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A Change in Designation, Not Evaluation: Deworm the World and GiveWell’s Top Charity Updates

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Each year, Evidence Action’s Deworm the World Initiative reaches hundreds of millions of children with deworming treatments that improve their health, education, and long-term wellbeing. We do this for an average cost of less than US$0.50 per treatment, and we know from field surveys that worm infections are decreasing – often dramatically – in the geographies where we work.

The benefits of deworming are immense: longitudinal research by Professor Ted Miguel, Nobel Laureate Michael Kremer, and colleagues found that 20 years after treatment, adults who were dewormed as children have incomes 13% higher than those who weren’t. Leveraging that same research, an open policy analysis estimates that for every dollar spent on deworming, each person who received treatment reaped economic benefits worth, on average, over $230 — illustrating that the benefits of deworming by far exceed the costs.

Since 2013, GiveWell has recognized Deworm the World for its cost-effective impact, stating, “of the deworming charities we have evaluated, [Deworm the World] has the strongest track record of demonstrating that its programs are effective.” Over the past nine years, GiveWell’s overall funding for Deworm the World has totalled more than $42M; their designation of the program as a “top charity” has driven significant additional funding as well. We are incredibly grateful for GiveWell’s support – it has been a key driver of our ability to help deliver over 1.5 billion deworming treatments since 2014.

As GiveWell has grown, they have increasingly recommended grants to programs outside the top charity list. This week, they’ve announced they are splitting their designations into two funds: “Maximum Impact” and “All Grants”. The Maximum Impact Fund, which is restricted to top charities, is in part intended to be accessible to individual donors, who GiveWell believes may prefer programs with higher certainty levels. As such, the top charities list will now emphasize programs GiveWell sees as “surer bets”, rather than prioritizing them based on “expected value” (this means GiveWell’s level of confidence in a charity’s impact will now carry greater weight than the potential magnitude of that impact). This change affects a number of charities, including Deworm the World.

GiveWell is highly confident that deworming reduces worm loads, but has less confidence in the causal relationship between reduced worm loads and improved life outcomes – this is why they see deworming as less of a “sure bet” than some other interventions. However, because the impact of deworming is massive if realized, the “expected value” is very high. This is why GiveWell continues to generously support Deworm the World via the All Grants Fund.

Our understanding is that GiveWell has taken this step to provide a clearer delineation between their two giving options; it is not intended to affect the total amount of funding that Deworm the World will receive from GiveWell. As GiveWell has made clear, it also does not reflect any change in their thinking about Deworm the World (read more on GiveWell’s blog). The program remains extremely effective according to their evaluation, which highlight’s our strong track record and excellent cost-effectiveness; strong process for assessing whether children are being successfully dewormed; standout transparency; and room for more funding.

Donors can still support programs that are potentially riskier, but have a higher expected value, via the All Grants Fund, which represents a very significant and growing proportion of GiveWell’s giving. (You can also give directly to Evidence Action here, and allocate your donation to a specific program if you wish).

We are excited about the All Grants Fund, and the growth it enables in dynamic and high-impact programming – GiveWell supports many of our programs this way, including Dispensers for Safe Water, iron and folic acid supplementation, maternal syphilis testing and treatment, and our more experimental work in our Accelerator.

Regardless of designation, Evidence Action and GiveWell agree that Deworm the World is an extremely cost-effective investment:

“Although we have updated our criteria for top charities, I want to emphasize that this does not represent any change in our opinion about the cost-effectiveness of deworming. We remain excited to support Evidence Action’s Deworm the World Initiative, and think it provides donors with an outstanding opportunity for cost-effective impact. At present, we’re providing funding for their existing programming in a number of locations, as well as for scoping new geographies for potential expansion.” – Natalie Crispin, Senior Program Officer at GiveWell

Over 868 million children globally are at risk of contracting parasitic worm infections, which interfere with nutrient uptake and threaten their health, education, and productivity. In our view, the need, the compelling evidence base, the high expected value, and the outstanding cost-effectiveness make deworming a best buy in international development.

We’d like to extend our heartfelt thanks to everyone who has supported Deworm the World to date, and reiterate our confidence in the evidence supporting its cost-effective impact.

If you have any questions or would like to speak to us about this change, you can reach out to [email protected].


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