GiveWell Conversations Beyond the Spreadsheets: Malawi Site Visit Day 2
Oct 2, 2025
Julie Fowler, a Senior Program Officer at GiveWell, shares insights from her firsthand experience during a site visit in Malawi. She dives into the challenges posed by recent cuts to foreign aid and their subtle, delayed impacts on healthcare. Conversations with district health officials reveal the complexities of local decision-making and difficulties in supply chains. Julie emphasizes the importance of data in understanding shifts in services like viral load testing and the broader implications for health systems amidst funding changes.
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Audit Record-Keeping To Pinpoint Failures
- Inspect pharmacists' record-keeping and understand the blend of paper and electronic systems at facilities.
- Check for user-error risk and whether systems collect the data needed for reliable forecasting.
Preventative Cuts Show Delayed Harm
- The health data didn't yet show impacts from aid cuts because terminated programs were largely preventative, not immediate treatment.
- Officials warned of delayed negative effects on population health if outreach stops.
Viral Load Testing Dropped Sharply
- Viral load testing records fell sharply after funding for testing was cut and a stop order issued.
- The hospital's data showed far fewer viral load tests in 2025 than in 2024.