# Prioritizing COVID-19 interventions & individual donations

**NOTE**: **The COVID-19 funding landscape is evolving rapidly, and we are making updates to reflect new developments and revised donation recommendations. Please check the [EA Forum version of this post](https://forum.effectivealtruism.org/posts/opdMXibKjkoL69s96/prioritizing-covid-19-interventions-and-individual-donations) for the latest information.**

_Authors: [Catherine Olsson](https://forum.effectivealtruism.org/users/catherio) and [Ian David Moss](https://iandavidmoss.com/), with contributions from the collective members of the "Funding Rational Actors Promptly" Pandemic Endowment (FRAPPE)._

At the beginning of April, a group of friends pulled together a messenger chat to discuss how to most effectively spend personal donation funds towards mitigating global suffering caused by COVID-19. We're about 20 people, with somewhere in the ballpark of $200k to donate. We gave out one chunk of ~$50k in mid-April, and are currently in the process of distributing a second round of funds.

A defining motivation of our group was to find **time-sensitive and neglected bottlenecks to effective COVID response** that could be eased with rapid funding or other supportive actions. [Fast action can be an important source of philanthropic leverage](https://marginalrevolution.com/marginalrevolution/2020/03/the-speed-premium-in-an-exponentially-growing-pandemic-world.html) in responses to the current pandemic, a factor that we did not see explored in depth in available analyses of COVID-related giving opportunities. Accordingly, we have summarized our research here in hopes that others can use it to inform their own giving.

This article is organized in two parts. The first shares our **working framework for prioritizing interventions**, which helped us get oriented in a fast-changing and otherwise confusing landscape.

In the second part, we enumerate **specific giving opportunities** ([jump to section](https://www.lesswrong.com/posts/AwHAfw3cpwnTZe6c4/prioritizing-covid-19-interventions-and-individual-donations#IV__Specific_giving_opportunities)) we have found that currently rate highly on this framework as of right now (early May 2020). **One of these has a high minimum donation; if you would like to join a pooled gift, please reach out.**

We've written this post primarily for the benefit of donors who have _already_ decided to focus on COVID-19 for their own reasons. We haven't made it a priority to weigh the relative value of COVID-related donations as compared to other issues or causes, although we address this briefly at the end.

Some disclaimers: this research is being done and our donations are being made in a purely personal capacity, and none of us is acting as an employee, representative, or spokesperson of our employer or any other organization. Furthermore, because we don't have complete information on many opportunities and the situation is changing so rapidly, none of what follows should be treated as the final word on COVID-related giving opportunities. With that said, we tried hard to come to the best decisions we could in a short period of time using the resources we had, and we hope to update this post periodically as our perspective continues to evolve.  

I. Executive Summary & Recommendations
======================================

When evaluating COVID-19 interventions for importance/scale, our intuition is to look for the following five "scale factors":

1.  ⏰**Acting quickly**, because widespread avoidable suffering is already taking place, because mitigation is more cost-effective when active case numbers are smaller, and because many potentially impactful interventions require lead time to set up.
2.  🌍Concentrating benefits on the **global poor,** due to both disproportionate vulnerability and huge numbers.
3.  😷**Reducing the spread** of the disease, even in populations where containment is not possible. Of particular interest is driving availability and adoption of **cheaper mitigation strategies.**
4.  🔬Scientific **research** & development in support of any of the above facets of the problem, because a dollar spent on research can unlock orders of magnitude more benefit later. This includes **treatments** (including but not limited to vaccines) that substantially reduce the severity of the disease; **diagnostics;** and other areas.
5.  📊Knowledge and advocacy to **inform and motivate policy responses** that are more likely to achieve desired outcomes from a global perspective.

For now, we are planning to pursue the following donation opportunities, as we believe they meet many of these criteria and have room for more funding:

*   **[Fast Grants](https://fastgrants.org/),** a rapid-turnaround funding mechanism for research on COVID-19.
*   **[Development Media International](https://www.developmentmedia.net/covid-19.html)**, an organization setting up radio-based campaigns to encourage social distancing and other preventative behaviors in 9 African countries.

In addition, we have identified a number of other organizations doing promising work that have the potential to emerge as top recommendations as we learn more about them and/or as their work develops.  

