B (3:44)

Where did the idea come from?

A (3:46)

Right. So a listener to Rational Reminder knows Ellie and sent me a message a while ago saying if you guys ever wanted to do a topic on giving that basically does what I just said, basically applies the Rational Reminder approach to giving, then he's got a great guest suggestion, said, yes, of course. And so he reached out to Ellie, Ellie was interested, and that's it. So he finally had him on.

B (4:10)

Let's go to our great conversation with Ellie Hassenfeld. Ellie Hassenfeld, welcome to the RationalMinder podcast.

C (4:23)

Glad to be here.

B (4:24)

Great to have you. So glad you could join us. So, off the top, what does GiveWell do?

C (4:29)

We're an organization that does rigorous research to identify places to direct charitable dollars to help people as much as possible in low income countries. So we do the research, we publish everything about our research, our findings and our recommendations on our site. And then donors can either give directly to us and enable us to regrant those funds out to organizations that are helping people, or they can go on our website, see our recommendations and just give directly.

A (4:58)

That's really cool. So you're providing research that people can use regardless, but you'll also direct their donations for them if they give through GiveWell.

C (5:04)

Exactly. And for donors who want to use our research, our operations are supported by another set of donors. So if you want to go to our website, you want to give to our recommendations, we don't take a cut, you don't need to give to us. We know that a lot of people, when they're giving, don't want to see more of what they're giving. Go to overhead. And with that in mind, we want to make it as easy as possible for folks to use our research. And that's the same reason donors support us. They want to make it as easy as possible possible for others users.

A (5:31)

How was GiveWell started?

C (5:33)

So right after I graduated from university, worked in finance at an investment firm. And after being there for a few years, a friend and I were young single guys making a little bit more than we needed. And we wanted to give money to charity. And at the time, I mean, we're trying to give a few thousand dollars away. And we went and tried to figure out which charities are doing the most good with their dollar, like what are they doing and how well is it working. And in the process of trying to figure out where to give, we realized that there was very little information available that could answer our questions. Happy to tell a bunch of stories about that. And we also just found ourselves kind of obsessed with this question. It becomes like a really interesting question. Well, there are all these problems in the world. What can you do to direct money to help people? And so we realized that this wasn't something that was available. You couldn't get these answers. We knew from all the work we were doing that folks in our position weren't able to determine where to give because the information wasn't there. And we were obsessed. So we left our jobs and started GiveWell as a full time project back in 2007 to really serve donors like us. Donors who wanted to give, wanted to give with confidence, wanted to have a lot of impact and wanted to understand and see themselves that the money they were giving was having a big impact.

A (6:48)

Do you tell one of the stories?

C (6:50)

Well, I'll tell a couple of them. I was really interested in giving to organizations that focused on water. So just helping people access clean water, which is a big problem in low income countries. And I called them up and I'm like, so if I give you money, what happens? How does that work? And they said $20 provides a child water for life. And I said, well, how does that work? Are you digging wells? And if you dig the wells, do you know if they're still there in a year and is the water clean? And they were like, all right, all right, we can't answer your questions right now, but we're going to send you information. About a week later, I got this giant package in the mail. And I was excited. I was, I don't know, academic papers like data reports. It was like a 25 page annual report that was 95% pictures of kids. And then it's sort of like Pedialyte, like the solution you can put into water if a kid has diarrhea to help them get over it. And I was just like, this is crazy. There were no answers to these questions. My co founder at Givelow, and he was interested in a different set of organizations and he just asked, how much money do you spend in each country you work on to get a sense of are you spending in the places that have more people and a greater degree of problem? And the organization accused him of being a spy for a rival charity because why else would anyone be asking questions like this? It didn't make any sense. And so it was just a picture back then. It's really changed now, which is great, but a picture back then where charitable organizations just like weren't getting these kinds of questions. I think one said to me, you guys are asking questions that we don't even get from our million dollar donors. And that really stuck with me because, I don't know, I just thought we were asking logical questions. And no one, I mean, I shouldn't say no one else was, but it certainly wasn't the norm.

B (8:32)

So how big is the GiveWell team?

C (8:35)

We're 80 people today. We have 50 people working on our research team and then about 15 who work on communications and fundraising, another 15 who work on business operations. So finance, legal, HR, et cetera.

A (8:49)

That's a serious operation.

C (8:50)

Yeah, GiveWell now in 2024, we directed about $395 million to the organizations that we recommend. And I don't know exactly where that stacks up as like private funding of international programs. I think we'd almost certainly be in the top 10 of private funders of global health programs and global health and development programs. Privately, governments are much larger, possibly in the top five. So it's a really large chunk of money that we're able to direct to people around the world.

A (9:19)

That was in a year?

C (9:21)

Yeah, that was just in 2024. So we've grown over time. When we started out, I think in our first year, we raised about 100 grand from our former coworkers. Our second year, we raised $35,000 and got it out the door and just have been grow ever since.

A (9:37)

That is wild. What was 2023 like? And what do you expect 2025 to be? Just trying to get an idea of the scale.

C (9:43)

You know, I don't even know that off the top of my head. You can see that on our website. We have, like, metrics, reports that we share that go into that data, but we've basically been operating at the scale of, like, low to mid. Hundreds of millions of dollars raised and directed every year. Wow. And then I hope we can raise a lot more money because, you know, especially now with cuts to aid globally, you know, with more funding, we'll be able to do a lot of good. We hope to keep raising money, and I hope we don't, you know, stop raising the money we have. You know, each year, donors need to step up again and give. And, you know, we're incredibly grateful for their consistent support. But, you know, we're not an endowed foundation. We don't, you know, we don't have a huge war chest in the bank. Basically every year we're, like, raising the money that we're able to direct in the subsequent year. And so every year, we need to keep doing our job, keep showing donors that we can direct their funds well so they can give to us and we can direct it on.

A (10:37)

Man, I got to ask. How does it feel to be directing that amount of money to causes that are important to you?

