2025

Clear vision allows adults to read, work, and maintain independence, yet millions lack access to something as simple as reading glasses. This year we provided more than 7,000 adults with glasses in Uganda while identifying models that could reliably reach those whose livelihoods depend on restored vision.

The pilot will continue into 2026 as we work to distribute a total of 25,000 pairs of eyeglasses. If results demonstrate cost-effectiveness and operational viability, we may explore expansion within Uganda or testing the model in other countries where governments support community-based vision care.

In 2025, we distributed 19,440 bottles of the prenatal vitamins across 90 health facilities in Nigeria. Interim analysis found that vitamin consumption increased by 60% among the women we reached, and we're now analyzing the full results to determine whether large-scale rollout in Nigeria and beyond can cost-effectively improve pregnancy outcomes for millions.

Efforts to provide chlorine broadly have been vital for expanding access to safe drinking water, especially for vulnerable families. But universal access alone doesn’t guarantee use — and when households accept chlorine but don’t consistently treat their water, programs experience avoidable waste that reduces cost-effectiveness and impact. The Vouchers for Safe Water pilot tested a practical alternative: a simple voucher system that still provides chlorine for free, but only to households who actively redeem it, helping ensure the product reaches those most likely to use it.

In 2025, the pilot enrolled 9,000 pregnant women and mothers in Liberia, closely tracking redemption to understand demand and behavior. The pilot concluded in September, and endline results are now being analyzed to guide next steps and assess the model’s potential for broader scale-up.

In 2025, we piloted a promising solution: providing children a full course of antimalarials at set intervals to clear existing infections and offer weeks of protection. Evidence shows this approach can reduce malaria by 40–50%, anemia by 15–23%, and may lower community transmission by 15–30%.

We delivered several cycles of treatment to school-aged children in two states in Nigeria, a country that bears 31% of global malaria deaths. Early 2026 results will assess whether this approach can be a cost-effective approach to reducing malaria transmission.

Millions of children continue to miss life-saving vaccines, often simply because families lack information or support. Research shows that combining simple tools like text reminders, community ambassadors, and incentives (e.g., mobile credit and coupons) can increase immunization rates by 44%. After scoping multiple countries in 2025, we have identified Nigeria — home to the world’s largest number of zero-dose children — as the highest-impact setting for a 2026 pilot.

Severe acute malnutrition remains a leading cause of child death, yet there’s a proven tool to prevent it: small quantity lipid nutrient supplements (SQ-LNS) – nutrient-dense, fortified pastes in small packets designed for young children – prevent approximately 1 in 4 child deaths.

The Nigerian government secured its first large order of the supplements, and in 2025 we built strong partnerships to provide the technical support needed to ensure they reach the children most at risk. Using geostatistical modeling to target distribution, and through additional program management support, we expect to maximize the impact of the intervention to save an additional ~2,000 young lives at $1,100 per life saved* – exceptionally cost-effective even by the highest standards in global health.

*For context, GiveWell's top-rated charities typically cost $3,000-$5,500 per life saved, making this intervention roughly 2-4x more cost-effective than other highly effective programs.

In August 2025, National Deworming Day — one of the world's largest single-day public health campaigns — delivered treatment to 146.8 million children across the three states where we continue to provide full technical support, maintaining the massive scale we've achieved over the past decade.

We anticipate all Indian state programs will operate independently by March 2027, proving that technical assistance can be time-bound and that government systems can fully own proven interventions.

This progress positions Kenya to eliminate worms as a public health problem by 2027. Thanks to strong government capacity and commitment, we're now exploring our pathway to conclude our technical assistance and provide the government with the tools and resources they need to keep worm infections under control.

The recent results – collected in partnership with the Cross River state government – informed the state’s decision to reduce treatment frequency in areas where worm prevalence is now low. This approach ensures that resources are allocated more effectively and targeted to communities with the greatest need.

At the same time, we’ve continued to work with the provincial governments to mobilize domestic resources towards the program, strengthening its long-term sustainability. As a result of these efforts, the government of Khyber Pakhtunkhwa recently made a three-year allocation to support 20% of the annual implementation budget. This represents a significant milestone and sets an important precedent for other provinces to follow.

By working directly with organizations like Innovation: Africa and GOAL Uganda that build piped water systems in rural areas, we can layer chlorination onto existing infrastructure — ensuring communities receive safe water from the start rather than building systems from scratch. Through these partnerships in Uganda and Malawi, we brought safe water to tens of thousands more people in 2025.

Additionally, as GiveWell explores funding to other organizations to pilot water chlorination, we're sharing our operational knowledge and implementation evidence across the water treatment space. This collaborative approach means more people around the world will gain access to safe drinking water, ultimately reducing illness and deaths caused by contaminated water.

Independent monitoring revealed the program was reaching approximately 40% fewer people using treated water than our data suggested. Combined with Kenya's remarkable development over the past 12 years — GDP nearly doubled, child mortality declined over 25% — the full program no longer met our internal cost-effectiveness threshold, though it remained highly effective by standard measures.

Even as evidence required us to change course, we are proud of what our dispensers program in Kenya has achieved: 19,000 chlorine dispensers installed and safe water access extended to 2 million people each year since 2015. We estimate this intervention has prevented over 1 million cases of diarrheal disease and saved over 3,700 lives. These tangible impacts demonstrate why safe water remains a priority, even as we refocus our geographical footprint to maximize effectiveness.

Throughout 2025, we worked to reach more children and make the program more sustainable. We supported states in expanding supplementation to private schools, ensuring children whose families pay for education aren't left behind. We helped governments improve supply chains so that when children show up for their weekly dose, the tablets are actually there. And we advanced strategies to improve coverage for the youngest children – those under five who don't attend school yet and rely on home visits from community health workers during their most critical developmental years.

We're now leveraging these proven strategies to expand to additional states across India. Over the two years, we anticipate roughly doubling our reach, providing millions more children with the energy to attend school, the cognitive capacity to learn and the physical strength to thrive.

We focused first on adolescent girls, who face increased anemia risk with the onset of menstruation, while supporting a pilot for younger girls and boys, to demonstrate feasibility and acceptability among this age group in 2025.

With 50% of Malawi's children currently infested with worms, anemic, or both, we have a clear path to national coverage in 2026, demonstrating how this layered approach can address multiple health challenges simultaneously at scale.