II. Big picture: What's the bad thing that's happening? What could cause less of it to happen?
==============================================================================================

In this section we lay out the basic moving parts of the current crisis that one could intervene on to produce a better outcome. Parts of this section might be obvious to some readers; however, what is "obvious" to some people can be "surprising" to others, so we think it's worthwhile to just re-state the essential picture.

Two things are going on:

*   **The first-order problem**: a disease is spreading around, causing illness that harms people.
*   **The second-order problem**: both the disease and the response are disrupting people's ability to work, consume, move around, distribute goods, and care for themselves and others, which is harming people.

First-order problem: a disease is spreading around, causing illness.
--------------------------------------------------------------------

The basic epidemiological picture is as follows:

1\. Each person who has the disease infects some number of other people on average.

2\. The disease at first spreads exponentially (R0 > 1) within populations of susceptible people who have contagious contact with each other.

*   The world is not uniformly mixed, so different "populations" are undergoing different transmission dynamics.

3\. If no measures are taken to bring R0 below 1 and there is no vaccine, the exponential spread begins to slow down in a population only when a large fraction of that population has been infected, such that the disease starts running out of susceptible hosts.

*   The number of infected people required to reach ["herd immunity" is 1-1/R0](https://www.quantamagazine.org/flu-vaccines-and-the-math-of-herd-immunity-20180205/) (for example, R=3 → 66.7%). However, epidemics have momentum, so a larger fraction of people ends up getting infected ("overshoot"). (see thread by [@CT_Bergstrom](https://twitter.com/CT_Bergstrom/status/1252077930286444545))

To get a feel for these dynamics, the simulator at [https://ncase.me/covid-19/](https://ncase.me/covid-19/) is the best pedagogical resource we've seen so far.

  

![](https://images.squarespace-cdn.com/content/v1/5ba54d50d74562f790206c7c/1588881073050-SKV134CJLONLK9BF2C14/ke17ZwdGBToddI8pDm48kCHAezwst5imXuZUeoHYTTcUqsxRUqqbr1mOJYKfIPR7LoDQ9mXPOjoJoqy81S2I8N_N4V1vUb5AoIIIbLZhVYxCRW4BPu10St3TBAUQYVKcatub2Vv5Iji7bfrjg0azeehl48IqMDifmSzZaTk9gpmBeh67O3me91wxO0T80fY_/image-asset.png)

_Graphic by Kristen Tonga for FRAPPE_

### What levers can we pull to make direct impacts less bad?

1\. Reduce the **total number** of people who get it. For example:

*   Mitigate until a vaccine. (See "[The Hammer and The Dance](https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56)")

*   Some populations can avoid ever reaching the point of herd immunity / population saturation, by deploying a combination of strategies that keep R0 small or even at times below zero. Mitigations will need to continue until a vaccine is available.

*   Lower the herd immunity saturation point.

*   Some populations will be unable to avoid hitting herd immunity, but since the percent of infected population at saturated steady-state is a function of R0, then if R0 can be kept lower (e.g. through wearing masks in public) fewer people get infected.

*   Reduce overshoot.

*   In populations trending towards herd immunity, a well-timed reduction in R0 near the peak of infection can reduce unnecessary infections from overshoot, at lower cost than maintaining that strategy for a longer period of time. ([@CT_Bergstrom](https://twitter.com/CT_Bergstrom/status/1252078649827667968))

*   Reduce contagious contact between hotspots and susceptible clusters.
*   Create and deploy a vaccine.

2\. Reduce the **amount of suffering per person** who gets it. For example:

*   Develop and deploy treatments that lower the severity or death rate among cases.
*   Spread out the infections within a population over a longer period, so people are treated by a less-overwhelmed medical system, or even just cared for by a less-overwhelmed social support network. (This is one motivation for the "Flatten the Curve" strategy)
*   Prevent health care workers in particular from getting infected, so the medical system can provide higher-quality care.

Second-order problem: disruptions to people's lives and livelihoods
-------------------------------------------------------------------

In addition to the direct health impacts on people who get sick, there are indirect impacts. People who are sick or concerned about getting sick will not work, consume, travel, distribute goods, or participate in their communities at the same rate or in the same patterns as before. Additionally, mitigation strategies (such as lockdowns, test-and-trace programs, mandatory face coverings, or education campaigns) will further shape people's behaviors, as well as costing money. These altered patterns of activity and production, and direct and indirect financial costs, are already manifesting as job losses, food shortages, and other disruptions to people's lives and livelihoods. Particularly in poorer countries, [the indirect effects of the disease could cause more harm than the disease itself](http://yrise.yale.edu/wp-content/uploads/2020/04/covid19_in_low_income_countries.pdf), as they are not only harmful in their own right but worsen many existing social problems (other diseases, [hunger](https://www.nytimes.com/2020/04/22/world/africa/coronavirus-hunger-crisis.html), domestic violence, education, inequalities in access to essential services, etc.).

