GiveWell Conversations

Routine childhood immunizations, provided on a set schedule over a child’s first two years of life, are very effective at reducing some of the major causes of death in young children. We estimate that in the provinces where we’ve supported programs in the Democratic Republic of the Congo (DRC), about one in 13 unvaccinated children dies from vaccine-preventable diseases before the age of five, yet only about half of children there receive the vaccinations they need. 

Much of our Vaccination research subteam’s work focuses on finding ways to make it easier for caregivers to have their children vaccinated, such as bringing vaccines closer to where parents and infants live. This is especially important in places like DRC, where coverage is low and disease burden is high. Following a request for proposals and a request for information seeking targeted vaccination outreach programs, we funded 11 additional programs, run by distinct organizations—six of which will be implemented in DRC. This portfolio builds on years of investment in our research team, which allowed us to evaluate more than 100 proposals and fund several programs side by side to learn which approaches work best. 

In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Senior Program Officer Natalie Crispin, who leads GiveWell’s vaccination grantmaking, about the programs we funded in DRC. They discuss barriers preventing many children in DRC from getting vaccinated, how the programs we’re funding aim to reach them, and what we hope to learn.

Elie and Natalie discuss:

• Identifying barriers to full vaccination in DRC: Based on the evidence we’ve reviewed, our past experience funding vaccination programs, and the experts we’ve consulted, we think reliable access to opportunities for children to be vaccinated is a major barrier to coverage. The typical immunization schedule requires eight or nine visits to a health facility over a child’s first 18 months. In DRC, families living within about three miles of a health facility are generally expected to travel there. This can mean walking several miles to the nearest health facility while carrying a small child, with no guarantee that the needed supplies or staff will be available to vaccinate their child when they arrive. Mobile vaccinators travel to reach families living further than three miles from a facility, but there are often insufficient resources to ensure these outreach sessions take place on the needed schedule and in the hardest-to-reach communities. 
• Funding different strategies for reaching under-vaccinated children: Each of the six outreach programs we are funding in DRC includes two core components: (1) a method for identifying the communities that need additional support and (2) a strategy for reaching those communities, often by increasing how often vaccination teams travel from health facilities to underserved villages. In many of the programs, a small vaccination team travels by motorbike with a cooler of vaccines, sets up in a central spot that community health workers often announce in advance, and gives each child the vaccines they need. The details of the programs vary. For example, one organization is implementing an app that helps health teams log their work, allowing supervisors to track activity and make changes in an effort to increase coverage rates. 
• Learning which approaches work best: In order to compare the cost-effectiveness of various approaches and organization types, we've chosen a diverse grant portfolio of programs and organizations (including large international NGOs, organizations focused on data and technology, and nonprofits with deep experience with the DRC health system). To assess the results, we’re funding independent coverage surveys before program implementation and every year afterward, using comparison groups wherever we can to assess whether changes in coverage were caused by the program. We’re also drawing on programs’ own monitoring data and talking with government officials, other funders, and implementers in the same areas. Over time, we plan to scale up those that increase coverage most cost-effectively to help people in need as much as we can. 

We expect efforts to increase coverage of routine childhood immunization to make up at least half of our vaccination grantmaking, as these vaccines have the greatest potential to save lives. The team is also assessing the cost-effectiveness of filling funding gaps for purchasing vaccines, starting with malaria vaccines, and researching other vaccines that aren’t fully funded. With a larger, more experienced team, we can now research vaccines in more depth and fund multiple vaccination outreach programs to assess which are most cost-effective. We’re bringing that approach to all of our work, so we can do the most good we can with donors’ funds.

For more on how our vaccination grantmaking has evolved, see our earlier podcast episode with Natalie. 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 October 27, 2026, and represents our best understanding at that time.

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.

This episode offers a behind-the-scenes look at how this expansion is playing out on GiveWell’s research team, as three researchers each describe a project they have taken on: reassessing how to prevent childhood pneumonia deaths, building a better estimate of how many children die of malaria, and developing an AI tool to check our work for errors.

In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Senior Program Officer Dilhan Perera, Senior Researcher James Watson, and Research Analyst Meghna Ray about the projects they’ve worked on and what it’s like to do research at GiveWell.

