Show Notes
The US government has historically been a major funder of HIV/AIDS programs, providing around $5 to $6 billion annually through PEPFAR and other initiatives. With anticipated major reductions in US government foreign aid, including potential cuts of 20% to 50% to HIV/AIDS funding, GiveWell is assessing where new, cost-effective needs might emerge.
GiveWell aims to find programs where additional funding can have the greatest impact. While HIV/AIDS has not historically been a focus for GiveWell due to substantial US government support, the current funding cuts might lead to potential cost-effective opportunities within HIV/AIDS programming. In the latest episode in our podcast series, GiveWell CEO and co-founder Elie Hassenfeld speaks with Program Officer Alice Redfern about our initial exploration into HIV/AIDS programming.
Elie and Alice discuss: Prevention programs for high-risk populations: While HIV/AIDS treatment and mother-to-child prevention programs are likely to retain funding, prevention programs targeting other high-risk groups have already seen significant cuts and program cancellations. GiveWell is focused on finding cost-effective opportunities within HIV/AIDS programming, and prevention efforts targeting high-transmission populations offer the greatest potential to reduce overall infection rates. The challenge of finding cost-effective opportunities: Unlike GiveWell’s typical approach of broad coverage in a targeted geography (like distributing malaria nets to all children under five in high-burden areas), HIV prevention requires targeting high-risk populations to be cost-effective. This creates a complex “search problem” of identifying programs that efficiently reach these populations in areas with high transmission rates. Promising innovations on the horizon: The emergence of highly effective, long-acting injectables like Lenacapavir offers game-changing potential for HIV prevention. However, their future cost-effectiveness and feasibility at scale depend on factors like price and real-world delivery challenges, including uptake and practical implementation.
This work is a good example of our ongoing efforts to identify where donor funding can be most impactful, which is especially important in the wake of recent cuts to US foreign assistance. We are working quickly to respond to emerging needs, leaning on partners and existing research to help us navigate the complexities and uncertainties of the HIV/AIDS funding landscape.
Visit our USAID Funding Cuts webpage to learn more about our response and how you can help, and listen or subscribe to our podcast for the latest updates. This episode was recorded on May 30, 2025 and represents our best understanding at that time.
More from GiveWell Conversations
In an effort to direct substantially more funding to the most cost-effective opportunities we can find to help people, GiveWell’s research is expanding in two directions at once: going broader, to cover more areas of global health and development, and going deeper, to improve the inputs that inform our decision-making.
GiveWell works to continually improve our research so we can make better grant decisions and direct donations where we believe they can do the most good. GiveWell’s Cross-Cutting research subteam is an important part of that effort—it investigates the impact of the programs we fund, works to resolve our largest uncertainties, and aims to improve our research. As GiveWell’s grantmaking grows, the Cross-Cutting subteam is strengthening our data collection and analysis to support that growth. In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Program Director Alex Cohen, who leads the Cross-Cutting subteam, about how better data can improve our decision-making, our work to gather stronger evidence, and the ways we’ve tested AI as a tool to increase our research capacity and quality.
GiveWell, with co-funding from Coefficient Giving, recently made our largest grant to date: $276 million to the Against Malaria Foundation (AMF) to support the procurement and distribution of 92 million nets in the Democratic Republic of the Congo (DRC) from 2027 through 2029. We estimate that the nets, 46 million of which we think would not otherwise be distributed, will avert roughly 67,000 deaths. We have supported AMF’s work for more than 15 years, and the insecticide-treated nets it procures and distributes remain one of the most cost-effective ways we've found to save lives.
When GiveWell investigates a new cause area, we’re often focused on two priorities: directing funding where we think it can help people most and generating evidence to inform larger investments later. Family planning is a clear example. Recent foreign aid cuts—including reductions from the US, UK, and Dutch governments—deepened an already substantial need and opened up new cost-effective funding opportunities.
Diarrhea is one of the leading causes of death for children under five, killing more than 400,000 children every year. GiveWell has funded several programs to prevent and treat diarrhea, and we recently expanded our work by making a grant to support the implementation and evaluation of WASHmobile in the Democratic Republic of the Congo (DRC) and South Sudan. The program, which was developed by Johns Hopkins University, delivers water treatment supplies and hygiene messaging to households at the highest risk of diarrheal disease. It has shown promising results in randomized controlled trials (RCTs) but hasn’t yet been implemented at scale in the challenging settings where the need is greatest.