Prioritizing COVID-19 interventions & individual donations

UPDATE 723: Our group has con­cluded re­search ac­tivi­ties for the time be­ing. Pre­vi­ous up­dates have been moved to the bot­tom of the post. All in­for­ma­tion and recom­men­da­tions be­low are cur­rent as of late June 2020. If you have ques­tions or are con­sid­er­ing a dona­tion, feel free to reach out to one of the au­thors and we will help you if we can.

Authors: Cather­ine Ols­son and Ian David Moss, with con­tri­bu­tions from the col­lec­tive mem­bers of the “Fund­ing Ra­tional Ac­tors Promptly” Pan­demic En­dow­ment (FRAPPE).

At the be­gin­ning of April, a group of about 20 friends pul­led to­gether a mes­sen­ger chat to dis­cuss how to most effec­tively spend per­sonal dona­tion funds to­wards miti­gat­ing global suffer­ing caused by COVID-19. What started as an in­for­mal effort has since re­sulted in the dis­tri­bu­tion of at least $410,000 to char­i­ties on this list and in­di­rectly in­fluenced $16 mil­lion in ad­di­tional cap­i­tal, mostly via the de­ci­sions of a sin­gle large foun­da­tion.

A defin­ing mo­ti­va­tion of our group was to find time-sen­si­tive and ne­glected bot­tle­necks to effec­tive COVID re­sponse that could be eased with rapid fund­ing or other sup­port­ive ac­tions. Fast ac­tion can be an im­por­tant source of philan­thropic lev­er­age in re­sponses to the cur­rent pan­demic, a fac­tor that we did not see ex­plored in depth in available analy­ses of COVID-re­lated giv­ing op­por­tu­ni­ties. Ac­cord­ingly, we have sum­ma­rized our re­search here in hopes that oth­ers can use it to in­form their own giv­ing.

This ar­ti­cle is or­ga­nized in two parts. The first shares our work­ing frame­work for pri­ori­tiz­ing in­ter­ven­tions, which helped us get ori­ented in a fast-chang­ing and oth­er­wise con­fus­ing land­scape. In the sec­ond part, we enu­mer­ate spe­cific giv­ing op­por­tu­ni­ties (jump to sec­tion) we have found that cur­rently rate highly on this frame­work as of right now (late June 2020).

We’ve writ­ten this post pri­mar­ily for the benefit of donors who have already de­cided to fo­cus on COVID-19 for their own rea­sons. We haven’t made it a pri­or­ity to weigh the rel­a­tive value of COVID-re­lated dona­tions as com­pared to other is­sues or causes, al­though we ad­dress this briefly at the end.

Some dis­claimers: this re­search is be­ing done and our dona­tions are be­ing made in a purely per­sonal ca­pac­ity, and none of us is act­ing as an em­ployee, rep­re­sen­ta­tive, or spokesper­son of our em­ployer or any other or­ga­ni­za­tion. Fur­ther­more, be­cause we don’t have com­plete in­for­ma­tion on many op­por­tu­ni­ties and the situ­a­tion is chang­ing so rapidly, none of what fol­lows should be treated as the fi­nal word on COVID-re­lated giv­ing op­por­tu­ni­ties. With that said, we have tried hard to come to the best de­ci­sions we could in a short pe­riod of time us­ing the re­sources we had, and are up­dat­ing this post pe­ri­od­i­cally as our per­spec­tive con­tinues to evolve.


I. Ex­ec­u­tive Sum­mary & Recommendations

When eval­u­at­ing COVID-19 in­ter­ven­tions for im­por­tance/​scale, our in­tu­ition is to look for the fol­low­ing five “scale fac­tors”:

  1. Act­ing quickly, be­cause wide­spread avoid­able suffer­ing is already tak­ing place, be­cause miti­ga­tion is more cost-effec­tive when ac­tive case num­bers are smaller, and be­cause many po­ten­tially im­pact­ful in­ter­ven­tions re­quire lead time to set up.

  2. 🌍Con­cen­trat­ing benefits on the global poor, due to both dis­pro­por­tionate vuln­er­a­bil­ity and huge num­bers.

  3. 😷Cheap miti­ga­tion strate­gies to limit or slow the spread of the dis­ease, even in pop­u­la­tions where full con­tain­ment is not pos­si­ble. We are par­tic­u­larly in­ter­ested in in­ter­ven­tions that are cost-effec­tive rel­a­tive to the bur­den they im­pose on so­ciety.

  4. 🔬Scien­tific re­search & de­vel­op­ment in sup­port of any of the above facets of the prob­lem, be­cause a dol­lar spent on re­search can un­lock or­ders of mag­ni­tude more benefit later. This in­cludes vac­cines to pre­vent con­trac­tion of the dis­ease, ther­a­peu­tic treat­ments that re­duce sever­ity for those who have it, di­ag­nos­tics, and other ar­eas.

  5. 📊Knowl­edge and ad­vo­cacy to in­form and mo­ti­vate policy re­sponses that are more likely to achieve de­sired out­comes from a global per­spec­tive.

For now, we have recom­mended the fol­low­ing dona­tion op­por­tu­ni­ties, as we be­lieve they meet many of these crite­ria and have room for more fund­ing:

  • Open Source Med­i­cal Sup­plies, a grass­roots col­lab­o­ra­tion lev­er­ag­ing the in­ter­na­tional maker com­mu­nity to de­sign, pro­duce, and dis­tribute med­i­cal sup­ply items for hos­pi­tal work­ers and the broader com­mu­nity.

  • Fast Grants, a rapid-turnaround fund­ing mechanism for re­search on COVID-19.

  • COVID-END, an ini­ti­a­tive to en­hance col­lab­o­ra­tion and re­duce du­pli­ca­tion among par­ties con­duct­ing rapid re­views of re­search to in­form COVID-19 policy.

In ad­di­tion, we have iden­ti­fied a num­ber of other or­ga­ni­za­tions do­ing promis­ing work that have the po­ten­tial to emerge as top recom­men­da­tions as we learn more about them and/​or as their work de­vel­ops.


II. Big pic­ture: What’s the bad thing that’s hap­pen­ing? What could cause less of it to hap­pen?

In this sec­tion we lay out the ba­sic mov­ing parts of the cur­rent crisis that one could in­ter­vene on to pro­duce a bet­ter out­come. Parts of this sec­tion might be ob­vi­ous to some read­ers; how­ever, what is “ob­vi­ous” to some can be “sur­pris­ing” to oth­ers, so we think it’s worth­while to restate the es­sen­tial pic­ture.

Two things are go­ing on:

  • The first-or­der prob­lem: a dis­ease is spread­ing around, caus­ing ill­ness that harms peo­ple.

  • The sec­ond-or­der prob­lem: both the dis­ease and the re­sponse are dis­rupt­ing peo­ple’s abil­ity to work, con­sume, move around, dis­tribute goods, and care for them­selves and oth­ers, which is harm­ing peo­ple.

First-or­der prob­lem: a dis­ease is spread­ing around, caus­ing ill­ness.

The ba­sic epi­demiolog­i­cal pic­ture is as fol­lows:

1. Each per­son who has the dis­ease in­fects some num­ber of other peo­ple on av­er­age.

2. The dis­ease at first spreads ex­po­nen­tially (R0 > 1) within pop­u­la­tions of sus­cep­ti­ble peo­ple who have con­ta­gious con­tact with each other.

    • The world is not uniformly mixed, so differ­ent “pop­u­la­tions” are un­der­go­ing differ­ent trans­mis­sion dy­nam­ics.

3. If no mea­sures are taken to bring R0 be­low 1 and there is no vac­cine, the ex­po­nen­tial spread be­gins to slow down in a pop­u­la­tion only when a large frac­tion of that pop­u­la­tion has been in­fected, such that the dis­ease starts run­ning out of sus­cep­ti­ble hosts.

