GiveWell Conversations

GiveWell has built its reputation on rigorous research—analyzing randomized controlled trials, building cost-effectiveness models, and reviewing monitoring data to identify cost‑effective ways to save and improve lives.In an effort to supplement this desk research and make better decisions, we’ve been working to gather more information directly from the people who live and work in the countries where we fund programs.In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Principal Researcher Alex Cohen about GiveWell’s work to gather local insights to check our assumptions and figure out what we might be missing.Elie and Alex discuss:Testing key hypotheses about the data GiveWell relies on: We’re working to improve the inputs in our decision making. This includes checks on coverage data, more information about how programs work in practice, and assessing whether estimated program effects are plausible. These efforts have already identified discrepancies between coverage surveys and other areas for improvement.Addressing the limitations of global health data: GiveWell depends on credible data for its research, yet global health and development data is quite limited. For example, basic measurements like child mortality rates rely on household surveys conducted only every five years. We’re employing multiple approaches to address these limits: funding independent survey firms; conducting site visits; hiring local consultants; and strengthening networks with government officials, implementing organizations, and other funders.Balancing the trade-offs between local work and desk research: Desk research will continue to make up the vast majority of our work. We believe that complementing that research with additional information we gather from local sources could meaningfully improve our grantmaking. We expect to dedicate around 5% of our research team’s time and around 1% of our total grantmaking to these efforts, which we believe will have an outsized impact.By prioritizing efforts to learn from people in the places where we fund programs, we hope to better understand how programs are being implemented, identify bottlenecks, and more. We believe that incorporating this information will improve our decision-making and our work to help people as much as we can. It provides checks on our primary models, increases confidence in our conclusions, and could highlight where we might be missing something important.Visit our 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 23, 2025 and represents our best understanding at that time.

Teryn Maddox, Director of Research at GiveWell, discusses the significant funding disruptions in global health during 2025. She shares insights on GiveWell's adaptive response strategies, balancing urgency with rigorous research. Teryn highlights the importance of pre-existing partnerships in malaria funding and explains the shift in focus towards HIV due to new treatment innovations. The conversation also covers lessons learned from navigating uncertainty, the evolving aid structure, and plans for future grantmaking in 2026.

On Thursday, December 4, 2025, GiveWell hosted a live webinar titled “Growing Needs, Shrinking Aid: Cost-Effective Action in a Year of Funding Cuts.” Major cuts to foreign aid this year created deep uncertainty for global health programs. In this live-recorded discussion, co-founder and CEO Elie Hassenfeld moderates a panel of GiveWell researchers to discuss the effects of these cuts and how GiveWell is leveraging its nearly two decades of experience in cost-effectiveness research and analysis to identify opportunities for exceptional donor impact.The panelists—Rosie Bettle (Program Officer, Malaria), Alex Bowles (Program Officer, Malaria), Meika Ball (Senior Research Associate, New Areas), and Dilhan Perera (Senior Research Associate, New Areas)—answered questions selected live by attendees and shared their insights. They discussed the challenges of understanding the cuts’ impacts, how GiveWell adapted its grantmaking approach to fund time-sensitive opportunities, the trade-offs the research team had to make in the face of uncertainty, and new areas that might have cost-effective funding gaps. The conversation explores what the research team has learned so far, along with their predictions and uncertainties about the future. We expect needs to continue growing in the years ahead as the effects of current and future cuts accumulate. In this context of growing need, it’s increasingly important that resources are used as effectively as possible. Check out this 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 4, 2025 and represents our best understanding at that time.