Elie, Dilhan, James, and Meghna discuss:

• Changing direction as we follow the evidence: Pneumonia causes around 10% to 15% of deaths among children under five globally. Our New Areas research subteam, which investigates cause areas that are newer to GiveWell, first examined community-based treatment options for reducing these deaths by treating children with amoxicillin, an inexpensive antibiotic. That approach initially looked promising, but conversations with researchers and implementers indicated that many pneumonia deaths today are caused by infections that amoxicillin doesn’t treat. We then shifted our attention toward another strategy for reducing pneumonia deaths: providing medical oxygen for severely ill children in hospitals. This costs more per patient but targets the children at greatest risk of dying and can also treat diseases beyond pneumonia. If expanding access to medical oxygen proves cost-effective, it could become a new way for GiveWell to help prevent these deaths.
• Improving our estimates for key cost-effectiveness inputs: Assessing the cost-effectiveness of malaria programs generally requires estimating the number of children who die from malaria in a given place, but that figure is surprisingly uncertain. In many places where we fund programs, cause-of-death data come mainly from interviews with families rather than from health system records. Because malaria symptoms are very similar to symptoms for many other diseases, knowing the symptoms a child was experiencing is often insufficient to determine whether malaria was the cause of death. To more accurately determine the share of deaths caused by malaria, we are developing an approach based on the share of school-aged children infected with malaria (which can be measured accurately using rapid fingerprick tests) and the overall child death rate (measured reliably using large household surveys). We then use the relationship between infection levels and deaths to estimate how many are attributable to malaria. Because this approach is based on data that we think can more reliably assess malaria-specific deaths, we expect it will be better at identifying differences in malaria deaths between regions, which could allow us to target malaria funding to the places where it will do the most good. 
• Developing new tools to increase research capacity: Our cost-effectiveness spreadsheets are often very complex, and errors in their formulas or inputs can meaningfully change our estimate of a program’s cost-effectiveness, which is a key factor in our funding decisions. Research analysts have long vetted these analyses line by line to ensure their accuracy. We recently built an AI tool to assist in that process. Early versions reliably caught errors in formulas but often missed issues a human reviewer would catch, such as outdated data or inconsistent assumptions. To address this, we compiled errors analysts had found in past reviews and refined the tool until it caught more than 90% of them. The tool now serves as a first pass, followed by a research analyst reviewing its findings. As a result, vetting that took as long as a week now takes a few hours. Speeding up this check while maintaining accuracy frees researchers to spend more time on the substantive questions behind our grants.

This conversation explores aspects of our research process: building models, engaging with academic experts and implementing organizations, prioritizing the questions most likely to change our minds, and checking our work. This is part of what our researchers do, and we're actively hiring for research roles so that we can keep identifying highly cost-effective programs and directing donors’ funds to the programs we think will do the most good.

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 September 16, 2026, and represents our best understanding at that time.

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.

Elie and Alex discuss:

• Triangulating multiple data sources to check impact: Directing donations to programs we believe will do the most good requires understanding the impact of the programs we support. Organizations provide us with monitoring data, but we know there are many ways that, despite the best intentions, this data can be biased or incomplete. To address this, we are investing in additional sources and types of data to improve the accuracy of our estimates. For example, in Burkina Faso we’re funding dried-blood tests to better understand whether caregivers are completing the second and third at-home doses of seasonal malaria chemoprevention (SMC), which provides preventive malaria medication. We think this will improve our understanding of how accurate self-reported data is and whether funding to boost coverage of second and third doses of the medication could cost-effectively help people.
• Setting quality standards for survey data: GiveWell often collects survey data at the end of a program to better understand its impact and answer our open questions, but survey data is prone to error. For example, GiveWell researchers shadowed surveyors in Uganda and Nigeria who worked long days under time pressure, creating conditions where hard-to-access households were more likely to be skipped. Because those households may also be the ones programs are most likely to miss, this could lead to overestimating coverage. We’re working to reduce these errors by investing in more independent data checks, and we’ve developed survey guidelines that include practices like GPS tracking and verifying whether a random sample of households was surveyed.
• Using AI to critique our work: GiveWell is experimenting with AI tools to increase our research capacity and improve its quality. Our cost-effectiveness models are an important part of our funding decisions, and we carefully vet them to reduce the chance of mistakes. We’ve developed and trained an AI model that, with human oversight, can catch errors that previously required tedious staff review, opening up some capacity for those reviewers to support the team in other ways. We're also experimenting with using AI to critique and identify weaknesses in our research, though we’ve had more limited success with this strategy.  