Some mitigation strategies are much more expensive than others, in money and in disruption. In the case of a previous pandemic, for example, [one analysis concluded that](https://www.medrxiv.org/content/10.1101/2020.04.20.20054726v1.full.pdf) "\[early\] contact tracing was estimated to be 4,363 times more cost-effective than school closures ($2,260 vs. $9,860,000 per death prevented)." While we can't assume that these ratios will necessarily hold for COVID, a similarly wide differential among the cost-effectiveness of different strategies would not be surprising.

Furthermore, some mitigation strategies take much more "setup time" than others (e.g. a school closure can be done immediately, but contact tracing cannot be started until tracers are trained and hired), and yet mitigations are best done when case numbers are low (which is true early in the course of disease spread, or after a successful period of suppression). This means that wealthier places can deploy expensive and disruptive methods early on to buy time to set up cheaper methods later while keeping case numbers low throughout the mitigation process; lower-income areas, by contrast, cannot afford to do so as easily.

### What levers can we pull to make indirect impacts less bad?

*   Direct (e.g. cash transfers) or indirect (e.g. programs and services) support to people whose lives have been disrupted or are likely to be disrupted in the near future.
*   Shift to mitigation strategies that are more effective for their cost, reducing dollars spent and disruption incurred for the same outcome.
*   Act more quickly when deploying mitigation strategies, as they are more effective when the case numbers are smaller.

III. Prioritization: Which levers are likely "most effective" to pull on?
=========================================================================

When prioritizing interventions, the usual factors to consider from an effective altruist perspective are scale, neglectedness, and tractability. We think that time-sensitivity is another important factor in this case.

Scale
-----

The above "napkin sketch" picture of what's going on yields some quick-and-dirty intuitions as to where the big "scale factors" are.

For one, exponential curves add orders of magnitude very quickly, so **reducing the spread** of the disease (especially in contexts where it can be done cheaply) is likely to be cost-effective. We emphasize that this is still the case even in communities that cannot avoid a high rate of infection. If a population has not been able to control the disease and cannot afford sustained lockdowns, and therefore may be on track to hit herd immunity before a vaccine is found, we originally entertained the hypothesis that it might not make a difference to the ultimate outcomes to slow the spread. However, we now understand that lowering R0 saves lives in all cases, because it both lowers the herd immunity saturation point, and [reduces "overshoot"](https://twitter.com/CT_Bergstrom/status/1252078649827667968) in which excess infections occur above the herd immunity level. These both correspond with vast numbers of lives saved.

Some strategies are orders of magnitude more cost-effective than others. We believe these cheaper strategies may include _wearing masks in public_, _handwashing_, _contact tracing when case numbers are low,_ _disease surveillance_ (i.e. finding undetected cases), and _personal protective equipment (PPE) for healthcare workers._ (see [Juneau et al.](https://www.medrxiv.org/content/10.1101/2020.04.20.20054726v1.full.pdf) preprint). We're excited about interventions that make **cheap mitigation strategies** more available, affordable, and accessible.

We also expect orders of magnitude could be found in substantially **reducing the severity of the disease,** through developing, manufacturing, and distributing highly-effective treatments.

Existing thinking about the role of **leverage** in cost-effectiveness can be applied here too. Borrowing from the framework from Open Philanthropy Project's blog post "[GiveWell's Top Charities Are Increasingly Hard to Beat](https://www.openphilanthropy.org/blog/givewells-top-charities-are-increasingly-hard-beat)," the following sources of leverage are ways to add multipliers to impact-per-dollar:

*   Concentrating benefits on the **global poor,** due to both disproportionate vulnerability and huge numbers
*   Knowledge and advocacy to **inform and motivate policy responses** that are more likely to achieve desired outcomes from a global perspective.

*   Note: several well-positioned contacts in our network have informed us that there is currently a lot of "noise" in this space, with many groups leaping forward to provide guidance. **Coordinating, unifying, or streamlining** this guidance therefore seems likely to be more impactful to us than simply creating more analysis.

