GiveWell’s response to the USAID funding cuts
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 ChemopreventionThis 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%.
These sorts of cuts highlight IMO the incorrect strategy EA has been on. Whereas the EA space deals with the millions of dollars, US government aid deals with the billions of dollars, orders of magnitude greater funding.
Yet EA’s refusal to engage in the political has created a huge blind-spot. As the United States unironically moves towards authoritarian dictatorship, of course the foreign aid is disappearing, and your cost effectiveness calculations are completely out of whack. How the hell are you going to fill the gap on billions with mere millions?
You wanted to settle for the ease of linear thinking. A particular set of interventions was easy to measure and had more linear responses, so that’s where your funding went. Politics is incredibly messy and the response is extremely nonlinear—you can pour money into politics and see no response, until perhaps one day you can have a huge response, or perhaps not. You didn’t want to deal with the nonlinearity.
So you forgot to think about protecting, or even enhancing, democracy. I suppose protecting democracy just wasn’t tractable enough. And we’re going to be suffering the consequences for thinking democracy just isn’t tractable, even though people had been sounding the alarm for years/decades.
All you can be is just reactive. You’ll react to the destruction of democracy. You’re about mitigation, not prevention or enhancement.
Maybe it is time to think about being pro-democracy. The consequences of forgetting about democracy will cause orders of magnitude more suffering than you have ever prevented.
I fully understand your anger, but it feels misdirected. If EA or GiveWell could have successfully protected democracy in the US or prevented Trump from getting elected we should have done that. However it’s very unclear that EA as a whole and especially GiveWell as an organization could have prevented this mess . Given the mess we are in what GiveWell is doing will still make it so many people survive who otherwise would have died. Every one of those people who might get to make friends, find love and meaning matter a ton. And that is not a solution to the problem, but it still good work.
So no millions cannot fill a gap of billions, but millions is still a lot better than nothing. If somehow those millions could be spent in a way that would have prevented the billions from disappearing, that would obviously have been more effective. But many millions have been spent on trying to prevent Trump 2.0 (including by EA’s) and it’s not clear what EA could have done.
It can not be simultaneously true that the awefulness of the current situation is a consequence of EA ‘forgetting about democracy’, and that protecting democracy is not tractable. If EA fully focussing on democracy as it’s singular cause area would have prevented the current situation protecting democracy would be tractable, that is what tractability means. The consequence you are drawing requires a lot more evidence than you are providing.
I’m sure many people at GiveWell are just as angry about the current situation as you are, they see the suffering every day. The argument that this is partly EAs fault requires a lot more evidence.
I’m not asking EA to focus singularly on democracy. I’m asking EA to give any resources at all to the cause of democracy. Prove my ignorance wrong. Is any organization in EA involved with democracy at this moment? Is any organization bothering to evaluate potential interventions? What work has been done? What papers have been written? Is there some work saying, “Look, we’ve done the work, yes it turns out democracy has a terrible ROI!” How about you guys? Are you making any consideration or analysis on potential pro-democracy interventions? If you have, I’d love to see the analysis. My search for it, I’ve seen nothing. I hear crickets.
Here’s the thing about evidence. You have to look for it. Is EA bothering to look for it? Is your organization bothering to look for it? Otherwise, you have no idea how tractable it is or is not.
There has been quite a bit written about democracy, I’m not sure if it fits your description but some of those posts might be related.
Effektiv Spenden also has a ‘Defending Democracy’ fund.
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:
the EA brand could be ill-suited or even detrimental to this kind of work, either due to FTX or its association with a tech billionaire who made a lot of money on a platform that many believe to be corrosive of democracy;
the EA “workforce” isn’t well suited to this kind of work;
there are plenty of actors working in these spaces already, and there was no great reason to think that EAs would be more effective than those actors;
being seen as too political would impose heavy costs on other EA cause areas, especially AI policy—and “anti-authoritarian” is not non-partisan in 21st century America.
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.
In my opinion, attempting to electioneer in 2024 by pumping money towards your preferred candidate, has little to do with democracy. It’s kind of the opposite. You’re engaging in oligarchy, trying to buy power with money, to attempt to save what democracy you have left. You’re not actually addressing the problems that led to the current crisis. As I said, mitigation and reaction.
>I think it’s generally okay to place the burden of showing that a cause area warrants further investigation on proponents,
And how can any cause area demonstrate this when you just won’t evaluate it anyways because of your limited evaluative capacity, because it’s not a priority cause area for your organization? Let’s imagine I have a proposal or a white paper. How and where can I submit it for evaluation? Take for example Open Philanthropy. Democracy’s not a cause area with any requests for proposals. Is there any organization accepting proposals?
The cause areas are driven from the top down, as far as I’m aware. Causes outside the org priorities are just not considered at all.
If you’re not proposing electioneering, what exactly is the program that you are suggesting could have prevented these USAID cuts? Because from where I’m sitting, I don’t really think there was anything EA could have done to prevent that, even if the whole weight of the movement were dedicated to that one thing.
