Tag Archives: Water quality interventions

Answering some questions about water quality programs

On June 22, we held a virtual event on research into water quality interventions, featuring presentations from Michael Kremer of the University of Chicago’s Development Innovation Lab; Brett Sedgewick from Evidence Action, the parent organization of Dispensers for Safe Water; and Stephan Guyenet, Elie Hassenfeld, and Catherine Hollander of GiveWell. (If you weren’t able to attend, we’ve published a video recording, audio recording, and transcript here.)
We hosted the event to provide some additional background for our recommendation of up to $64.7 million to Dispensers for Safe Water, which installs chlorine dispensers to treat water at rural collection sites in Kenya, Malawi, and Uganda. This grant was the result of a lengthy investigation and a significant update in our views on the cost-effectiveness of water treatment, which we’ve written about here.
Several attendees wrote in with a range of thoughtful questions—about our analysis of the effects of chlorination interventions, about the particulars of Dispensers for Safe Water’s program, or more generally about our work. We covered as many as we could during the event and followed up on others by email. Below, we’re sharing a selection of the questions we responded to in writing, along with other questions we’ve gotten about this work outside of the event, in the hope that they’ll be of interest to a broader audience. Questions and answers have been anonymized; some have been edited slightly for brevity, or to fill in important context that was missing.
We always appreciate getting your questions—beyond giving us a chance to clarify our work, it provides valuable insight into what we’re not communicating as well as we could. Feel free to email us with your own questions, about water quality or anything else, at info@givewell.org. You can also comment directly on this blog post or on our most recent open thread. We aim to respond to all questions, though it may take us a few days to get back to you.
Table of contents
On Dispensers for Safe Water and our grant recommendation

Q: What kind of monitoring does Dispensers for Safe Water do to make sure its chlorine dispensers are in working order?
Q: How much would it cost to get safe water to all of the approximately two billion people who need it worldwide?

On our meta-analysis of water treatment’s effects

Q: What are the benefits

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A major update in our assessment of water quality interventions

As we continue to grow, GiveWell seeks to maximize both the cost-effectiveness of the funding we direct and the likely room for more funding of the programs we support. We think we’ve identified a category of interventions that rates really well on both: water treatment, such as chlorination.
This is a major update for us. Before 2020, based on the available evidence, we didn’t believe that water quality interventions had a large enough effect on mortality to make them a competitive target for funding. We’ve since seen new evidence that has led us to significantly increase our estimate of the mortality reduction in young children that’s attributable to these interventions: a 14% reduction in mortality from any cause,[1] up from around 3%.
Though we have remaining uncertainties about these numbers, we’ve substantially updated our view of the promisingness of water treatment. Where we previously found that Evidence Action’s Dispensers for Safe Water program was about as cost-effective as unconditional cash transfers, we now believe it’s about four to eight times as cost-effective, depending on the location. That was a primary factor in our decision to recommend a grant of up to $64.7 million to Dispensers for Safe Water in January 2022.
We’re sharing this news in brief form before we’ve published a grant page, because we’re excited about the potential of this grant and what it represents. It’s an area of work we haven’t supported to a significant degree in the past, but one that we now think could absorb hundreds of millions of dollars in funding for cost-effective programming.
The problem and the intervention
In low-income settings, contaminated water is a major cause of diarrhea, a leading cause of death in children under five years old.[2] Several interventions exist to either purify water or protect it from contamination in the first place, but chlorination has a number of features that made it an attractive intervention for us to explore: it is inexpensive and widely used, several charities are already set up to implement it, and the technology behind it is well established.[3]
Chlorine is well-known as a disinfectant; it reacts with disease-causing microorganisms in water, inactivating viruses and bacteria.[4] There is evidence that chlorination programs, such as distributing chlorine to households, reduce diarrhea in children, but there had been scant evidence that such

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