Reports

Students watching a satellite-transmitted lesson as part of Making Ghana Girls Great (MGCubed), a program under evaluation by Innovations for Poverty Action (Loïc Watine/IPA/JPAL - poverty-action.org)

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Notice about research

Giving What We Can no longer conducts its own research into charities and cause areas. Instead, we're relying on the work of organizations including J-PAL, GiveWell, and the Open Philanthropy Project, which are in a better position to provide more comprehensive research coverage.

These research reports represent our thinking as of late 2016, and much of the information will be relevant for making decisions about how to donate as effectively as possible. However we are not updating them and the information may therefore be out of date.

Reports are listed by publication date. You can also view reports relating to specific charities/causes under the 'Related Reports' section in the sidebar on our charities page or causes page.


Parasitic Worms

Donating to an organisation which focuses on treating children with parasitic worms through mass drug administration (MDA) represents an excellent giving opportunity for a donor focused on having a high impact on both health and economic empowerment. As the drugs used to treat parasitic worms have only mild side effects, they can be administered without the need for individual diagnosis (which is both expensive and requires medical expertise).

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Schistosomiasis Control Initiative

We believe that the Schistosomiasis Control Initiative (SCI) is one of the most effective charities in the world. It works in a high priority area, combination deworming, which may be extremely cost-effective. SCI also has a strong track record in delivering the intervention, demonstrates a commitment to evidence and transparency, and continues to have room for more funding to be used productively.

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Against Malaria Foundation

The Against Malaria Foundation (AMF) is a charity that works on malaria bed net distributions. Specifically, it identifies countries which have gaps in funding for long-lasting insecticide-treated bednets, finds partners to distribute nets to households, and then buys nets and delivers them to the distribution partners. AMF is currently working in, or has agreed to work in, Malawi, Ghana, DRC and Uganda. All these countries have high rates of the disease transmission and significant bed nets gaps. DRC, Uganda and Ghana feature in the list of the 15 countries which, according to the 2015 World Malaria Report, accounted for 80% of cases of malaria as well as the list of the 15 countries that accounted for 78% of deaths caused by malaria[1].

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Malaria

According to the World Health Organisation, in 2015 there were about 214 million cases of malaria. The disease caused 438,000 deaths, of which 306 000 were of children under 5[1]. However, the total number of deaths could be as high as 1 million[2] since, due to diagnostic limitations, malaria incidence is hard to assess[3]. About 3.2 billion people – almost half the world’s population – are at risk of malaria[4]. 91% of all malaria deaths occur in sub-Saharan Africa[5].

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Citizens' Climate Lobby / Citizens' Climate Education

Citizens’ Climate Lobby (CCL) is a grassroots advocacy organisation based in the United States which advocates for climate mitigation policies such as a carbon tax-and-dividend system (sometimes called carbon fee-and-dividend).[^fn-2] Supporters of CCL organise meetings with congressional representatives and produce media to advocate for emission reduction policies.[^fn-3] In particular, CCL’s volunteers and programs target areas where there is relatively poor understanding of climate change and climate policy, as well as targeting members of congress in key committees and positions of authority.[^fn-4] The resources, research, communication protocols and staff used by CCL, however, are sourced from sister organisation Citizens’ Climate Education (CCE).[^fn-5]  Likewise, the supporters and volunteers who participate in CCL meetings and outreach (currently more than 25,000) are trained and supported by CCE.[^fn-6] The annual budget of CCE ($2.295 million) is roughly 10 times greater than that of CCL ($205,000).[^fn-7]

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Cool Earth

We estimate that Cool Earth is able to reduce emissions by 1 tonne of CO2-equivalent for every $1.34 donated, for directly protected forest specifically (although this figure may be as low as $0.65). If indirectly shielded forest is also included, this drops to $0.38 per tonne of CO2-equivalent. This is 25 times less expensive than most carbon offset providers, which typically reduce emissions by 1 tonne for roughly every $10 spent.[^fn-13][^fn-14]

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Determining the cost-effectiveness of climate change interventions

When it comes to choosing between cause areas and choosing where to donate, it’s obviously quite important to have some idea of how cost-effective different interventions are. That’s largely why GiveWell and Giving What We Can do research in the first place. But to work out the cost-effectiveness of an intervention, we need to have a reasonably good idea of what the impacts (particularly quantitative impacts) of that intervention will be. For climate change interventions, many of which currently focus on directly mitigating greenhouse gas emissions, this is a major problem and one for which there is yet to be a satisfactory solution. This is largely due to the extreme degree of uncertainty which plagues the modelling of climate change and, in particular, its predicted impacts.

