Update 4th Dec 2023:

It currently looks like Spiro is on track to fill our fundraising budget for the year. Our heartfelt thanks to people who’ve reached out or donated already. <3

If you haven’t been in touch already and were considering donating, you might like to check out other new Charity Entrepreneurship supported charities such as https://www.clearsolutions.global/ or https://lafiyanigeria.org/

And please do keep an eye out as we if things go well we will hopefully be fundraising again next year to expand!

Summary

Note: You can’t give to Spiro as part of the donation election, if you’d like to donate to Spiro, see details in the donations section below.

We (Roxanne Heston and Habiba Banu—formerly Habiba Islam!) have launched Spiro, a new TB screening and prevention charity focused on children. Our website is here.

We are fundraising $198,000 for our first year. We’re currently reaching out to people in the EA network. So far we have between 20%-50% of our budget promised and fundraising is currently one of the main things we’re focusing on.

The major components of our first year budget are co-founder time, country visits, and delivery of a pilot program, which aims to do household-level TB screening and provision of preventative medication.

We think that this project has a lot of promise:

Tuberculosis has a huge global burden, killing 1.3 million people every year, and is disproportionately neglected and fatal in young children.
The evidence for preventative treatment is robust and household programs are promising, yet few high-burden countries have scaled up this intervention.
Modeling by Charity Entrepreneurship and by academics indicate that this can be competitive with the best GiveWell-recommended charities.

If we don’t manage to raise at least half of our target budget by the beginning of December 2023 then we’ll switch from our intended focus for the next month from program planning to additional fundraising. This will push out our timelines for getting to the useful work.

If we don’t manage to raise our full target budget by the end of 2023 then we’ll scale back our ambitions in the immediate term, until we put additional time into fundraising a few months later. The lower budget will also limit the size of our proof-of-concept effort since we and our government partners will need to scale back work to the available funds.

You can donate directly via our Cornerstone page—best for most countries.

You can alternately donate via Giving What We Can’s fund for charities incubated through Charity Entrepreneurship—best for the UK and the Netherlands. Please also email habiba.banu@spiro.ngo letting us know how much you have donated if you donate this way, so that we can identify the funds and allocate them to Spiro.

For large donations please get in touch so we can share details for the most efficient donation method.

Who are we?

Spiro is co-founded by Habiba Banu and Roxanne Heston.

Habiba worked for the last three years at 80,000 Hours and before that as Senior Administrator at the Future of Humanity Institute and the Global Priorities Institute. Her background is working as a consultant at PwC with government and non-profit clients.

Rox has worked for the last few years on international AI policy in the U.S. Government and at think tanks. She has worked with and for various EA organizations including the Centre for Effective Altruism, the Future of Humanity Institute, Open Philanthropy and the Lead Exposure Elimination Project.

We have received Charity Entrepreneurship support so far:

Charity Entrepreneurship’s research team did the initial research into this idea and shared their work with us.
Habiba went through Charity Entrepreneurship’s Incubator Programme earlier this year. Rox started working with Habiba to find an idea together about halfway through the program.
Charity Entrepreneurship has provided stipend funding, advice, and operational support (e.g. website design). It will continue to provide mentorship from its leadership team and a fiscal sponsorship arrangement.

What are we going to do?

Spiro will implement sustainable household screening programs in low- and lower-middle income countries. Spiro aims to curb infections and save lives of children in regions with high burdens of tuberculosis by identifying, screening, and treating household contacts of people living with TB.

We will initially establish a proof of concept in one region, working closely with the government TB program. We will then aim to scale nationally, with funding from the Global Fund, and expand to other countries.

Currently, we are planning a visit to Uganda to shadow existing programs to learn from their work. We are also looking into our shortlist of countries to establish where to start our pilot.

Why TB?

Tuberculosis presents a huge global burden, particularly affecting those from the most disadvantaged backgrounds, but has historically received less than half the money required according to the Global Plan to End TB.

But ending the tuberculosis epidemic is possible and a highly effective focus area. The Stop TB Partnership estimates returns of $59 of benefits for every $1 spent up to 2050.

Why this intervention?

People ill with TB can infect up to 10-15 other people through close contact over the course of a year − 43% of their contacts will have a latent TB infection. But preventative treatment is highly effective—it reduces progression from latent TB to active TB illness by 60-90%.

