GiveWell Conversations

This episode was recorded on August 20, 2025 and represents our best understanding at that time. Foreign aid funding cuts are reshaping the global health landscape, creating urgent funding gaps and forcing difficult prioritization decisions across health systems worldwide. To understand the real-world effects, it’s essential to hear from the organizations working on the front lines with government partners to navigate the funding crisis. The Clinton Health Access Initiative (CHAI) is a large global health nonprofit and an important GiveWell partner in this work.In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with CHAI CEO Dr. Neil Buddy Shah about how the aid cuts are affecting vital health programs and what it takes to build a strategic response. They discuss the hidden complexities of the funding landscape, the difficult choices governments are being forced to make, and what this pivotal moment could mean for the future of global health.Elie and Buddy discuss:The “gap identification” challenge: In many countries, a significant portion of the national health budget comes from foreign aid, and the funding cuts revealed a surprising vulnerability—many national health ministries don’t have a comprehensive map of who funds what within their own systems. The first step needed was a complex data-gathering exercise to identify where the gaps emerged.A strategic response to the crisis: CHAI is helping governments implement a three-pronged response. This includes (1) driving efficiencies to make existing funds go further, (2) reprioritizing budgets to protect the most essential services, and (3) advocating for increased domestic health funding.The long-term view: While the cuts are already causing significant drops in areas like HIV testing, the most severe health consequences are expected to hit in the coming years. The crisis represents a major shakeup of the funding and delivery system that has defined global health for 20 years, creating a critical opportunity to rethink what should come next.The conversation reveals both the immediate crisis and long-term transformation occurring in global health. While governments are working to maintain some vital services through improved efficiency and reprioritization, these measures cannot compensate for the scale of funding reductions. GiveWell is working closely with partners like CHAI to understand the complexities of this new funding landscape and direct funding where our research shows it can have the greatest impact.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 August 13, 2025 and represents our best understanding at that time. GiveWell’s ability to find and fund highly cost-effective health programs relies on a foundation of credible data. A key source of that data, the Demographic and Health Surveys (DHS), recently had its primary funding from USAID discontinued. This creates the potential of a significant challenge for GiveWell’s research—and for evidence-based grantmaking across the global health sector.In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Senior Researcher Adam Salisbury to explore the implications of this funding gap. They discuss how the DHS program works, why it’s essential for informed decision-making, and how GiveWell is responding to the growing limitations of public health data.Elie and Adam discuss:The surprising source of global health data: In many countries where GiveWell works, basic health metrics like child mortality rates aren’t comprehensively tracked in official registries. The DHS program fills this data gap by conducting 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.Why good data is difficult to get: The DHS is resource-intensive, costing tens of millions of dollars per year to administer in-person, house-to-house surveys across more than 50 countries. Enumerators must travel to remote areas where unreliable internet and postal systems necessitate this approach. The logistical complexity and high cost are primary reasons the surveys in any given country often happen only once every five years.GiveWell’s approach to repairing data gaps: With USAID funding discontinued, GiveWell is considering whether to support these surveys directly, coordinating with other global health partners who share similar interests. GiveWell is also funding targeted data collection to address questions the DHS doesn’t cover, such as bed net durability or how people in low-income countries value consumption versus health gains.The loss of funding for DHS creates a significant gap in global health infrastructure that affects decision-making across the sector. GiveWell is working with other global health organizations to explore sustainable solutions, while considering the trade-off between funding programs that help people now and funding research that guides future effective giving. Visit our All Grants Fund webpage 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 24, 2025 and represents our best understanding at that time. As GiveWell’s research team grows, that increased capacity and expertise allows us to evaluate a wider range of programs to find the most cost-effective opportunities to help people. Over the past year and a half, we’ve been investigating a new research area—family planning services that help people decide whether and when to have children. Family planning programs have