C (10:43)

Yeah, I guess two different ways. It's real crazy to think back to those early years before we started recording. You were saying how we post a lot of information on our website, and some of it's a little weird. I remember this board meeting we had in the summer of 2010. So that's about three years into GiveWell. Unfortunately, I think that recording is still on our website. And it was a depressing board meeting. You know, we were not sure that we were going to survive. We didn't know if anyone cared about what we were doing. We didn't have a bunch, you know, we didn't have fans. In hindsight, even by then, people had already learned about us who were going to give in the future, and we were sort of on the path. But when I think back to where we came from and where we are. Yeah, I mean, it's extremely gratifying that so many people have come to work at GiveWell and made our work as impactful as it is and that donors want to give to us. It's pretty amazing. I never would have imagined it. And at the same time, yeah, I think it's pretty stressful sometimes to just think about the stakes of the work that we do. If we make mistakes with directing $100,000, which is a fraction of the total that really affects people's lives around the world. It has a history of doing a lot of good and sometimes doing some harm. It can easily be wasted. And we just take that responsibility really seriously, man.

A (11:56)

Yeah. You mentioned the website. I don't know if I'd call it weird, but it's like, it's radically transparent. And my comment to you is that it's like, transparent to the point of me as the reader being uncomfortable reading the amount of detail that you guys publish about past mistakes and past issues that have come up. And it's like, I mean, it's really incredible for an organization to be that transparent where me as the user or consumer of that information is like, kind of squirming, like, I can't believe they're this transparent. I'd say that it's impressive.

C (12:21)

I think it's good. I mean, we're asking people to take their money, trust us to direct it 10,000 miles away. And there are a lot of worry people have about charitable organizations being scams. And the truth is most charitable organizations mean well. They're doing their best. But I think people should be skeptical that the places they're sending their money are having the impact they hope. And so I don't know if we can send the message that we're bending over backward to tell you what we're doing and trying to be open about mistakes we've made, then I think we're doing a good job because, I don't know, I think you should demand that. I think more people should be demanding. In some ways, that's what we're going for. I don't know.

A (13:03)

It's a great precedent to set. I agree.

B (13:05)

Ellie, can you talk about GiveWell's values?

C (13:08)

I'd say that our North Star value is just trying to have as much impact as we can on people who are in need. So that could mean that means improving their lives or saving their lives. That could be via health programs, increasing their income so they can buy the things they want, just improving their lives via improving their health, providing them people who want it with contraception so they can decide when and how many children to have. So that's Our North Star. And then the main ways we go about that is through two other core values, which are transparency, which we've already talked about, which to me is just. I don't know, it's so easy to make all sorts of claims about things, and we just want folks to know that when we say we think it costs this much to save a life, or we directed money to this organization because of what we think it will do, you don't have to take our word for it. You can go check it out yourself. And if you don't want to do that, you can have the confidence that there's a bunch of other people out there who are doing that, and that should give you more comfort. So transparency is a core value, and that's helping us achieve this other goal we have, which is being truth seeking in our work, just trying to get the right answers to questions. And I feel a little bit sheepish about using. We talked about truth seeking as a value because I don't know, there's no capital T truth in what we do. It's not like we never really know the impact for sure. We try to trade off between the good achieved by increasing someone's income versus the good achieved by reducing some sickness they have, and there's no answer to how to trade off to those. But that's our anchor of our work, is just we ask questions. We ask questions, we ask questions. We dig and we dig and we dig. And really the only thing that stops that digging is the fact that we're not an academic group. We're actually directing money. So at some point, we just got to do the best we can and push money out into the world. And a final value we take really seriously is just being considerate for two big reasons. One is, I think groups that talk about maximizing impact, being transparent, being truth seeking that has a certain vibe, can be really cold and challenging to engage with. And we just. We're not that way. We don't want to be that way. And I think it's like a good corrective. And then also, we're a nonprofit. We raise funds, but at the same time, we're directing funds to other groups. And when you're directing a lot of money out the door, people have every incentive in the world to bend over backward to do what you want. Organizations we've taken a call with, and then next thing we know, they've spent days preparing a long report for us to try to convince us that we should give them money. And so we really try to be forward Thinking about what's going on on the side of the organizations we're considering supporting, ultimately the people who we're trying to help, and just have them front of mind in everything we do so we don't get too lost in our own research and models and just remember that it's like the other groups that are really the priority in our work.

A (16:04)

The truth seeking really shows up in the information on the website too, because you have a thesis for something, but then you'll come back a few years later and question whether you were right and reevaluate. It's like it does exactly what you just described, which is incredible. What would you say sets GiveWell apart from other nonprofit evaluators that are doing maybe similar ish work?

C (16:24)

Ultimately, it's the combination of those factors, the values that I described, that no one else brings together. So there are evaluators that focus on, primarily focused on financial ratios, like how much is going to overhead versus programs. Well, we're focusing on impact, like how much are we able to help people. There are lots of groups that grant out money and make recommendations, but they don't share the level of detail about the underlying reasons for those recommendations that we do. And so I think that we're rigorous and truth seeking in a way that's unique, though, that I think is harder to really know and say about other groups. But ultimately, it's that focus on impact and then being transparent that I don't think you'll find anywhere else.

B (17:08)

How do you evaluate the success of GiveWell?

C (17:11)

Our success comes down to how much we're able to help people. And that's a function of two factors, basically. One is how much money we raise and are able to direct. You could complicate that a little if you want. And then also how good our recommendations are. The first one, how much money we raise, well, that's measurable, that's straightforward. So we measure that, we report on that, and then it's really hard to say how good our research is. There's no external number that we can point to that says, well, this is how much additional good GiveWell created in the world because of its existence. You can't have the equivalent of the annual return on an investment portfolio because there's just no way to get at that number. What we try to do to assess the quality of our research is put our work out in the open, invite external critique, try to critique it ourselves. And that intense focus on what we believe, what we decided, what we were right about, what we were wrong about, and where we need to get better. You know, we think that's the other way that we're assessing whether or not we're successful.

A (18:14)

We'll talk more about how you guys are doing that in a bit. You mentioned this, but I still want to ask, can you describe GiveWell's business model?

C (18:21)

We're just a nonprofit. We raise money from donors to support our operations. That enables us to have an office, pay staff, travel to see the programs in person that we need to see. Then with that operational funding taken care of, donors can come and support us without having to pay in if they don't want to. And so that can be. Some donors just come to our website, use our research for free. We don't ever know about it. They give directly to organizations and then others are giving through us. There are, depending on how people decide to give, there can be a transaction fee on their donation. But, you know, we don't need to take a cut of what they're giving. And so that's how we operate.