    • The num­ber of in­fected peo­ple re­quired to reach “herd im­mu­nity” is 1-1/​R0 (for ex­am­ple, R=3 → 66.7%). How­ever, epi­demics have mo­men­tum, so a larger frac­tion of peo­ple ends up get­ting in­fected (“over­shoot”). (see thread by @CT_Bergstrom)

To get a feel for these dy­nam­ics, the simu­la­tor at https://​​ncase.me/​​covid-19/​​ is the best ped­a­gog­i­cal re­source we’ve seen so far.


Graphic by Kristen Tonga for FRAPPE

What lev­ers can we pull to make di­rect im­pacts less bad?

1. Re­duce the to­tal num­ber of peo­ple who get it. For ex­am­ple:

    • Miti­gate un­til a vac­cine. (See “The Ham­mer and The Dance”)

      • Some pop­u­la­tions can avoid ever reach­ing the point of herd im­mu­nity /​ pop­u­la­tion sat­u­ra­tion by de­ploy­ing a com­bi­na­tion of strate­gies that keep R0 small or even at times be­low one. Miti­ga­tions will need to con­tinue un­til a vac­cine is available.

    • Lower the herd im­mu­nity sat­u­ra­tion point.

      • Some pop­u­la­tions will be un­able to avoid hit­ting herd im­mu­nity, but since the per­cent of in­fected pop­u­la­tion at sat­u­rated steady-state is a func­tion of R0, then if R0 can be kept lower (e.g. through wear­ing masks in pub­lic), fewer peo­ple get in­fected.

    • Re­duce over­shoot.

      • In pop­u­la­tions trend­ing to­wards herd im­mu­nity, a well-timed re­duc­tion in R0 near the peak of in­fec­tion can re­duce un­nec­es­sary in­fec­tions from over­shoot, at lower cost than main­tain­ing that strat­egy for a longer pe­riod of time. (@CT_Bergstrom)

    • Re­duce con­ta­gious con­tact be­tween hotspots and sus­cep­ti­ble clusters.

    • Create and de­ploy a vac­cine.

2. Re­duce the amount of suffer­ing per per­son who gets it. For ex­am­ple:

  • Develop and de­ploy treat­ments that lower the sever­ity or death rate among cases.

  • Spread out the in­fec­tions within a pop­u­la­tion over a longer pe­riod so that peo­ple are treated by a less-over­whelmed med­i­cal sys­tem, or even just cared for by a less-over­whelmed so­cial sup­port net­work. (This is one mo­ti­va­tion for the “flat­ten the curve” strat­egy.)

  • Prevent health care work­ers in par­tic­u­lar from get­ting in­fected so that the med­i­cal sys­tem can provide higher-qual­ity care. Ac­cord­ing to one anal­y­sis, ap­ply­ing this in­ter­ven­tion in low-in­come coun­tries offers a cost-effec­tive­ness pro­file that is com­pet­i­tive with GiveWell top-recom­mended char­i­ties.

Se­cond-or­der prob­lem: dis­rup­tions to peo­ple’s lives and livelihoods

In ad­di­tion to the di­rect health im­pacts on peo­ple who get sick, there are in­di­rect im­pacts. Peo­ple who are sick or con­cerned about get­ting sick will not work, con­sume, travel, dis­tribute goods, or par­ti­ci­pate in their com­mu­ni­ties at the same rate or in the same pat­terns as be­fore. Ad­di­tion­ally, miti­ga­tion strate­gies (such as lock­downs, test-and-trace pro­grams, manda­tory face cov­er­ings, or ed­u­ca­tion cam­paigns) will fur­ther shape peo­ple’s be­hav­iors, as well as cost­ing money. Th­ese al­tered pat­terns of ac­tivity and pro­duc­tion, and di­rect and in­di­rect fi­nan­cial costs, are already man­i­fest­ing as job losses, food short­ages, and other dis­rup­tions to peo­ple’s lives and liveli­hoods. Par­tic­u­larly in poorer coun­tries, the in­di­rect effects of the dis­ease could cause more harm than the dis­ease it­self, as they are not only harm­ful in their own right but worsen many ex­ist­ing so­cial prob­lems (other dis­eases, hunger, do­mes­tic vi­o­lence, ed­u­ca­tion, in­equal­ities in ac­cess to es­sen­tial ser­vices, etc.).

Some miti­ga­tion strate­gies are much more ex­pen­sive than oth­ers, in terms of both money and dis­rup­tion. In the case of a pre­vi­ous pan­demic, for ex­am­ple, one anal­y­sis con­cluded that “[early] con­tact trac­ing was es­ti­mated to be 4,363 times more cost-effec­tive than school clo­sures ($2,260 vs. $9,860,000 per death pre­vented).” While we can’t as­sume that these ra­tios will nec­es­sar­ily hold for COVID, a similarly wide differ­en­tial among the cost-effec­tive­ness of differ­ent strate­gies would not be sur­pris­ing.

Fur­ther­more, some miti­ga­tion strate­gies take much more “setup time” than oth­ers (e.g. a school clo­sure can be done im­me­di­ately, but con­tact trac­ing can­not be started un­til trac­ers are trained and hired), and yet miti­ga­tions are best done when case num­bers are low (which is true early in the course of dis­ease spread, or af­ter a suc­cess­ful pe­riod of sup­pres­sion). This means that wealthier places can de­ploy ex­pen­sive and dis­rup­tive meth­ods early on to buy time to set up cheaper meth­ods later while keep­ing case num­bers low through­out the miti­ga­tion pro­cess; lower-in­come ar­eas, by con­trast, can­not af­ford to do so as eas­ily.

Fi­nally, miti­ga­tion strate­gies ex­ist in a policy and in­for­ma­tion en­vi­ron­ment that can ei­ther fa­cil­i­tate or hin­der de­sir­able out­comes. As one par­tic­u­larly high-pro­file ex­am­ple, the World Health Or­ga­ni­za­tion and United States Cen­ters for Disease Con­trol recom­mended that the gen­eral pub­lic avoid ob­tain­ing or wear­ing face masks in the ini­tial months of the pan­demic, only to even­tu­ally re­verse those recom­men­da­tions in the face of new ev­i­dence. The fact that these in­sti­tu­tions made what was ap­par­ently the wrong call early on ar­guably made it more difficult for pub­lic offi­cials to en­force mask-wear­ing now that it is broadly ac­cepted prac­tice.

What lev­ers can we pull to make in­di­rect im­pacts less bad?

  • Direct (e.g. cash trans­fers) or in­di­rect (e.g. pro­grams and ser­vices) sup­port to peo­ple whose lives have been dis­rupted or are likely to be dis­rupted in the near fu­ture.

  • Shift to miti­ga­tion strate­gies that are more effec­tive for their cost, re­duc­ing dol­lars spent and dis­rup­tion in­curred for the same out­come.

  • Act more quickly when de­ploy­ing miti­ga­tion strate­gies, as they are more effec­tive when the case num­bers are smaller.


III. Pri­ori­ti­za­tion: Which lev­ers are likely “most effec­tive” to pull on?

When pri­ori­tiz­ing in­ter­ven­tions, the usual fac­tors to con­sider from an effec­tive al­tru­ist per­spec­tive are scale, ne­glect­ed­ness, and tractabil­ity. We think that time-sen­si­tivity is an­other im­por­tant fac­tor in this case.

Scale

The above “nap­kin sketch” pic­ture of what’s go­ing on yields some quick-and-dirty in­tu­itions as to where the big “scale fac­tors” are.