By investing in more and better data and experimenting with new tools, we’re working to expand our research capacity while strengthening the rigor of our work as our grantmaking scales. 

Growing our research team is central to these goals, and GiveWell is actively hiring researchers and program officers. New members of our research team typically start on the Cross-Cutting subteam as part of their onboarding and training. If someone you know might be a good fit, please share our open roles!

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 August 21, 2026, and represents our best understanding at that time.

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. The same capacity that allowed us to research this grant, which we expect to save tens of thousands of lives, is also helping us look ahead to newer strategies that could save even more lives in the future.

Visit our All Grants Fund and Top Charities 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 August 14, 2026, and represents our best understanding at that time.

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.

When we published our last podcast episode on family planning, GiveWell had made only a couple of small grants. Since then, we’ve made a number of additional grants totaling around $20 million, exemplifying how our growing research capacity and expertise enable us to expand into new areas. By doing so, we aim to move more donor funding faster to global health programs where it can do extraordinary good.

In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Senior Program Officer Dilhan Perera about the family planning programming we’ve funded over the past year, how we’ve structured our grant portfolio, and what we’re hoping to learn.

Elie and Dilhan discuss:

• Funding across the family planning system: Providing people with family planning resources requires a three-tiered system: (1) purchasing contraceptives, (2) moving them through the supply chain to health facilities, and (3) delivering services to clients. We have made grants at all three levels. For example, we recommended a grant for contraceptive procurement through UNFPA Supplies, which works in dozens of countries, addressing a chronic shortfall that deepened after US government cuts. We also approved a one-year grant to MSI Reproductive Choices to help move supplies from national warehouses to local health facilities in the Democratic Republic of the Congo, Malawi, and Zambia. By funding across all three levels rather than at a single point, GiveWell aims to identify the areas of greatest need where additional funding could do the most good.
• Reaching people with limited access: Many people in low- and middle-income countries have limited access to modern contraception. GiveWell has made two grants aiming to increase access at the local level, each taking a different approach. The first supports MSI Reproductive Choices’ mobile outreach program, which we are funding in Nigeria and Sierra Leone. Small teams, typically two nurses and a driver, travel to communities identified as having limited access to services. The nurses offer a group information session and individual counseling, after which people who are interested can obtain a range of contraceptive methods, including long-acting options like implants and IUDs that health workers at nearby facilities often aren’t trained to administer. The second supports Lafiya, which operates in northern Nigeria, where modern contraceptive use is among the lowest in the world. Lafiya trains nurses, midwives, and community health workers who already live in these communities to provide family planning counselling, short-term contraceptives, and referrals for other methods. By funding both approaches, we hope to learn more about differing strategies for delivering family planning and the programs’ cost-effectiveness, potentially leading to opportunities to help people in need even more. 
• Building evidence alongside the grants: There are relatively few randomized trials of family planning programs and limited rigorous evidence on the specific programs we’re funding. As a result, we have a number of uncertainties. We’re particularly interested in getting better answers to the following questions: Does providing family planning commodities actually increase use, or does it substitute for what people would’ve gotten another way? Do the commodities we help procure actually reach facilities? And to what extent are people making informed choices about whether or not they want to take up contraception? We’ve built learning opportunities into all of our family planning grants, including, for example, separately funding Innovations for Poverty Action to conduct independent surveys of clients and households in the areas where MSI’s mobile outreach program works. 

GiveWell’s research and grantmaking for family planning programs is still in its early stages, but it reflects a strategy across many of our newer grantmaking areas: directing donations to help people now, while generating the evidence needed to direct more funding to highly cost-effective programs in the future. 

Read more about how we're thinking about family planning mobile outreach, visit our All Grants Fund page to learn how you can support this work, and listen or subscribe to our podcast for our latest updates.