This episode follows up on the November 26, 2025 episode of Planet Money, “Saving lives with fewer dollars,” which covered GiveWell’s evaluation of a grant to the Alliance for International Medical Action (ALIMA) to maintain primary healthcare, hospital services, and malnutrition treatment in two subdistricts of North Cameroon following unexpected aid cuts earlier this year. We recommend listening to the Planet Money episode first, as it provides important context. ***Significant changes to foreign aid this year created challenges for implementing organizations—and for funders evaluating which programs to support with limited resources. The Planet Money team followed along as we assessed the effects of the cuts in real time, focusing on our evaluation of a potential grant to ALIMA to maintain nutrition and primary healthcare services in Cameroon. Following the announcement of the US government’s stop-work order and funding freeze in January, we created a rapid response research team and began assessing opportunities we thought were potentially highly cost effective. In March, we launched an investigation of the $1.9 million ALIMA grant, which we funded in June based on the team’s findings.In this episode, GiveWell CEO and co-founder Elie Hassenfeld dives deeper into the grant investigation with Program Officers Rosie Bettle and Alice Redfern, discussing the timeline, modeling approach, and what ultimately led us to make the grant.Elie, Rosie, and Alice discuss:The grant investigation timeline: GiveWell completed the investigation in about six weeks from start to finish. Typically, GiveWell grant investigations build on months or years of prior research. While we’ve researched and funded malnutrition programs in the past (including ALIMA’s programs), this program’s scope was wider—covering primary healthcare, disease surveillance, and hospital logistics.  How we adapted our modeling: As part of evaluating this grant, GiveWell attempted to estimate several parameters related to mortality, then used a series of simple models—rather than one comprehensive model—to estimate cost-effectiveness based on those parameters. These models, along with conversations with experts and other inputs, allowed the team to move quickly and respond to the urgent need. An update on grant progress: With GiveWell’s funding, ALIMA’s program is now up and running again. The program has been adapted to incorporate mobile clinics, and ALIMA is on track to treat the number of children GiveWell expected. Based on a number of conversations, we believe that ALIMA’s programs are leading to increased care-seeking behavior. As GiveWell’s research team grows, that increased capacity and expertise allows us to evaluate a wider range of programs and adapt our approaches to better find the most cost-effective opportunities to help people. In this case, that growth enabled us to move quickly and navigate uncertainty to evaluate and fund ALIMA’s program.  Visit our Foreign Aid Funding Cuts page 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 3, 2025 and represents our best understanding at that time.

Natalie Crispin, a seasoned program officer at GiveWell, shares her insights on the crucial Seasonal Malaria Chemoprevention (SMC) program. She discusses the impact of recent foreign aid cuts and the urgent need for careful planning to deliver antimalarial medications to vulnerable children. Natalie explains the logistical challenges of coordinating across multiple countries and the flexibility of funding mechanisms that allowed campaigns to proceed despite disruptions. The conversation highlights the program's effectiveness, with significant lives saved per dollar spent.

Explore the vibrant lives of families in urban Malawi, highlighting the contrast between rural and peri-urban experiences. Learn about schooling aspirations and the challenges of access to health care amidst foreign aid cuts. Discover the impact of inflation on wages, seasonal farming versus steady urban income, and the nuances of food insecurity. The discussions reveal how community dynamics evolve, shedding light on the human cost of funding disruptions and the importance of ongoing support in improving livelihoods.

Our Beyond the Spreadsheets mini-series lets you ride along with our leadership team on their recent weeklong site visit to Malawi. Recorded daily during the trip, the series shares the behind-the-scenes experience of a GiveWell site visit through real-time reflections and clips of conversations. On day four, the GiveWell team visited community projects funded by Spark Microgrants, including a maize mill and a sunflower oil mill, and spoke with residents about their impact. New to the series? Start with day one here. Throughout the week, the team visited health clinics, schools, and local villages to speak with healthcare workers and community members who shared a glimpse into their lives. This new mini-series offers a candid, day-by-day account of our learning process and some of the new insights and questions that will inform our future research. We invite you to listen, subscribe, and follow along!This episode was recorded on August 2, 2025 during GiveWell's site visit to Malawi and represents our best understanding at that time.

Our Beyond the Spreadsheets mini-series lets you ride along with our leadership team on their recent weeklong site visit to Malawi. Recorded daily during the trip, the series shares the behind-the-scenes experience of a GiveWell site visit through real-time reflections and clips of conversations. On day three, the GiveWell team visited a rural health outpost where they met with health care workers to discuss the services they provide through village clinics and home visits—and the impact of foreign aid cuts on their work. Listen to day one and day two of the series here.Throughout the week, the team visited health clinics, schools, and local villages to speak with healthcare workers and community members who shared a glimpse into their lives. This new mini-series offers a candid, day-by-day account of our learning process and some of the new insights and questions that will inform our future research. We invite you to listen, subscribe, and follow along!This episode was recorded on August 1, 2025 during GiveWell's site visit to Malawi and represents our best understanding at that time.

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.

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.