For one, ex­po­nen­tial curves add or­ders of mag­ni­tude very quickly, so re­duc­ing the spread of the dis­ease (es­pe­cially in con­texts where it can be done cheaply) is likely to be cost-effec­tive. We em­pha­size that this is still the case even in com­mu­ni­ties that can­not avoid a high rate of in­fec­tion. If a pop­u­la­tion has not been able to con­trol the dis­ease and can­not af­ford sus­tained lock­downs, and there­fore may be on track to hit herd im­mu­nity be­fore a vac­cine is found, we origi­nally en­ter­tained the hy­poth­e­sis that it might not make a differ­ence to the ul­ti­mate out­comes to slow the spread. How­ever, we now un­der­stand that low­er­ing R0 saves lives in all cases, be­cause it both low­ers the herd im­mu­nity sat­u­ra­tion point and re­duces “over­shoot” in which ex­cess in­fec­tions oc­cur above the herd im­mu­nity level. Th­ese both cor­re­spond with vast num­bers of lives saved.

Some strate­gies are or­ders of mag­ni­tude more cost-effec­tive than oth­ers. We be­lieve these cheaper strate­gies may in­clude wear­ing masks in pub­lic, hand­wash­ing, con­tact trac­ing when case num­bers are low, dis­ease surveillance (i.e. find­ing un­de­tected cases), and per­sonal pro­tec­tive equip­ment (PPE) for health­care work­ers. (see Juneau et al. preprint). We’re ex­cited about in­ter­ven­tions that make cheap miti­ga­tion strate­gies more available, af­ford­able, and ac­cessible.

We also ex­pect or­ders of mag­ni­tude could be found in sub­stan­tially re­duc­ing the sever­ity of the dis­ease, through de­vel­op­ing, man­u­fac­tur­ing, and dis­tribut­ing highly-effec­tive treat­ments.

Ex­ist­ing think­ing about the role of lev­er­age in cost-effec­tive­ness can be ap­plied here too. Bor­row­ing from the frame­work from Open Philan­thropy Pro­ject’s blog post “GiveWell’s Top Char­i­ties Are In­creas­ingly Hard to Beat,” the fol­low­ing sources of lev­er­age are ways to add mul­ti­pli­ers to im­pact-per-dol­lar:

  • Con­cen­trat­ing benefits on the global poor, due to both dis­pro­por­tionate vuln­er­a­bil­ity and huge numbers

  • Knowl­edge and ad­vo­cacy to in­form and mo­ti­vate policy re­sponses that are more likely to achieve de­sired out­comes from a global per­spec­tive.

    • Note: sev­eral well-po­si­tioned con­tacts in our net­work have in­formed us that there is cur­rently a lot of “noise” in this space, with many groups leap­ing for­ward to provide guidance. Co­or­di­nat­ing, unify­ing, or stream­lin­ing this guidance there­fore seems likely to be more im­pact­ful to us than sim­ply cre­at­ing more anal­y­sis.

  • Scien­tific re­search & de­vel­op­ment in sup­port of any of the above facets of the prob­lem (in­clud­ing but not limited to treat­ments, vac­cines, and test­ing/​di­ag­nos­tics in sup­port of treat­ment and miti­ga­tion strate­gies), be­cause a dol­lar spent on re­search can un­lock or­ders of mag­ni­tude more benefit later.

We boil this down to five “scale fac­tors”: ⏰Act­ing quickly, 🌍Fo­cus­ing on the global poor, 😷Re­duc­ing the spread via cheaper strate­gies, 🔬Scien­tific re­search, and 📊In­form­ing & co­or­di­nat­ing policy.

Ne­glect­ed­ness, and other prop­er­ties of the ecosys­tem & or­ga­ni­za­tions.

We found that es­ti­mat­ing ne­glect­ed­ness was crit­i­cal to our un­der­stand­ing of op­por­tu­ni­ties, but more challeng­ing than we ex­pected be­cause the land­scape of other fun­ders’ at­ten­tion is both difficult to track and evolv­ing rapidly. For ex­am­ple, a sim­plis­tic view is that too much money is be­ing spent on “cop­ing with” the pan­demic, as com­pared to “solv­ing” it (see, e.g., the COVID-Zero mes­sag­ing, and this tweet from Paul Romer). This lens might give the im­pres­sion that vac­cines are cur­rently un­der-re­sourced; how­ever, vac­cines seem to have at­tracted a lot more at­ten­tion com­pared to other treat­ments and have re­ceived billions of dol­lars in in­vest­ment. The sim­plis­tic “cop­ing” vs. “solv­ing” lens also misses that many of the world’s poor­est peo­ple need sup­port to liter­ally sur­vive pan­demic-in­duced dis­rup­tion, not just “cope” with it.

In ad­di­tion to the usual ITN anal­y­sis, we came to re­al­ize that act­ing ap­pro­pri­ately quickly is un­usu­ally im­por­tant to an in­ter­ven­tion’s effec­tive­ness on COVID-19 miti­ga­tion. This con­sid­er­a­tion is not usu­ally called out ex­plic­itly in the ITN pri­ori­ti­za­tion frame­work. In ad­di­tion to the fact that ex­po­nen­tial curves add or­ders of mag­ni­tude very quickly (as dis­cussed above as a “scale fac­tor”), there’s the fact that fast-mov­ing ac­tors are rare; it’s much more typ­i­cal for de­ci­sion-mak­ers to re­spond slowly. This means that in­ter­ven­tions that need to be un­der­taken quickly seem more likely to end up ne­glected, due to a lack of ac­tors who can ori­ent and act fast enough to do them. Slow-mov­ing or­ga­ni­za­tions might be ap­pro­pri­ate to fund if the in­ter­ven­tion is not es­pe­cially time-sen­si­tive, but if there is a nar­row win­dow of op­por­tu­nity, and the op­por­tu­nity passes, money spent on the at­tempt could be to­tally wasted. Find­ing an ap­pro­pri­ate match be­tween the time-sen­si­tivity of in­ter­ven­tions and the prompt­ness of rele­vant ac­tors is es­pe­cially key. As a re­sult, some dona­tion op­por­tu­ni­ties that oth­er­wise look good might not be effec­tive due to a lack of ur­gency or readi­ness on the part of the spe­cific po­ten­tial re­cip­i­ents.


IV. Spe­cific giv­ing opportunities

We high­light first the top few over­all giv­ing op­por­tu­ni­ties we have found so far at this stage of our in­ves­ti­ga­tion, fol­lowed by other promis­ing can­di­dates by topic area. While we have had limited time to iden­tify and eval­u­ate or­ga­ni­za­tions, we have now reached a point in our re­search where we feel quite good about most of the op­por­tu­ni­ties listed be­low.

Op­por­tu­ni­ties we plan to give to

Open Source Med­i­cal Sup­plies: 😷Cheap miti­ga­tion, 🌍Global poor, ⏰Act­ing quickly.

  • What they do: Open Source Med­i­cal Sup­plies is a re­mark­able pro­ject that started as a Face­book group in mid-March. In its first eight weeks of op­er­a­tion, it had grown to over 74,000 mem­bers, pub­lished speci­fi­ca­tions for 20 med­i­cal sup­ply items, and cre­ated lo­cal re­sponse guides trans­lated into 40 lan­guages. Most im­por­tantly, OSMS has lev­er­aged its in­ter­na­tional maker com­mu­nity to pro­duce more than 8 mil­lion med­i­cal sup­ply items by lo­cal small-scale man­u­fac­tur­ers around the globe. Prod­ucts cre­ated from OSMS’s de­signs have fully sup­plied some lo­cal hos­pi­tal sys­tems, and Afghanistan’s na­tional COVID-19 re­sponse plan ex­plic­itly lev­er­ages OSMS’s guide and speci­fi­ca­tions.