This episode was recorded on July 22, 2026, and represents our best understanding at that time.

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.

In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Senior Program Officer Erin Crossett, who leads GiveWell’s water research subteam, about the grant. They discuss how the program works, what prior research tells us about its potential, the significant uncertainties involved, and what GiveWell expects to learn.

Elie and Erin discuss:

• How WASHmobile works: When someone in a household has diarrheal disease, others in the household are at much higher risk. To reduce this risk, WASHmobile first identifies children who have been hospitalized with severe diarrhea. A health worker visits their family to provide handwashing supplies and chlorine tablets to disinfect water, then follows up with phone reminders about safe water practices. Because household members often share the same water source and live in close quarters, treating water and improving hygiene during this critical window can prevent further infections and deaths. Trials of more intensive versions of this program found reductions in diarrheal disease of roughly 60%. Our grant also includes a second, lower-cost component that sends SMS alerts and digital chlorine vouchers to people living near detected outbreaks. 
• Navigating uncertainty in fragile contexts: WASHmobile is being implemented in South Kivu (DRC) and Jonglei State (South Sudan) by Tearfund, which is partnering closely with the countries’ ministries of health. Because of active armed conflict, severe flooding, and large displaced populations, these areas are challenging for health program implementation. GiveWell is funding a version of the program that is less intensive than the one studied in trials, with shorter duration and less intensive follow-up, and we have discounted expected effects accordingly. Even with those adjustments and a substantial probability of program failure built into our modeling, we estimate the program could be highly cost-effective because disease burden in these areas is so high. 
• Building learning into the grant: Roughly half of the grant funds implementation, and half is dedicated to evaluation and data collection. In DRC, GiveWell is funding Johns Hopkins University, in partnership with Catholic University of Bukavu, to conduct a randomized controlled trial alongside implementation to measure the program’s effect on hospital admissions for diarrhea among children under five. The trial will also help test one of the key assumptions in our cost-effectiveness model: that the families this program targets are actually at higher mortality risk than the general population. In South Sudan, where a full trial wasn’t feasible, we’re funding mortality surveys and operational monitoring to better understand baseline mortality and whether the program is being implemented as intended.

This grant reflects how GiveWell’s growing team capacity allows us to do more than scale up proven programs; it also enables us to investigate new, cost-effective ways to save and improve lives beyond our traditional grantmaking portfolio. In addition, our growing capacity means we’re increasingly able to help bridge the gap between academic research and real-world implementation—funding promising programs alongside the rigorous evaluation needed to determine whether they should be scaled further. 

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 June 10, 2026, and represents our best understanding at that time.

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.

Serious health problems, such as lack of medical oxygen and stockouts of essential medicines at health facilities, affect millions of people in low-income countries. There may be highly cost-effective solutions to these problems that haven’t been thoroughly evaluated or adequately funded. One of the ways GiveWell is searching for these solutions is through the new areas research subteam, which investigates programs in cause areas GiveWell hasn’t historically focused on.

In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Senior Program Officer Dan Brown about GiveWell’s new areas research subteam and three grants that illustrate the team’s work.

Elie and Dan discuss:

• Evaluating whether electronic tracking can improve access to health supplies: In many low- and middle-income countries, health facilities track their medicine supplies on paper, with stock counted roughly once a month for only a subset of products. As a result, staff may be less able to accurately predict inventory levels. This can lead to stockouts, making it more difficult for people to access the treatment they need, or to surplus commodities, which could result in expired medicines. GiveWell is funding the Clinton Health Access Initiative (CHAI) and mSupply Foundation to implement an electronic supply chain management system in health facilities in Laos and conduct a randomized controlled trial measuring whether the system reduces stockouts and improves patients’ access to the treatments they need. If we learn that more people are able to access treatment as a result, funding the rollout of this type of software in countries facing higher burdens of disease could be a cost-effective strategy for reducing mortality. 
• Supporting a new approach to medical oxygen production: Medical oxygen is essential for treating severe pneumonia, malaria, and many other health conditions—yet access in low-income countries remains limited. GiveWell is funding PATH to assess the market viability of a recently developed oxygen-producing device that appears to require far less maintenance than existing technology. This is an early-stage investment focused on understanding manufacturing costs and potential demand. PATH’s work will run concurrently with research funded by other organizations assessing whether the device works effectively in real-world conditions in low-income countries. We’re also investigating other opportunities to improve the ability to diagnose low oxygen and increase access to a reliable oxygen supply in health facilities. 
• Investigating a caregiver training program for newborn health: Noora Health’s Care Companion Program trains family members in practices that support maternal and newborn health, including skin-to-skin contact, breastfeeding techniques, and how to recognize illness warning signs. The existing evidence base for these practices is limited to one study without a control group (making it difficult to assess if the practices actually caused the results), so GiveWell is funding two studies in India: a pilot study assessing intermediate health outcomes like sepsis and umbilical cord infections that are linked to newborn mortality, and a larger randomized controlled trial measuring the program’s effect on neonatal mortality. We expect that these studies will provide additional evidence needed to assess whether to fund the program at scale, potentially reducing childhood deaths.

These grants reflect just a few of the ways GiveWell’s research is expanding to identify more high-impact opportunities to help people. GiveWell is hiring to expand our research team further—including positions on the new areas subteam—so we can cover more ground and ultimately direct more donor funding faster to programs where it can do extraordinary good.

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 June 12, 2026, and represents our best understanding at that time.

In September 2025, we created a livelihoods research subteam to specifically focus on programs that increase the economic well-being of people in extreme poverty. While we have evaluated and funded livelihoods programs throughout GiveWell’s history, we now have a dedicated program officer overseeing this portfolio, which has allowed us to build on and deepen that work. 

Historically, GiveWell has predominantly focused on health-related programs. Diseases like malaria, diarrhea, and pneumonia can be prevented fairly cheaply, and the evidence for health programs is often strong relative to other areas. As our research team has grown, we’ve been building capacity to explore programs that increase people’s incomes, where the long-term impact is often more challenging to measure and effectiveness differs from context to context.   

In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Senior Program Officer Adam Salisbury about GiveWell’s expanding work on livelihoods programs, which programs might be the most cost-effective, and research we’re funding to help answer some key questions. 

Elie and Adam discuss:

• Testing variations of cash transfers: GiveDirectly’s flagship cash transfer program currently falls below our cost-effectiveness threshold for livelihoods interventions, but it has a proven ability to scale. We funded three pilots to test whether specific program adaptations could improve cost-effectiveness enough to meet our threshold: (1) pairing small grants to local businesses with household cash transfers so vendors can stock up to meet new demand, (2) timing cash transfers to coincide with the construction of a new footbridge so recipients can access markets more easily, and (3) targeting cash transfers to the poorest young adults, who may be at a stage in their lives where a large lump sum transfer might be especially impactful.
• Exploring poverty graduation programs: Poverty graduation programs provide extremely poor households with a tool to generate income, such as a sewing machine, along with training and small amounts of money or food so that families have what they need without selling the asset. Evidence shows that these programs increase incomes over the first couple of years, and more recent evidence suggests these effects can persist for five years or longer. We are considering grants for research to assess which program designs are most cost-effective, whether income increases hold up over even longer time periods, and whether the programs can be implemented effectively at scale. Because around two-thirds of poverty graduation programs are now delivered by governments rather than NGOs, we are also exploring opportunities to support these programs by providing technical assistance to governments. 
• Funding research to address key uncertainties: By funding research directly tied to programs we are considering supporting, we aim to make better funding decisions and increase donors’ impact. For example, we had a consultant scrutinize the original data from a randomized controlled trial of GiveDirectly’s flagship program in Kenya that showed positive economic effects in the broader community—and the research held up. We’re now funding other research to assess whether the results can be generalized and considering studies to learn whether their effects persist beyond a few years.

GiveWell is expanding our search for highly cost-effective ways to help people in new areas this year by hiring for new research positions, including a senior livelihoods researcher. As the livelihoods team grows, we aim to evaluate more of the areas in the space, including expanding financial access, improving agricultural activity, and looking at humanitarian response efforts—to make better-informed decisions about where donor funding can do the most good.