A (19:00)

You have no incentive to convince people to give through you, but you need people to support the operations.

C (19:06)

Yeah, we want people to support the operations. At the end of the day, I mean, we're not completely indifferent to people giving through us versus giving directly, but we're nearly indifferent about those two options. And the reason we're not completely indifferent, if it comes to us, it's easier for us to measure. If we can measure it, we're better able to go to our donors and say, look, it's worth supporting us. Look at the money we're raising. And then also we have more control over the money that comes through us. So sometimes we might want to support a particular program in a particular region of a country. If the money comes through us, we can go to an organization and say, for example, there's a lot more malaria in this part of Democratic Republic of Congo than in that part. We really want to make sure you're supporting the part where your activities will have greater impact. And then on the other hand, if you give directly sometimes, and I think for the organizations we recommend, I hope that they're normally taking that into account. But really that sort of comparison and quantification is our bread and butter. And organizations have like different means of operating. And so it's also helpful to us because we can say right now, this particular region and this particular program is the place that has the greatest need and direct funds there.

B (20:13)

So where are your donors typically located?

C (20:16)

So very broadly, I'd say, like in the English speaking world, so us, Canada, uk, Australia would be the biggest locations. US is by far the largest. And then in the US across the whole country. But like the big centers would be New York and the Bay Area. You might think of the, again, this is overly simplified, but the sort of paradigmatic donor is someone who is on one hand maybe working in finance and saying, I'm quantitative about my investing, about how I think about my life, how I get return on my investment. I want to bring that same mindset to charitable giving. So that is a big group that supported us. I'd say that's primarily centered in New York. And then at the same time a bunch of folks in the tech sector primarily centered around San Francisco and the Bay Area were, and again, also around the world. But people say kind of bring that technical and careful rigorous mindset to what they do and then they expect to see the same kind of supporting evidence and argumentation, or they see that in our work that they're used to in other things they do.

A (21:20)

You could have been describing our podcast audience just now.

C (21:24)

Good, that's music to my ears.

A (21:26)

You mentioned Canadians. How can Canadians participate? Can Canadians give to GiveWell or what is the alternative?

C (21:32)

We work with a group called RC Forward. It's a Canadian registered organization and through them, Canadian donors can donate directly to GiveWell's top charities. If people wanted, they could donate to our operations directly and do that in a tax advantaged way. RC Forward does charge like a small fee. They do charge a fee and that's to support their ongoing operations in addition to the transaction cost. And we also just have, sometimes Canadian donors will reach out to us directly for support. And then, you know, we work with them and connect them with RC Forward. And you know, there's an email address on our website if you're looking for help, which is just infoil.org I'm really.

B (22:08)

Curious if Sam Bankman freed his association with effective altruism if that had any effect on GiveWell.

C (22:16)

I wouldn't say it had any direct effects, but I think it might have had some hard to measure indirect effects. You know, GiveWell as an organization predated the effective altruism movement. And the term effective altruism. There are things in the effective altruism movement that are obviously very similar to how GiveWell thinks about things. But it was always really important to me and to us at GiveWell that we said we have these core values, truth seeking, transparency, impact, being considerate, and those I think stood on their own, stand on their own regardless of the effective altruism movement as a whole. And so then, I think because of that, there's one blog post we wrote a long time ago where we talked about being part of the effective altruism movement, but predominantly, we just didn't directly align ourselves fully with that movement as our identity. And I think that helped insulate us. When everything happened with Sam Bankman Fried, we just didn't have these direct negative effects via Sam or some foundation of his. I think organizations that we recommend received about a million and a half dollars, and that came through us, and we returned the money to the bankruptcy estate that it wanted because we were able to do that and thought that was the right thing to do. And then the indirect effects are harder to measure and probably are more potentially concerning where, you know, people just have. There was a time when effective altruism and the ideas surrounding givewell were thought of, like, almost entirely in a positive way. And then in the years following that, and maybe still, like, those ideas are thought about in a more negative way. And so what was a tailwind may have become a headwind, but it's just, like, hard to know the extent to which that headwind is affecting us and how much.

A (23:58)

All right, we're going to move on to how you guys evaluate charities. What are your criteria for grantmaking?

C (24:03)

Yeah, so there's, like, four very broad things that we're looking at, and then each of these will, like, break down into almost, like, infinite levels of inquiry. But, you know, the big questions are, first, you know, what's the evidence that this works? How do we know that this program is having the impact you expect on the world? And so let me give an example. We provide a lot of support to malaria nets. These are nets that people hang over their beds at night. They protect against the mosquitoes that transmit malaria. There are more than 20 randomized controlled trials. You know, that's the sort of gold standard for assessing the impact of a medical program that shows that when you give out these nets, they reduce cases of malaria. There's also a number of studies that measure mortality directly. They reduce deaths from malaria. And so question number one is just like, what's the evidence that this program works? Question number two is, how cost effective is it? What bang do you get for your buck? So, okay, I can tell you that malaria nets are effective, but now you want to know, well, how much does it cost to buy one, and how much does it cost to distribute them and get them to the people? You know, all the way from the factory to the village. You want to know if you Purchase a hundred? How many actually reach the village? Some of them might get lost or stolen, and some do get lost and stolen. How often do people hang it up? How often do people not even bother to hang their nets up or use it for something else? Over time, mosquitoes get resistant to the insecticide in the net. All of that, take that into account and you say, all right, like, what am I getting with the money that I'm spending? That's cost effectiveness. And what we're aiming to do is then direct funds to the programs that are most cost effective. Get the biggest bang for your buck. And let me just pause here because I don't know, it's like easy to talk about rigor and throw a lot of numbers out there. And I think something that's just like worth keeping in mind is that we don't. We use these numbers. And in some ways, doing all this work helps discipline our thinking because we can compare things to each other. But when we talk about, oh, it costs this much to avert a death from malaria, I mean, there's a huge uncertainty band around that number because there's so many factors. Those are kind of the core. And then two others are what we call room for more funding, which is really asking the question, what would marginal funding do in this? Cause you might say, historically you've given all this money to a program and it's had all this effect. But what you really want to know is right now, given all the money it's got, if you're a donor who's giving additional dollars, what's the marginal effect that'll happen? And I don't know. This is true everywhere. As organizations, as companies reach larger scale, their ability to have impact shifts based on their place in the ecosystem. And so we're looking at this room for more funding question. And then finally transparency, which is both the fact that I mentioned this at the beginning, that information wasn't available. Well, it's still the case that most information about organizations impact is not readily available. And so we need organizations that are collecting data and willing to share data with us. And if they're not going to share, if they're not going to be transparent, there's really nothing we can do because the information doesn't exist. I will say, having gone from raising like $30,000 a year to moving, you know, a multiple of that, organizations have an incentive to share more information with us now. So that's become clear over time. And then also transparency is important because we're never going to see everything. And so we're looking for organizations that are going to proactively share with us the information that's most important, meaning tell us when something goes wrong, tell us that they're struggling with something, rather than, like, try to hide it and have us find it after the fact. And there are a bunch of organizations that we work with that I think do that well. And so, yeah, those are, like, the four big buckets of things that we're looking at when we assess organizations.