*   Scientific **research** & development in support of any of the above facets of the problem (including but not limited to treatments, vaccines, and testing/diagnostics in support of treatment and mitigation strategies), because a dollar spent on research can unlock orders of magnitude more benefit later.

We boil this down to five "scale factors": ⏰Acting quickly, 🌍Focusing on the global poor, 😷 Reducing the spread via cheaper strategies, 🔬Scientific research, and 📊Informing & coordinating policy.

Neglectedness, and other properties of the ecosystem & organizations.
---------------------------------------------------------------------

We found that estimating **neglectedness** was critical to our understanding of opportunities, but more challenging than we expected because the landscape of _other funders' attention_ is both difficult to track and evolving rapidly. For example, a simplistic view is that too much money is being spent on "coping with" the pandemic, as compared to "solving" it (see, e.g., [the COVID-Zero messaging](https://wellcome.ac.uk/what-we-do/our-work/coronavirus-covid-19/investment/covid-zero), and this [tweet from Paul Romer](https://twitter.com/paulmromer/status/1243158510025744385)). This lens might give the impression that vaccines are currently under-resourced; however, vaccines [seem to have attracted a lot more attention compared to other treatments](https://www.ft.com/content/bd28d79f-8a0a-44c6-ac74-1abb17344c5b) and have received [billions of dollars in new investment](https://www.washingtonpost.com/world/europe/the-world-comes-together-for-a-virtual-vaccine-summit-the-us-is-conspicuously-absent/2020/05/04/ac5b6754-8a5c-11ea-80df-d24b35a568ae_story.html?fbclid=IwAR0tBxDbS_kSvfeCJEKixfJd-Ux3Q8b3MMijRP-pt5Bl5y4fHqYTNMNJBCE) just this week. The simplistic "coping" vs. "solving" lens also misses that many of the world's poorest people need support to literally _survive_ pandemic-induced disruption, not just "cope" with it.

In addition to the usual ITN analysis, we came to realize that **acting appropriately quickly** is unusually important to an intervention's effectiveness on COVID-19 mitigation. This consideration is not usually called out explicitly in the ITN prioritization framework. In addition to the fact that exponential curves add orders of magnitude very quickly (as discussed above as a "scale factor"), there's the fact that fast-moving actors are rare; it's much more typical for decision-makers to respond slowly. This means that **interventions that need to be undertaken quickly seem more likely to end up neglected, due to a lack of actors who can orient and act fast enough to do them.** Slow-moving organizations might be appropriate to fund if the intervention is not especially time-sensitive, but if there is a narrow window of opportunity, and the opportunity passes, money spent on the attempt could be totally wasted. Finding an appropriate match between the time-sensitivity of interventions and the promptness of relevant actors is especially key. As a result, some donation opportunities that otherwise look good might not be effective due to a lack of urgency or readiness on the part of the specific potential recipients.  

IV. Specific giving opportunities
=================================

We highlight first the top few overall giving opportunities we have found so far at this stage of our investigation. Then we outline other promising candidates by topic area. We emphasize that as an all-volunteer team we had limited time to identify and evaluate organizations, but still wanted to prioritize giving quickly to opportunities we felt we understood well enough.

**Opportunities we plan to give to**
------------------------------------

[**Fast Grants**.](https://fastgrants.org/) 🔬Scientific research, ⏰Acting quickly.

*   **What they do:** Fast Grants is a rapid-turnaround funding mechanism for research on COVID-19, mostly but not exclusively biomedical in nature. Marginal donations help more research projects get funded. Project proposals are reviewed by an expert advisory committee and divvied up by expertise area, with decisions rendered within 48 hours. Average project size in the first round of grants was $175k.
*   **Why we want to fund them:** They focus specifically on funding research that is currently bottlenecked by funding availability and whose outputs could be directly useful on a six-month timescale. Fundraising for scientific research is a [notoriously slow and time-consuming process](https://www.vox.com/future-perfect/2020/4/21/21228156/coronavirus-fast-grants-tyler-cowen-patrick-collison), actively inhibiting the production of relevant knowledge in the current crisis. Even though Fast Grants has already awarded more than $20 million in just a month of operation, the team has told us that many worthwhile projects remain unfunded even under very high standards. They have indicated they can absorb an additional $1-2 million to fund the current pool of applicants and will solicit new applications if further resources become available.
*   **Actions:** We've already given Fast Grants $50,000. They take a minimum donation of $10,000. We're setting up a second pooled donation via donation-swapping. **If you would like to join, please contact [catherio@mit.edu](mailto:catherio@mit.edu) before May 11, 2020.**

**[Development Media International](https://www.developmentmedia.net/covid-19.html)**. 😷Cheap mitigation, 🌍Global poor, ⏰Acting quickly.

