GiveWell Conversations

Alex Cohen, Principal Researcher at GiveWell, sheds light on the looming cuts to global health funding, predicting a staggering 50% reduction in U.S. aid. He discusses the potential $20 billion annual funding gap and its impact on vital programs like malaria prevention and HIV treatment. The episode highlights the strategic approaches needed in navigating these uncertainties, emphasizing prioritization and adaptability to protect the most effective health initiatives. Cohen's insights offer a crucial look into the future of global health philanthropy.

Alice Redfern, a Program Officer at GiveWell specializing in global health, discusses significant cuts to U.S. HIV/AIDS funding. She explores the impact of potential reductions on prevention programs targeting high-risk populations. The conversation highlights the need for innovative strategies to compensate for gaps in funding, especially for new treatments like lenacapavir. Redfern emphasizes the urgency of finding cost-effective opportunities to combat transmission and maintain stability in ongoing outreach initiatives.

Dan Brown, a Program Officer leading GiveWell's new areas team, discusses the impact of U.S. funding cuts on global health programs. He explains the creation of Technical Support Units (TSUs) to assist Ministries of Health in six African countries, highlighting their role in enhancing local capacity and decision-making. Brown emphasizes the tailored approaches of TSUs in navigating funding challenges and ensuring the sustainability of essential health initiatives. The conversation also touches on the importance of qualitative factors in grant-making amidst these drastic changes.

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.

In this conversation, Natalie Crispin, a global health expert and Program Officer at GiveWell, joins Elie Hassenfeld to discuss the urgent challenges facing seasonal malaria chemoprevention (SMC) in light of U.S. aid cuts. They delve into how SMC campaigns work, ensuring children under five receive preventive medicines, and how paused USAID funding has disrupted critical preparations for upcoming campaigns. Natalie and Elie highlight funding gaps and the logistical hurdles organizations face, underscoring the vital need for timely resources to combat malaria effectively.

Julie Faller, Senior Program Officer at GiveWell with a focus on global health program analysis, joins Elie Hassenfeld to discuss urgent funding challenges in global health. They examine how U.S. aid cuts force countries to prioritize HIV treatment over prevention, impacting vital health services. Supply chains for therapeutic foods are in disarray, and layoffs threaten the capacity of implementing organizations. Strategies for addressing these gaps include innovative funding approaches and a spotlight on the critical need to combat acute malnutrition among children.