Written by Erin Crossett and Keir Bradwell
Water is a relatively new area of grantmaking for GiveWell, but we’re excited about its potential. Two billion people around the world lack access to clean drinking water, and unclean water is a major cause of illness and death, primarily through waterborne diseases such as diarrhea and cholera.
Within the water portfolio, we think about which specific programs in which specific places are likely to address these health burdens most cost-effectively, and what additional evidence we need to gather in order to make that determination.
In this blog post, we detail our current approach to our water portfolio, explore the areas we’re excited to investigate next, and share the work we’re doing this year to deepen our understanding of the sector. Through this work, we aim to make more highly cost-effective grants that bring clean water to many more people around the world.
Where are we now?
So far, our grants have focused on improving water quality, rather than access. This is because we think there is a strong link between water quality and health outcomes, and that other donors in the sector are generally more focused on access. Because water quality is relatively neglected, we think there is plenty of room for us to make an impact.
Based on our review of a recent meta-analysis, we estimate that chlorination, a common approach to water treatment, reduces all-cause mortality in children under five by 12%. (The meta-analysis itself reports a much larger effect; our reasoning for using a smaller effect size in our grantmaking can be found here.) This estimate means that in certain locations, the water quality programs we currently support look highly cost-effective, even relative to other opportunities in other sectors that GiveWell could choose to fund.
Since we began our water portfolio, our support has focused on two main interventions: chlorine dispensers and in-line chlorination. We funded Evidence Action to install chlorine dispensers in Kenya, Malawi, and Uganda and in-line chlorinators in Malawi, and to work with state governments to provide in-line chlorination in India. We have also funded exploratory work on providing vouchers for a free supply of chlorine, which can be redeemed in shops and health clinics. When we made these grants, we estimated that these programs looked anywhere between 4 and 22