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Charity evaluations

Overview

We aim to find the charities that improve happiness most effectively, so you can maximise the impact of your donations. We focus on charities in low-income countries, as that’s where we think donations will have the biggest impact. This page summarises the moderate- and high-depth charity evaluations we’ve completed to date.

To help donors make decisions about where to donate, we distinguish between our top recommended charities, promising charities, and non-recommended charities (see below).

Our process starts by assessing charities by the type of intervention they provide. We’ve conducted either moderate-depth or high-depth investigations into four interventions so far:

  1. Talk therapy (i.e., psychotherapy) for those with depression
  2. Antimalarial bednets
  3. Cash transfers to very poor families
  4. Deworming tablets to treat intestinal worms

We’ve found that:

  • Treating depression via talk therapy is about four times more cost-effective than cash transfers to very poor families, although there is uncertainty here.
  • Talk therapy can be more or less cost-effective than antimalarial bednets depending on your philosophical views, as it depends heavily on difficult moral questions of how to value saving lives against improving lives.1HLI doesn’t currently take a view on this; we leave it to donors.
  • It’s very uncertain if deworming has any long-term effect, so we do not currently recommend it.

Top charities meet all of the following four criteria:

  1. Cost-effective: they are among the most cost-effective interventions we’ve found so far2 We don’t currently use a ‘bar’ to judge cost-effectiveness: we simply recommend the best things we know of. Though, we often estimate how cost-effective interventions are relative to cash transfers as a convenient point of comparison. Other evaluators may also use cash transfers as a benchmark, but unless they use the WELLBY framework, the cost-effectiveness ratios would not be directly comparable.
  2. Evidence-based: they have moderate or strong evidence underlying them
  3. Investigated: we’ve conducted a medium or deep assessment of the organisation
  4. Tractable: the charity has a proven track record and we expect it can productively use additional funding

We think of top charities as comparatively safer bets.

Promising charities are those that meet (1) but not all of (2)-(4). They can be more cost-effective, in expectation, than top charities, but either have weaker evidence or we’ve not yet been able to look into them sufficiently to feel comfortable recommending them. These may appeal to donors interested in ‘higher-risk, possibly higher-reward’ giving.

Non-recommended charities are charities we have investigated (3), but do not, in our assessment, meet (1); they may also not meet (2) or (4).

A graph comparing the cost-effectiveness of the charities we have evaluated is included at the bottom of this page.

The bottom of this page also includes some speculative opportunities. This refers to interventions we believe could be cost-effective but where we’ve not yet been able to investigate them in-depth.

While the ‘top charities’ are the most cost-effective charities we have evaluated so far for improving wellbeing, there are likely other highly impactful organisations we have not yet investigated. We aim to continually expand our research and look at further causes, interventions, and charities. Our recommendations may change over time as we discover more cost-effective opportunities or as new data is published concerning the ‘top charities’. We welcome feedback on our methodology and suggestions for other organisations to consider.

Learn more:

We provide a fuller explanation of our 2023 evaluations (including things we don’t recommend) in our Giving Season Research Overview.

Our top charities

We have two top charities, StrongMinds and the Against Malaria Foundation.

StrongMinds

Cause area

Mental health

Intervention

Psychotherapy

Description

StrongMinds is a non-profit that provides group interpersonal psychotherapy (g-IPT) for women struggling with depression in Uganda and Zambia. In previous years, StrongMinds provided g-IPT over 12 weeks, but as of 2024 they plan to shorten the delivery to 6 weeks.

Cost-effectiveness 3 This is the estimated cost to produce one wellbeing-adjusted life year (WELLBY). One WELLBY is equivalent to a 1-point increase on a 0-10 happiness scale for one year. The cost-effectiveness is calculated by dividing the cost per treatment by the number of WELLBYs produced by each treatment. So, a $10 treatment that produces 2 WELLBYs has a cost-effectiveness of $5 per WELLBY. Learn more.

30 WELLBYs per $1,000. This is 3.7 times more cost-effective than cash transfers delivered by GiveDirectly4 We use GiveDirectly’s cash transfers as a benchmark because they are simple, scalable, and well-evidenced with precisely estimated effects.
.

Quality of evidence 5 Our assessment of the quality of evidence is based on a holistic evaluation of the quantity and quality of the data. Briefly:
• High: evidence from multiple well-conducted RCTs that consistently demonstrate effectiveness.
• Moderate: evidence from a single well-conducted RCT, or evidence from multiple well-designed but non-randomised studies that consistently demonstrate effectiveness.
• Low: evidence is primarily based on observational studies, such as cross-sectional, case-control, or cohort studies.
• Very low: evidence is based on case studies, anecdotal reports, expert opinions, or narrative reviews.

