Early in the new year I am finally finding the time to get some reading done. So forgive the latecomer to the party… one short piece at the top of the heap is this posting from the New York Times by Tina Rosenberg, “Putting Charities to the Test.” Reading the posting, I am struck once again by the problem of mission creep. Is it a good or a bad thing when our well-founded eagerness to do what is effective means we do only what is easily quantifiable?
Rosenberg talks about donors’ new focus on impact and effectiveness in their charitable giving. She profiles a Brooklyn-based organization called GiveWell, which rates and ranks the effectiveness of various international charitable organizations. GiveWell uses a combination of academic research as well as monitoring and evaluation data to assess the impact of the organizations they research. This assessment is designed to help individual donors figure out how to direct their money towards the most effective organizations out there.
GiveWell, as Rosenberg acknowledges, “emphasizes health charities.” The work is “indisputably important, and it’s also relatively easy to measure.” GiveWell presents its list of focus issues here. GiveWell’s reliance on academic research to support assessments of effectiveness is laudable. But speaking only to what is already researched can produce a worrisome sort of mission creep.
In our eagerness to do what is effective, we turn to what is easily quantifiable. Health initiatives in the developing world—bed nets, condoms, clean water—are critically important. But of course the health problems these initiatives are designed to address—malaria, treatable venereal diseases and contaminated water—are more often than not symptomatic of deeper political problems and underdevelopment. Weak states, corruption, intractable violent conflict, poor accountability structures, or all of the above. It is a good question to ask whether neglecting the deeper causes and focusing attention on their easier-to-measure symptoms is really the most enlightened strategy—or simply another form of fire-fighting that feels rigorous.
It’s probably wise to go after both deeper causes and treatable symptoms at the same time. And rather than avoid the issues where evidence doesn’t exist, we should work to generate better evidence—acknowledging that this takes time.
The potential for well-crafted and well-executed political development, conflict resolution and peacebuilding work to have large spillover effects into individual health and well-being is there. When they are successful, such initiatives will help create the conditions in which governments have the incentives and the capacity to address local health concerns themselves. Donors should continue to be courageous in supporting such initiatives, and sophisticated about how to do so. Evaluators and academics must be creative and transparent in designing smart research to assess their effectiveness.