  • Why we want to fund them: Since we know the virus spreads pri­mar­ily via droplets and much trans­mis­sion is asymp­tomatic or presymp­tomatic, face masks are a key part of the solu­tion to con­trol­ling the spread. OSMS is one of the few char­i­ties we’ve found fo­cused on rapidly scal­ing mask pro­duc­tion and dis­tri­bu­tion, alongside other PPE items and even spe­cial­ized ma­chines like ven­tila­tors. One of the co-founders of OSMS was also a co-founder of Maker Faire, giv­ing the group ac­cess to a huge global DIY com­mu­nity. The group has also formed a part­ner­ship with the Toy­ota Re­search In­sti­tute and Mak­er­sRe­spond.org, which is a kind of sister ini­ti­a­tive fo­cused on ral­ly­ing pro­fes­sional man­u­fac­tur­ers to sup­port the re­sponse. As im­pres­sive as OSMS’s work has been, its reach in poor coun­tries has lagged be­hind its suc­cesses in the US and Europe, and there is a time-sen­si­tive, cheap op­por­tu­nity to help bolster the ini­ti­a­tive’s ca­pac­ity to ex­tend its im­pact in other ar­eas of the world. OSMS is seek­ing to raise $300,000 im­me­di­ately for this and other pur­poses and an ad­di­tional $700,000 to sus­tain its efforts into next year.

  • Ac­tions: Our group has di­rected $20,250 to Open Source Med­i­cal Sup­plies to date. The or­ga­ni­za­tion is fis­cally spon­sored by RESOLVE, and donors wish­ing to sup­port OSMS can email info@open­sourcemed­i­cal­sup­plies.org for in­struc­tions.

Fast Grants. 🔬Scien­tific re­search, ⏰Act­ing quickly.

  • What they do: Fast Grants is a rapid-turnaround fund­ing mechanism for re­search on COVID-19, mostly but not ex­clu­sively biomed­i­cal in na­ture. Marginal dona­tions help more re­search pro­jects get funded. Pro­ject pro­pos­als are re­viewed by an ex­pert ad­vi­sory com­mit­tee and divvied up by ex­per­tise area, with de­ci­sions ren­dered within 48 hours. Aver­age pro­ject size in the first round of grants was $175,000.

  • Why we want to fund them: They fo­cus speci­fi­cally on fund­ing re­search that is cur­rently bot­tle­necked by fund­ing availa­bil­ity and whose out­puts could be di­rectly use­ful on a six-month timescale. Fundrais­ing for sci­en­tific re­search is a no­to­ri­ously slow and time-con­sum­ing pro­cess, ac­tively in­hibit­ing the pro­duc­tion of rele­vant knowl­edge in the cur­rent crisis. After award­ing more than $20 mil­lion in just a month of op­er­a­tion, Fast Grants is now so­lic­it­ing pre­vi­ous win­ners for recom­men­da­tions of new pro­jects to sup­port, and re­ports steady or even in­creas­ing qual­ity of fund­able op­por­tu­ni­ties via this route.

  • Ac­tions: Our group has given Fast Grants more than $193,000 to date. If you are in­ter­ested in donat­ing, please con­tact fund@fast­grants.org.

COVID-END: 📊In­form­ing & co­or­di­nat­ing policy, 🌍Global poor, ⏰Act­ing quickly.

  • What they do: En­hance col­lab­o­ra­tion and re­duce du­pli­ca­tion among par­ties con­duct­ing rapid re­views of re­search to in­form COVID-19 policy, so that, e.g. “Rather than have 33 groups con­duct rapid re­views on the same or similar ques­tions about face masks in a one-week pe­riod (as we re­cently found), COVID-END could en­able these groups to find what’s already there.” The pro­gram has also de­vel­oped a pro­to­type for on-de­mand rapid ev­i­dence re­views on any COVID-re­lated ques­tion. The 40+ part­ners in­volved in the col­lab­o­ra­tion are among the lead­ing in­sti­tu­tions in the field of re­search syn­the­sis method­ol­ogy, in­clud­ing Cochrane, the Camp­bell Col­lab­o­ra­tion, the Global Ev­i­dence Syn­the­sis Ini­ti­a­tive, and more.

  • Why we want to fund them: We’re es­pe­cially ex­cited about groups that are co­or­di­nat­ing, unify­ing, or stream­lin­ing policy guidance, rather than merely con­tribut­ing to the pro­lifer­a­tion of ad­vice in the space. That’s ex­actly what this group works on. The value propo­si­tion of COVID-END is a no-brainer and could lead not only to less wasted time and money, but more im­por­tantly to bet­ter-qual­ity in­ter­pre­ta­tion of ev­i­dence by poli­cy­mak­ers around the world; for ex­am­ple, they are work­ing di­rectly with the WHO on the tech­ni­cal guidelines and ad­vice be­ing pro­vided to the WHO’s mem­ber states. De­spite its promise, COVID-END is cur­rently op­er­at­ing on a shoestring bud­get us­ing re­pur­posed funds from other ini­ti­a­tives. We es­ti­mate that it could pro­duc­tively ab­sorb at least $200,000 in ad­di­tional sup­port.

  • Ac­tions: Our group has di­rected more than $168,000 to COVID-END, which is housed at McMaster Univer­sity in Canada. Cana­dian donors and those who do not need a tax re­ceipt can donate to the pro­ject on­line here. Non-Cana­dian donors who need a tax re­ceipt for their re­spec­tive coun­try can send a check to Friends of McMaster, Inc. at McMaster Univer­sity, 1280 Main Street West, OJN 432, Hamil­ton, ON, Canada L8S 4L8. Be sure to re­fer to the al­lo­ca­tion code COVID-END Fund (PJS266A) on the check.

Promis­ing, with some open ques­tions/​reservations

Global poor

Medecins Sans Fron­tieres. 😷Cheap miti­ga­tion, 🌍Global poor, ⏰Act­ing quickly.

  • What they do: Medecins Sans Fron­tieres (MSF) is un­der­tak­ing a wide range of in­ter­ven­tions in­clud­ing con­struc­tion or setup of COVID wards in hos­pi­tals and train­ing/​tech­ni­cal as­sis­tance to care­givers in many coun­tries around the world, in­clud­ing some poorly served by other aid groups.

  • Why we found this op­por­tu­nity promis­ing: The ge­o­graphic reach of MSF’s COVID re­sponse is im­pres­sive and it is one of the only or­ga­ni­za­tions ac­tively work­ing to in­crease treat­ment ca­pac­ity at hos­pi­tals in the Global South. MSF is GiveWell’s go-to recom­men­da­tion for dis­aster philan­thropy and is a well-re­garded or­ga­ni­za­tion in the in­ter­na­tional com­mu­nity.

  • Why we didn’t rate it higher: At the time we re­viewed them, MSF was not mak­ing a big push for COVID-spe­cific fund­ing and de­scribed its abil­ity to help in the cur­rent pan­demic as “limited.” We be­lieve the or­ga­ni­za­tion is do­ing highly valuable work with its ex­ist­ing re­sources, but it is un­clear to us how ad­di­tional funds would be spent.

GiveDirectly (In­ter­na­tional). 🌍Global poor, ⏰Act­ing quickly.

  • What they do: GiveDirectly fun­nels cash pay­ments to low-in­come in­for­mal sec­tor work­ers in ur­ban ar­eas of Kenya, Uganda, Malawi, and Libe­ria. The or­ga­ni­za­tion is ac­tively seek­ing ad­di­tional part­ner­ships in other coun­tries and ul­ti­mately aims to dis­tribute up to $100 mil­lion to aid re­cip­i­ents.

