GiveWell Conversations

Diarrhea is one of the leading causes of death for children under five, killing more than 400,000 children every year. GiveWell has funded several programs to prevent and treat diarrhea, and we recently expanded our work by making a grant to support the implementation and evaluation of WASHmobile in the Democratic Republic of the Congo (DRC) and South Sudan. The program, which was developed by Johns Hopkins University, delivers water treatment supplies and hygiene messaging to households at the highest risk of diarrheal disease. It has shown promising results in randomized controlled trials (RCTs) but hasn’t yet been implemented at scale in the challenging settings where the need is greatest.

In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Senior Program Officer Erin Crossett, who leads GiveWell’s water research subteam, about the grant. They discuss how the program works, what prior research tells us about its potential, the significant uncertainties involved, and what GiveWell expects to learn.

Elie and Erin discuss:
How WASHmobile works: When someone in a household has diarrheal disease, others in the household are at much higher risk. To reduce this risk, WASHmobile first identifies children who have been hospitalized with severe diarrhea. A health worker visits their family to provide handwashing supplies and chlorine tablets to disinfect water, then follows up with phone reminders about safe water practices. Because household members often share the same water source and live in close quarters, treating water and improving hygiene during this critical window can prevent further infections and deaths. Trials of more intensive versions of this program found reductions in diarrheal disease of roughly 60%. Our grant also includes a second, lower-cost component that sends SMS alerts and digital chlorine vouchers to people living near detected outbreaks. 
Navigating uncertainty in fragile contexts: WASHmobile is being implemented in South Kivu (DRC) and Jonglei State (South Sudan) by Tearfund, which is partnering closely with the countries’ ministries of health. Because of active armed conflict, severe flooding, and large displaced populations, these areas are challenging for health program implementation. GiveWell is funding a version of the program that is less intensive than the one studied in trials, with shorter duration and less intensive follow-up, and we have discounted expected effects accordingly. Even with those adjustments and a substantial probability of program failure built into our modeling, we estimate the program could be highly cost-effective because disease burden in these areas is so high. 
Building learning into the grant: Roughly half of the grant funds implementation, and half is dedicated to evaluation and data collection. In DRC, GiveWell is funding Johns Hopkins University, in partnership with Catholic University of Bukavu, to conduct a randomized controlled trial alongside implementation to measure the program’s effect on hospital admissions for diarrhea among children under five. The trial will also help test one of the key assumptions in our cost-effectiveness model: that the families this program targets are actually at higher mortality risk than the general population. In South Sudan, where a full trial wasn’t feasible, we’re funding mortality surveys and operational monitoring to better understand baseline mortality and whether the program is being implemented as intended.

This grant reflects how GiveWell’s growing team capacity allows us to do more than scale up proven programs; it also enables us to investigate new, cost-effective ways to save and improve lives beyond our traditional grantmaking portfolio. In addition, our growing capacity means we’re increasingly able to help bridge the gap between academic research and real-world implementation—funding promising programs alongside the rigorous evaluation needed to determine whether they should be scaled further. 

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 June 10, 2026, and represents our best understanding at that time.

GiveWell tends to be known for its work in areas like malaria prevention, water treatment, and nutrition. But as our research team has grown, so has our ability to search for cost-effective programs across a much wider range of issues.

Serious health problems, such as lack of medical oxygen and stockouts of essential medicines at health facilities, affect millions of people in low-income countries. There may be highly cost-effective solutions to these problems that haven’t been thoroughly evaluated or adequately funded. One of the ways GiveWell is searching for these solutions is through the new areas research subteam, which investigates programs in cause areas GiveWell hasn’t historically focused on.
In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Senior Program Officer Dan Brown about GiveWell’s new areas research subteam and three grants that illustrate the team’s work.

Elie and Dan discuss:
Evaluating whether electronic tracking can improve access to health supplies: In many low- and middle-income countries, health facilities track their medicine supplies on paper, with stock counted roughly once a month for only a subset of products. As a result, staff may be less able to accurately predict inventory levels. This can lead to stockouts, making it more difficult for people to access the treatment they need, or to surplus commodities, which could result in expired medicines. GiveWell is funding the Clinton Health Access Initiative (CHAI), mSupply Foundation, and University of California, Berkeley to implement an electronic supply chain management system in health facilities in Laos and conduct a randomized controlled trial measuring whether the system reduces stockouts and improves patients’ access to the treatments they need. If we learn that more people are able to access treatment as a result, funding the rollout of this type of software in countries facing higher burdens of disease could be a cost-effective strategy for reducing mortality. 
Supporting a new approach to medical oxygen production: Medical oxygen is essential for treating severe pneumonia, malaria, and many other health conditions—yet access in low-income countries remains limited. GiveWell is funding PATH to assess the market viability of a recently developed oxygen-producing device that appears to require far less maintenance than existing technology. This is an early-stage investment focused on understanding manufacturing costs and potential demand. PATH’s work will run concurrently with research funded by other organizations assessing whether the device works effectively in real-world conditions in low-income countries. We’re also investigating other opportunities to improve the ability to diagnose low oxygen and increase access to a reliable oxygen supply in health facilities. 
Investigating a caregiver training program for newborn health: Noora Health’s Care Companion Program trains family members in practices that support maternal and newborn health, including skin-to-skin contact, breastfeeding techniques, and how to recognize illness warning signs. The existing evidence base for these practices is limited to one study without a control group (making it difficult to assess if the practices actually caused the results), so GiveWell is funding two studies in India: a pilot study assessing intermediate health outcomes like sepsis and umbilical cord infections that are linked to newborn mortality, and a larger randomized controlled trial measuring the program’s effect on neonatal mortality. We expect that these studies will provide additional evidence needed to assess whether to fund the program at scale, potentially reducing childhood deaths.

