On December 4, 2025, we held a panel discussion titled “Growing Needs, Shrinking Aid: Cost-Effective Action in a Year of Funding Cuts.” The discussion, which was moderated by GiveWell co-founder and CEO Elie Hassenfeld, addressed the effects of recent cuts, how GiveWell is responding, and what we’re learning along the way—including our predictions and uncertainties about the future. GiveWell researchers Alex Bowles, Dilhan Perera, Meika Ball, and Rosie Bettle answered questions and shared their latest insights. Watch the video or read the transcript.
Because of limited time, we were unable to answer all of the questions live. Below we’ve answered some of the questions that weren’t addressed during the webinar, along with some additional questions submitted by audience members, focusing on four themes:
The challenges of an uncertain future
Taking action in the face of uncertainty
The role of cost-effectiveness
Future GiveWell grantmaking
The challenges of an uncertain future
What is the biggest impact of the cuts you have seen in your research area?
Meika Ball: My work has focused on health systems strengthening, which are interventions that strengthen the foundational systems and processes needed to deliver health services, such as supply chain management, data systems, and health financing. Health systems strengthening is a new area for GiveWell. We prioritized it this year largely because a lot of this work had lost funding after previously being supported by the US government and other donors.
We have consistently heard about large cuts to this work, though the full magnitude has been challenging to understand. Especially during the stop-work order, we heard about countries losing access to their own data systems, health supplies being stuck at various points in the supply chain, and staff being laid off. This loss of staff capacity was especially evident during our team’s recent trip to Zambia. Officials in one province told us they had lost funding for around half of their staff. Community-based outreach work, where health worker stipends had been cut, was also impacted.
Because various components and processes within health systems underlie many other health programs, the cuts to health systems have been particularly challenging. I think strengthening health systems, including support for health workers, is likely to be a substantial need in the future as governments face more limited budgets.
Could you share more about the data challenges arising from funding cuts and provide an example of how it is impacting your work?
Dilhan Perera: Understanding the impact of changes to US government funding for HIV services has been very challenging. Many programs halted by the stop-work order were eventually terminated, but others