Caroline Wood

Isn’t poverty just a symptom and not the real problem we should be addressing?

‘Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime’

This popular saying is often used to illustrate the argument that, over the long-term, it is more efficient to address the fundamental issues causing a problem rather than relying on ‘quick fixes.’ For example, the effective altruism (EA) community, along with other organisations which work to alleviate poverty, has occasionally been criticised for focusing on short-term solutions instead of tackling the root causes of poverty. Sometimes these interventions are given the (rather derogatory) name ‘band-aid’ solutions, implying that they merely cover up the superficial symptoms of poverty like a bandage would, without doing anything to improve the underlying situation.

But is this really fair? After all, achieving systemic change takes time, and may even eclipse the lifetimes of those suffering right here and now. Sometimes, a quick-fix might actually be the most empowering thing you can do, and be 

the first step that helps break the cycle of poverty

 found that children who received deworming treatment had significantly fewer school absences, and earned 13% more income as adults, compared with children who did not receive the treatment. Given that deworming treatment costs less than $1 US per child per year, the researchers estimated the social rate of return to be 37%. Not bad for a band-aid surely?

Nevertheless, it’s true that a lack of strategy or long-term thinking can allow problems to perpetuate, or even get worse. For instance, providing food to the hungry through charity-funded food banks 

may shift the responsibility from governments, making them less compelled to introduce state support

. Similarly, although camps for refugees and displaced people are a quick solution to save lives and provide food, water, shelter, and medical care, they are incredibly costly to run, undignified, and can lead to long-term dependency. Paul Spiegel, a former senior official at the United Nations High Commissioner for Refugees, 

 would introduce policies to give displaced people work permits, besides access to educational and healthcare systems within their host countries.

Perhaps the ultimate band-aid example comes from ‘

’ itself: the charity supergroup founded in 1984 by Bob Geldof and Midge Ure to raise money for anti-famine efforts in Ethiopia. This culminated in the legendary 1985 Live Aid concert, which raised $127 million, sparking real hope that this would start to reverse Ethiopia’s desperate levels of poverty. But 35 years later, 

Ethiopia remains a ‘Humanitarian Catastrophe’

, crippled by drought, famine and conflict. 

, key reasons for this include lack of investment in broad, long-term policies for agricultural development, managing natural resources, and credit/insurance.

When we consider the examples above, it can seem obvious that the most effective strategy would be to tackle the major causes of suffering - as the fifteen-year 

 aimed to do. These addressed eight grand challenges, with the first being to ‘eradicate extreme poverty and hunger.’ And indeed, the goals definitely made some progress towards this: within the project’s timeframe 

the number of those living in extreme poverty

 halved, reducing the number of people living on less than $1.25 a day from 1.9 billion in 1990 to 836 million in 2015. However, several reasons mean that addressing the root causes of poverty that remain will be much, 

1. Poverty looks very different depending on where you are

In some countries, while only a small proportion of their population lives in poverty, this translates into large 

 numbers. For instance, the countries with the highest numbers of people living below the poverty line are India, Nigeria and the Democratic Republic of Congo, 

which have a combined total of over 280 million people

. But there are many smaller countries that have higher 

 levels of poverty: in South Sudan and Burundi, for example, 

around 80% of the population lives below the poverty line

. On top of this, each country has its own unique combination of political systems, infrastructure, environmental resources, cultural traditions, and foreign policy. Improving people’s livelihoods as quickly as possible will therefore require an individual, tailored plan for every region.

2. Poverty is now concentrated in extremely challenging environments

Most (96%) of those living in extreme poverty 

live in countries that are environmentally vulnerable, politically unstable, or both

the largest recipient countries of international humanitarian aid are burdened with protracted or recurring crises

. In these circumstances it is difficult, if not impossible, to plot a route out of poverty, and this is typically well beyond the scope of a charity or NGO to deal with. 

Writing for Vox, journalist and EA advocate Kelsey Piper put it this way:

“… there’s no doubt that it’s significantly more complex to identify the best ways to do good in [lobbying and advocacy work] than it is to identify the best ways to distribute bednets.”

