Vaccines are remarkably effective at preventing deadly diseases, and, while global needs for them are great, vaccines already receive substantial global funding. This creates a challenge: How do you identify opportunities where additional funding can meaningfully increase vaccination rates and save lives?

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.

Seasonal malaria chemoprevention (SMC)—a program that provides preventive antimalarial medication to young children during the months when malaria is mostly likely to be transmitted—is one of the most cost-effective programs GiveWell has identified. Malaria Consortium’s SMC program has been one of our Top Charities since 2016, and we’ve recommended more than $500 million in grants to the program.

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.

GiveWell is often thought of for its Top Charities, but over the last several years, we’ve been substantially broadening our work. We’ve developed new ways to identify potential grantees, funded research to fill gaps in our understanding, and explored new program areas where we believe cost-effective opportunities exist but other funders aren’t investing. This increased breadth isn’t a goal in itself—we’ve been laying the groundwork to deliver more impact, now and in the future.

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.

GiveWell has built its reputation on rigorous research—analyzing randomized controlled trials, building cost-effectiveness models, and reviewing monitoring data to identify cost‑effective ways to save and improve lives.

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.

Global health programs faced major disruptions to their funding in 2025. Back in March, we published our first podcast episode to share a timely snapshot of the immediate impacts caused by the foreign aid freeze and GiveWell’s initial response strategy. It was unclear whether and when funding would resume, and what the medium and long-term implications would be for life-saving programs. 

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.

On Thursday, December 4, 2025, GiveWell hosted a live webinar titled “Growing Needs, Shrinking Aid: Cost-Effective Action in a Year of Funding Cuts.” 

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.

This episode follows up on the November 26, 2025 episode of Planet Money, “Saving lives with fewer dollars,” which covered GiveWell’s evaluation of a grant to the Alliance for International Medical Action (ALIMA) to maintain primary healthcare, hospital services, and malnutrition treatment in two subdistricts of North Cameroon following unexpected aid cuts earlier this year. We recommend listening to the Planet Money episode first, as it provides important context. 

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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.

Despite significant progress over the past several decades, malaria remains a leading cause of death globally for children under five. This year’s cuts to foreign aid funding disrupted highly effective programs to prevent malaria, such as seasonal malaria chemoprevention (SMC).  

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.

Our Beyond the Spreadsheets mini-series lets you ride along with our leadership team on their recent weeklong site visit to Malawi. Recorded daily during the trip, the series shares the behind-the-scenes experience of a GiveWell site visit through real-time reflections and clips of conversations. 

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.

Our Beyond the Spreadsheets mini-series lets you ride along with our leadership team on their recent weeklong site visit to Malawi. Recorded daily during the trip, the series shares the behind-the-scenes experience of a GiveWell site visit through real-time reflections and clips of conversations. 

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.