  • Why we found this op­por­tu­nity promis­ing: GiveDirectly has been a GiveWell top char­ity for a num­ber of years and is widely rec­og­nized as an out­stand­ing or­ga­ni­za­tion. In ad­di­tion, cash trans­fers are one of the most-stud­ied forms of aid out there and are par­tic­u­larly rele­vant dur­ing this crisis. GiveDirectly has shown an im­pres­sive abil­ity to scale up its US-based ac­tivi­ties in re­sponse to the pan­demic, and we hope to see similarly rapid progress on the in­ter­na­tional front. In con­trast to its more re­source-in­ten­sive tra­di­tional screen­ing pro­cess, GiveDirectly is part­ner­ing with tel­cos and NGOs to iden­tify vuln­er­a­ble pop­u­la­tions and ex­pects COVID re­sponse funds to reach re­cip­i­ents in one month rather than the usual six months.

  • Why we didn’t rate it higher: We have great re­spect for GiveDirectly as an or­ga­ni­za­tion, but its cur­rent in­ter­na­tional pro­gram mostly reaches coun­tries where COVID out­breaks have been rel­a­tively mild to date. The or­ga­ni­za­tion is in the pro­cess of sourc­ing ad­di­tional part­ners, but its abil­ity to scale up quickly may be limited by the fact that it has only ever op­er­ated in sev­eral Afri­can coun­tries and the United States.

GiveIn­dia. 🌍Global poor, ⏰Act­ing quickly.

  • What they do: Give about $60-100 to fam­i­lies of un­em­ployed daily wage earn­ers in both ur­ban and ru­ral ar­eas of In­dia, through part­ner­ships with lo­cal char­i­ties.

  • Why we found this op­por­tu­nity promis­ing: In­dia is the world’s sec­ond-most pop­u­lous coun­try and the coun­try’s lock­down is likely to make life much worse for the tens of mil­lions there who live in ex­treme poverty. We thus be­lieve that GiveIn­dia looks like a promis­ing GiveDirectly-like or­ga­ni­za­tion in an­other part of the de­vel­op­ing world.

  • Why we didn’t rate it higher: Un­like GiveDirectly, we aren’t very fa­mil­iar with GiveIn­dia and we weren’t quickly able to learn enough about the or­ga­ni­za­tion’s track record to feel con­fi­dent about recom­mend­ing dona­tions at this time. We also lack clar­ity on how much ad­di­tional fund­ing GiveIn­dia could pro­duc­tively ab­sorb once its cur­rent fundrais­ing tar­get, which is close to be­ing met, is hit.

Devel­op­ment Me­dia In­ter­na­tional. 😷Cheap miti­ga­tion, 🌍Global poor, ⏰Act­ing quickly.

  • What they do: DMI is set­ting up ra­dio-based cam­paigns to en­courage so­cial dis­tanc­ing, hand­wash­ing, and other pre­ven­ta­tive be­hav­iors in nine Afri­can coun­tries. They are up and run­ning in three so far and need fund­ing to ex­pand to the other six (Cote d’Ivoire, Ethiopia, Mada­gas­car, Malawi, Uganda, and Zam­bia). DMI es­ti­mates that the cam­paigns could in­crease phys­i­cal dis­tanc­ing by up to 10 per­centage points, mean­ingfully low­er­ing R0 and slow­ing the spread.

  • Why we found this op­por­tu­nity promis­ing: DMI is an or­ga­ni­za­tion we’re already fa­mil­iar with, named by GiveWell as a stand­out char­ity since 2014. This work is highly time-sen­si­tive, as it will be more effec­tive if done while case num­bers are smaller; the fact that they are already run­ning their cam­paigns in three coun­tries tells us they’re equipped to act fast enough to cap­i­tal­ize on this op­por­tu­nity. Although GiveWell re­cently made a grant to DMI for this work, the or­ga­ni­za­tion is still seek­ing ad­di­tional funds for this effort. Even if con­tri­bu­tions end up fung­ing against DMI’s other ac­tivi­ties, DMI’s non-COVID-re­lated work is also work we feel good sup­port­ing, so we are con­fi­dent that this will be on net a good use of money for the world.

  • Why we didn’t rate it higher: Although DMI spe­cial­izes in ev­i­dence-based pub­lic in­for­ma­tion cam­paigns, it is far from the only gov­ern­ment or non­profit en­tity en­gag­ing in such efforts in the cur­rent crisis, and it is un­clear to us whether the need to con­duct such cam­paigns re­mains as ur­gent as was the case early in the pan­demic. With that said, our group has col­lec­tively given DMI nearly $20,000 and we con­tinue to be­lieve it is a strong giv­ing op­por­tu­nity.

Africa CDC. 😷Cheap miti­ga­tion, 📊In­form­ing & co­or­di­nat­ing policy, 🌍Global poor, ⏰Act­ing quickly.

  • What they do: Africa CDC is part of the Afri­can Union, work­ing with gov­ern­ments across the con­ti­nent to co­or­di­nate policy re­sponses to the pan­demic, such as de­vel­op­ing test-and-trace solu­tions and man­ag­ing sup­ply chains and stock­piles. It is also pro­duc­ing knowl­edge re­sources and track­ing policy ac­tions at a reg­u­lar clip.

  • Why we found this op­por­tu­nity promis­ing: We’ve been im­pressed with the pace and clar­ity of Africa CDC’s lead­er­ship thus far. By con­ven­ing na­tional gov­ern­ments, the or­ga­ni­za­tion helped to fa­cil­i­tate a re­sponse in late Fe­bru­ary and for­mal­ized a con­ti­nent-wide strat­egy by late March. It has the trust of ma­jor global health fun­ders and mul­ti­lat­eral agen­cies. A strong track record of co­her­ent guidance to shape policy around slow­ing the spread in lower-in­come coun­tries is a pro­file we’re ex­cited about. There seems to be an out­stand­ing need for more fund­ing, al­though the situ­a­tion is un­clear. At the start of April Africa CDC is­sued a re­quest for $400 mil­lion jointly with the Afri­can Union (its par­ent or­ga­ni­za­tion); we have only been able to doc­u­ment about $65 mil­lion raised since then, with most of that com­ing from a pledg­ing event on May 5.

  • Why we didn’t rate it higher: De­spite mul­ti­ple at­tempts, we were un­able to reach any­one at Africa CDC to dis­cuss the or­ga­ni­za­tion’s cur­rent fund­ing needs and pri­ori­ties. We have got­ten the im­pres­sion that while the or­ga­ni­za­tion is do­ing some great work, it is difficult for in­di­vi­d­ual donors to work with them di­rectly. As a re­sult, we don’t have knowl­edge of mean­ingful fund­ing con­straints that could be bridged with smaller gifts at this time.

Vac­cines, di­ag­nos­tics, and treatments

COVID-19 Early Treat­ment Fund: 🔬Scien­tific re­search, ⏰Act­ing quickly.

  • What they do: Founded by ven­ture cap­i­tal­ist Steve Kirsch, the COVID-19 Early Treat­ment Fund fo­cuses re­search­ing the effects of early, out­pa­tient treat­ment with a short­list of promis­ing an­tiviral med­i­ca­tions. The ini­ti­a­tive hopes to save lives by a) low­er­ing mor­tal­ity rates and b) re­duc­ing hos­pi­tal­iza­tion bur­den. The fund tar­gets ne­glected clini­cal tri­als mostly run out of uni­ver­si­ties.

  • Why we found this op­por­tu­nity promis­ing: Ab­sent a vac­cine, effec­tive treat­ments are the only way to re­duce the death and suffer­ing caused by COVID with­out econ­omy-kil­ling shut­downs or difficult-to-pull-off test-and-trace solu­tions. Treat­ments us­ing ex­ist­ing drugs can be made available to the world much sooner than a vac­cine, but fund­ing efforts have dis­pro­por­tionately fo­cused on the lat­ter to date. The Early Treat­ment Fund ap­proaches this work with a unique and com­pel­ling the­ory of change, and its work was en­dorsed by promi­nent epi­demiol­o­gist Marc Lip­sitch in a re­cent pod­cast in­ter­view with 80,000 Hours. It is seek­ing to raise $20 mil­lion, with about 10% of that goal met as of May 20.