These grants reflect just a few of the ways GiveWell’s research is expanding to identify more high-impact opportunities to help people. GiveWell is hiring to expand our research team further—including positions on the new areas subteam—so we can cover more ground and ultimately direct more donor funding faster to programs where it can do extraordinary good.

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 June 12, 2026, and represents our best understanding at that time.

GiveWell tends to be known for its work in areas like malaria prevention, water treatment, and nutrition. But as our research team has grown, so has our ability to search for cost-effective programs across a much wider range of issues.

Serious health problems, such as lack of medical oxygen and stockouts of essential medicines at health facilities, affect millions of people in low-income countries. There may be highly cost-effective solutions to these problems that haven’t been thoroughly evaluated or adequately funded. One of the ways GiveWell is searching for these solutions is through the new areas research subteam, which investigates programs in cause areas GiveWell hasn’t historically focused on.
In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Senior Program Officer Dan Brown about GiveWell’s new areas research subteam and three grants that illustrate the team’s work.

Elie and Dan discuss:
Evaluating whether electronic tracking can improve access to health supplies: In many low- and middle-income countries, health facilities track their medicine supplies on paper, with stock counted roughly once a month for only a subset of products. As a result, staff may be less able to accurately predict inventory levels. This can lead to stockouts, making it more difficult for people to access the treatment they need, or to surplus commodities, which could result in expired medicines. GiveWell is funding the Clinton Health Access Initiative (CHAI), mSupply Foundation, and University of California, Berkeley to implement an electronic supply chain management system in health facilities in Laos and conduct a randomized controlled trial measuring whether the system reduces stockouts and improves patients’ access to the treatments they need. If we learn that more people are able to access treatment as a result, funding the rollout of this type of software in countries facing higher burdens of disease could be a cost-effective strategy for reducing mortality. 
Supporting a new approach to medical oxygen production: Medical oxygen is essential for treating severe pneumonia, malaria, and many other health conditions—yet access in low-income countries remains limited. GiveWell is funding PATH to assess the market viability of a recently developed oxygen-producing device that appears to require far less maintenance than existing technology. This is an early-stage investment focused on understanding manufacturing costs and potential demand. PATH’s work will run concurrently with research funded by other organizations assessing whether the device works effectively in real-world conditions in low-income countries. We’re also investigating other opportunities to improve the ability to diagnose low oxygen and increase access to a reliable oxygen supply in health facilities. 
Investigating a caregiver training program for newborn health: Noora Health’s Care Companion Program trains family members in practices that support maternal and newborn health, including skin-to-skin contact, breastfeeding techniques, and how to recognize illness warning signs. The existing evidence base for these practices is limited to one study without a control group (making it difficult to assess if the practices actually caused the results), so GiveWell is funding two studies in India: a pilot study assessing intermediate health outcomes like sepsis and umbilical cord infections that are linked to newborn mortality, and a larger randomized controlled trial measuring the program’s effect on neonatal mortality. We expect that these studies will provide additional evidence needed to assess whether to fund the program at scale, potentially reducing childhood deaths.

These grants reflect just a few of the ways GiveWell’s research is expanding to identify more high-impact opportunities to help people. GiveWell is hiring to expand our research team further—including positions on the new areas subteam—so we can cover more ground and ultimately direct more donor funding faster to programs where it can do extraordinary good.

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 June 12, 2026, and represents our best understanding at that time.