particularly complex challenges around targeting, logistics, and ensuring informed and voluntary choice. However, GiveWell's increasing research capacity now positions us to take on new and complex investigations like this. We’ve been reviewing evidence, consulting with experts, modeling the benefits of contraception, and conducting initial grant investigations, focusing on programs that aim to increase access to and use of modern contraception. This work is especially timely as anticipated cuts to foreign assistance could significantly reduce existing family planning support, creating substantial new funding gaps.In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Senior Research Associate Dilhan Perera about the complexity of evaluating family planning programs. They explore the types of programs GiveWell is considering, the unique challenges this area presents, and key questions we’re working to answer.Elie and Dilhan discuss:Types of family planning programs: GiveWell is investigating several approaches, including direct service delivery to underserved communities, programs that provide counseling, and supply chain interventions that work with health facilities to prevent stockouts of contraceptives.The complexity of evaluation: Unlike programs such as malaria prevention that target a well-defined population and try to maximize coverage, family planning programs must account for individual preferences and avoid coercing people into using contraception they don’t want. This requires more sophisticated monitoring systems to prevent coercion, which raises the overall cost and complexity of effective program delivery.Operational challenges and trade-offs: Programs must often choose between reaching the most underserved communities (which are often remote and expensive to reach) and working within existing health facilities. The challenges in either approach include making sure people are accurately informed about their family planning options and navigating supply chain issues like stockouts. We’re actively considering a handful of funding opportunities in family planning. Our goal is to make initial grants that will not only have a direct impact but also help us learn more about this type of intervention, helping us better compare these programs against other funding opportunities.Visit our All Grants Fund webpage 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 July 16, 2025 and represents our best understanding at that time. Malaria is the cause area where GiveWell has directed the most funding over our 18-year history. We’ve recommended over $1 billion to malaria programs, which we estimate will avert over 200,000 deaths, mostly in young children, through support for programs like Against Malaria Foundation’s insecticide-treated nets and Malaria Consortium’s seasonal malaria chemoprevention.Despite significant progress against malaria in the past 25 years, malaria is still a leading cause of death globally for children under five. The current status of malaria prevention—and all the progress that’s been made—is now in a precarious position. Significant reductions in funding from key donors like the US President’s Malaria Initiative and the Global Fund are anticipated and threaten to create substantial new gaps in life-saving malaria programs.In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Program Officer Alex Bowles and Senior Researcher Rosie Bettle about the impacts these funding cuts could have. They offer a timely look at the uncertainty of the funding landscape, the life-saving malaria programs that are most at risk, and how GiveWell is leveraging its expertise to respond to emerging needs.Elie, Alex, and Rosie discuss:The impact of foreign aid funding cuts: Significant funding cuts for malaria are expected, potentially in the range of 20% to 30%. This has prompted the Global Fund to instruct recipient countries to prepare for cuts across its malaria programs, forcing countries to reorganize entire malaria campaigns in just two months—a process that normally takes a full year.Program prioritization decisions: Countries are facing difficult choices as a result of reduced funding and will have to cut some programs. Highly cost-effective malaria prevention programs are at a high risk of being deprioritized to ensure malaria treatment remains available for people who are already sick. This is concerning because these prevention tools, such as insecticide-treated net campaigns and seasonal malaria chemoprevention, have been a major driver in reducing malaria deaths.How we’re responding: GiveWell is working to identify and fund emerging needs created by the funding shortfalls. This includes an emergency grant to procure three million rapid diagnostic tests for Nigeria and cover a last-minute gap in supplies. We’re also investigating funding for the delivery costs of mosquito nets—costs previously covered by large donors like the Global Fund—to ensure that already-purchased nets reach the people who need them.GiveWell has a long history of finding and funding highly cost-effective malaria programs. We’re working closely with our partners to understand the complexities of this new funding landscape, prepare for emerging cost-effective needs, and direct funding where our research shows it can have the greatest impact. 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 the latest updates.