*   **What they do:** DMI is setting up radio-based campaigns to encourage social distancing, handwashing, and other preventative behaviors in nine African countries. They are up and running in three so far and need funding to expand to the other six (Cote d'Ivoire, Ethiopia, Madagascar, Malawi, Uganda, and Zambia). DMI estimates that the campaigns could increase physical distancing by up to 10 percentage points, meaningfully lowering R0 and slowing the spread.
*   **Why we want to fund them:** DMI is an organization we're already familiar with, named by GiveWell as a [standout charity](https://www.givewell.org/charities/DMI) since 2014. This work is highly time-sensitive, as it will be more effective if done while case numbers are smaller; the fact that they are already running their campaigns in three countries tells us they're equipped to act fast enough to capitalize on this opportunity. Although [GiveWell recently made a grant to DMI for this work](https://forum.effectivealtruism.org/posts/stoidt2ajFA76Liuv/three-grants-in-response-to-the-covid-19-pandemic), the organization is still seeking additional funds for this effort. Even if contributions end up [funging](https://blog.givewell.org/2018/02/13/revisiting-leverage/) against DMI's other activities, DMI's non-COVID-related work is also work we feel good supporting, so we are confident that this will be on net a good use of money for the world.
*   **Actions:** Members of our group have pledged funds in our second round of donations. The Life You Can Save has set up a [special page](https://tlycs.networkforgood.com/projects/52903-development-media-international) for contributions to DMI's COVID-19 work so that they can pass them along more quickly than usual. They can accept donations of any size.

**Promising, with some open questions**
---------------------------------------

### Global poor

**[Africa CDC](https://africacdc.org/covid-19/)**. 😷Cheap mitigation, 📊Informing & coordinating policy, 🌍Global poor, ⏰Acting quickly.

*   **What they do:** Africa CDC is part of the African Union, working with governments across the continent to coordinate policy responses to the pandemic, such as developing test-and-trace solutions and managing supply chains and stockpiles. It is also producing knowledge resources and tracking policy actions at a regular clip.
*   **Why we found this opportunity promising:** We've been impressed with the pace and clarity of Africa CDC's leadership thus far. By convening national governments, the organization helped to facilitate a response in late February and formalized a continent-wide strategy by late March. It has the trust of major global health funders and multilateral agencies. A strong track record of coherent guidance to shape policy around slowing the spread in lower-income countries is a profile we're excited about. There seems to be an outstanding need for more funding, although the situation is unclear. At the start of April Africa CDC issued a [request for $400m](https://www.africanews.com/2020/04/07/coronavirus-africa-african-union-and-african-private-sector-launch-covid-19-response-fund/) jointly with the African Union (its parent organization); we have only been able to document about $65 million raised since then, with most of that coming from [a pledging event](http://www.xinhuanet.com/english/2020-05/05/c_139032465.htm) on May 5.
*   **Open questions**: We've asked Africa CDC for an update on what their funding need is and what they would do with additional funding. We also want to confirm that the wire transfer instructions in [this press release](https://www.africanews.com/2020/04/07/coronavirus-africa-african-union-and-african-private-sector-launch-covid-19-response-fund/) are the correct way to send money to the right financial instrument for Africa CDC. If we like what we hear, we're actively interested in donating.