This forum might not be a bad place to start?
>If you’re not proposing electioneering, what exactly is the program that you are suggesting could have prevented these USAID cuts?
“When should you have planted the seeds to grow a tree”? Just last year is a bit too late to grow a strong and capable democracy able to resist a tyranny.
A better year might have been 2016, when we were better understanding what the stakes were. That gives you 10 years. Or people have been complaining about the downfall of democracy since Occupy Wall Street. That’s 17 years (And people have obviously been complaining about democracy for far longer than that). But the next best thing might be now.
Throwing money at Biden/Harris 2025 is a method of last resort, particularly when it seems that money is highly ineffective in high-profile, money-saturated presidential campaigns.
Now let’s imagine that Trump actually does succeed in turning America into a dictatorship. Does that mean all hope is lost? No, there’s plenty of other countries where democracy can be strengthened.
>This forum might not be a bad place to start?
Plenty of ideas have been posted and ignored. I posted something for example on sortition which I’m a big fan of. Crickets. Neil Dullaghan made a great post about deliberative democracy here. What came of that?
Now maybe my idea is utter shit. OK sure, strikes and gutters. The silence is much more annoying.
Just so I understand you correctly, is your claim that if the EA movement had in 2016 spent resources advocating for sortition or electoral system changes, that we would not now be seeing cuts to USAID?
I’m asking because you started this thread with “These sorts of cuts highlight IMO the incorrect strategy EA has been on.” and finished with an article advocating sortition and an article advocating policies like approval voting (which EA already funds).
No, I’m requesting EA actually take the importance of improving democratic decision making seriously. Even if no action was able to stop these 2025 cuts, do you actually think “it’s over”? What about 2026? What about 2028? What about 2050? America is going to continue to make just stupid decisions until enough people get together and change the dumb way the system makes its decisions.
Moreover the second article isn’t about approval voting, I’m not sure how the only thing you got out of deliberation was approval voting.
If people in America were serious enough about improving democratic decision making, is it conceivable a reform could have stopped Trump? Imagine a new and improved Democratic Party was able to clearly demonstrate its ability to govern. Imagine a California government that was actually sufficiently competent to build high speed rail and more and more residential to attract more people into its borders. Instead Californians are fleeing because of rising costs.
Imagine an improved Democratic Party primary system that could elect a younger candidate that wouldn’t have grown senile by 2024.
Are these things *possible* within a small time frame? They certainly are. Trump himself demonstrates how quickly norms can be changed.
What’s wrong with US democracy isn’t just Trump, it’s an incompetent opposition party that people hate so much they’d rather trust something like Trump.
Finally yes, you mentioned approval voting. Would that ever be enough? Why are you putting all your eggs in just this one basket? IMO it’s a clear sign of EA’s myopia and lack of engagement with election theory, to ignore what is out there such as Single Transferable Vote, condorcet methods, and STAR voting. Even in this small niche of election reform in my opinion EA is far behind the theory.
For what it’s worth, https://forum.effectivealtruism.org/users/aaronhamlin has been engaging with the EA community on the topic of electoral reform.
The best rebuttal to this is that EA regularly tackles “longtermism” causes regularly, on the basis that they can use small bits of influence and money to help address major causes with disproportionate impact. AI is the biggest one the community is interested in.
And this is purely irrational.
The entire fabric of society is set to unravel by, say, next week. There’s a near zero percent chance of anything good happening on any of EAs fronts, including AI. If the government either collapses or becomes unaligned there’s absolutely no reason to think regulations or guidelines on AI will be followed or effective. There are few heuristics we can agree on with AI, but it should be absolutely obvious that an unaligned government creates an unaligned AI, and that government resources are orders of magnitude higher than anyone else.
Hence every cent of money or effort spent by EA on any non political long term cause is meaningless. Even if the money spent couldn’t have mattered if it was political it’s still an example of invalid and irrational spending; worrying about earthquakes while your house is on fire type logic. Nothing was more threatening than the collapse of democracy, including AI, not because AI is theoretically less destructive but because the risk was orders of magnitude more immediate.
Yes, the risk was known. No, pleading ignorance doesn’t absolve anyone.
This could and was predicted a decade ago. Decades if you view EA as an offshoot of the rationalist community and lump their efforts; as early as the “politics is the mind killer” post on less wrong people have been criticizing the de facto political neutrality of the movement, and they were right. I won’t say it’s the original sin, that’s absolutely the obsession with the highly degenerative silicon valley tech sphere at the expense of humanities and social sciences (that could have addressed this too) in recruiting, outreach, and messaging, but it’s up there.
Basically, EA choose political neutrality and what it got was eaten by politics. Now it’s irrelevant. Nothing that’s been done or will be done matters.
You’ve lost.
EA is a zombie.
It’s dead.
I think it is basically erroneous to say that EA has “refused to engage in the political”.