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Climate Change (Part 1 of 2)

Anthropogenic climate change poses a significant threat to human well being on a global scale. It has been claimed by leading health journals that dealing with expected warming “...could be the greatest global health opportunity of the 21st century...”.[^fn-1] The Earth’s mean surface temperature has already increased by 0.8°C since the beginning of the 20th century,[^fn-2] and 0.6°C since only 1980.[^fn-3] This increase in temperature has been attributed primarily to increased concentrations of greenhouse gases in the Earth’s atmosphere, which is itself attributed to the release of such gases through human activities such as energy production, agriculture, transport and land clearing.[^fn-4] For instance, the concentration of carbon dioxide, one of the most prevalent such gases, has risen by more than 40% since the start of the Industrial Revolution, from approximately 280 parts per million (ppm) to over 400 ppm (see Figure 1).[^fn-5] Notably, prior to 1950, the highest concentration over the last 400,000 years is estimated to be roughly 100 ppm less than our current level.[^fn-6]

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Dementia (Alzheimer's Disease)

The following cause-level investigation was completed as part of a bespoke report for an individual donor. Giving What We Can has not prioritised dementia as a primary cause area and our investigation to date has not suggested a high level of cost-effectiveness or of neglectedness. In addition, for this report we only considered charities working within the United Kingdom. Although anti-tobacco advocacy groups in general are likely to be one of the more cost-effective methods of reducing dementia prevalence, they may be a great deal more or less cost-effective than Action on Smoking and Health UK. Given this, the following report may provide some useful insights into dementia as a cause area, but we do not recommend donations in this area or to this charity as one of the most effective ways to improve overall human health.

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Action on Smoking and Health

ASH is an advocacy group originally established by the Royal College of Physicians and currently overseen by an advisory board of 70 academics and professionals from the fields of medicine, public health, public relations and politics.[^fn-244] They are active in two separate areas: providing information and networking, particularly aiming to develop awareness of the health impacts of tobacco and develop public opinion; and advocacy and campaigning, through which they attempt to bring about policy changes which reduce the disease burden due to tobacco.

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New Incentives

New Incentives was founded in 2011\. It provides conditional cash transfers for women with HIV or at-risk pregnancies working in partnership with the Ministry of Health in Nigeria. They provide transfers up to about $150 over the course of the program. The transfers are conditional on the mother registering her pregnancy and being tested for HIV, delivering in a clinic, and (if HIV-positive) having their newborns tested for HIV. The program started by only focusing on mother-to-child HIV transmission. However, New Incentives found it would not be feasible to scale its operations by only focusing on prevention of mother to child transmission (PMTCT). It thus expanded its program as to also include at-risk pregnancies, to be able to work in smaller clinics which work with fewer HIV-positive woman[^fn-177]. Risk factors include anemia, hepatitis, old age, young age, tuberculosis, and previous non-facility births[^fn-178].

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GiveDirectly

GiveDirectly makes unconditional cash transfers to low-income households. The organisation transfers approximately one year’s worth of annual income (~$1,000) directly to beneficiaries using mobile-payment systems. Specifically, GiveDirectly transfers $1,040 to each enrolled household in Kenya, and $875 in Uganda. These transfer amounts are based on GiveDirectly's standard transfer size and adjusted for purchasing power. GiveDirectly makes three transfers in Kenya (a small initial $90 transfer followed by two $475 transfers). While the grant structure was different in Uganda (9 monthly transfers of about $97 each) the more recent campaign  in the country have employed a structure similar to the Kenyan programs[^fn-191]. GiveDirectly has recently announced they will provide at least 6,000 Kenyans with a basic income for 10 to 15 years. The evaluation  of the project will be run by a research team including Abhijit Banerjee of MIT[^fn-192]. GiveWell estimates the overall cost of the project will be roughly $30M[^fn-193].

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Cancer (Part 2 of 2)

Lung cancer is the single largest contributor to cancer deaths, resulting in 1.59 million deaths each year.[1] Tobacco use is the single most important risk factor for cases of lung cancer, to which 70% of those 1.59 million deaths can be attributed.[2] In addition, smoking is the single greatest identifiable risk factor for deaths due to all forms of cancer worldwide (see Figure 10), resulting in 20.89 cancer deaths per 100,000 - 2.73% of all deaths worldwide, from any cause.[3]

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Economic Empowerment (Part 1 of 2)

Poverty is a significant challenge to human well-being, and its eradication is a high-priority goal for development. This report focuses on the income-based definition of extreme poverty. There are a variety of interventions which attempt to alleviate poverty: we focus on microcredit and direct cash transfers since, for these interventions, we were able to find adequate evidence about organizations administering them.