3. Solving poverty is not a linear process

Unlike giving a child a vaccination or installing a well, solving poverty isn’t a simple ‘once it’s done, it’s done’ process. The overall success of the Millennium Development Goals wasn’t felt everywhere, 

with some areas experiencing little change and 30 countries seeing the number of people living in extreme poverty actually increase

. Furthermore, sudden conflicts and political instability can rapidly undo decades of slow policy change, 

4. Assumptions about the best way out of poverty aren't always correct

It is often assumed that if you can increase a country’s economic growth, poverty levels will naturally fall, but this isn’t always the case in reality. Without policies that ensure that increased wealth is distributed across many levels of society, 

growth alone typically lifts few people out of poverty

. We also lack measures that link overall economic growth with the amount of poverty within a country. One of the most commonly used measures, Gross Domestic Product (GDP), simply measures the total value of goods produced and services provided in a country during one year, 

but it doesn’t say anything about how this wealth is shared, and the gulf between the highest and lowest levels of society.

 Economic growth can simply lead to the rich getting richer and the poor getting poorer, 

particularly if there are high levels of corruption.

Arbitrary attempts to change systems are unlikely to have positive effects, 

particularly if we aren’t clear on what the causes of the problem are, and what the best solutions may be

. Even worse, they can actually do harm, especially when led by rich Westerners who assume that their money and background means they have more knowledge and expertise than local groups 

(also known as ‘White Saviour Complex’).

In combination, these reasons mean that addressing poverty at a systems-level — whether through advocacy, policy engagement or research — carries a much higher risk of being ineffective or totally unsuccessful. 

An evidence-based approach to systemic change

However, since ‘bigger picture’ approaches can (if successful) have a much higher 

impact, we shouldn’t disregard them completely. Thanks to increasingly sophisticated data sources and new approaches, the EA community is beginning to also assess charities working for systemic change. For instance, in 2019 

GiveWell announced that it would be expanding its scope

 to include interventions where causality is harder to establish, as part of its mission to provide guidance on everything that could potentially be among the most cost-effective giving opportunities. This could include charities that provide technical assistance, work to influence government policies, organisations undertaking research and development, or groups supporting social entrepreneurship.

The aim is to support the best charities, using evidence as a guide (bearing in mind that 

). Some examples of evidence-based charities include:

to ban the pesticides that cause accidental poisonings and are used most in suicides

. Ending the ready availability of these harmful substances could prevent thousands of deaths each year.

 to support small business owners. This can have major ripple effects within families, for instance by generating enough income to enable children to attend school.

Public health campaigns, including anti-smoking legislation, 

, strategies to tackle air pollution, and stronger policies against counterfeit medicines. These promote healthier environments, leading to greater societal wellbeing.

Organisations lobbying for producers in low- and middle-income countries 

. This can open up new markets and income sources for farmers working at all scales.

 to be given to the poorest countries, thus removing a severe constraint on national economic growth.


In all cases, working for societal change is most likely to succeed 

when there is a focused strategy, and donor charities work in partnership with local communities

, drawing on their expertise, resources, and connections. For instance, 

the Centre for Pesticide Suicide Prevention (CPSP)

 collaborates with local and regional governments to collect information on the use of lethal pesticides in their country, then trains local researchers to identify the suicide, accidental poisoning, and environmental consequences of their use.

At the end of the day, the distinctions between short-term, individualised solutions and societal change can be highly arbitrary, and not the most helpful way to evaluate charities. The band-aid metaphor, for instance, assumes that the intervention can only be applied retrospectively - it can’t stop you getting the cut in the first place. But many so-called band-aid solutions can actually prevent the harm from happening, for example 

providing vitamin A supplements to stop children from developing blindness

In any case, a charity’s strategy will likely include both direct interventions and broader, systemic work. For instance, despite their big picture approach, the successes of the Millennium Development Goals were partly achieved through apparently short-term methods, including distributing millions of measles vaccinations and insecticide-treated mosquito nets.

the guiding principle for effective altruism remains the same

: to support charities which the evidence suggests will achieve the most good

 to donate a portion of your regular income to help the world’s poorest, then you are already part of a systemic change within society — one that asks ‘What can I give?’ instead of ‘What can I get?’ Telling others about your decision and explaining effective altruism to your friends and family can have a ripple effect that sees even more people lifted out of poverty. And isn’t that a beautiful thing?