This episode was recorded on June 25, 2025 and represents our best understanding at that time. GiveWell has long grappled with fundamental questions about how to value different positive impacts and make funding decisions across diverse programs. In particular, how much more valuable it is to save a life than to substantially improve it? And how can we prioritize between programs that achieve those outcomes in different measures when there’s no “right” answer to that question?In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Senior Program Officer Julie Faller about why GiveWell is dedicating more capacity to researching livelihoods programs that aim to increase people's incomes. They discuss how we're building on existing work, searching for new cost-effective opportunities, and exploring more of the impactful programs we've long cared about.Elie and Julie discuss:A new funding threshold: GiveWell uses a framework of “moral weights” to compare different outcomes across interventions, but they are a necessary tool and not an absolute truth. To account for this, we’re using a different cost-effectiveness threshold for our expanded livelihoods portfolio. This enables us to evaluate and fund programs that would appear as cost-effective as our standard recommendations to a donor who values income gains twice as much as our standard model.How we’re expanding our livelihoods work: GiveWell is hiring a dedicated Livelihoods Program Officer to lead a more focused search for impactful livelihoods programs. This increased capacity will allow us to develop a long-term livelihoods strategy, build an expert network, and collaborate directly with implementing organizations to find and co-create promising programs. Some areas we plan to explore more deeply: Promising areas for investigation include programs that create positive economic “spillover” benefits for entire communities and community-driven development projects. We’ll also analyze results from our previously funded research on interventions like footbridges and eyeglasses to understand the potential impact these programs could have if scaled. Our new program officer will lead the search for livelihoods opportunities over the next year that meet our high bar for funding, and we plan to keep growing this research if it proves successful. We’re excited that this expansion of our research team will allow us to explore more of the impactful opportunities that we—and our donors—have long cared about.Visit our All Grants Fund webpage 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 11, 2025 and represents our best understanding at that time. In the face of potential major cuts to foreign aid, how can we anticipate the impact on global health and effectively direct resources to the areas of greatest need?In this episode, GiveWell’s CEO and co-founder, Elie Hassenfeld, speaks with Principal Researcher Alex Cohen to discuss the forecasting work GiveWell has undertaken to better understand what the future of global health funding might look like. They explore the potential size of the funding gaps, which programs might be affected, and how GiveWell is preparing to respond in a new era for global health philanthropy.Elie and Alex discuss:The scale of potential aid cuts: Informed by insights from professional forecasters, policy experts, and other partners, GiveWell anticipates a potential 50% cut in US global health funding and a 35% reduction in overall global health funding, creating a funding gap of approximately $20 billion annually. These estimates are highly uncertain, but they provide a directional view of what the funding landscape could look like.The impact on the most cost-effective programs: While some prioritization is expected to protect cost-effective programs, we estimate around $1.5 billion in cuts to programs that are 20x our benchmark or greater—in addition to another $1.5 billion in cuts to programs that are 10x to 20x our benchmark. This includes programs like malaria prevention, HIV treatment, and childhood vaccinations. How GiveWell is preparing to respond: In response to these potential gaps, GiveWell is working to increase its research capacity to investigate new funding areas like HIV/AIDS, which have historically been well-funded. We’re also engaging with supporters to highlight the exceptional impact additional funding could have. While forecasting provides a valuable framework for planning, these estimates are highly uncertain, and the situation remains fluid. GiveWell is monitoring the funding landscape through regular check-ins with partners and experts, as we recognize that the impacts of the coming cuts will likely emerge gradually rather than all at once. Whatever the exact outcome, the scale of cuts we're forecasting will likely create significant new funding needs, and we will do all we can to find and fund them.Visit our USAID Funding Cuts webpage to learn more about our response and how you can help, and listen or subscribe to our podcast for the latest updates.

This episode was recorded on May 30, 2025 and represents our best understanding at that time. The US government has historically been a major funder of HIV/AIDS programs, providing around $5 to $6 billion annually through PEPFAR and other initiatives. With anticipated major reductions in US government foreign aid, including potential cuts of 20% to 50% to HIV/AIDS funding, GiveWell is assessing where new, cost-effective needs might emerge.GiveWell aims to find programs where additional funding can have the greatest impact. While HIV/AIDS has not historically been a focus for GiveWell due to substantial US government support, the current funding cuts might lead to potential cost-effective opportunities within HIV/AIDS programming. In the latest episode in our podcast series, GiveWell CEO and co-founder Elie Hassenfeld speaks with Program Officer Alice Redfern about our initial exploration into HIV/AIDS programming.Elie and Alice discuss:Prevention programs for high-risk populations: While HIV/AIDS treatment and mother-to-child prevention programs are likely to retain funding, prevention programs targeting other high-risk groups have already seen significant cuts and program cancellations. GiveWell is focused on finding cost-effective opportunities within HIV/AIDS programming, and prevention efforts targeting high-transmission populations offer the greatest potential to reduce overall infection rates.The challenge of finding cost-effective opportunities: Unlike GiveWell’s typical approach of broad coverage in a targeted geography (like distributing malaria nets to all children under five in high-burden areas), HIV prevention requires targeting high-risk populations to be cost-effective. This creates a complex “search problem” of identifying programs that efficiently reach these populations in areas with high transmission rates.Promising innovations on the horizon: The emergence of highly effective, long-acting injectables like Lenacapavir offers game-changing potential for HIV prevention. However, their future cost-effectiveness and feasibility at scale depend on factors like price and real-world delivery challenges, including uptake and practical implementation.This work is a good example of our ongoing efforts to identify where donor funding can be most impactful, which is especially important in the wake of recent cuts to US foreign assistance. We are working quickly to respond to emerging needs, leaning on partners and existing research to help us navigate the complexities and uncertainties of the HIV/AIDS funding landscape.Visit our USAID Funding Cuts webpage to learn more about our response and how you can help, and listen or subscribe to our podcast for the latest updates.