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 May 26, 2026 and represents our best understanding at that time.

Anemia, which is commonly caused by iron deficiency, can cause fatigue, cognitive impairment, and complications during pregnancy—and it affects roughly a quarter of the world’s population. Over the last decade, GiveWell has directed nearly $50 million to programs to address this health issue. 

Because of the large number of people affected and the low cost to provide people with iron, we are evaluating additional iron fortification and supplementation programs to potentially increase our grantmaking in this area. At the same time, it has been difficult to determine exactly how much providing people with additional iron improves their lives. GiveWell’s growing research capacity is allowing us to study the programs we’ve funded and to support new research, then to use what we learn to continue improving our funding decisions.

In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Researcher Andrew Martin about GiveWell’s work on iron: why the evidence is more complicated than it might seem, what we’ve learned from years of funding iron programs, and what’s ahead.

Elie and Andrew discuss:

• The evidence for iron: Anemia is a significant problem, but it can be hard to determine the exact magnitude of the benefit that comes from addressing it. In addition, current definitions of anemia, which can be caused by iron deficiency, are based on statistical data about typical hemoglobin levels rather than on people’s symptoms. GiveWell is supporting a randomized controlled trial in Bangladesh that aims to address this by measuring how providing additional iron affects perceived fatigue and other health outcomes—helping determine measurable thresholds at which people experience significant symptoms. We think the findings could reshape our understanding of how anemia affects people's lives and improve our anemia-related grantmaking.
• Looking back at Fortify Health’s progress: Fortify Health partners with wheat flour mills in India to fortify flour with iron and other micronutrients. After earlier grants to Fortify Health providing general support, GiveWell made a larger $8.2 million grant in 2021. At the time GiveWell made this grant, Fortify Health was working with seven mills and reaching roughly 350,000 people per year. Over the next three years, it expanded to 125 open-market mills producing more than 30 times more flour (see chart below) at about half the cost per person reached of our original estimate. We now estimate that our 2021 grant was about twice as cost-effective as we initially projected. Based on this track record, we recently renewed our support to Fortify Health with a $10 million two-year grant.
• What’s next for GiveWell’s research into iron: GiveWell currently supports two iron programs in India: Fortify Health’s work expanding iron fortification of wheat flour and Evidence Action’s iron and folic acid supplementation program for schoolchildren. To date, GiveWell has not funded iron fortification or supplementation programs in Africa, despite the region’s high anemia burden, in part because of concerns about potential harm from iron interventions in high-malaria settings. To help expand our work in this area, we issued a request for information for iron programs earlier this year—focusing on lower-malaria contexts—and are currently evaluating responses. We’re also considering support for historical research studying countries that have introduced fortification programs to help assess the long-term income effects of providing iron. 

GiveWell’s research on iron supplementation and fortification programs exemplifies this moment in GiveWell’s evolution: The research capacity and track record we’ve built are now enabling us to assess past grants, build and evaluate the evidence base, and expand our support of new cost-effective ways to help 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.

To learn more about how we’re learning and improving by analyzing past grants, like the one described in this episode, join our webinar on June 9. Elie will moderate a conversation with Program Directors Alex Cohen and Julie Faller about our grant lookbacks methodology, what we’ve learned, and how the findings are informing our grantmaking. Learn more and register.

This episode was recorded on May 15, 2026 and represents our best understanding at that time.

GiveWell’s research doesn’t end once we’ve made a grant. We evaluate a subset of completed grants, comparing what we thought would happen to what actually took place, then try to use what we learn to improve our future funding decisions. Over the past year, we’ve formalized and expanded this work, publishing comprehensive “lookbacks” for select grants.

A recent lookback on grants GiveWell made to fund insecticide-treated net distributions supported by the Against Malaria Foundation (AMF) in the Democratic Republic of Congo (DRC) illustrates the growing capacity of GiveWell’s research team. We drew on multiple independent data sources, funded qualitative interviews to gather more information, and conducted a novel empirical analysis to deepen our confidence.