In September 2025, we created a livelihoods research subteam to specifically focus on programs that increase the economic well-being of people in extreme poverty. While we have evaluated and funded livelihoods programs throughout GiveWell’s history, we now have a dedicated program officer overseeing this portfolio, which has allowed us to build on and deepen that work. 
Historically, GiveWell has predominantly focused on health-related programs. Diseases like malaria, diarrhea, and pneumonia can be prevented fairly cheaply, and the evidence for health programs is often strong relative to other areas. As our research team has grown, we’ve been building capacity to explore programs that increase people’s incomes, where the long-term impact is often more challenging to measure and effectiveness differs from context to context.   
In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Senior Program Officer Adam Salisbury about GiveWell’s expanding work on livelihoods programs, which programs might be the most cost-effective, and research we’re funding to help answer some key questions. 
Elie and Adam discuss:
Testing variations of cash transfers: GiveDirectly’s flagship cash transfer program currently falls below our cost-effectiveness threshold for livelihoods interventions, but it has a proven ability to scale. We funded three pilots to test whether specific program adaptations could improve cost-effectiveness enough to meet our threshold: (1) pairing small grants to local businesses with household cash transfers so vendors can stock up to meet new demand, (2) timing cash transfers to coincide with the construction of a new footbridge so recipients can access markets more easily, and (3) targeting cash transfers to the poorest young adults, who may be at a stage in their lives where a large lump sum transfer might be especially impactful.
Exploring poverty graduation programs: Poverty graduation programs provide extremely poor households with a tool to generate income, such as a sewing machine, along with training and small amounts of money or food so that families have what they need without selling the asset. Evidence shows that these programs increase incomes over the first couple of years, and more recent evidence suggests these effects can persist for five years or longer. We are considering grants for research to assess which program designs are most cost-effective, whether income increases hold up over even longer time periods, and whether the programs can be implemented effectively at scale. Because around two-thirds of poverty graduation programs are now delivered by governments rather than NGOs, we are also exploring opportunities to support these programs by providing technical assistance to governments. 
Funding research to address key uncertainties: By funding research directly tied to programs we are considering supporting, we aim to make better funding decisions and increase donors’ impact. For example, we had a consultant scrutinize the original data from a randomized controlled trial of GiveDirectly’s flagship program in Kenya that showed positive economic effects in the broader community—and the research held up. We’re now funding other research to assess whether the results can be generalized and considering studies to learn whether their effects persist beyond a few years.

GiveWell is expanding our search for highly cost-effective ways to help people in new areas this year by hiring for new research positions, including a senior livelihoods researcher. As the livelihoods team grows, we aim to evaluate more of the areas in the space, including expanding financial access, improving agricultural activity, and looking at humanitarian response efforts—to make better-informed decisions about where donor funding can do the most good.

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 May 26, 2026 and represents our best understanding at that time.

Anemia, which is commonly caused by iron deficiency, can cause fatigue, cognitive impairment, and complications during pregnancy—and it affects roughly a quarter of the world’s population. Over the last decade, GiveWell has directed nearly $50 million to programs to address this health issue. 
Because of the large number of people affected and the low cost to provide people with iron, we are evaluating additional iron fortification and supplementation programs to potentially increase our grantmaking in this area. At the same time, it has been difficult to determine exactly how much providing people with additional iron improves their lives. GiveWell’s growing research capacity is allowing us to study the programs we’ve funded and to support new research, then to use what we learn to continue improving our funding decisions.
In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Researcher Andrew Martin about GiveWell’s work on iron: why the evidence is more complicated than it might seem, what we’ve learned from years of funding iron programs, and what’s ahead.

Elie and Andrew discuss:
The evidence for iron: Anemia is a significant problem, but it can be hard to determine the exact magnitude of the benefit that comes from addressing it. In addition, current definitions of anemia, which can be caused by iron deficiency, are based on statistical data about typical hemoglobin levels rather than on people’s symptoms. GiveWell is supporting a randomized controlled trial in Bangladesh that aims to address this by measuring how providing additional iron affects perceived fatigue and other health outcomes—helping determine measurable thresholds at which people experience significant symptoms. We think the findings could reshape our understanding of how anemia affects people's lives and improve our anemia-related grantmaking.
Looking back at Fortify Health’s progress: Fortify Health partners with wheat flour mills in India to fortify flour with iron and other micronutrients. After earlier grants to Fortify Health providing general support, GiveWell made a larger $8.2 million grant in 2021. At the time GiveWell made this grant, Fortify Health was working with seven mills and reaching roughly 350,000 people per year. Over the next three years, it expanded to 125 open-market mills producing more than 30 times more flour (see chart below) at about half the cost per person reached of our original estimate. We now estimate that our 2021 grant was about twice as cost-effective as we initially projected. Based on this track record, we recently renewed our support to Fortify Health with a $10 million two-year grant.
What’s next for GiveWell’s research into iron: GiveWell currently supports two iron programs in India: Fortify Health’s work expanding iron fortification of wheat flour and Evidence Action’s iron and folic acid supplementation program for schoolchildren. To date, GiveWell has not funded iron fortification or supplementation programs in Africa, despite the region’s high anemia burden, in part because of concerns about potential harm from iron interventions in high-malaria settings. To help expand our work in this area, we issued a request for information for iron programs earlier this year—focusing on lower-malaria contexts—and are currently evaluating responses. We’re also considering support for historical research studying countries that have introduced fortification programs to help assess the long-term income effects of providing iron. 

GiveWell’s research on iron supplementation and fortification programs exemplifies this moment in GiveWell’s evolution: The research capacity and track record we’ve built are now enabling us to assess past grants, build and evaluate the evidence base, and expand our support of new cost-effective ways to help people in need.
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.
To learn more about how we’re learning and improving by analyzing past grants, like the one described in this episode, join our webinar on June 9. Elie will moderate a conversation with Program Directors Alex Cohen and Julie Faller about our grant lookbacks methodology, what we’ve learned, and how the findings are informing our grantmaking. Learn more and register.

This episode was recorded on May 15, 2026 and represents our best understanding at that time.