We recommended a $38.8 million grant to Evidence Action to support the Indian government in providing clean water by setting up in-line chlorination in two states, Andhra Pradesh and Madhya Pradesh.
This isn’t a grant designed to directly deliver a service or commodity; instead, Evidence Action will use the funding to work in close partnership with state and local governments, providing technical assistance to support the delivery of the program. Providing all rural households with access to clean, piped water is a major priority for the Indian government. In-line chlorination, which uses a device to automatically disinfect water by adding chlorine as the water passes through a pipe, is a way to make drinking water safe.
We believe this grant may not only increase access to chlorinated water in the states it directly supports, but also inspire other states to adopt similar practices. A core part of the program’s theory of change is that governments in locations outside the grant area may take up a program they might not otherwise adopt. This is the first very large grant we’ve made where that’s been an important consideration. We think the upside is unusually high—if successful, this grant could eventually lead to tens or even hundreds of millions of additional people receiving safe water—but it’s also riskier than most of our grants, as there are a number of ways the program could fail to have the desired impact. Our hope is that this grant will reduce mortality and improve health at a very large scale.
The rest of this post describes the importance of clean water, the benefits of partnering with government, why we think this opportunity has such a large potential upside, our estimate of the program’s cost-effectiveness, and some of our uncertainties. You can read the full rationale for the grant here.
Why is clean water important?
Consuming contaminated water can lead to intestinal infections that are sometimes fatal. The evidence we’ve reviewed suggests that improving water quality also reduces mortality from causes not directly linked to water quality, such as respiratory infections (more here).
We estimate that this program will reduce overall mortality by about 4% among people reached with in-line chlorination. Given that we anticipate the program may reach tens of millions of people over the course of around a decade, the impact

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