GiveWell Conversations

Beyond the Spreadsheets: Malawi Site Visit Day 1

Sep 25, 2025
Taryn Maddox, Director of Research at GiveWell, shares her insights from a site visit in Malawi. The conversation explores the impacts of foreign aid cuts on local health services and the urgent need for viral load testing amid staffing shortages. Maddox reveals how residents of GiveDirectly villages are improving food security and investing in small businesses thanks to cash transfers. The discussion also highlights significant challenges like critical drug shortages and the importance of understanding on-the-ground realities for effective aid.
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INSIGHT

Why Malawi Is A Useful Case Study

  • Malawi may be unusually exposed to U.S. aid cuts because U.S. health funding added ~80% to the government's health budget.
  • GiveWell visited to understand how those cuts and livelihoods programs interact on the ground.
INSIGHT

Viral Load Testing Suspension Harms HIV Care

  • Viral load testing suspension threatens monitoring of ART effectiveness and resistance prevention.
  • Loss of testing also halts PrEP initiation and disrupts HIV care protocols.
ANECDOTE

Lab Technician Reports Testing Backlogs

  • Lab technician Ronald Pandey described stopped viral sample collection and missing reagents after USAID cuts.
  • Riders for Health transport fell from multiple weekly pickups to once a week or less, creating backlogs.
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