In this episode, based on a conversation originally aired on GiveWell’s internal podcast for staff, GiveWell’s co-founder and CEO Elie Hassenfeld provides additional context while GiveWell’s Chief Research and Program Officer Teryn Mattox dives deep into the details with Program Director Alex Cohen and Researcher Steven Brownstone, examining how we conducted the lookback, what we found, and how what we learned may shape our future nets grantmaking. 

Elie, Teryn, Alex, and Steven discuss:

• A more expansive and rigorous approach to evaluating past grants. This lookback draws on three independent quantitative sources—AMF’s monitoring data, a recent Demographic and Health Survey (DHS) conducted in the DRC, and an original survey commissioned by GiveWell—alongside qualitative research involving in-depth interviews with people involved in DRC’s net distribution system, from health zone administrators to village focus groups. 
• Conducting a novel mortality analysis using DHS microdata. Because net campaigns roll out on staggered schedules across DRC’s provinces, we were able to use the timing of children’s births relative to the date of local net campaigns as a natural experiment. We compared mortality risk for children based on when they were born, and thus the length of time they had protection from a net, and found that the net campaigns reduced the risk of death by around a quarter. That finding provides additional support for the mortality effect estimate we use in our cost-effectiveness models.
• What qualitative research revealed. Interviewers asked people across five provinces in DRC whether households received nets and whether households were using nets—and in cases where they either didn’t receive nets or weren’t using them, why not. Although we heard some anecdotes of misuse or diversion of nets, the data suggested overall that the nets are highly valued by the communities receiving them. 
• How durability data could inform campaign design. Our analysis of DHS data confirmed earlier research indicating that nets in DRC degrade before they are replaced through new distributions. As a result, it’s possible that changes in DRC like more frequent campaigns or increased support of routine net distribution through other channels may increase protection. 

If you’re interested in learning more about grant lookbacks like this one—and how they’re improving our research and shaping our future funding decisions—we invite you to join our next webinar on June 9. Alex Cohen, who was featured in this episode, and Program Director Julie Faller will walk through our lookback process, what we’re learning, and how we’re applying those lessons to help more people. Learn more and register here.

This episode was recorded on April 22, 2026 and represents our best understanding at that time.
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Glossary

Because the conversation in this episode first aired as part of GiveWell’s internal podcast for staff, there are a number of names, acronyms, and other terms that are not explained. To make it easier to follow along, we’ve provided a glossary below. 

• all-cause mortality. All-cause mortality measures the total number of deaths from any cause in a specific group of people over a specific period of time. 
• AMF. The Against Malaria Foundation, one of GiveWell’s Top Charities, collaborates with national malaria programs and other partner organizations in low- and middle-income countries to distribute insecticide-treated nets. 
• CEA. We build cost-effectiveness analyses to assess how much good can be achieved by giving money to a certain program. 
• Cox proportional hazards model. The Cox proportional hazards model is used to estimate how much different factors, such as time since an insecticide-treated net campaign, speed up or slow down the time to death. It assigns each factor a “hazard ratio,” which is a multiplier of the baseline risk of dying: a hazard ratio of 2 for smoking means that smokers face double the risk of death at any given moment compared to nonsmokers, all else equal. 
• DHS. Demographic and Health Surveys are 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.
• funging. What we call “funging” (from fungibility) refers to the effect of crowding out funding that would have otherwise come from other sources.  
• insecticide-treated nets. These nets have been treated with insecticide to deter and kill the mosquitoes that transmit malaria. Distributing insecticide-treated nets, which are then hung over sleeping spaces, can be a cost-effective way of preventing malaria.
• lookbacks. Lookbacks are reviews of past grants published on the GiveWell website that assess how well they’ve met our initial estimates and what we can learn from them.
• Marakuja. Marakuja Kivu Research is a nonprofit organization in DRC that we have contracted with to conduct quantitative and qualitative surveys. 
• M&E. GiveWell asks organizations that we fund to share detailed monitoring and evaluation data on their programs to assess the quality of program implementation and whether it is reaching recipients as intended. 
• net durability. Insecticide-treated nets decay over time, both through loss of insecticide and physical wear.
• nets team. In internal conversations, this is what we sometimes call our vector control team (see below for definition).  
• OnFrontiers. OnFrontiers is a company that sets up interviews with subject matter experts around the world.  
• PDM....