A (27:46)

All obviously, great criteria. The one that jumped out at me when I was reading through this initially was the room for more funding things. It reminds me of stock prices. Like, if you find a really good stock and then everyone buys it, eventually it's not a good stock anymore. It sounds like it's a similar kind of principle where if you find a. Like a really, really good, efficient way to give. If you give all of your money there, all of a sudden it's actually not so productive anymore.

C (28:06)

Yeah. So I think it's a great. I want to, like, say why it's a great analogy. And then I think there's, like, an important way in which the analogy. It's, like, really different in charitable giving from the stock market. So I think it's a great analogy because you don't get to buy the average return. You only get to buy, like, what's happening in the future. And if the price got bid up, or in the case that I'm talking about, if malaria nets were totally funded already, you don't want to give more to there. I mean, it is not the case that malaria nets are totally funded. They need more money. So in that way, the analogy holds. And then I think there's this important way where the analogy breaks down, which is in the private markets, the person who's paying is the same as the person who's benefiting. So, for example, if you buy an iPhone, you know, the iPhone is good because you get to use the iPhone. And if the iPhone was terrible, Apple would not have succeeded because people wouldn't have kept buying it. And this, like, totally breaks down in the charitable market, so to speak, because the person who is benefiting from the program is the, like, person living in the Democratic Republic of Congo, and the person deciding to pay for the program is the donor, you know, sitting somewhere else around the world. And that creates a real problem because the fact, basically, the fact that the price got bid up doesn't necessarily mean that. That it's a good deal or the fact that so much money has come in doesn't necessarily Mean that it was successful anyhow. That implies a lot of things. But one of the important things that it implies is that there can be places where a lot of money is flowing in, there's more room to keep giving more, and you're still getting, I don't know how to put it exactly, but like a ridiculous price for your money. Because the charitable market doesn't have the same mechanism to be efficient that the investment market does.

B (29:42)

How do you identify top charities?

C (29:45)

There's basically like three ways that we go looking for organizations. One is we're looking at academic papers that are reporting on the effectiveness of programs. So, you know, first criterion, evidence of effectiveness. Most of the information about what is effective is coming from the community of academics who are studying things like, well, how do we increase growth in low income countries? How do we improve health? Does this particular program work? So we're just staying up to date on that. When there's a program that's effective, we are looking to see if an organization is implementing it. Second, we are talking to major international non governmental organizations, often referred to as INGOs. We're asking them the question, what are your programs? And do you know if they're working? So go right to the implementing organizations themselves to say, what are you doing? And do you know if it works? And then finally we have our research team. And one of the reasons we're fairly large is teams that focus on different cause areas. So malaria, water, vaccines. And they are very embedded in the community of people working on those programs. And so they're telling us about what's happening and what's working. And when we hear about new things that we should look at, we're able to bring them in and put them through our process.

A (30:58)

So reviewing research, but also kind of being on the ground where stuff is happening to identify opportunities.

C (31:03)

Yep.

A (31:04)

What are the current top charities?

C (31:06)

We have four organizations. So two work on preventing malaria. You know, malaria still kills about 600,000 people a year, most of them young children. Think about that in like daily terms. It's like a crazy number. There's two organizations. One is the Against Malaria Foundation. They purchase and then facilitate the distribution of malaria nets that protect against malaria all around the world. They've been a top charity for a long time. The other one is an organization called Malaria Consortium. They run a program called Seasonal Malaria Chemo Prevention. You can sort of see these are maybe organizations not the best at marketing and fundraising, but the actual programs they run are amazing. This is a newer program, like the studies for this Seasonal Malaria Chemo prevention is preventative malaria medicine were only conducted, I think they finished getting in 2011, 2012, these studies were finished. Then they started getting rolled out globally. And basically it's delivering a set of preventative malaria medication to children under five during the first week of each month during the time of year when malaria is most prevalent, like mostly in the area of Africa called the Sahel. So that's another very cost effective program. These programs, just to give you a ballpark figure, cost about $5 per person, reach like order of magnet. You know, it could be a few dollars less, a few dollars more, but you know, per year we estimate all in. Again, like very roughly, we're talking about like about $5,000 to avert the death of a young child from those programs. So those are two, the other two, one is Helen Keller International's vitamin A supplementation program. They're serving areas where vitamin A deficiency is extremely high. There's a series of randomized trials from maybe like 30 to 40 years ago at this point that show big reductions in child mortality from delivering vitamin A supplementation in high vitamin A deficiency context. And so that's a very simple, straightforward program that we support. And then finally an organization called New Incentives, and they provide conditional cash transfers that are incentives for immunization. So basically these are families who live in northern Nigeria. At the time that we started supporting new incentives, about 60% of children were receiving their full vaccine series in that location. I think there could be a lot of reasons why they weren't receiving their vaccines. It could be some vaccine hesitation. It costs money and is pretty challenging often in rural areas to get from home to the clinic to receive the vaccine. And so these relatively small cash incentives encourage them to come in. And in a randomized trial that we actually supported to measure the effects, that immunization rate went from 60% to 80%, roughly among children. And so that program is now scaled up across other states in Nigeria. And that rounds out our four top charities. So it's a very short list. We're not trying to say these are the only good organizations out there. There's actually a lot of other organizations we give to through the direct grant making that GiveWell is able to do. But these are the four that I'd say have the combination of the strongest evidence behind them. We've worked with them for a long time. They have a strong track record and frankly, just additional money to them at the margin is funds that we think are competitive for doing some of the most impact that you could with charitable dollars.

