Making Cost-Effective Grants Amid Uncertainty: April 23, 2025

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 April 15, 2025 and represents our best understanding at that time.