  • Why we didn’t rate it higher: As a new ini­ti­a­tive very strongly driven by a sin­gle per­son’s vi­sion (read the web­site if you don’t be­lieve us), we see this op­por­tu­nity as higher-risk than many oth­ers on this list. On the sur­face, there is no rea­son why other, bet­ter funded play­ers in this space, such as the Gates-Master­card-Wel­l­come Trust Ther­a­peu­tics Ac­cel­er­a­tor or the FDA’s CTAP pro­gram, shouldn’t be fund­ing the clini­cal tri­als tar­geted by this ini­ti­a­tive, and even if the Early Treat­ment Fund is on to some­thing here, its work could be­come du­plica­tive and un­nec­es­sary very soon. We also noted that the ini­ti­a­tive’s dona­tion page offers some un­usual quid-pro-quo lan­guage promis­ing “ex­clu­sive med­i­cal benefits that we can­not make available to ev­ery­one (due to the very limited sup­ply)” to en­tice donors at the $100,000 level and above, which some mem­bers of our team felt was highly in­ap­pro­pri­ate and in ten­sion with our de­sire to pro­tect the most vuln­er­a­ble mem­bers of so­ciety.

ACT Ac­cel­er­a­tor: 🔬Scien­tific re­search, 🌍Global poor, 📊In­form­ing & co­or­di­nat­ing policy, ⏰Act­ing quickly.

  • What they do: In early March, a group called the Global Pre­pared­ness Mon­i­tor­ing Board ar­tic­u­lated an ur­gent $8 billion fund­ing need to en­sure that vac­cines, ther­a­peu­tic treat­ments, and di­ag­nos­tics for COVID-19 are de­vel­oped rapidly enough, man­u­fac­tured at scale, and de­liv­ered in equitable fash­ion to peo­ple all over the world. Since then, gov­ern­ments and civic in­sti­tu­tions have en­gaged in ag­gres­sive fundrais­ing efforts to meet that tar­get, fi­nally hit­ting the goal on May 4. The pack­age of in­ter­ven­tions sup­ported by this effort, now grouped un­der the head­ing of the ACT Ac­cel­er­a­tor, is with­out ques­tion the world’s most am­bi­tious and im­por­tant COVID-re­lated philan­thropic effort by a very large mar­gin. Benefi­cia­ries in­clude the Coal­i­tion for Epi­demic Pre­pared­ness In­no­va­tions, a global part­ner­ship mak­ing pos­si­ble some of the most promis­ing vac­cine tri­als cur­rently un­der­way; the new Gates-Wel­l­come-Master­card Ther­a­peu­tics Ac­cel­er­a­tor, which aims to fa­cil­i­tate the de­liv­ery of a non-vac­cine COVID treat­ment to 100 mil­lion peo­ple by the end of 2020; Gavi, a key part­ner in the effort to en­sure that ev­ery­one in the world will have ac­cess to a vac­cine against COVID-19 when one is available; and the World Health Or­ga­ni­za­tion, which is helping the world’s poor­est coun­tries im­ple­ment a pan­demic pre­pared­ness plan that was de­vel­oped prior to the out­break.

  • Why we found this op­por­tu­nity promis­ing: Although the $8 billion fund­ing goal has been met, the prin­ci­pals in­volved have char­ac­ter­ized that figure as a mere “down pay­ment” on what will even­tu­ally be re­quired, which is es­ti­mated to be in the tens of billions. The US gov­ern­ment has dis­tanced it­self from the effort thus far, de­spite pro­vid­ing more than two-thirds of global gov­ern­ment fund­ing for ne­glected dis­eases as re­cently as 2018.

  • Why we didn’t rate it higher: Be­cause of the mas­sive amounts of money in­volved, it seems un­likely that the ACT Ac­cel­er­a­tor is a good dona­tion tar­get for non-billion­aires. How­ever, we sus­pect that ad­vo­cacy to urge the US gov­ern­ment to sup­port the ini­ti­a­tive may be very high-im­pact. We have found a few at­tempts to do so by non­prof­its such as the ONE Cam­paign, Global Ci­ti­zen, and Ox­fam, but don’t yet know enough about these efforts to be able to recom­mend them.

1 Day Sooner: 🔬Scien­tific re­search, ⏰Act­ing quickly.

  • What they do: 1 Day Sooner ad­vo­cates for hu­man challenge tri­als (HCTs) for COVID-19. The hope is that HCTs will speed up the vac­cine trial and ap­proval pro­cess by al­low­ing Phase 3 tri­als to be con­ducted over a much shorter pe­riod of time and with many fewer par­ti­ci­pants by de­liber­ately in­fect­ing par­ti­ci­pants with the virus rather than wait­ing to see if peo­ple get it or not. 1 Day Sooner is cur­rently seek­ing to raise up to $1.5M for its efforts over the next year, with the bulk of that money go­ing to­ward pro­duc­ing suffi­cient quan­tities of the virus to use as an in­fec­tant in an ac­tual challenge trial.

  • Why we found this op­por­tu­nity promis­ing: If ev­ery­thing goes ac­cord­ing to plan, hu­man challenge tri­als could shave off as much as a cou­ple of months from the vac­cine de­vel­op­ment and dis­tri­bu­tion timeline, which would al­most cer­tainly save thou­sands of lives. De­spite a fair amount of pub­lic dis­cus­sion, challenge tri­als have met with a lot of re­sis­tance from the med­i­cal es­tab­lish­ment thus far, and 1 Day Sooner is the only or­ga­ni­za­tion we know of work­ing to change that.

  • Why we didn’t rate it higher: Challenge tri­als are a very risky in­ter­ven­tion, as they in­volve in­ten­tion­ally in­fect­ing hu­mans with the virus which could ob­vi­ously re­sult in a lot of suffer­ing, up to and in­clud­ing death, for a very un­cer­tain re­ward. The or­ga­ni­za­tion’s work is premised on the as­sump­tion that Phase 3 tri­als are coun­ter­fac­tu­ally much more difficult to con­duct, and its promised im­pact will only be re­al­ized if the vac­cines be­ing tested ac­tu­ally prove to be effec­tive. In ad­di­tion, there is a risk that HCTs could play into anti-vac­ci­na­tion cam­paign­ers’ nar­ra­tives and de­crease trust in vac­cines over­all.

Policy ad­vice/​knowl­edge/​resources

IDin­sight: 🌍Global poor, 📊In­form­ing & co­or­di­nat­ing policy, ⏰Act­ing quickly.

  • What they do: IDin­sight’s de­mand-driven re­sponse to COVID-19 in­cludes policy briefs, re­mote data col­lec­tion in­clud­ing phone sur­veys of af­fected in­di­vi­d­u­als, and di­rect ad­vis­ing of gov­ern­ment en­tities. GiveWell re­cently gave IDin­sight a grant to bolster its data col­lec­tion and gov­ern­ment ad­vis­ing ca­pa­bil­ities speci­fi­cally, which it is mostly offer­ing pro-bono.

  • Why we found this op­por­tu­nity promis­ing: IDin­sight has an im­me­di­ate $2.6 mil­lion fund­ing gap for spe­cific pro-bono COVID-re­lated pro­jects in its pipeline, in­volv­ing a mix of data sup­port to lo­cal and na­tional gov­ern­ments, sur­veys, and eval­u­a­tion ser­vices. A con­fi­den­tial list of un­funded pro­jects was shared with FRAPPE, and sev­eral of these looked quite valuable to us. We have been im­pressed with IDin­sight’s thought­ful ap­proach to se­lect­ing and pri­ori­tiz­ing part­ner­ships on the ba­sis of po­ten­tial im­pact and ne­glect­ed­ness. Be­cause the ser­vices are pro­vided pro bono and the re­quests are com­ing from poor coun­tries where IDin­sight has ex­ist­ing re­la­tion­ships, it seems like a rea­son­ably good bet that the spe­cific pro­jects serve ne­glected needs and that in­for­ma­tion pro­vided will be acted upon.