B (34:27)

Why do top charities focus on global poverty?

C (34:31)

It's actually not how we started out, but we came to it through our research. So when we started out, we were looking both at social programs. At the time in the United States, we were living in New York, so looking at social programs in New York City. And after a couple years of research, what we found was just how big the differences are in terms of what money can accomplish for us at home versus overseas. So we think we're talking about single digit thousands of dollars to avert the death of a young child from giving overseas. Some of the programs we looked at in New York, it might be a, a charter school program. So bringing kids from low income families in New York into an improved school to improve educational outcomes, that was in the range of one to $2,000 per year in school. And so just like the difference in the magnitude of the effect, a few thousand dollars per life saved a few thousand dollars per year in school really caused us to focus our energy overseas where we think just in aggregate, the money we direct will do more good.

B (35:33)

How frequently do the top charities change?

C (35:36)

They've been pretty static recently. I mean, we've recommended the Against Malaria foundation for a really long time and there just isn't that much news that comes out that would cause them to fall off that we're looking at it. But they've shifted a lot over history. So we've had times where the top charities list was like eight or nine organizations. We've had organizations that we put on and came off for various reasons. It could be because there were updates to evidence. It could be because we just frankly thought we could get a higher impact like giving elsewhere and they weren't competitive anymore with the best things that we could find. Maybe I'll just tell one example is we supported. One of the things that we've done in our history is try to support the creation of new top charities. So we've said when we started out, our attitude was let's just see what exists and try to direct funding to the very best things we can find. And after, let's see, like six or seven years of doing that, we're like, all right, we've seen a lot. What can we do now to try to create more organizations that we could add to this list? So one of the groups I mentioned, new incentives which does immunizations. They're a group that we really help support, and we support it through the way they have a sort of a long winding story of getting data and having to pivot and learning that what they were doing wasn't working and moving on to other things. There was actually an organization. When do we do this? This was about 10 years ago. We supported an organization to test an idea for what they called seasonal migration. And the idea is that in Bangladesh, many people are small scale farmers. And during the farming season they have plenty of food. But in the lean season, when there's no harvesting in crops, they don't have money. And people are really struggling. They don't have enough food to eat. And some folks migrate from rural areas to urban areas. And there were a series of randomized trials coming out of economics departments and universities that showed if you gave people a small cash incentive, they would migrate and then they would earn more money, send it back to their families, and I think most interestingly would then migrate without the incentive in subsequent years. And the basic idea behind it was then people were feeling some risk aversion about migration. But if you could show them with this cash incentive, reduce that risk a version, then they see that it was good. Okay. So we decided this looked great. This was a very promising program. And we supported an organization called Evidence Action to roll this out as a new charitable program. It was actually on our top charities list, I think, for a year. But at the same time, we said, consistent with our earlier discussion about scale, the research studies, I think I may be getting these numbers wrong, but they were reaching about 1,000 people, 2,000 people at a time. At scale, it was 100,000 people. And all of a sudden you need to come up with like a new way of operating. We supported a randomized trial of that program. And the trial found no net increase in migration between the treatment group and the control group. We kind of tracked those results over two years. And they're like, all right, I don't know, this is just not working. And so they shut down the program and they came off the list and we moved on. And I don't know, I just think it's a good example of how we try to operate and also, like, why it's important to operate the way we do. There's this alternative universe where we're just like, seasonal migration. Go. Like, this obviously works. There's randomized trials. I mean, that's even better than what most things would have behind them. But it was that extra effort to keep measuring and I don't know, seeing that we could be wrong and we were wrong, that I think over time is leading our recommendations to be higher quality.

A (39:03)

Such an awesomely nerdy way to approach this stuff. I Love it.

C (39:06)

Awesomely nerdy described this pretty well. Or at least nerdy, hopefully. Awesomely nerdy.

A (39:11)

You mentioned the cost to save a life. You mentioned a couple numbers, like a few thousand dollars, maybe $5,000. Why is the cost to save a life so high when something like mosquito nets or malaria drugs are pretty inexpensive?

C (39:23)

There's a few reasons. The biggest one is that even though malaria kills so many people every year and is so prevalent, the chance that any individual child will die of malaria is relatively low. I don't want to quote this number wrong, but it would be in the range of like half a percent to 1% per year is like the risk of death, I think. And so with that in mind, you have to distribute a lot of nets in order to prevent one child from dying. And then you have all the other problems that I mentioned along the way with that's assuming nets being perfect at preventing malaria, but they're not. Nets only prevent about 50% of the cases because mosquitoes bite at night. Well, some of that is when you're sleeping, some of that is when you're outside. Some nets get stolen, A bunch of nets don't get used. Insecticide resistance builds up, Nets have holes over time. You got to redistribute them. And so we have to take all of that into account when we're trying to come to that bottom line figure. And I actually think this is a mistake that we see sometimes when people are trying to do more simple calculations. If you assume everything goes right, your numbers are going to look really compelling. But in reality, in every program, a lot of things go wrong because you're trying to like, deliver something to some of the hardest to work places in the world. It's places where literally like people are dying for the lack of a $5 malaria net. I mean, that's a place that's quite challenging to be in. A lot goes wrong. And so when you add all those things up, the cost to save a life is much more expensive than that, like cost to purchase that commodity. And then at the same time, it's sort of crazy to think about the fact that you could save someone's life for like single digit thousand. That's like kind of a wild reality.

B (41:07)

So how do you evaluate whether your top charities are actually producing the results that were expected based on like some of this past academic research you talked about?