Moderate

Depth of our analysis 6 The depth of our analysis is based on a combination of how extensively we have reviewed the literature and how comprehensive our analysis is.
• High: We believe we have reviewed most or all of the relevant available evidence on the topic, and we have completed nearly all (e.g., 90%+) of the analyses we think are needed.
• Medium: We believe we have reviewed most of the relevant available evidence on the topic, and we have completed the majority (e.g., 60-90%) of the analyses we think are needed.
• Low: We believe we have only reviewed some of the relevant available evidence on the topic, and we have completed only some (10-60%) of the analyses we think are needed.

Moderate to high. We have completed a substantial amount of work to date, but there is still room for further analysis.

Funding need 7 How much funding can the charity productively absorb? For example, some charities may have their funding needs already met, and they may be unable to use more funds immediately or they may use the funds for less effective purposes.

StrongMinds is planning for rapid growth. In order to do this, it needs to raise a further $19 million over the next two years (i.e., 2023-2024).

Our recommendation

StrongMinds is one of the most cost-effective life-improving charities we have evaluated so far. We have moderate confidence in the evidence, so it is possible that future research could update our evaluation. Overall, we think StrongMinds is one of the most cost-effective ways to improve global wellbeing, and is a particularly good fit for donors who value improving lives.

Comprehensive summary
For more details, view our comprehensive summary of StrongMinds.

Donate to StrongMinds

 

Against Malaria Foundation

Cause area

Health

Intervention

Antimalarial bednets

Description

The Against Malaria Foundation (AMF) funds, and helps coordinate, the distribution of long-lasting insecticidal nets (LLINs) to help prevent malaria in sub-Saharan Africa, South Asia, South and Central America, and Oceania.

Cost-effectiveness

The cost-effectiveness of AMF depends heavily on difficult moral questions of how to value saving lives against improving lives. Depending on the assumptions made, we estimate the cost-effectiveness of AMF’s distribution of bednets ranges between 7-90 WELLBYs per $1,000. This range means AMF is 0.8-11 times as cost-effective as GiveDirectly cash transfers for increasing wellbeing.

Quality of evidence

Moderate

Depth of our analysis

Moderate

Funding need

GiveWell estimated that AMF could absorb $33.2 million in 2023.

Our recommendation

Our analysis suggests that the cost-effectiveness of AMF depends heavily on one’s philosophical views. Under views more favourable to improving lives, AMF is less cost-effective than treating depression with psychotherapy. However, under views more favourable to saving lives, AMF is more cost-effective than treating depression with psychotherapy. Thus, AMF may be a good option for donors who highly value saving lives. We have made an online app that you can use to examine the cost-effectiveness of AMF under various philosophical views.

Comprehensive summary
For more details, view our comprehensive summary of AMF.

Donate to AMF

Promising charities

We have one promising charity, Friendship Bench. We believe this could be as or more cost-effective than our two top charities, but we have not yet been able to investigate it as thoroughly. Because we are in the early stage of our evaluation, our cost-effectiveness estimate is more uncertain and more likely to change.

Friendship Bench

Cause area

Mental health

Intervention

Problem solving therapy

Description

Friendship Bench is a non-profit that treats people for depression with problem-solving therapy (PST), primarily in Zimbabwe. Friendship Bench’s standard programme consists of 6 sessions of individual counselling, followed by optional group support sessions with others who’ve finished Friendship Bench counselling.

Cost-effectiveness

58 WELLBYs per $1,000. This is 7.0 times more cost-effective than cash transfers delivered by GiveDirectly8 We use GiveDirectly’s cash transfers as a benchmark because they are simple, scalable, and well-evidenced with precisely estimated effects. .

Quality of evidence

Moderate

Depth of our analysis

Moderate. While our cost-effectiveness estimate is based on a moderate-to-high depth analysis of psychotherapy, we have only conducted a shallow evaluation of their programme to date, so we rate our overall depth of analysis as moderate.

Funding need

Friendship Bench is planning for rapid growth. In order to do this, it needs to raise a further $10 million over the next two years (i.e., 2024-2025).