This episode was recorded on May 2, 2025 and represents our best understanding at that time. Cuts to US government foreign assistance have created unprecedented challenges for global health programs. Countries that have relied on this funding must now navigate substantial gaps and make difficult decisions about program priorities. In the fourth episode of GiveWell’s podcast series on these cuts, GiveWell CEO and co-founder Elie Hassenfeld speaks with Program Officer Dan Brown about grants to create technical support units (TSUs) in six African countries. These TSUs will provide support to the ministries of health in Burkina Faso, Democratic Republic of the Congo, Malawi, Nigeria, Uganda, and Zambia as they navigate funding transitions to maintain essential health services. The work is being led by the respective governments, and the support will be tailored to their individual priorities, as well as the work they have already done. Elie and Dan discuss:What are TSUs?: Technical support units are small teams of three to five people, typically nationals of the countries they serve, who work directly with ministries of health. They provide additional capacity to support governments’ planning and prioritization, making them particularly valuable as officials navigate decisions about health programs in response to US funding cuts.How do TSUs create impact?: TSUs help ministries assess funding gaps, identify cost-saving opportunities, analyze the cost-effectiveness of different programs, and develop strategies to secure additional funding sources. By creating in-depth analyses and evidence-based recommendations, TSUs enable ministries to make informed decisions quickly. What’s unique about these grants?: These grants are a good illustration of how GiveWell is applying increased flexibility, speed, and risk tolerance to respond to urgent needs caused by recent cuts to US foreign assistance. Funded by our All Grants Fund, the grants also demonstrate how GiveWell has broadened its research scope beyond its Top Charities while maintaining its disciplined approach—comparing each new opportunity to established interventions, like malaria prevention or vitamin A supplementation, as part of its grantmaking decisions. GiveWell co-investigated and co-funded these grants with Open Philanthropy. The TSUs will be implemented by two international organizations with established relationships at the respective ministries—Clinton Health Access Initiative (CHAI) in five countries (Burkina Faso, Nigeria, Malawi, Uganda, and Zambia) and PATH in Democratic Republic of the Congo.To date, GiveWell has committed around $23 million in grants in response to US funding cuts. Visit our USAID Funding Cuts webpage to learn more about our response and how you can help, and listen or subscribe to our podcast for the latest updates.

This episode was recorded on April 15, 2025 and represents our best understanding at that time. The US government has historically spent approximately $12 billion to $15 billion annually in foreign assistance dedicated to global health. The funding cuts announced in the first few months of 2025 disrupted the global health landscape and created the possibility of enormous funding gaps that are still coming into focus. In response, GiveWell has approved around $18 million in grants to support urgent needs—but why has our research led us not to grant more funds yet?In today’s episode, the third in our series examining the impact of these cuts, GiveWell CEO and co-founder Elie Hassenfeld is joined by Director of Research Teryn Mattox to explore this question. Building on our previous conversations about program disruptions and emergency responses, they dive into the nuanced reality of the current funding landscape and GiveWell’s evidence-based approach to grantmaking during uncertainty.Elie and Teryn discuss:Increased need on the horizon: While current impacts haven’t been as severe as the 90% cuts that we initially feared, forecasts suggest that US global health aid may be cut by approximately 50% in fiscal year 2026. We anticipate the most significant funding gaps will likely emerge later. For example, a new fiscal year begins for the US government after September 2025, and the administration will have greater flexibility to enact reductions to global health spending it has discussed.Reinstatement of many critical programs: Many initially terminated contracts, particularly in high-impact areas that we know well like malaria programs, have been reinstated in the short term. A rough analysis suggests that more than 80% of malaria programming has been reinstated for the time being, including some of the most cost-effective programs we’ve identified, which has reduced the immediate need for emergency funding.Expanding our search for emerging opportunities: We think the shifts in US government funding have likely created new, highly cost-effective opportunities. We’re rapidly exploring new areas that have been hit hard by these funding cuts, such as integrated health programs (which deliver multiple services to communities) and family planning. While it takes time to get up to speed before we can make cost-effective grants in these new areas, we are aiming to move more quickly than is typical by leaning on learning over time versus building a high degree of confidence first.GiveWell is actively identifying funding opportunities and recommending grants to help with urgent situations, but we are now primarily concerned with predicting and planning for likely significant cuts in the upcoming US government fiscal year, and with gathering the resources needed to respond. We’ve formed a “rapid response team” to quickly assess urgent funding gaps, and we are considering a “learn by giving” approach in promising new areas to build organizational knowledge while addressing immediate needs.Visit our USAID Funding Cuts webpage to learn more about our response and how you can help, and listen or subscribe to our podcast for the latest updates.