**[GiveDirectly (International)](https://www.givedirectly.org/covid-19-international/).** 🌍Global poor, ⏰Acting quickly.

*   **What they do:** Give $25-50/mo for three months to low-income informal sector workers in urban areas of the developing world that they estimate to be hardest hit by COVID-19. Initial focus on slums of Nairobi, Kenya.
*   **Why we found this opportunity promising**: GiveDirectly has been a GiveWell top charity for a number of years and is widely recognized as an outstanding organization. In addition, cash transfers are one of the most-studied forms of aid out there and are particularly relevant during this crisis. GiveDirectly has shown an impressive ability to [scale up its US-based activities](https://www.givedirectly.org/covid-19/us/) in response to the pandemic, and we hope to see similarly rapid progress on the international front. In contrast to its more resource-intensive traditional screening process, GiveDirectly is partnering with telcos and NGOs to identify vulnerable populations and expects COVID response funds to reach recipients in one month rather than the usual 6 months.
*   **Open questions:** While we have great respect for GiveDirectly as an organization, the reach of its current international program—a single city in a single country—is extremely narrow in comparison to other opportunities on this list. The organization is in the process of sourcing additional partners, but its ability to scale up quickly may be limited as it has only ever operated in several African countries and the US.

**[GiveIndia](https://indiafightscorona.giveindia.org/support-families/)**. 🌍Global poor, ⏰Acting quickly.

*   **What they do**: Give about $60-100 to families of unemployed daily wage earners in both urban and rural areas of India, through partnerships with local charities.
*   **Why we found this opportunity promising:** GiveIndia is intriguing to us because GiveDirectly has no history of involvement in Asia. India is the world's second-most populous country and the country's lockdown is likely to make life much worse for the tens of millions there who live in extreme poverty. We thus believe that GiveIndia looks like a promising GiveDirectly-like organization in another part of the developing world.
*   **Open questions**: Unlike GiveDirectly, we aren't already familiar with GiveIndia, and we weren't quickly able to learn enough about the organization's track record to feel confident about recommending donations at this time. We also lack clarity on how much additional funding GiveIndia could productively absorb once its current fundraising target, which is close to being met, is hit.

**[Medecins Sans Frontieres](https://www.msf.org/covid-19-depth)**. 😷Cheap mitigation, 🌍Global poor, ⏰Acting quickly.

*   **What they do:** Medecins Sans Frontieres (MSF) is undertaking a wide range of interventions including construction or setup of COVID wards in hospitals and training/technical assistance to caregivers in many countries around the world, including some poorly served by other aid groups.
*   **Why we found this opportunity promising:** The geographic reach of MSF's COVID response is [impressive](https://www.msf.org/covid-19-depth) and it is one of the only organizations actively working to increase treatment capacity at hospitals in the Global South. MSF is [GiveWell's go-to recommendation for disaster philanthropy](https://blog.givewell.org/2011/03/15/update-on-how-to-help-japan-funding-is-not-needed-we-recommend-giving-to-doctors-without-borders-to-promote-better-disaster-relief-in-general/) and is a well-regarded organization in the international community.
*   **Open questions**: At the time we reviewed them, MSF was not making a big push for COVID-specific funding and described its ability to help in the current pandemic as "limited." We believe the organization is doing highly valuable work with its existing resources, but it is unclear to us how additional funds would be spent.

### Vaccines, diagnostics, and treatments

**[ACT Accelerator](https://www.who.int/who-documents-detail/access-to-covid-19-tools-(act)-accelerator):** 🔬Scientific research, 🌍Global poor, 📊Informing & coordinating policy.

