
Show Notes
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.
This grant, which involved a more rigorous investigation process than most, is part of a larger story about scaling our team and systems to handle substantially more funding while deepening our research rigor. Last year, we directed more than $400 million to highly cost-effective programs to save and improve lives and, this year, we expect our grantmaking to approach, and possibly exceed, $1 billion. This increase in grantmaking aims to meet global needs faster and more effectively. In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Senior Program Officer Alex Bowles about the questions the team set out to answer during the grant investigation. Elie and Alex discuss: Assessing the impact of insecticide-treated nets in DRC: GiveWell usually estimates a program’s cost-effectiveness and impact by analyzing academic evidence, particularly randomized trials, and making a number of adjustments. Because of our growing capacity, we were able to do something new for this grant: We tested our assumptions about DRC’s past net campaigns by drawing on two new, independent lines of evidence. First, we analyzed a recent national survey, which showed a reduction in malaria infections close to what we had predicted. Second, we commissioned a firm based in DRC to interview households and community leaders. Those interviews confirmed records about nets received and provided information about the challenges of conducting net campaigns in DRC. Taken together, this more robust approach increased our confidence that nets work well and are likely to reach intended households in the locations funded by this grant. Planning and coordinating at scale: This grant is nearly three times the size of our previous largest grant (also to AMF) and is concentrated in one country rather than being spread across several. The grant commits funds at the beginning of a multi-year planning cycle, which we think will make these campaigns easier to plan. It also aims to ensure that campaigns happen across all 26 of DRC’s provinces, in some cases on an expedited timeline. This shift in our funding approach makes close coordination with AMF and other partners—including the Global Fund, which is funding much of the net distribution, and the national malaria program—even more important than before. Rethinking how often nets are distributed: In most countries, nets are distributed every three years, but evidence shows that nets wear out more quickly in DRC, in part because of the climate. Our analysis of national survey data, net durability studies, and AMF’s post-distribution monitoring suggests that nets in DRC last roughly 18 to 24 months. DRC had already shortened its campaign cycle, aiming to distribute nets every 30 months. With the support of the government, GiveWell is supporting net campaigns every 24 months in several provinces with high rates of malaria transmission, and funding evidence gathering so we can learn whether more frequent net campaigns is a cost-effective strategy for further reducing malaria rates. We think this approach will help further prevent malaria and potentially save more lives. A larger, more experienced team enabled us to investigate this grant more deeply than we could have even two years ago—looking back at past grants to assess their estimated impact and asking important questions about the challenges of implementing such a large program
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.
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.
GiveWell tends to be known for its work in areas like malaria prevention, water treatment, and nutrition. But as our research team has grown, so has our ability to search for cost-effective programs across a much wider range of issues.