  • Why we didn’t rate it higher: IDin­sight’s in­bound re­quests are com­ing from a het­ero­ge­neous mix of stake­hold­ers with small-to-medium-sized benefi­ciary sets. While this patch­work pat­tern of op­por­tu­nity is not sur­pris­ing given the or­ga­ni­za­tion’s rel­a­tive youth and mod­est size, it is in some ten­sion with the global, in­ter­con­nected na­ture of the COVID challenge, and we are un­sure how to judge the po­ten­tial scale fac­tors from this ap­proach to ser­vice pro­vi­sion.

Cen­ter for Global Devel­op­ment: 🌍Global poor, 📊In­form­ing & co­or­di­nat­ing policy.

  • What they do: Pro­duce high-qual­ity COVID-re­lated briefs and anal­y­sis, with a fo­cus on im­pli­ca­tions for the Global South.

  • Why we found this op­por­tu­nity promis­ing: CGD is well-re­garded as an or­ga­ni­za­tion by peo­ple we trust (such as Open Phil, which sent them ad­di­tional fund­ing for COVID-re­lated pro­jects re­cently). They’re pro­duc­ing highly rele­vant and use­ful con­tent at a rapid pace. Ev­i­dence that they’re hav­ing in­fluence on cur­rent policy de­ci­sions in­cludes the fact that ACT Ac­cel­er­a­tor’s strat­egy of us­ing ad­vance mar­ket com­mit­ments (AMCs) to se­cure vac­cine pro­duc­tion emerged from an ad­vo­cacy effort that CGD ini­ti­ated in 2005.

  • Why we didn’t rate it higher: While CGD ap­pears to be do­ing great work with ex­ist­ing re­sources, it’s un­clear what ad­di­tional dona­tions would make pos­si­ble. There is no COVID-re­lated ap­peal on CGD’s web­site.

Rapid Re­views COVID-19 (no link): 🔬Scien­tific re­search.

  • What they do: MIT Press and UC Berkeley’s School of Public Health are in the pro­cess of launch­ing Rapid Re­views COVID-19, an open ac­cess jour­nal for ac­cel­er­ated cu­ra­tion and peer re­view of COVID-19-re­lated re­search. The jour­nal pub­lishes un­so­lic­ited peer re­views of se­lected preprints of schol­arly ar­ti­cles posted on pub­lic web­sites like medRxiv, thus pro­vid­ing a layer of qual­ity as­surance for im­por­tant COVID re­search with­out in­terfer­ing with its pub­lic availa­bil­ity.

  • Why we found this op­por­tu­nity promis­ing: The pro­posal cites sev­eral ex­am­ples where poor-qual­ity preprints got picked up in the me­dia and mis­led the pub­lic, or even be­came weaponized by those with an agenda. If the jour­nal built a strong enough brand, it could there­fore act as a vec­tor against dis­in­for­ma­tion in ad­di­tion to helping raise visi­bil­ity for un­der­ap­pre­ci­ated re­search. As of May 21, the ini­ti­a­tive has raised enough fund­ing to pro­ceed but could pro­duc­tively ab­sorb at least an­other $150,000. Ad­di­tional fund­ing would go to­ward hiring ad­di­tional re­view­ers and in­creased mar­ket­ing ac­tivi­ties, both valuable uses of re­sources to de­liver on the po­ten­tial of the pro­ject in our view.

  • Why we didn’t rate it higher: The jour­nal will need to quickly gain a high pro­file both within the re­search com­mu­nity and in the me­dia in or­der to mean­ingfully shape dis­course about emerg­ing re­search. Achiev­ing that goal is by no means a sure bet, and we weren’t sure if the pro­ject plan that was shared with us prop­erly re­flects the level of effort re­quired to meet the challenge.

What about Johns Hop­kins CHS?

The Johns Hop­kins Cen­ter for Health Se­cu­rity has been the most fre­quently cited top dona­tion op­por­tu­nity for COVID-19 so far in EA com­mu­nity write­ups such as the Founders Pledge COVID-19 Re­sponse Fund and SoGive’s post on EA Fo­rum. Pan­demic pre­pared­ness is core to the cen­ter’s mis­sion and it has been quite ac­tive in the cur­rent crisis, hav­ing launched a widely fol­lowed coro­n­avirus case track­ing map/​database; it also pub­lishes nu­mer­ous white pa­pers ad­dress­ing ques­tions of in­ter­est to poli­cy­mak­ers and its ex­perts have been promi­nently fea­tured in the me­dia. There are a few rea­sons why we have not pri­ori­tized it in our own re­search. For one thing, the pro­file of the cen­ter has been raised con­sid­er­ably as a re­sult of the pan­demic and we are un­sure what ad­di­tional fund­ing would make pos­si­ble in the short term. In ad­di­tion, the cen­ter’s track record in pro­vid­ing high-qual­ity ad­vice does not ap­pear to be un­blem­ished; we noted that its ex­perts ex­plic­itly recom­mended against wear­ing DIY masks in early March (a po­si­tion re­versed by the end of the month) and were not dis­cour­ag­ing peo­ple from press­ing ahead with travel plans as late as March 6, ad­vice that may have led to costly de­ci­sions and missed op­por­tu­ni­ties dur­ing a pe­riod when in­fec­tions were rapidly in­creas­ing.

Also considered

Other or­ga­ni­za­tions we con­sid­ered in­cluded Part­ners in Health, PATH, CARE, the Food and Agri­cul­tural Or­ga­ni­za­tion of the United Na­tions (FAO), Epi­demicFore­cast­ing.org, Y-RISE, the Cen­ter for Disaster Philan­thropy, GiveDirectly (for its US-fo­cused Pro­ject 100 cam­paign), the Emer­gent Fund’s Peo­ple’s Bailout, Na­tional Do­mes­tic Work­ers Alli­ance, Meals on Wheels, Amer­ica’s Food Fund, United Way, Med­i­cal Credit Fund, ONE Cam­paign, Ox­fam, Pop­u­la­tion Ser­vices In­ter­na­tional, and Give2Asia. While we have elected not to pur­sue these op­tions at this time, we be­lieve they are all do­ing rele­vant work and in­tend to track their ac­tivi­ties pe­ri­od­i­cally as band­width per­mits. Com­plete anal­y­sis of all or­ga­ni­za­tions con­sid­ered is available here.

Cer­tain of these merit men­tion for donors with spe­cific prefer­ences or pri­ori­ties that may be differ­ent from ours. For ex­am­ple, the Cen­ter for Disaster Philan­thropy’s COVID-19 Re­sponse Fund is a good op­tion for donors who want to make a sin­gle dona­tion to cover a wide range of in­ter­ven­tions globally. For donors in­ter­ested in helping vuln­er­a­ble pop­u­la­tions in the US, the Feed­ing Amer­ica/​World Cen­tral Kitchen part­ner­ship looks at­trac­tive on the ba­sis of scale of im­pact and fast im­ple­men­ta­tion. For US-fo­cused donors with very strong so­cial jus­tice val­ues, the Emer­gent Fund’s Peo­ple’s Bailout could be an in­trigu­ing op­tion.

If an or­ga­ni­za­tion doesn’t ap­pear any­where in this blog post, it’s pos­si­ble we are not aware of it, or it’s pos­si­ble we were but de­cided not to in­ves­ti­gate it in depth.