This episode was recorded on March 31, 2025 and represents our best understanding at that time. Our first episode shared a broad overview of the impacts of US government aid cuts and GiveWell’s initial response. This time, GiveWell Program Officer Natalie Crispin joins CEO and co-founder Elie Hassenfeld to zoom in on a specific case, focusing on grants we’ve made to support urgent funding gaps for seasonal malaria chemoprevention (SMC). SMC is one of the most cost-effective programs we’ve found—GiveWell has historically funded around $60-80 million annually for Malaria Consortium’s SMC program, which is one of our Top Charities.  Elie and Natalie discuss:How SMC campaigns work: SMC campaigns involve community health workers going door-to-door to deliver preventative malaria medicines to children under five in regions with highly seasonal malaria, particularly in Africa's Sahel region. These campaigns run during the rainy season (June-October) when malaria transmission is highest. The campaigns require pre-campaign preparation including training, supplies, and logistics planning, and staff to manage this work.The impact of USAID funding pauses on SMC campaigns: When USAID funding was paused in January 2025, organizations implementing SMC in many countries couldn't proceed with critical pre-campaign activities required before June campaign launches. While most medicine had been purchased, supplies, staff, and preparation activities like training were left unfunded, putting entire campaigns at risk.GiveWell’s response to keep SMC campaigns on track: Our research team quickly identified and filled approximately $3 million in critical funding gaps for pre-campaign activities across five countries. If these timely activities didn’t take place, the campaigns wouldn’t be prepared to run if funding returns by June. By maintaining the existing implementation ecosystem, campaigns can proceed with preparations as planned, preserving the potential for USAID funding to seamlessly resume and enable the distribution of these life-saving drugs.GiveWell has so far directed approximately $15 million toward urgent needs caused by cuts to US foreign aid, focusing on highly cost-effective interventions at risk of near-term disruption. Our research team is continuing to investigate more than $100 million of potential grants to support similar needs across a wide range of impacted programs, including in areas like vaccines and malnutrition treatment.Visit our USAID Funding Cuts webpage to learn more about our response and how you can help, and listen or subscribe to our podcast for the latest updates.

This episode was recorded on March 12, 2025 and represents our best understanding at that time. In this discussion between GiveWell CEO and co-founder Elie Hassenfeld and Senior Program Officer Julie Faller, we provide snapshots of how US funding changes are affecting global health programs:Immediate program trade-offs: As funds are paused, country governments are having to choose between essential health services, including one country that said it would prioritize HIV treatment programs while indefinitely pausing HIV prevention programs.Supply chain breakdown: Essential supplies like ready-to-use therapeutic food for malnourished children have been stranded throughout the supply chain (in ports, warehouses, and transit) with no systems to track or distribute them, as the electronic logistics management systems were operated by now-dismissed US government contractors.Implementation capacity concerns: Widespread layoffs at implementing organizations raise questions about whether these groups can effectively deliver programs even if alternative funding becomes available.The episode also offers a look at our initial response strategy, which has focused on:Addressing urgent gaps in high-impact program areas we’re familiar with, such as malaria prevention and malnutrition treatmentExploring flexible funding options such as forgivable loans or phased disbursements to help mitigate risks during this volatile periodPreparing for longer-term needs that could arise due to sustained reductions in foreign assistance from the US and other donor countries