Our recommendation

Our cost-effectiveness estimates suggest that the Friendship Bench may be more cost-effective than StrongMinds. However, we are in the early stage of our process to thoroughly understand Friendship Bench’s treatment model, theory of change, operations, and other qualitative factors like track record, strength of team, strength of future projects, need for funding, and transparency. Thus, we think the Friendship Bench is a promising charity, but we refrain from giving it our top recommendation until we have completed further research.

Comprehensive summary
For more details, view our comprehensive summary of Friendship Bench.

Non-recommended charities

We’ve also evaluated other charities that ultimately didn’t end up meeting our criteria to be considered a recommended charity. The reasons may include:

  • We estimated the charity has relatively low cost-effectiveness.
  • The quality of the evidence supporting their cost-effectiveness is low.
  • We have determined the charity does not have a strong track record or we expect it cannot productively use additional funds

To be clear, these may be high-quality charities. However, we refrain from recommending them because they do not meet all our criteria.9 There are other charities we don’t recommend that we’ve only evaluated in a shallow manner. We discuss these here.

GiveDirectly

Cause area

Poverty reduction

Intervention

Cash transfers

Description

GiveDirectly is a non-profit that provides cash transfers to people living in poverty. Its primary focus is in sub-Saharan Africa, but it has recently expanded to provide emergency relief and cash transfers in the US.

Cost-effectiveness

8 WELLBYs per $1,000.

Quality of evidence

Very strong

Depth of our analysis

High

Funding need

GiveWell estimated that GiveDirectly could absorb $456 million between 2021 and 2023. We think that this could be a lower bound for future funding needs over the next three years.10 GiveDirectly writes on their website: “With the successes in our remote targeting and payment technologies in a variety of settings, emerging relationships with key telecom partners in Africa, and current operational capabilities, we have the technical capacity to reach more than 5M people per year. This translates to the potential ability to deliver in excess of $ 5B per year to those living in extreme poverty today.”

Our recommendation

GiveDirectly has strong evidence to support its effectiveness. However, we estimate that its programme is several times less cost-effective at increasing wellbeing than our top charities, so it is not one of our recommended charities to donate to. However, it could be a good fit for donors who value the certainty of the evidence, the simplicity of the intervention, or the autonomy it provides to recipients.

Comprehensive summary
For more details, view our comprehensive summary of GiveDirectly.

Deworming charities

Cause area

Health

Intervention

Mass deworming

Description

Deworming organisations help deliver mass deworming medication programmes, often by coordinating with existing structures and governments. They typically operate in lower-income settings in sub-Saharan Africa and South Asia.

Our analysis was based on the average treatment costs of four organisations initially evaluated by GiveWell:

  • SCI Foundation (now Unlimit Health)
  • Evidence Action’s Deworm the World Initiative
  • Sightsavers’ deworming programme
  • The END Fund’s deworming programme

Cost-effectiveness

Uncertain

Quality of evidence

Very weak

Depth of our analysis

High. We believe that we have reviewed all of the available evidence (mainly one RCT on the long term effect of deworming). We would be surprised if there were important studies that we weren’t aware of. We have spent considerable time on the analysis.

Funding need

We use GiveWell’s estimates of how much the different deworming charities could absorb:

Our recommendation

Based on the limited evidence, deworming treatment has a small, non-significant effect on happiness. Because the evidence is so uncertain, we do not recommend donations to deworming programmes for now.

Comprehensive summary
For more details, view our comprehensive summary of deworming charities.

Charity comparison

We show the cost-effectiveness of the charities or interventions we have evaluated so far in Figure 1. The graph shows our estimate of how many WELLBYs would be generated from a $1,000 donation.

Figure 1. Cost-effectiveness of charities and interventions.

Note. The diamonds represent the central estimate of cost-effectiveness (i.e., the point estimates). The shaded areas are probability density distribution and the solid whiskers represent the 95% confidence intervals for StrongMinds, Friendship Bench, and GiveDirectly. The lines for AMF (the Against Malaria Foundation) are different from the others11 They represent the upper and lower bound of cost-effectiveness for different philosophical views (not 95% confidence intervals as we haven’t represented any statistical uncertainty for AMF). Think of them as representing moral uncertainty, rather than empirical uncertainty. The upper bound represents the assumptions most generous to extending lives and the lower bound represents those most generous to improving lives. The assumptions depend on the neutral point and one’s philosophical view of the badness of death (see Plant et al., 2022, for more detail). These views are summarised as: Deprivationism (the badness of death consists of the wellbeing you would have had if you’d lived longer); Time-relative interest account (TRIA; the badness of death for the individual depends on how ‘connected’ they are to their possible future self. Under this view, lives saved at different ages are assigned different weights); Epicureanism (death is not bad for those who die – this has one value because the neutral point doesn’t affect it).
. Deworming charities are not shown, because we are very uncertain of their cost-effectiveness.