Op­por­tu­ni­ties we wish we’d found more of

Based on our anal­y­sis of the big pic­ture, and the im­por­tant lev­ers we iden­ti­fied, we felt there were a num­ber of gaps in the land­scape that we wished we could sup­port, but we could not quickly find as many strong or­ga­ni­za­tions ded­i­cated to­wards those efforts as we would’ve hoped to see. (Such or­ga­ni­za­tions may ex­ist, in which case we’d love to hear about them.)

  • Ad­vo­cacy to drive global en­gage­ment by the US gov­ern­ment. The US has been con­spicu­ously ab­sent from many of the most con­se­quen­tial in­ter­na­tional efforts to co­or­di­nate dis­tri­bu­tion of vac­cines, treat­ments, and di­ag­nos­tics to the world’s pop­u­la­tion. Global ac­cess to these goods is in the US’s na­tional in­ter­est since an ac­tive pan­demic any­where is a threat to health ev­ery­where. How­ever, it was difficult to find or­ga­ni­za­tions ac­tively work­ing to or­ga­nize sup­port for these in­ter­ven­tions in Congress or other rele­vant chan­nels. All of the ac­tivity we saw was limited to on­line pe­ti­tion drives, al­though there may be other work tak­ing place be­hind the scenes.

  • Sup­port­ing fast/​early con­tact trac­ing for lower-in­come coun­tries. When case num­bers are small, con­tact trac­ing seems to be one of the most effec­tive and cost-effec­tive strate­gies in con­trol­ling an out­break (Juneau et al.); how­ever, it has diminish­ing re­turns with scale (see guidance from Africa CDC) and thus be­comes too ex­pen­sive for lower-in­come coun­tries when case num­bers get too high. Lower-in­come coun­tries that can­not af­ford ex­pen­sive lock­downs are par­tic­u­larly in need of cheaper in­ter­ven­tions, and con­tact trac­ing could fill that role only if it is done swiftly enough. We would like to find can­di­dates that are helping lower-in­come coun­tries de­ploy early con­tact trac­ing. The TCN coal­i­tion co­or­di­nates or­ga­ni­za­tions work­ing on mo­bile con­tact trac­ing, but we didn’t see a spe­cific fo­cus on poorer re­gions with­out Ap­ple/​An­droid phones. Part­ners in Health has launched a ma­jor con­tact trac­ing ini­ti­a­tive, but for now it is pri­mar­ily fo­cused on the United States.

  • Sup­port­ing health sys­tems and cash trans­fers in ne­glected re­gions, par­tic­u­larly Latin Amer­ica. This may par­tially re­flect our ex­ist­ing net­works and knowl­edge base, but have been able to find many more promis­ing op­tions fo­cused on benefi­cia­ries in Africa and In­dia than in other parts of the Global South. Most in­ter­ven­tions in South­east Asia ap­pear to be coun­try-spe­cific rather than re­gion-wide, and many large in­ter­na­tional re­lief NGOs ap­pear to have limited pres­ence in Cen­tral and South Amer­ica, an area of the world that is cur­rently ex­pe­rienc­ing a rapid in­crease in cases. We would be par­tic­u­larly in­ter­ested to find or­ga­ni­za­tions offer­ing cash trans­fers in these re­gions.

V. Ad­den­dum: Should you pri­ori­tize COVID re­sponse over other EA pri­ori­ties?

We’ve writ­ten this post pri­mar­ily for the benefit of donors who have already de­cided to fo­cus on COVID-19 for their own rea­sons. We have not made it a pri­or­ity to an­a­lyze the rel­a­tive value of COVID-re­lated dona­tions as com­pared to other is­sues or causes. This post should not be seen as tak­ing any po­si­tion for/​against pri­ori­tiz­ing COVID-19 over other is­sues or causes.

That said, we know this ques­tion is top of mind for many EAs, and we wanted to offer some brief thoughts on it here.

Eval­u­at­ing the rel­a­tive cost-effec­tive­ness of “COVID-themed” vs. “non-COVID-themed” dona­tions is more difficult than if these were wholly sep­a­rable top­ics/​ar­eas. In­stead, the effects of the pan­demic it­self are in­ter­twined with both donors’ ac­tions and the work of the or­ga­ni­za­tions they sup­port in sev­eral ways. (This in­ter­twine­ment seems less pro­nounced for cause ar­eas such as AI x-risk, and more pro­nounced for cause ar­eas such as global health and pan­demic pre­pared­ness).

Some of these en­twined in­ter­ac­tions point against pri­ori­tiz­ing COVID:

  • Donors and other fun­ders are fac­ing im­mense pres­sure to step up their giv­ing and di­rect at­ten­tion to­wards this pan­demic. As a re­sult, anti-malaria and other global health in­ter­ven­tions will likely be even more un­der­funded than usual as a re­sult, not only to­day but po­ten­tially for sev­eral years.

Some in­ter­ac­tions point in fa­vor of pri­ori­tiz­ing COVID:

  • The tremen­dous global dis­rup­tion set in mo­tion by the pan­demic could be harm­ful to other work that EAs con­sider im­por­tant (for ex­am­ple, sup­ply chain dis­rup­tions may dis­rupt ac­cess to malaria con­trol tools), such that work­ing to re­solve the root cause of the dis­rup­tion may be one of the most effec­tive ways to al­low the most im­por­tant work to get back on track.

  • An im­proved re­sponse to this crisis may trans­late into bet­ter pre­pared­ness for fu­ture pan­demics.

  • GiveWell donors mo­ti­vated by the promise of guaran­teed im­pact from in­tensely vet­ted, cost-effec­tive char­i­ties must ac­cept that the cur­rent en­vi­ron­ment marks a sig­nifi­cant de­par­ture from the con­di­tions un­der which those in­ter­ven­tions were shown to work well.

Th­ese fac­tors point to a com­pli­cated pic­ture that we have not un­der­taken to dis­en­tan­gle here. Over­all, while we do not sug­gest that EAs redi­rect their giv­ing away from effec­tive char­i­ties they already sup­port, es­pe­cially in the global health arena, we do feel there are strong rea­sons for EAs to con­sider ad­di­tional, COVID-spe­cific giv­ing. More­over, the situ­a­tion is so quickly evolv­ing that there is not yet an es­tab­lished con­sen­sus about what is most effec­tive to do, so we be­lieve it is im­por­tant that in­di­vi­d­ual EAs take up the man­tle of think­ing care­fully about what they think is best to do in the cur­rent un­usual times, rather than ex­clu­sively defer­ring to the opinion of trusted voices in the EA world.

(For an­other EA Fo­rum post which has a differ­ent take, see COVID-19 re­sponse as XRisk in­ter­ven­tion)

Pre­vi­ous up­date log

Oc­to­ber 7:

  • Re­moved Protege BR from recom­men­da­tions for non­re­spon­sive­ness.

June 22:

  • Added Protege BR as a top recom­men­da­tion.

  • Added 1 Day Sooner as a promis­ing op­por­tu­nity.

  • We are seek­ing ad­di­tional recom­men­da­tions for char­i­ties that op­er­ate in Latin Amer­ica and the Ara­bian Pen­in­sula, par­tic­u­larly in the ar­eas of di­rect aid (cash trans­fers) and strength­en­ing health sys­tems.

May 22:

  • Added COVID-END and Open Source Med­i­cal Sup­plies as top recom­men­da­tions.

  • Added Devel­op­ment Me­dia In­ter­na­tional (pre­vi­ously listed as Top), IDin­sight, Rapid Re­views COVID-19, and the COVID-19 Early Treat­ment Fund as promis­ing op­por­tu­ni­ties.

  • Wrote up re­views for above char­i­ties plus Med­i­cal Credit Fund, ONE Cam­paign, Ox­fam, Pop­u­la­tion Ser­vices In­ter­na­tional, and Give2Asia in our full database of op­por­tu­ni­ties.