C (41:17)

Yeah, I mean, this is really hard. So what we're doing is we're constantly looking back at what we expected to happen, what organizations are able to share with us about their program delivery, what problems they ran into. So we can say, well, you thought it was going to cost you $5 to deliver a net and that 80% of the nets were going to be used. And then in reality it cost $4 and maybe 70% of the nets were used. So we can get all that data and reassess the results relative to expectations. That's like one input. Another thing that we do is try to go back and obsess about our research and where we might be wrong. What are we missing, what could we get wrong? Get outsiders to do that, and then at the end of the day, there's just a lot that's unknowable. So we rely on a bunch of randomized trials from a long time ago and the world is different today than it was a long time ago. We've tried to collect some of that data and reanalyze the data ourselves because we have these published academic papers from the 90s and the early 2000s and we've just like failed to be able to get our hands on that data. We thought about ways that we could pay for new randomized controlled trials of the same programs. And there's a variety of challenges I'm happy to go into that make that difficult. And so at the end of the day, there's like also a lot that is unknowable. Maybe most importantly, like, we have estimates of the number of deaths averted because new incentives has caused more kids to get vaccines than they otherwise would have. But that relies on a lot of guessing and thinking and making our best analysis of how many additional kids are going to get served. That's not a quantity that we can then follow up on and measure empirically. And what those vaccines did for mortality rates from the diseases they're protected against, we just don't know. So we do our best and also just recognize that there's a lot that is unknown at the end of the day about what's ultimately happening.

A (43:14)

You're not an academic organization. You have to find the places to give, the money has to move. In some cases, you have to make a best effort. How do you measure the cost effectiveness of the charities when you're evaluating them?

C (43:26)

Mostly we're just trying to turn more or less everything into either an impact on health, which could either be averting a death or giving people more additional years of healthy life. And the high income countries we talk about qualities, quality adjusted life years and low income countries people talk about DALYs, Disability Adjusted Life years, which are just the inverse. But Just trying to look at those two quantities. And then a lot of programs also have effects on people's ability to earn money. And then we say, how much did you increase income? And put all that together into some overall measure of Give well's version of the good. And really the question we're asking is how much does a donor have to put in to get out that amount of good, that reduction in deaths, that improvement in health, that increase in income? Lots of guesses that go in there, lots of things in there are debatable philosophically. But we're doing all of that in these giant spreadsheets that if you want, you can kind of look at on our website. And we try to make all the reasoning behind them available. But we're trying to do that very meticulously to try to get the best answers we can.

B (44:33)

And what effect does uncertainty have on your cost effectiveness evaluations?

C (44:38)

We don't do something where we're very or we're formally modeling the uncertainty and then have a formal way in which the uncertainty influences what we do. But the fact that we know that we have a huge uncertainty about these numbers has a big effect on how we operate as an organization. So if you go to a bunch of our pages, like our top charities page, there'll be this simplified cost effectiveness model where we try to show our best estimate. But then also, well, I don't know what we call it either like low and high or like 25th percentile and 75th percentile outcomes. You can see there's like a wide variation in there. And so the biggest thing that that does in our work, it does like two big things. The first is it's a reason we care a lot about that follow up information. Because we just, we really want to know, like, what world are we in? Half the time we'll be outside the 25th or the 75th percentile in our outcomes. And so we really need to keep getting more information to learn because we know that X ante we just don't really have the answer. And so it's imperative that we keep learning. And then the second thing is at some level, we just don't let our decisions be made only by the numbers. And so what I mean by that is to give sort of a simplified example, like let's say that our threshold for cost effectiveness with $5,000 per death averted, and then one organization is 5101 organization is $4,900 per death averted. We don't view those as meaningfully distinct at that Point we're like, okay, those are close enough quantitatively that qualitative factors have to be the driving factor in the decision. And that's part of the reason that the transparency is so critical. So we can describe what those qualitative factors are and people can look at them themselves. The final thing I'd say is that we are more prone sometimes to want to take some, you know, be open to doing things where we're not sure. I don't know how to put this exactly, but, like, the bet we're making is right up front, but there's some chance that it could be really good. And so we'll take the bet. We know that, you know, we don't know how it will turn out. And then we'll see down the line if it worked out or not. And then we can either, you know, go forward and scale up if it goes positively or, like, move on if it didn't.

A (46:46)

Man. These next couple questions are. Might be the most interesting ones, in my opinion. Like, everything else has been kind of almost quantitative, but, like, all of that hinges on this piece. So I'll ask the question, how impactful are moral weights to the granting decisions and charity evaluation that you guys are doing?

C (47:04)

They make a big difference to our decisions. Let me just kind of explain what they are. So we as an organization are trying to allocate the money that we're responsible for to the places we think it'll do the most good. And a lot of donors say to us, we trust you. We want you to make the best decision that you can give. Well, so then we have this problem, which is not every outcome that an organization achieves is comparable to every other outcome. Like, one organization saves the lives of children under the age of five. Another organization gives people money so they can buy more of the things they want. And that or no, like, improves their lives in countless ways that might flow through to mortality, but do other good things for people's lives. And so we've tried to come up with a way for us to compare these two things, in some sense create the exchange rate between the value that comes from increasing income and the value that comes from averting deaths. We have that. We've done that. Just to be clear, this is not true. We don't think we have some special information. These are just things that we. We have to come up with, because otherwise there's other ways you could do this. You could sort of refuse to make the choice and make donors make the choice, but donors want us to. We could do this Arbitrarily in some way. Like, we'll give 20% to this and 20% to that. But why. And so we've done this, I'd say, with, I hope, a fair degree of humility in understanding that we don't really know what they should be. But it's useful in our work to be able to make decisions about how to allocate between these different kinds of good.

A (48:37)

If you tweaked your moral weights, for example, would it change how much you're giving to each organization that you're currently giving to?

C (48:44)

Yeah, I think the numbers I'm going to give you are right. But roughly speaking, we. Our current moral weights say that averting the death of a child under five is equivalent to doubling the income of 100 families for a year. Okay. And I think it's important to remember, just in a low income context, like doubling someone's income really changes what their quality of life is. Like where. I don't know. I feel very fortunate. If you doubled my income, it would enable me to do things I can't do today. But I'm comfortable. It's not really changing the. I mean, I've talked to people, they had a thatched roof over their head, and when it rains, they get wet and they have to leave their house in the middle of the night, go to their friend's house, they get like a bag of rice just so it's backup food. So when they don't have enough food, they have this backup rice. They got school uniforms for their kids. Because in some parts of the world, if you don't have a school uniform, you can't go to school. So if you can't pay for the uniform anyhow, we're trying to come up with this. That's the ratio we use. So that's kind of like the assignment that we have made. And then, like, how did we come to that? Like, where did those numbers come from? It's a combination of a few places. Like, none of which I think has, like, given us a whole lot of confidence, if you ask me. What's the thing that someone should be most focused on in GiveWell's work and where they most disagree? It's here because if you were to say, well, I don't want to make it 100 to 1, I want to make it 200 to 1, you would allocate even more money towards health programs and wouldn't do any of the work that we've done to support programs that focus on increasing people's incomes. If you made Income less valuable. And on the other hand we used to put more weight on income several years ago. If you doubled the weight you put on income so made it 50 to 1 instead of 100 to 1, you would be supporting a lot more income increasing programs than we do today.