Speculative opportunities

We’ve also conducted shallow investigations into a number of other interventions. We’re excited about these, but haven’t yet done enough research to determine which of the other three categories they fall into. These include:

  • preventing lead exposure
  • improving childhood nutrition
  • improving parenting (e.g., encouraging stimulating play, avoiding maltreatment)
  • preventing violence against women and children

These can be seen as even higher risk-reward opportunities than our ‘promising’ charities’. We describe our thinking about these opportunities in our Giving Season Research Overview. We think it’s reasonable for donors to wait until we’ve been able to do further research before giving to these.

Endnotes

  • 1
    HLI doesn’t currently take a view on this; we leave it to donors.
  • 2
    We don’t currently use a ‘bar’ to judge cost-effectiveness: we simply recommend the best things we know of. Though, we often estimate how cost-effective interventions are relative to cash transfers as a convenient point of comparison. Other evaluators may also use cash transfers as a benchmark, but unless they use the WELLBY framework, the cost-effectiveness ratios would not be directly comparable.
  • 3
    This is the estimated cost to produce one wellbeing-adjusted life year (WELLBY). One WELLBY is equivalent to a 1-point increase on a 0-10 happiness scale for one year. The cost-effectiveness is calculated by dividing the cost per treatment by the number of WELLBYs produced by each treatment. So, a $10 treatment that produces 2 WELLBYs has a cost-effectiveness of $5 per WELLBY. Learn more.
  • 4
    We use GiveDirectly’s cash transfers as a benchmark because they are simple, scalable, and well-evidenced with precisely estimated effects.
  • 5
    Our assessment of the quality of evidence is based on a holistic evaluation of the quantity and quality of the data. Briefly:
    • High: evidence from multiple well-conducted RCTs that consistently demonstrate effectiveness.
    • Moderate: evidence from a single well-conducted RCT, or evidence from multiple well-designed but non-randomised studies that consistently demonstrate effectiveness.
    • Low: evidence is primarily based on observational studies, such as cross-sectional, case-control, or cohort studies.
    • Very low: evidence is based on case studies, anecdotal reports, expert opinions, or narrative reviews.
  • 6
    The depth of our analysis is based on a combination of how extensively we have reviewed the literature and how comprehensive our analysis is.
    • High: We believe we have reviewed most or all of the relevant available evidence on the topic, and we have completed nearly all (e.g., 90%+) of the analyses we think are needed.
    • Medium: We believe we have reviewed most of the relevant available evidence on the topic, and we have completed the majority (e.g., 60-90%) of the analyses we think are needed.
    • Low: We believe we have only reviewed some of the relevant available evidence on the topic, and we have completed only some (10-60%) of the analyses we think are needed.
  • 7
    How much funding can the charity productively absorb? For example, some charities may have their funding needs already met, and they may be unable to use more funds immediately or they may use the funds for less effective purposes.
  • 8
    We use GiveDirectly’s cash transfers as a benchmark because they are simple, scalable, and well-evidenced with precisely estimated effects.
  • 9
    There are other charities we don’t recommend that we’ve only evaluated in a shallow manner. We discuss these here.
  • 10
    GiveDirectly writes on their website: “With the successes in our remote targeting and payment technologies in a variety of settings, emerging relationships with key telecom partners in Africa, and current operational capabilities, we have the technical capacity to reach more than 5M people per year. This translates to the potential ability to deliver in excess of $ 5B per year to those living in extreme poverty today.”
  • 11
    They represent the upper and lower bound of cost-effectiveness for different philosophical views (not 95% confidence intervals as we haven’t represented any statistical uncertainty for AMF). Think of them as representing moral uncertainty, rather than empirical uncertainty. The upper bound represents the assumptions most generous to extending lives and the lower bound represents those most generous to improving lives. The assumptions depend on the neutral point and one’s philosophical view of the badness of death (see Plant et al., 2022, for more detail). These views are summarised as: Deprivationism (the badness of death consists of the wellbeing you would have had if you’d lived longer); Time-relative interest account (TRIA; the badness of death for the individual depends on how ‘connected’ they are to their possible future self. Under this view, lives saved at different ages are assigned different weights); Epicureanism (death is not bad for those who die – this has one value because the neutral point doesn’t affect it).