Recent cuts to US government foreign assistance have destabilized global health programs, impacting some of the most cost-effective interventions we’ve found for saving and improving lives, such as malaria nets, malaria chemoprevention, and community-based management of acute malnutrition. This situation is a major focus of our research team at the moment, and we’re working to balance a targeted, near-term response to urgent needs with a broad, long-term perspective of needs that may emerge.
The US has historically provided roughly 20% to 25% ($12 billion to $15 billion) of the total global aid to support health programs, which combat malaria, tuberculosis, HIV, maternal and child health issues, and much more.[1] While the long-term effects remain uncertain and exact numbers remain difficult to ascertain, cuts of 35% to 90% of US foreign aid dollars are being publicly discussed by the administration.[2]
We’ve created a webpage to provide an overview of how we’re responding, and we’ve started to record a series of conversations with our research team that shares timely snapshots of this rapidly evolving situation. Our first episode shared a broad overview of the impacts of US government aid cuts and GiveWell’s initial response.
In our newly released second episode, GiveWell Program Officer Natalie Crispin joins CEO and co-founder Elie Hassenfeld to zoom in on a specific case, focusing on grants we’ve made to support urgent funding gaps for seasonal malaria chemoprevention (SMC). They discuss how SMC campaigns work, the impact of USAID funding pauses on SMC campaigns, and GiveWell’s response to keep SMC campaigns on track.
Listen to Episode 2: Addressing Urgent Needs in Seasonal Malaria Chemoprevention
This situation is changing daily, and we’re constantly learning more. You can listen or subscribe to our podcast for the latest updates and read a summary of key takeaways from each podcast conversation on our blog.
GiveWell has so far directed approximately $15 million toward urgent needs caused by cuts to US foreign aid, focusing on highly cost-effective interventions at risk of near-term disruption. Our research team is continuing to investigate more than $100 million of potential grants to support similar needs across a wide range of impacted programs. This is in addition to our normal grantmaking to support cost-effective interventions—many of which have also been impacted.
Our work to help donors do the most good they can with each dollar is as important and difficult as ever, and we believe the highest-leverage opportunities for impact may emerge as the full effects of these changes become clearer. We are actively fundraising for what we expect to be larger gaps to help people in need, and we expect to find far more excellent giving opportunities than we’ll be able to fund in the coming years.
If you want to help respond to this situation, donating to our funds based on your giving preference remains our recommendation. The funds enable us to respond in different ways, but both use 100% of your gift, after transaction fees, to support the best giving opportunities we find.
- Giving to our All Grants Fund provides us with more flexibility to respond strategically to the greatest emerging needs we identify. While we have less certainty about some of the individual programs supported by this fund, we think they collectively have the highest impact per dollar spent.
- Giving to our Top Charities Fund ensures your money is deployed quickly and exclusively to the four highly cost-effective programs that we have the most confidence in.
Visit our USAID Funding Cuts webpage to learn more about our response and how you can help.
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According to KFF (chart 5), enacted US government global health funding was $12.2B for fiscal year 2022, $12.9B for 2023, and $12.4B for 2024. “Note: Represents total known funding provided through the State Department, USAID, CDC, NIH, and DoD. FY13 includes the effects of sequestration. Does not include emergency supplemental funding. Some global health funding that is not specified in the appropriations bills and is determined at the agency level is not yet known for FY23-FY24” KFF 2025, note for chart 5.
The Institute for Health Metrics and Evaluation estimates total US government health aid at $14.6 billion in 2023. See IHME, VizHub - Financing Global Health, DAH flows, 2023.
According to the Institute for Health Metrics and Evaluation, total global health aid spending for 2023 was $64.6 billion. See IHME, VizHub - Financing Global Health, Health Focus Areas of DAH, 2023.
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On March 10, Secretary of State Marco Rubio tweeted that “83%” of USAID programs were being cancelled, with 5,200 cancelled and 1,000 retained. The Center for Global Development estimates that this represents a cut of approximately 34% of USAID programming by dollar value (Kenny and Sandefur, March 14, 2025).
“In his statement to the lower court, Pete Marocco, who is performing the duties of the deputy administrator of USAID, said each of USAID’s grants had been reviewed and Secretary of State Marco Rubio decided to eliminate about 92% worth of the agency’s grants. The State department also cut around 4,100 grants. The government claimed a total savings of nearly $60 billion dollars.” Tanis and Langfitt, February 26, 2025. $60B in cuts / $68B total obligations = total cuts of around 88%; if the total obligations are actually $79B and the government's other estimates are accurate, then total cuts would be around 76%.
I understand your frustration here, but EAs may have decided it was better to engage in pro-democracy activity in a non-EA capacity. One data point: the pre-eminent EA funder was one of the top ten donors in the 2024 US elections cycle.
Or they may have decided that EA wasn't a good fit for this kind of work for any combination of a half-dozen reasons, such as:
I don't think it is necessary to rule out all possible alternative explanations before writing a critical comment. However, I think if you're going to diagnose what you perceive as the root cause -- "You wanted to settle for the ease of linear thinking" -- I think it's fair for us to ask for either clear evidence or a rule-out of alternative explanations.
As David points out, there have been a number of posts about democracy and elections, such as this analysis about the probability that a flipped vote in a US swing state would flip the presidential election outcome. I recall some discussion of the cost-per-vote as well. There are a lot of potential cause areas out there, and limited evaluative capacity, so I don't think the evaluations being relatively shallow is problematic. That they did not consider all possible approaches to protecting/improving democracy is inevitable. I think it's generally okay to place the burden of showing that a cause area warrants further investigation on proponents, rather than those proponents expecting the community to do a deep dive for them.