International aid is a promising cause, but also a challenging one. Promising because it involves helping the world's lowest-income people. This means that even giving a little can make a huge difference in - even save - someone's life.2

Challenging because it involves a completely different part of the world. The distance makes it very hard for you as a donor to really tell what an organization's doing or hold it accountable.

How do charities help?

Because the need is so vast, charities run a wide variety of programs. Most programs focus on health (aiming to prevent or treat conditions like HIV/AIDS, malaria, or deaths during childbirth), poverty reduction (aiming to increase individuals' income and standard of living through programs like microfinance, agricultural training, or introducing new technologies), or education (aiming to provide expanded and improved educational opportunities for youth).3

We've primarily reviewed charities working on the above areas. Charities also do many other things that we haven't yet considered as carefully, such as rebuilding after disasters (e.g., the 2004 Asian Tsunami), empowering women through programs focused on increasing cultural sensitivity, and advocating to governments for increased funding or legal change.

If you're interested in an area we haven't covered yet, please contact us and let us know. We want to hear from you.

What are the challenges of finding a great international charity?

Though the need is vast, it's difficult to find a great charity that will use your donation well. That's because lots of approaches to helping people haven't historically actually helped that much.4 At the same time, the best approaches have had a huge impact.5

Many charity programs don't have a track record of success

Many large international charities run lots of different types of programs. For example, UNICEF (possibly the biggest and best-known international charity) runs some programs that have great track records of success (such as vaccination or salt iodization programs, but also programs without a track record (such as constructing wells or working to achieve gender equality).6

When you give to UNICEF, you're supporting the organization as a whole, both the projects with strong track records and those without. Even when a donation restriction is formally honored, the donation can often be effectively unrestricted (more at our discussion of fungibility).

Few charities focus on programs with strong track records.7 The charities that work on programs with strong track records (like distributing nets to prevent malaria8) often work on many other things too, and charities that only run one program often choose an approach that doesn't have much evidence behind it.

What difference does your donation make?

Even when you give to a charity running a strong program, your donation may not result in more people helped.

For example, some charities focus on providing surgeries to children suffering from birth defects (like a cleft lip or palate), elderly people who are blind because they can't afford a cataract operation, or young women with a condition called obstetric fistula.

As long as charities can show that they only use expert surgeons to perform these operations and that they carefully monitor surgical complications and success rates, it's likely that the surgeries are helping people. However, we have yet to find a charity where we can be confident that they use additional donations to help additional individuals. That's because there's a limited supply of expert surgeons in many countries and training new surgeons may be a difficult endeavor.9

The issue of limited trained capacity applies to any charity whose work depends on the availability of skilled labor, whether they're focused on surgery, malaria diagnosis, HIV treatment, or a wide variety of other programs.

Where should you give?

We think that health is the strongest area.10 It could be because health is easier to measure and document than other areas. It could be because Western medical knowledge translates better to another culture than Western knowledge of business/community mobilization/education. Whatever reason - health is something that donors can help with.

We urge donors not just to focus on the problems they care most about, but also to consider whether they - as donors - can make a difference in these problems. For health, we believe the answer is yes; for other sectors we believe it is often no.

Our two top-rated charities are:

• VillageReach: VillageReach aims to improve the logistics - particularly tracking and distribution of supplies - for health systems in rural areas in Africa. Its programs include both technical support staff and changes in logistical setups (such as moving from a system in which health clinics collect their own supplies to a centralized delivery system). Based on results from its pilot project, we believe its model has significant impact, well under $1000 per infant death averted. (For more, see our full review of VillageReach.)
• Stop Tuberculosis Partnership: The Stop Tuberculosis Partnership aims to increase access to life-saving tuberculosis treatment using the World Health Organization's recommended approach ("DOTS") all across the developing world, primarily by providing government health programs with TB drugs through its Global Drug Facility. We believe it is averting (adult) deaths from tuberculosis for under $1000 each. (For more, see our full review of Stop TB.)

For more charities, see our full list of recommended international charities.

1. 1.

   See http://www.givewell.net/recommended-charities#WhatdoyougetforyourdollarA...

2. 2.

   We estimate that the best international charities can save a life for as little as $200-$1000. In the U.S. it is much more expensive to make a difference. See our cost-efficiency comparison of our top international and U.S. causes.

3. 3.

   We've evaluated over 300 international charities. Summaries of what we've learned and links to more information are at our developing-world health overview, our developing-world poverty reduction overview, and our developing-world education overview.

4. 4.

   There are a number of examples of ways in which well-intentioned projects may fail to achieve desired results. Building wells has often failed to reduce water-related illness (detailed analysis here); agriculture programs in Africa have failed to increase crop yields; programs providing textbooks and other supplies have not raised students' test scores, and many other developing-world education programs have weak, if any, evidence of success.

5. 5.

   Most successful projects are in the area of health and include such large-scale successes as the eradication of smallpox and the dramatic reduction of infant mortality in Africa (see our developing-world health overview). For a full list of health programs that have been rigorously shown to save lives and reduce suffering, see our summary of proven health programs.

6. 6.

   The evidence for the positive impact of vaccination programs is at our full review of immunization coverage expansion programs. For more information on the success of salt iodization programs see the case study by the Center for Global Development at http://www.cgdev.org/section/initiatives/_active/millionssaved/studies/c....

   UNICEF describes these programs on its website:

   • Expanding immunization coverage: http://www.unicef.org/immunization/index_coverage.html

   • Salt iodization: http://www.unicef.org/nutrition/index_iodine.html
   • Well construction: http://www.unicef.org/wash/index_watersecurity.html
   • Gender equality promotion: http://www.unicef.org/gender/index_action.html

7. 7.

   We've evaluated over 300 international charities. Fewer than 30 either published impact reports of their own programs or focused on programs that had strong external evidence of effectiveness.

8. 8.

   See our detailed analysis of insecticide-treated net distribution programs for more information.

9. 9.

   For a more detailed discussion on the issue of limited capacity and questions to ask a surgery charity before making a donations see our developing-world surgery overview.

10. 10.

    For reasons why, see our developing-world health overview.