Farm animal welfare programs are inherently political
Much of the EA safety advocacy is inherently political
Open Philanthropy specifically has had a program area since 2022 to influence global aid policy, which is obviously and directly political.
Thank you for writing this John!
I’m not sure this post (from Givewell, who are great and are doing the best they can in a bad situation) is the right place.
I also agree with other commenters that many EA’s do engage with political topics, with policy makers and some of the most impactful examples of EA work have been where we have succeed in changing laws (for example, about lead pollution).
I also accept that many EA’s (for example, myself) tend to engage in politics separately from EA activities, and maybe see the two as complementary activities.
So it’s not about engaging in politics—EA’s do that—but about engaging in large-scale politics, and especially at critical moments like now.
But I find a massive disconnect when a group claims to be looking to do the most effective things possible, and when obviously by far the most effective thing to do right now is to engage in preventing President Trump from destroying the world, and yet any suggestion that EA’s get involved in that gets shot down. I made a post on this theme that has MINUS 29 Karma. My point was just that we need to put energy into stopping President Trump from destroying the world. Nobody explained what they had against it, they just voted it down.
I think there is an important distinction here. I don’t think this is about EA’s becoming associated with one political party (in the US or elsewhere). That would just put people off.
But the follow-up question would be how to get involved.
Because right now, absurdly, EA does not have a high reputation with the general public. Recently, in an article on AI Safety, about the AI-2027 paper that you may have heard about, the NY Times had the following quote: “Mr. Kokotajlo and Mr. Lifland both have ties to Effective Altruism, another philosophical movement popular among tech workers that has been making dire warnings about A.I. for years.” The clear implication was that that somehow gives their opinions less credibility, as if EA were some sort of cult—rather than a group of people who think clearly and rationally.
In a better society, EA’s would be an important influence group, just like doctors, scientists, economists or whatever. People would say “this action is strongly opposed by EA’s” as a strong argument against something. Right now, we are not there. If the EA community were to come out officially as calling President Trump a threat to democracy, this would probably be seized upon by the right-wing media as proof that he was doing a great job and annoying all the right people.
[My second most downvoted post was one where I dared to suggest that EA’s should do more to stand up for ourselves when we are ridiculed in the press … unfortunately we live in a world where, much as we may not like it, image matters, and if we let others treat us like a small, weird minority, then when important moments like AGI or Trump come along, we don’t have as much influence as we should have with the general public.]
So, basically, I love your post, I think I fully feel how you feel—but I’m also not sure what exactly we should do. Maybe EA’s engaging as individuals to stop Trump, encouraging all their friends to do the same is the best we can hope for.
I’m curious to know if you have tangible suggestions of what the EA community can and should do.
My interest is in improving democracy. I believe things like Trump, or Netanyahou, or Erdogan, or most democratic backsliding is a sign of democratic incompetence.
I think most people have little to no long-term vision for the question, “What would an advanced government of the future actually look like?” How much better could the world become if governments were smarter and more capable and just produced vastly more utility for people?
There is one thing I think is a strong contender for a superior future government. It’s called sortition. The premise is simple. In elections everybody participates. In sortition, a random sample of the public is chosen to participate. The benefit of sortition is scalability. Randomly chosen people, compensated or forced to participate, can engage in politics at enormous timescales compared to the average voter. More time to ask questions. Resources to become informed. The ability to seek and hire expertise. I elaborate about alleged benefits here.
Of course there’s a lot to do. First we need to prove the hypothesis. We have reasons why we think this is good, next we need to actually go out and test it. That takes a lot of money and research. This research will add evidence in its feasibility and capability. After that, if testing determines this thing to actually be good, more money is needed to campaign in favor of it.
Trump assuredly will not be the last authoritarian to arise out of liberal elections. If you value people’s freedom, if you wish to maximize utility, we should be looking for better things out there.
As far as why things like sortition would stop Trump, competent governments that are able to make their citizens feel content and satisfied with government performance, do not tend to appeal to tyrants for aid. Moreover if sortition is actually an effective way to organize people, it also might be an effective way to organize the Democratic Party.
Another powerful feature of sortition is its potential ability to create Democratic Legitimacy without going through the bureaucracy of government. For example, a Citizens’ Assembly can be potentially created through private funding, or through a referendum. A Citizens’ Assembly could be used as a presidential candidate selection system, and could delegitimize Trump or any other un-endorsed candidate.
Even if this is a “long-termist” project, the resources needed to say, test sortition, or launch a Citizens’ Assembly, are only in the millions of dollars. The economic benefits could be immense. Imagine a government that’s only 5% more efficient at increasing utility… that’s hundreds of billions of dollars of value per year. If the will was there, testing could happen immediately and we’d have results out before the end of Trump’s term.
Of course this won’t happen, not because it’s infeasible, but because there’s not yet funding, because sortition is mostly unheard of, because the idea hasn’t reached the ears of funders. Or if it has, the funders have just written it off for unknown reasons. Tractability is a typical excuse I hear, yet I’m not sure how sortition is any less tractable than any other long-termist project out there.