From Priorities to Impact: Our take on “Smart Aid for the World’s Poor”

In Smart Aid for the World’s Poor,  Matt Ridley, author of The Rational Optimist: How Prosperity Evolves and a member of the British House of Lords, outlines a list of priorities that offer the biggest benefits for every dollar spent. His suggestions are informed by the work of Bjorn Lomborg, whose Copenhagen Consensus recommends prioritizing aid based on an analysis of available evidence and assessment of the relative cost-benefit profiles of various options.  Such priority-setting is a necessary first step in achieving social impact. However, once those priorities are set, the next question is: How best can we achieve these goals? For donors focused on impact, here’s how:

Ridley’s Priority 1 – Reduce malnutrition. He cites that such action can yield $59 in benefits for every dollar spent.

Opportunities for donors to achieve Priority 1:

  • Care Groups – estimated cost of $450 per life saved
  • Ready to use Therapeutic Food

Globally, one in four children is malnourished. Malnutrition contributes to 35% of under-five child deaths annually. On average, only 35% of children under six months of age are exclusively breastfed, and few children receive appropriate complementary foods. In our Child Survival Guidance, we identified care groups as a proven, peer-based approach that utilizes mothers groups to improve child nutrition and health by supporting healthy behaviors. We estimate the model’s cost-per-impact of less than $450 per life saved.

Our Haiti Guide profiled Zanmi Agrikol, a Haitian program that seeks to address child malnutrition, food insecurity and unemployment. The program trains and employs local farmers and families to grow ingredients needed for Nourimanba, a fortified peanut-based food supplement (also called a “Ready to use Therapeutic Food” or RUTF) and Nourimil, a nutritious blend of cereal and legumes. Similar programs have been used effectively to combat child malnutrition in Africa and Asia.

Ridley’s Priority 2 – Tackle malaria and tuberculosis. He cites a 35 to 1 benefit-cost ratio.

Opportunities for donors to achieve Priority 2:

  • Community case management of malaria and long lasting insecticide treated bednet programs – estimated cost of less than $1000 per life saved
  • Bednets

Children sick with malaria often go undiagnosed and/or lack access to effective medications for malaria, such as Artemisinin Combination Therapy (ACT).  By supporting community case management programs that use well-trained and supervised community health workers to diagnose the disease and disseminate medication, donors can tackle malaria with an estimated cost-per-impact of less than $1000 per child life saved (see more in our guide Lifting the Burden of Malaria).  Such programs that break down geographic barriers and bring treatment close to the home have also proved effective in combatting tuberculosis.

Another way donors can help prevent malaria is by supporting programs that encourage the use of long-lasting insecticide treated bednets (see more in our guide Lifting the Burden of Malaria).  Such programs can yield a cost-per-impact of under $1000 per life saved.

In addition to these priorities, our recently released Invest in a Strong Start for Children explores the evidence base and strategies to boost pre-primary education (Ridley’s priority #3).  Our coverage of Melinda Gates’ TEDx talk on family planning and our Mother’s Day blog highlight ways to ensure access to sexual and reproductive healthcare (Ridley’s priority #4).

Ridley’s and Lomborg’s work urge those who care to move from good intentions to smart priorities. By identifying specific high impact philanthropic opportunities, we at the Center hope our work moves donors even closer towards the actual impact they seek.