In this guest blog, Caroline Wood addresses whether trying to eliminate poverty  through charity is just a 'band-aid' fix to larger systemic problems.

Do many charities fail to help people?

Whether their mission is combating malaria, improving global literacy, researching cancer cures, or fighting climate change, we naturally assume that charitable organisations have noble intentions. Indeed, the very word ‘charity’ 

, describing affectionate love towards fellow human beings. So it can feel incredibly mean-spirited to stop and ask whether charities 

 benefit the people they intend to help. If their motives are altruistic and their methods are plausible, shouldn’t we just trust them to put our donations to good use?

Unfortunately, this isn’t always the case: despite their worthy motives, many charities don’t help people as effectively as they could, and some even cause harm. Acknowledging this doesn’t mean we are being cynical and judgemental; rather, it allows us to make the biggest possible difference to alleviate the suffering of others by supporting causes using methods that have been proven to work.

For a perfect illustration of a charity that is ineffective at best and harmful at worst, look no further than 

. The idea is simple: children play on a specially-designed roundabout, water is drawn up through a connected borehole to the surface, and the result is a new playground

system for providing safe water. On the surface, it seems a brilliantly creative solution. Within a few years of launching, 

PlayPumps were being hailed as a game-changer solution

, having won a World Bank Development Marketplace Award, as well as sponsorship from 

PlayPump Example

when major flaws in PlayPumps’ design became apparent.

 The pumps often broke down, were difficult to maintain and repair, and could only draw water when the roundabout was in motion —  resulting in exhausted, weary children, compelled to keep turning the unwieldy devices long after the fun had worn off. When consulted by aid organisations, the communities said they preferred the previous hand pumps, which dispensed more water for considerably less effort. In 2007, 

UNICEF issued a highly critical report of PlayPumps,

key stakeholders in the water sector are not comfortable knowing that the $14,000 paid for each unit would have covered several conventional handpump-equipped boreholes or wells, thereby providing safe drinking water to far more people than one PlayPump can

It wasn’t simply a case of PlayPumps not being the best approach to the problem: they were actually getting in the way of better solutions. Yet the charity is 

We can find more examples from medical aid. Across the world, NGOs, pharmaceutical companies, and charities distribute medical devices and drugs to low-income countries, yet often these are highly unsuited to local contexts. At worst, this can result in

 ‘graveyards’ of defunct equipment cluttering up hospitals

high disposal costs for inappropriate medicines

 on the effectiveness of medical donations made between 2009–2017, researchers from the University of Sydney concluded that most did not fully comply with World Health Organization guidelines, and that “40–70% of donated medical devices are not used as they are not functional, appropriate, or staff lack training.” Other issues included lack of spare parts to fix devices that broke, instructions provided in non-native languages, equipment being donated without all the required parts, and devices requiring a different power voltage to that used within the country.

Six reasons why ineffective charities exist

Even when charities don’t cause outright harm, their effectiveness can vary massively

. But if certain charities are so much better than others, why do the less effective ones persist? Some of the main reasons include:

1. We underestimate the differences in effectiveness

Most people are unaware of just how large the differences in charities’ effectiveness can be. For instance, 

 found that members of the general public estimated the most effective charities helping the global poor to be only 1.5 times more effective than average charities, while charity experts estimated the factor to be 100.

Charities are not like ‘for-profit’ companies selling products and services. If one company sold its products at 100x the price of the market average, it would quickly go out of business. But as we are generally ignorant about the difference in effectiveness between charities, this means that 

donors do not consistently donate more to the most effective charities.

 Consequently, there is no equivalent market pressure in the charity sector, which allows ineffective charities to persist.

3. Charities underinvest in overhead costs

Often, charities try to minimise overhead costs to appeal to donors but this can lead to counterproductive outcomes

, such as underinvestment in staff salaries (making it hard to recruit skilled labour) and outdated administration systems. In contrast, 

 that well-organised charities backed by solid infrastructures and highly trained staff typically leverage greater impact from their funds.

4. Charities fail to consult their intended beneficiaries

Many of the pitfalls behind PlayPumps could have been avoided if the time and effort had been made to consult the people the charity was trying to help, and to understand their local environment. Similarly, many charities fail to involve end-users, assuming a (rather arrogant) ‘West knows best’ approach. In their review on medical aid, for instance, the Sydney researchers found that “few donor organisations conducted needs assessments prior to donations.”