A (50:33)

How do you guys come up with those exchange rates? How do you assign the moral weights?

C (50:37)

So there's three basic inputs that we've used over time. First is I'm trying to think what order to go in. Well, I'll go kind of in chronological order of how we did it and then now they are all combined. So the first thing we did is we just like surveyed give well staff and give well donors. Not because that is like the best answer, but it was like where do we even begin with this question. And so we tried to get people's input on how they would weigh and then we've like aggregated those up. That's kind of step one. Step two was looking at academic literature. The academic literature on this question is, I mean there isn't. It sort of exists, there's value of statistical life studies where you can say like, well how much is the US government willing to pay to reduce or the Canadian government, sorry, I'm sort of US centric, apologies for that. But how much is a country's government willing to pay to reduce deaths from traffic accidents? And that can give you some sense at the country level. They also do surveys of people. There are some in low income countries, but it's less. And then the final thing we've done is supported some studies where we've paid for research groups to go and try to ask people. So far we've done this in Kenya and Ghana. We're kind of working on another round of these studies in the future, actually this year. And we want to know from them, well, how do you person in Kenya or how do you think about this question and what would you want? Those are the three things we're bringing together. That third set, you can read all about it on our website if you want. It was really hard as you might imagine to get answers. I think it would be hard for anyone to answer those questions and then doing it via translation, often with people who have less sophisticated numeracy than others. I think it made it really challenging. But we're just trying to do what we can and bring it all together to come up with a number that seems, what should I say, willing to work with or use in our operation.

B (52:26)

And how much do you worry about whether or not your moral weights are Right.

C (52:30)

Well, I guess we know they're not right, because that's kind of impossible. But yeah, I mean, how much do we worry about the fact that it's just this, I don't know what to call it, sort of unempirical philosophical input that makes a big difference on some level, it's a big worry. And then so we just want to do more. And at the same time, I think we're just limited in what we're able to do to get an answer to this question. But it's something that we are as a team, it's a very present topic where we're asking the question, what else could we do empirically to get better answers? And I think the pathway in our future is just continuing to get more information from people in the communities that we're trying to help. I think that's the input that I think we have the least of and could make the biggest difference. It's also like the hardest information to access. And then at the same time thinking about whether there are other ways, and I don't know what the answer would be here, but just in sort of like the set of possibilities, like other ways we could set up our work to direct funds without having to deal with this kind of question. But at least for now, it seems pretty critical.

A (53:34)

Well, what can individual donors do to assess the effects of their own moral weights if they think they may be different from GiveWell's on their individual giving strategy?

C (53:44)

We created a tool where people could plug in their own weights and then they'd be in a position to see how that might change where they want to give. Another thing that we've done and we're doing this year is because of how our moral weights were set and because of the programs that we were finding. We just put significantly less time into poverty reducing programs or what we call livelihoods programs than we otherwise might. And so consistent with this theme of uncertainty, we're trying to hire someone to focus on livelihoods programs specifically. We're going to direct some amount of money to it, even though it might not be competitive according to the moral weights we set. But the idea here is if we sort of have this systematic reason that we're never looking at it, well, we're not going to learn. And so we want to put some energy into learning because we know that one of the reasons we're not looking into it is this number that is not right. And then over the next couple of years, having put more energy into it, I think we'll have a better sense of the quality and the promise of programs in livelihoods and can decide whether we want to do more or less.

B (54:47)

I'm curious how you assess or whether you assess your top charities if they're saving the same lives, thus reducing the, I guess, the per dollar efficiency of grants.

C (54:57)

The thing you could be worried about here is there are a lot of causes of death for children under five in low income countries. Kids die from malaria, pneumonia, diarrhea, and let's say that when you save the life of someone from malaria, they would just go on to die from pneumonia or go on to die from diarrhea. And this could happen if like death is so prevalent that that's a problem. We did like sort of a real deep dive on this last year and you know, we think we might have been overestimating, you know, kind of under appreciating this problem to a small extent. But overall we think the deaths are like pretty independent. And the basic reason is that the odds of death for any one child are extremely low in the scheme of things. And the window in which people are at risk of death and are dying is like fairly narrow. So we talk about under 5 mortality, but mortality is really concentrated in the first month of life and then there's another concentration in the first year of life and then it really peters out after that. And people who are surviving those first few years, if you look at life expectancy, tend to go on to live fairly long lives, not at the length of people in high income countries, but into deep adulthood and older age. And so when we looked at this question, we felt like this was the kind of thing that had come up. We were worried that maybe our analysis was just missing this. And when we dug in, we feel like we've answered that question on the.

A (56:20)

Stock price analogy that we talked about earlier. How do you actually determine whether an organization has enough capacity to use the dollars that you're planning to grant to them?

C (56:28)

So it's a combination of a lot of due diligence upfront. So that means asking a lot of questions. And it's like, well, what do you plan to do? Where are you going to go? Why do you need the money? Who else might you get the money from? What will happen? And then over time seeing what occurs and when time passes. Especially when we've worked with organizations over time, for us, I think ideally we're operating in a repeated game framework where organizations have the incentive to be truthful with us because if they're truthful, we'll see the results of that over Time, and that will then be conducive to more giving over time. For me, it's like some significant upfront due diligence, but then following up after the fact is absolutely critical. And I guess in my opinion, that's the thing that sometimes gets missed a little too much. It's like doing a lot of research is great, but you got to see the results of what you thought. Because as careful as we've been, we've just made so many mistakes in our history. And then I think what has really helped us is that we've been there to learn and learn from them and see what happens so we can do better. And so in this case, just like, all right, well, what did happen with the money? You know, did you deliver the number of things that you expected? How much money do you have in the bank? Like, are you spending the money that we have? Are you expanding into other areas? And then there can be more like sneaky ways in a sense that this happens where maybe organizations aren't building a fundraising team because they're like, oh, GiveWell's got it covered. And that's another thing we'd want to be looking out for because that's a, maybe a subtler way in which we're pushing out other donors, but it's just a big focus of what we do after the fact.

