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 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.

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.

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.

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.

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.

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.

***

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.

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 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.

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.

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.

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.

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.

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. 

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.

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.

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.

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. 

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 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.

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 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.

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.

• 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.