There are millions of children at risk of catching this deadly disease and we are failing to protect them from falling ill.

There are many reasons childhood TB prevention has been historically neglected:

In an under-resourced setting, preventative treatment is often deprioritized compared to active case treatment due to the latter’s urgency even when prevention works out well over the long-run.
There has been a historic focus on preventing cases in adults because they are more infectious than children, but children have higher mortality rates from TB.
Only in more recent years have there been innovations to make the medicine water dispersible and child-friendly and to reduce the duration of treatment regimes from nine months to three months or even one month—all of which makes prevention more viable.

Experts we spoke to supported Spiro starting such a program and research suggests it would be highly cost-effective at scale:

Charity Entrepreneurship modeled the cost-effectiveness of household child contact management as ~$3,600/life saved.
GiveWell has funded and recommended TB programs in the past and is now revisiting the area. GiveWell’s top recommended charities save a life for $3,500 to $5,500.
One academic cost-effectiveness study found that, in the best circumstances, child contact management programs could save a life for $3,000 to $4,000.

We aim to reach this level of cost-effectiveness in two years, in line with successful Charity Entrepreneurship-incubated nonprofits.

Why Spiro?

There are large organizations that work on TB, including the Clinton Health Access Initiative (CHAI) and Partners in Health (PIH). But the burden of TB is huge—beyond even their reach—and there are still significant gaps in preventative treatment even in countries with high TB burdens.

Selecting our country of operation carefully, we think we can provide the focus and resources to launch high-impact programs and help people who would otherwise be missed.

Focus: We are cost-effectiveness minded and, without the mandate of focusing on active cases, we have the affordance to think long-term.
Resources: We can mobilize funding and attention to this neglected area, and can act nimbly as a new organization. We bring strong stakeholder and project management skills for execution.

Budget

We’re seeking to raise $198,000 to fund our first year of work—accounting for planning and carrying out a proof of concept covering an estimated 200 children across 73 households and then a full pilot covering 1000 children across 366 households.

We’re currently reaching out through the EA network. Although we have Charity Entrepreneurship support we are starting this project outside the incubator schedule and are therefore fundraising ourselves rather than through the Charity Entrepreneurship seed funding circle.

So far we have between 20%-50% of our budget promised. Fundraising is currently one of the two main things we’re focusing on (alongside the shadowing trip).

We’re relatively hopeful that we can raise at least half our budget, but we do need more people to donate in order to get there. If we don’t do this by the beginning of December then we’ll switch our focus away from program planning (particularly country selection) and spend more time on fundraising instead, which we expect will push out our timelines for getting to the useful work by one month.

If we don’t manage to raise our full budget by the end of 2023 then we’ll scale back our ambitions in the immediate term and expect to come back to fundraising a few months later.

You would only want to donate to us if you’re interested in taking a gamble on a new project that has promise but doesn’t have a track record yet. (See this post)

We expect that, like most new projects, what we focus on will shift as we learn more. So potential funders should probably be compelled by the case that there’s something cost-effective we can find to do in the TB space, even if the program design doesn’t end up precisely the same as our current best guess.

You might be particularly interested in donating to us if you’re excited to see people involved in the EA community try working on tuberculosis.

Learn more

If you would like to talk to Habiba or Rox or read our full funding please reach out on habiba.banu@spiro.ngo or roxanne.heston@spiro.ngo. We’d be happy to talk!

Donations

We’re so early on in our charity journey every little helps! We’re really grateful to anyone who’s interested in helping us kickstart this project.

Large donations

If you would like to make a large donation, please get in touch as we can let you know the most efficient way to donate!

Most countries

If you are donating from most countries including the US, you can donate directly to Spiro via our Cornerstone page. Donations are tax deductible in the US.

Donate (from the US or most countries)

UK and the Netherlands

If you are donating from the UK or the Netherlands, you can donate through Giving What We Can’s fund for charities incubated through Charity Entrepreneurship. Donations are tax deductible in the US, the UK and the Netherlands.

Donate (from the UK or the Netherlands)

If you do this, please also email habiba.banu [at] spiro.ngo letting us know how much you have donated so that we can identify the funds and allocate them to Spiro.

Spiro—New TB charity raising seed funds