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Economic Empowerment (Part 2 of 2)

Among organizations that target poverty reduction, there is a long tradition of directly providing aid. Historically, this has come largely in the form of in-kind transfers, including food, asset distribution (e.g. livestock) or the supply of medical care[1]. In recent years, however, cash transfers have emerged as an increasingly popular strategy for poverty alleviation. Generally speaking, there exist two types of cash transfers: conditional and unconditional.

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Cancer (Part 1 of 2)

Cancer is a collection of related diseases, all of which involve the uncontrolled division of cells within the body.[1] These cell growths, also referred to as neoplasms, can spread to surrounding tissues and the rest of the body. Many common cancers can be treated, particularly if they are detected quickly, through methods such as radiotherapy, chemotherapy, and surgery. Many cancers can also be prevented by reducing or eliminating exposure to external agents, such as carcinogens found in tobacco smoke.[2]

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Freedom Fund

The Freedom fund is a private donor fund dedicated to identifying and investing in the most effective front-line efforts to end slavery.

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BasicNeeds

Our assessment of BasicNeeds leads us to tentatively conclude that the narrow impact of their intervention is cost-effective but an order of magnitude less cost-effective than our top charities. On the other hand, BasicNeeds is conducting pioneering advocacy work which is difficult to measure, but equally difficult to ignore.

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Human Trafficking and Modern Slavery

Human trafficking and modern slavery have been estimated to affect 36 million people worldwide. In this area, the best charity we have identified is the The Freedom Fund, a regranting organisation that coordinates global attempts to eliminate modern slavery through a combination of direct interventions and political advocacy. Regranting and advocacy organisations are particularly hard to evaluate but, at a very high level, it has been estimated that one slave in India has been freed for every US$657 donated.

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Mental Health

Mental health problems impose a very large burden of disease and are relatively neglected, particularly in the developing world. On the other hand, they are generally quite expensive to treat, and so are not as tractable as other cause areas.

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Micronutrient Fortification

Even though there are some uncertainties with regard to estimating the cost-effectiveness of micronutrient fortification programmes and there is variation in cost-effectiveness across programmes[^fn-13], fortification is generally considered to be a very cost-effective intervention. Early estimates suggested that fortification with iron, vitamin A and zinc were well below $100 per DALY averted (see Figure 9).

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Medical Research - Part 2

  • Published 21 Sep 2015
  • Updated 24 Jun 2016

Note that any attempt to estimate the returns to research funding will depend on which disease is funded, and the type of funding given. All of these estimates are for a particular disease/funding type combination, and this may explain some of the variation between them.

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Medical Research - Part 1

  • Published 21 Sep 2015
  • Updated 24 Jun 2016

The aim of this report is to provide estimates of the cost-effectiveness of medical research into diseases prevalent in low-income countries. This should help to assess whether it is a promising area for further research or even recommendations from Giving What We Can. I am attempting to assess this primarily by assessing the current literature on the topic, complemented by some simple modelling.

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Medical Research - Part 3

  • Published 21 Sep 2015
  • Updated 24 Jun 2016

This section notes disease specific evidence that I turned up in my literature review. I did not try to do a thorough literature review into these questions, but I thought it worth recording what I did find.

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Tobacco Control

Tobacco kills up to half of all people who use it (i.e. shortens their lifespan), and has a global death toll of almost 6 million people per year (600,000 of whom are non-smokers exposed to secondhand smoke).[1][2] This figure is expected to rise to 10 million deaths per year by the middle of this century.[3] In response to these figures and the detrimental effect of tobacco use, the tobacco control policies and anti-smoking mass media campaigns conducted in developed nations have resulted in decreases in incidence of lung cancer and other common diseases.[4] Meanwhile, however, many developing countries have not had the benefit of these policies or campaigns and, as a result, deaths due to smoking-related diseases are increasing (see Figure 11).[5][6][7][8]

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Deworm The World Initiative

The Deworm the World Initiative (DtWI) has been one of our highly recommended charities for several years now. Our colleagues at Givewell have recently published an extensive update recently that was generally very favourable, and they continue to rank among Givewell’s top charities. You can read more about the general case for deworming on Givewell’s page on deworming. In this blog post, we will give you an update about their efforts that we feel complements Givewell’s report. You can find more general information about DtWI on our website. In our opinion, DtWI continues to be a very promising charity and could be one the most effective charities in the world.

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Road Traffic Injuries

Most of us have seen the aftermath of numerous road accidents and many of us will have been in one ourselves, but we are likely to underestimate the sheer scale of the devastation caused by road traffic injuries (RTIs). In 2010, according to the Global Burden of Disease Study, RTIs killed around 1.33 million people worldwide[1] – more than 3,000 a day – making them the eighth biggest killer in the world, ahead of diseases like tuberculosis.[2]

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