Co-Funding with the Gates Foundation

One of our initial strategies for finding outstanding giving opportunities has been offering to co-fund promising and underfunded projects with major foundations and government aid agencies.

Today, I’m excited to report that we’ve selected our first project to co-fund: an effort in Myanmar to contain and eliminate growing drug resistance to the highly effective antimalarial medication artemisinin. We’re contributing $1 million to this project, which is being carried out by Population Services International (PSI) and was recommended to us by the Bill & Melinda Gates Foundation.

This post describes our rationale for co-funding and the process by which we selected the above-mentioned project. We’ll describe the details of the project in an upcoming post, so stay tuned for more information.

Why co-fund?

Our rationale for offering to co-fund projects with major foundations and aid agencies is twofold:

  1. Due to their scale, access and experience, these organizations are well-positioned to find outstanding giving opportunities. By offering to co-fund projects with them, we hope to leverage their search processes and find giving opportunities we might not have found otherwise.
  2. We also see the process of co-funding with these organizations as the best way to learn about how major funders identify, vet, monitor and evaluate projects.

Early on, GiveWell expressed enthusiasm for this idea and offered to assist Good Ventures in its co-funding efforts. Today, GiveWell is providing Good Ventures with significant support on this front, offering advice on which foundations and aid agencies to approach about the possibility of co-funding, helping us to investigate more co-funding opportunities at a greater depth than we could have otherwise, and offering recommendations on which projects to fund.

Broadly speaking, we are seeking out potential co-funding partners in two ways:

  1. Opportunistically, by speaking with foundations we’ve met through our network. This includes foundations a) in the San Francisco Bay Area, b) whose philosophies appear to overlap with ours and/or c) whose benefactors we’ve met at Giving Pledge events or hail from the technology industry.
  2. Systematically, by speaking with the foundations that are largest, most focused on unusual causes and/or most focused on causes we find particularly promising. (Our main reference point for this has been the spreadsheet titled “Program Areas for Top 100 U.S. Foundations (XLS)” linked from this GiveWell blog post.

Discussions with the Gates Foundation

Among the first foundations we approached about co-funding was the Gates Foundation. The Gates Foundation is the largest and one of the best-known foundations in the world, and it’s one of the few foundations we know of that spends a large proportion of its budget on global health, which we consider a particularly promising issue area (for reasons described well in this GiveWell blog post).

After an initial meeting with leaders from the Gates Foundation’s global health program in September 2011, we asked to learn more about three specific areas in which the Gates Foundation works: malaria, tuberculosis (TB) and nutrition. We chose these areas based on GiveWell’s list of particularly proven and cost-effective interventions. (We also sought information on immunization from the Gates Foundation; however, we did not discuss specific co-funding opportunities in this area. We felt we had ample opportunities to explore neglected tropical diseases separately.)

In December 2011, we met with members of the Gates Foundation’s Malaria, Tuberculosis and Family Health teams to learn more about their strategies and discuss opportunities for co-funding. (Family Health includes nutrition, family planning and maternal, newborn and child health.)

We expressed an interest in projects that offered a good opportunity for learning as well as where additional incremental funding would have a meaningful impact. Subsequently, the these teams offered us a total of 10 projects — summarized below — to consider co-funding:

  1. [Nutrition] A project to design and investigate the viability of incentive prizes for improving breastfeeding practices (primarily) and developing new approaches to reducing infant undernutrition (secondarily) in order to boost innovation in these areas. Estimated project cost: $250,000
  2. [Nutrition] A project to develop a marketing plan for the commercial sale of "multiple micronutrient powders," which can be added to children’s meals to improve their vitamin and mineral status. Estimated project cost: $700,000
  3. [Nutrition] A project to work with faith-based communities to boost advocacy for increasing U.S. government funding and improving U.S. policies in support of global maternal and child nutrition. The project will include analysis and framing of issues, media work, non-legislative advocacy, coalition building and education. Estimated project cost: $1.2 million
  4. [Maternal, Newborn and Child Health] An opportunity to support an on-going initiative to reduce newborn deaths by researching cost-effective approaches to saving infant lives in low-income settings and advocating for the use of this research in decision-making. The co-funding opportunity would be to finance a specific study or policy-engagement activity. Estimated cost of the co-funding opportunity: unspecified (The next phase of the overall initiative is estimated to cost $40 million)
  5. [Maternal, Newborn and Child Health] Possible future opportunity: A project to investigate the role of social networks in determining health practices and outcomes, towards the goal of utilizing social networks to disseminate and increase adoption of community-based interventions. The project will focus specifically on neonatal mortality reduction in the Indian subcontinent. Estimated project cost: unspecified
  6. [Family Planning] A project to deliver injectable contraceptives through non-clinical networks, in partnership with other organizations. This project aims to increase access to injectable contraceptives in regions where medical clinics are scarce and demonstrate how such contraceptives can save lives and improve maternal health. Estimated project cost: $7 million
  7. [Family Planning] A project to spur replication of an ongoing initiative to improve reproductive health in developing-world cities. The project aims to replicate the initiative in eight additional cities by creating and disseminating a "tool kit" — including best practices and lessons learned from the pilot cities — and encouraging host-country governments and donors to participate and contribute funds. Estimated project cost: $20 million
  8. [TB] An opportunity to co-fund a key grant in support of advocacy for both donor countries and endemic countries to continue funding TB control efforts, the Global Fund and other activities. Estimated project cost: $6 - 12 million over three years
  9. [TB] An opportunity related to an existing effort to help policymakers and donors prioritize among approaches to TB control by encouraging coordination and consensus among TB-focused quantitative researchers and mathematical modelers. The co-funding opportunity would be to provide small grants to researchers to pursue ideas that emerge from the effort. Estimated cost of the co-funding opportunity: $400,000 - 450,000
  10. [Malaria] A project to prevent and slow the emergence of drug-resistant malarial parasites in Myanmar by replacing artemisinin monotherapies (AMTs) with artemisinin combination therapies (ACTs) as the main mode of treatment available for individuals to buy through the private sector. The project also aims to promote the proper diagnosis and treatment of malaria. Estimated project cost: $35 million, with approximately $27.5 million total already committed by the Gates Foundation and the UK Department for International Development

How we selected

For our first foray into co-funding, we hoped to find a project with strong potential for both positive impact on people’s lives (i.e. with high potential upside or high “cost-effectiveness”) and learning. In our view, a good learning opportunity is one that we can expect to generate meaningful data in a reasonable time frame that will help us understand whether the project lives up to expectations or not.

Project #10 was appealing by both of these criteria. In particular, it seemed to be the project most likely to generate data that would reflect directly on its impact. (We would have sacrificed the “learning opportunity” presented by #10 if we thought another project looked clearly superior in terms of its likely impact, but we did not.)

In addition, the Gates Foundation’s Malaria team — which made a positive impression on us during our December meeting — expressed a clear, unambiguous preference for a single project, which we found to be a positive signal concerning this opportunity. The Malaria team stressed the project’s unmet funding need and indicated that the project might have to be scaled back due to the shortfall. We saw this as a signal that our funding likely would not displace funding from other sources but rather would allow the project to accomplish more than it otherwise would.

Note: We are continuing to explore additional opportunities to co-fund with the Gates Foundation, including looking more closely at some of the projects listed above.

We are deeply grateful to the Gates Foundation for its help and encouragement over the last year. We are learning far more quickly about the field of global health than we would have without its guidance. As Good Ventures grows, we hope to pass this generosity forward by sharing what we’re learning with other donors seeking to make the biggest possible impact with their giving.

- Holden Karnofsky and Eliza Scheffler of GiveWell contributed to this post.