A (57:57)

Wow, you're talking to them. Do you ever go to Africa or wherever they are and like audit the location and talk to people?

C (58:03)

Yeah, we talk to them a lot. I'm actually heading to Malawi this Sunday to be there for a few days with other members of the team. But yeah, like right now we have folks in Uganda looking at programs. Another group which got back from Sierra Leone. It's not as big a part of our work as it is, I think, like other funders, I would say on average people on our research team. So that's like the team making these giving decisions would spend about a week in country looking at programs in the course of a year. And I think that makes it's like about the right balance. I believe that most of what we need to know to make these decisions are zoomed out questions like, do you focus on high income countries versus low income countries? Do you focus on India versus Kenya versus Democratic Republic of Congo? Do you focus on the program that has zero evidence behind it or more evidence? All of that you can do from your desk and you can have a lot of conversations, but then you always learn things by going on the ground and just seeing like last year I was In Kenya. And I was looking at a water program and we had supported an organization to put chlorine in the water. I mean, they were just like running around putting chlorine. It's a program that allows people to like, access chlorine to clean their water. And you know, Interestingly, only about 50% of people were, you know, accessing that chlorine. Some people just skipped it. But the thing the organization has to do is then measure, you know, monitor, like, is chlorine actually in the water to get at that number. And there's three different ways they measure it. One is this like color strip. One is a kind of a handheld dial where they're like comparing colors between two vials and then one is digital. And I think that like, we knew that vaguely, but there's something about like getting there and seeing it in your hand. You're like, this is really error prone. You know, the comparing the level of pink in these two vials is much more prone to error than digital device that reads out a number of like chlorine content in the water. And that's just like one example of the kind of thing that you might not think to ask about, like, what is the mechanism through which you measure? I mean, that I could tell other stories about that whole topic, but being there on the ground, it's really helpful to just like see things with eyes, talk to people directly and hear from them.

A (60:14)

So would you then tell the organization that you guys should be using the digital thing more?

C (60:19)

So they were there, we talked a lot about it with them. And one of the ways that we were good at asking questions, but also they often know the answers. And when you're trying to operate in these low income contexts, there's the question of I might be getting this wrong, but I think the digital device cost $100. And if they were going to roll that device out to all their teams, it's not clear that that would be the right decision because they're trying to balance getting good data and understanding against the fact that like every $100 you spend on monitoring and evaluation is $100 you're not spending on chlorine for water, malarina, et cetera. And so I don't remember the answer in that case, but what we see our job as doing is like asking lots of questions and then evaluating the answers rather than thinking that, like, we know the best way to run a water. We definitely don't know that, like, they are the experts. And so all we can do is poke and poke and poke and Then, you know, ensure that we're satisfied with the answers we're getting.

A (61:07)

Second to last question for you here. Giving seems like a pretty subjective act. Like someone might give to cancer research because their parent or whatever family member had cancer, or to animal shelters because they like cats. Why do you think it's important to place such a heavy emphasis on evidence and quantification?

C (61:27)

I mean, first off, I think I'm not here telling people what they should do with their money. People spend their money, they're charitable money, they're non chair woman and all sorts of things. It's their money, your money, do what you want. That's kind of my starting point. Second, for me, the subjective part of giving or the motivation comes from the emotional, subjective place. It's people are suffering, people can be helped, and I want to help them. And that motivation, I think for some people leads them to want to give to the particular cause where that motivation comes from. And so that's like, oh, I know this person who suffered from this. I want to give to this, or I know this person who this happened to them, or I can see them right now. And instead, to me, I try to imagine, instead of thinking about this person suffered from cancer or this person had this problem, instead say this person suffered. What can I do to alleviate suffering? I'm a parent, I have young children. And I just think about the what, what I would want someone to do for me if I were in a different position to like help my children. And you know, the fact is the people who have the greatest needs like that are people that we don't get to see every day and who live 10,000 miles away. So the reason we put the heavy focus on evidence is just, I don't know, I don't know of a better way to like do this seriously and to do it well. And in the same way that when I decide what I do with my savings or what treatment and medicine my kid is going to get if they need it, I want that to be based on the best possible evidence and data because I really care about the outcomes. To me, it just seems the same thing here. And then even for me, the vast majority of the charitable giving that my family, my wife and I, and I guess our kids do goes to give. Well, I think what we do is great, but we give to a lot of other things in smaller ways. We give to the local community we're in and things we're a part of. And yeah, I don't know, I'm glad that we're doing that too. It's in my head. It's not part of the project of trying to help people as much as possible, but just being a good community member. It's participating in the Parent Teachers association at my kids school. And we do all those things too. We're just really prioritizing in this section of our charitable giving, this part of our giving portfolio, where we're just trying to do the most we can with the best results.

A (63:50)

Yeah, makes sense.

B (63:51)

Ellie, how do you define success in your life?

C (63:54)

I love this question and I have no idea. I was like, what? It's a good question. I mean, I guess there's like three things that I think are really important to me. So I'd say it's like deep relationships, personal growth, and then direct impact. So it's like, am I present, am I engaged, am I deepening relationships with my family, my colleagues, my friends when I've looked back sometimes, I don't know, had some management coaches and they're like, you know, what are you most excited about in your past? I'm like, oh, I had really built up this relationship with this colleague or I have children and it's, I don't know, really fulfilling to just be like spending time with them and understanding them and having them show me all the ways that I'm wrong about so many things. You know, when you see your kids and they're like, I'm like, why are you doing that? I'm like, oh God, I do that too. Just like that whole thing is really meaningful for me. Another is just, I really enjoy like learning new things and getting better. And so am I growing as a parent, as a leader, as a person, I guess. And then finally just is the work that GiveWell is doing improving people's lives around the world in a direct, demonstrable way, Those are the things I'm looking at and then haven't come up with the quantitative metric to pull them all together. So, you know, those are, I don't know, maybe more like still a question more than answers.

A (65:06)

It's a great answer. All right, Ellie, that's.

C (65:08)

That's it.

A (65:08)

Thanks so much for coming on the podcast. We really appreciate it. I think this is a great conversation.

B (65:12)

Great conversation.

C (65:13)

My pleasure.

D (65:18)

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