitude of the benefit that comes from addressing it. In addition, current definitions of anemia, which can be caused by iron deficiency, are based on statistical data about typical hemoglobin levels rather than on people’s symptoms. GiveWell is supporting a randomized controlled trial in Bangladesh that aims to address this by measuring how providing additional iron affects perceived fatigue and other health outcomes—helping determine measurable thresholds at which people experience significant symptoms. We think the findings could reshape our understanding of how anemia affects people's lives and improve our anemia-related grantmaking.
• Looking back at Fortify Health’s progress: Fortify Health partners with wheat flour mills in India to fortify flour with iron and other micronutrients. After earlier grants to Fortify Health providing general support, GiveWell made a larger $8.2 million grant in 2021. At the time GiveWell made this grant, Fortify Health was working with seven mills and reaching roughly 350,000 people per year. Over the next three years, it expanded to 125 open-market mills producing more than 30 times more flour (see chart below) at about half the cost per person reached of our original estimate. We now estimate that our 2021 grant was about twice as cost-effective as we initially projected. Based on this track record, we recently renewed our support to Fortify Health with a $10 million two-year grant.
• What’s next for GiveWell’s research into iron: GiveWell currently supports two iron programs in India: Fortify Health’s work expanding iron fortification of wheat flour and Evidence Action’s iron and folic acid supplementation program for schoolchildren. To date, GiveWell has not funded iron fortification or supplementation programs in Africa, despite the region’s high anemia burden, in part because of concerns about potential harm from iron interventions in high-malaria settings. To help expand our work in this area, we issued a request for information for iron programs earlier this year—focusing on lower-malaria contexts—and are currently evaluating responses. We’re also considering support for historical research studying countries that have introduced fortification programs to help assess the long-term income effects of providing iron. 

GiveWell’s research on iron supplementation and fortification programs exemplifies this moment in GiveWell’s evolution: The research capacity and track record we’ve built are now enabling us to assess past grants, build and evaluate the evidence base, and expand our support of new cost-effective ways to help people in need.

Visit our All Grants Fund page to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

To learn more about how we’re learning and improving by analyzing past grants, like the one described in this episode, join our webinar on June 9. Elie will moderate a conversation with Program Directors Alex Cohen and Julie Faller about our grant lookbacks methodology, what we’ve learned, and how the findings are informing our grantmaking. Learn more and register.

This episode was recorded on May 15, 2026 and represents our best understanding at that time.

In September 2025, we created a livelihoods research subteam to specifically focus on programs that increase the economic well-being of people in extreme poverty. While we have evaluated and funded livelihoods programs throughout GiveWell’s history, we now have a dedicated program officer overseeing this portfolio, which has allowed us to build on and deepen that work. 

Historically, GiveWell has predominantly focused on health-related programs. Diseases like malaria, diarrhea, and pneumonia can be prevented fairly cheaply, and the evidence for health programs is often strong relative to other areas. As our research team has grown, we’ve been building capacity to explore programs that increase people’s incomes, where the long-term impact is often more challenging to measure and effectiveness differs from context to context.   

In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Senior Program Officer Adam Salisbury about GiveWell’s expanding work on livelihoods programs, which programs might be the most cost-effective, and research we’re funding to help answer some key questions. 

Elie and Adam discuss:

• Testing variations of cash transfers: GiveDirectly’s flagship cash transfer program currently falls below our cost-effectiveness threshold for livelihoods interventions, but it has a proven ability to scale. We funded three pilots to test whether specific program adaptations could improve cost-effectiveness enough to meet our threshold: (1) pairing small grants to local businesses with household cash transfers so vendors can stock up to meet new demand, (2) timing cash transfers to coincide with the construction of a new footbridge so recipients can access markets more easily, and (3) targeting cash transfers to the poorest young adults, who may be at a stage in their lives where a large lump sum transfer might be especially impactful.
• Exploring poverty graduation programs: Poverty graduation programs provide extremely poor households with a tool to generate income, such as a sewing machine, along with training and small amounts of money or food so that families have what they need without selling the asset. Evidence shows that these programs increase incomes over the first couple of years, and more recent evidence suggests these effects can persist for five years or longer. We are considering grants for research to assess which program designs are most cost-effective, whether income increases hold up over even longer time periods, and whether the programs can be implemented effectively at scale. Because around two-thirds of poverty graduation programs are now delivered by governments rather than NGOs, we are also exploring opportunities to support these programs by providing technical assistance to governments. 
• Funding research to address key uncertainties: By funding research directly tied to programs we are considering supporting, we aim to make better funding decisions and increase donors’ impact. For example, we had a consultant scrutinize the original data from a randomized controlled trial of GiveDirectly’s flagship program in Kenya that showed positive economic effects in the broader community—and the research held up. We’re now funding other research to assess whether the results can be generalized and considering studies to learn whether their effects persist beyond a few years.

GiveWell is expanding our search for highly cost-effective ways to help people in new areas this year by hiring for new research positions, including a senior livelihoods researcher. As the livelihoods team grows, we aim to evaluate more of the areas in the space, including expanding financial access, improving agricultural activity, and looking at humanitarian response efforts—to make better-informed decisions about where donor funding can do the most good.

Visit our All Grants Fund page to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on May 26, 2026 and represents our best understanding at that time.