In general, people’s generosity does not scale proportionately with the number who could benefit. For instance, 

that people were willing to spend nearly the same amount to save 2,000, 20,000, or 200,000 birds from a disastrous oil spill. 

Studies have also confirmed that we can be misled by ‘pseudoinefficacy’

, where if a vast number of people are suffering or at risk from a problem, we feel that acting to save a single life is just ‘a drop in the ocean’ and therefore less valuable. It appears that we are more drawn to causes where we can help the highest proportion of affected people, rather than focusing on the absolute numbers.

Our giving habits can be heavily influenced by our emotions, with the result that 

fundraising appeals that induce feelings such as empathy, compassion or guilt are more likely to move us to donate

. We can also be easily led by ‘trendy’ campaigns backed by celebrities (remember 

The great tragedy is that by being drawn to easily marketable gimmicks, more appropriate and sustainable projects are in ever greater danger of being neglected.”

We are also more likely to donate to causes we feel a personal connection with, even if they won’t achieve the most additional impact possible. For instance, in high-income countries virtually everyone has either battled cancer or known someone who has. Consequently, many can be more inclined to donate to cancer research instead of, for instance, malaria prevention, despite the fact that additional funding towards cancer research is unlikely to save as many lives as anti-malaria interventions.

The solution to ineffective charities: Effective altruism

If we want to do good in the world, it is important that we are aware of the differences in charities effectiveness, because these have huge implications for the world’s poor. When a weaker solution is backed at the expense of a better one, it ultimately means fewer lives saved or improved. What’s more, our budgets are limited, and every dollar donated to an ineffective charity is one that could have been given to an exceptionally high-performing charity.

Happily, we are free to donate our money as we choose. This means we can simply focus on 

for areas with the potential to make a strong impact. 

Indeed, doing the most good we can with the resources we have (including our time, career and income) is the fundamental principle of effective altruism

. But how do we work out which are the most effective charities?

Thankfully there are several organisations that have already done the hard work for us, rigorously evaluating charities through many lenses. Their assessments consider factors such as evidence of successful programmes, 

, transparency, what they would do with additional funding, and whether the issue is being addressed by other charities and organisations (or ‘how neglected the issue is’). This means that if you donate to charities on their recommended lists, you can be confident that your dollars (or equivalent) will achieve as much good as possible.

: Focuses on charities with the potential to save and improve as many human lives as possible. By donating to their 

, your donation will be allocated to the charity or charities that Givewell’s research team recommends at the end of each quarter will likely achieve the most impact with your money.

: Reviews charities dedicated to helping animals (wild and domestic) including through lobbying for improved animal welfare, advocating dietary change and by providing veterinary care.

: A London-based charitable initiative, which encourages entrepreneurs to donate a portion of their personal proceeds to charity when they sell their business. Their advisory team produce 

research reports with recommended charities

For those passionate about preventing global catastrophic risks, such as nuclear war and bioterrorism, you can find advice from both 

on key priority areas. And for new or small charities that may not have been assessed yet, William MacAskill, author of 

 to help you decide whether it is worth your money.

Sometimes, effective altruism is misinterpreted as a cold-hearted, emotionless logic-driven approach to giving. But at its core, effective altruism is driven by a desire to do the most good for others. Your money is precious and deciding to give it to others is a beautiful act of compassion. How empowering it is then, to donate to charities that you can trust to be achieving the most impact from your gift.

So next time you are presented with a collection bucket, stop and ask — is this charity really helping people as well as it could be?

Caroline Wood works as a Communications Officer for the University of Oxford's Department for Population Health. Her work involves converting technical data from large-scale research studies into accessible language that the public can easily understand. After completing a doctorate in plant science research at the University of Sheffield, she worked as a Research Fellow for the UK Parliament, and then as a policy officer for the UK's Research Councils. She has also been a freelance writer for over ten years, specialising in biological science, food security and environmental issues. In her spare time, she enjoys hill walking, painting, and volunteering at the theatre.

Caroline Wood

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Isn’t poverty just a symptom and not the real problem we should be addressing?

Do many charities fail to help people?