Lenacapavir: a long-acting PrEP breakthrough

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.