Insider look: GiveWell

The latest edition of Impact magazine seeks to uncover global health’s best investments, identify global health trends, and discuss barriers and solutions to scaling up promising interventions. Read the interview below from the issue,  find the rest of the articles from the magazine here, and continue the conversation on Twitter using #BestBuys4GH.

Impact: GiveWell is known for using the very clear and direct framework of ‘proven/cost-effective/scalable’ when evaluating charities for public health. With your initiative, GiveWell Labs, you’re moving into new territory with the evaluation of areas outside public health and less straightforward frameworks. What was the impetus for this change and what challenges are you experiencing?

GiveWell: When GiveWell started, its co-founders had no experience in the non-profit sector, so they decided to focus on programs whose impact is easiest to measure: interventions with strong formal evidence of effectiveness from high-quality studies, such as randomized controlled trials. Now that we’ve been using this approach for a long time, we’re eager to learn about opportunities that might have great impact even if they are harder to measure, which is what GiveWell Labs is designed to do. The greatest challenge we have faced with GiveWell Labs so far is getting the information we need to make informed decisions.  Some of the questions we’re asking have been asked by foundations in the past, but usually those foundations don’t invest the time and money it would take to make that information publicly available.

Impact: In your model of philanthropy, where does advocacy fit in? Would funding a policy change that could save millions of lives be equal to funding specific and proven health interventions?

GiveWell: Advocacy can be a great way to have an enormous impact; our impression is that it led to many of philanthropy’s large-scale success stories. We have come to believe that there have been a lot of cases where a philanthropist decided he or she wants an idea or a cause to get more attention, and he or she has successfully put it on the map, and that has successfully made a difference to how governments and other funders behave.

Holding everything else constant, we prefer more reliable and proven interventions, but if advocacy can magnify our impact beyond what we could get with simpler strategies, we’re going to be highly open to that.

Impact: What are a few specific health interventions you think are among the best investments in 2014?

GiveWell: We maintain a public list of ‘priority programs’, which are interventions we would be excited to scale due to their strong evidence of effectiveness and cost-effectiveness. We’ve directed funds to organizations working on bednet distribution for malaria, cash transfers and mass administration of deworming, but our full list also holds many other interventions.

Our list continues to evolve as we have the capacity to research additional interventions and new evidence for others is released. For example, we are currently researching several nutrition and immunization interventions, as well as other health-related programs.

Impact: What are a few of the greatest lessons Givewell has learned?

GiveWell: #1: It’s hard to beat international direct aid for confidence in philanthropic impact because (a) it is easier to determine whether a program has succeeded or failed compared with less direct types of philanthropy and (b) the needs in the developing world are so great that a relatively small amount of money can make a very big difference.

#2: Highly rigorous evidence connecting aid activities to improved life outcomes (for example, “distributing insecticide treated nets reduces the burden of malaria and saves lives”) is found in academic literature, and very rarely in internal self-evaluations by charities. Self-evaluations may provide an important part of the picture, helping to assess whether a charity is carrying out activities as intended, but rigorous evidence that a program has the intended effect on life outcomes is generally found in academia, if it exists at all.

#3: In 2011, we discovered that one of the key cost-effectiveness estimates for deworming was flawed, and contained several errors that overstated the cost-effectiveness of deworming by a factor of about 100. The case illustrated how opaque, formal calculations can obscure important information and demonstrate high sensitivity to minor errors.

#4: Improving the quality of our research has been our best way of reaching new donors. We believe that our chances for growing over the long term are highly dependent on finding the most outstanding giving opportunities possible. A highly dedicated effort to outreach would not clearly have greater returns (just in terms of attracting attention) than continuing to improve the quality of our research.

#5: Increasing GiveWell’s staff size is difficult and risky, even when we have the funding to hire more staff. In our view, hiring people for startup organizations like GiveWell – whether as employees or as third-party contractors – generally means sacrificing today’s staff capacity for future staff capacity, and is always a risky (though essential) long-term investment.