*   **What they do**: In early March, a group called the Global Preparedness Monitoring Board [articulated an urgent $8 billion funding need](https://apps.who.int/gpmb/assets/pdf/COVID_19_Press_Release_GPMB_9Mar.pdf) to ensure that vaccines, therapeutic treatments, and diagnostics for COVID-19 are developed rapidly enough, manufactured at scale, and delivered in equitable fashion to people all over the world. Since then, governments and civic institutions have engaged in aggressive fundraising efforts to meet that target, [finally hitting the goal on May 4](https://www.washingtonpost.com/world/europe/the-world-comes-together-for-a-virtual-vaccine-summit-the-us-is-conspicuously-absent/2020/05/04/ac5b6754-8a5c-11ea-80df-d24b35a568ae_story.html?fbclid=IwAR0tBxDbS_kSvfeCJEKixfJd-Ux3Q8b3MMijRP-pt5Bl5y4fHqYTNMNJBCE). The package of interventions supported by this effort, now grouped under the heading of the [ACT Accelerator](https://www.who.int/who-documents-detail/access-to-covid-19-tools-(act)-accelerator), is without question the world's most ambitious and important COVID-related philanthropic effort by a very large margin. Beneficiaries include the **[Coalition for Epidemic Preparedness Innovations](http://cepi.net/)**, a global partnership making possible some of the most promising vaccine trials currently underway; the new Gates-Wellcome-Mastercard **[Therapeutics Accelerator](https://www.therapeuticsaccelerator.org/)**, which aims to facilitate the delivery of a non-vaccine COVID treatment to 100 million people by the end of 2020; **[Gavi](https://www.gavi.org/covid19),** a key partner in the effort to ensure that everyone in the world will have access to a vaccine against COVID-19 when one is available; and the **[World Health Organization](https://covid19responsefund.org/faq)**, which is helping the world's poorest countries implement a pandemic preparedness plan that was developed prior to the outbreak.
*   **Why we found this opportunity promising**: Although the $8 billion funding goal has been met as of this week, the principals involved have characterized that figure as a mere "down payment" on what will eventually be required, which is [estimated to be in the tens of billions](https://www.ft.com/content/bd28d79f-8a0a-44c6-ac74-1abb17344c5b). The US government has been conspicuously absent from the effort thus far, despite providing more than two-thirds of global government funding for neglected diseases [as recently as 2018](https://s3-ap-southeast-2.amazonaws.com/policy-cures-website-assets/app/uploads/2020/02/07161934/GF-6pSummary2019.pdf?fbclid=IwAR0PRKy7Tw9IUvr6xyBYFzhksL428mgx0cbvNFqs9bVubBc-Zk-AEaGAwBM).
*   **Open questions**: Because of the massive amounts of money involved, it seems unlikely that the ACT Accelerator is a good donation target for non-billionaires. However, we suspect that advocacy to urge the US government to support the initiative may be very high-impact.

### Policy advice/knowledge/resources

**[Center for Global Development](https://www.cgdev.org/topics/coronavirus):** 🌍Global poor, 📊Informing & coordinating policy.

*   **What they do**: Produce high-quality COVID-related briefs and analysis, with a focus on implications for the Global South.
*   **Why we found this opportunity promising:** CGD is well-regarded as an organization by people we trust (such as [Open Phil](https://www.openphilanthropy.org/focus/global-health-and-development/miscellaneous/center-global-development-general-support-2019), which sent them [additional funding for COVID-related projects](https://www.openphilanthropy.org/focus/global-health-and-development/miscellaneous/center-global-development-covid-19-net-health-impact-calculations) recently). They're producing highly relevant and useful content at a rapid pace. Evidence that they're having influence on current policy decisions includes the fact that ACT Accelerator's strategy of using advance market commitments (AMCs) to secure vaccine production emerged from an advocacy effort that CGD initiated in 2005.
*   **Open questions**: While CGD appears to be doing great work with existing resources, it's unclear what additional donations would make possible. There is no COVID-related appeal on CGD's website.

**[COVID-END](https://www.mcmasterforum.org/networks/covidend)**: 📊Informing & coordinating policy.

*   **What they do**: Enhance collaboration and reduce duplication among parties conducting rapid reviews of research to inform COVID-19 policy, so that, e.g. "Rather than have 33 groups conduct rapid reviews on the same or similar questions about face masks in a one-week period (as we recently found), COVID-END could enable these groups to find what’s already there." The program has also developed a prototype for on-demand rapid evidence reviews on any COVID-related question.
*   **Why we found this opportunity promising**: We're especially excited about groups that are coordinating, unifying, or streamlining policy guidance, rather than merely contributing to the proliferation of advice in the space. That's exactly what this group works on. Many of the organizations involved in the collaboration are among the leading institutions in the field of research synthesis methodology.
*   **Open questions**: The collaboration does not directly involve policymakers, so we have some concerns that the knowledge resources may not have a close enough connection to the decision-making process to be useful. In addition, we were not able to learn whether the group has a need for additional funds prior to publication time.

### What about Johns Hopkins CHS?

The **[Johns Hopkins Center for Health Security](https://www.centerforhealthsecurity.org/resources/COVID-19/)** has been the most frequently cited top donation opportunity for COVID-19 so far in EA community writeups such as the [Founders Pledge COVID-19 Response Fund](https://founderspledge.com/stories/covid-19-response-fund) and [SoGive's post on EA Forum](https://forum.effectivealtruism.org/posts/wpaZRoLFJy8DynwQN/the-best-places-to-donate-for-covid-19). Pandemic preparedness is core to the center's mission and it has been quite active in the current crisis, having launched a widely followed coronavirus case tracking map/database; it also publishes numerous white papers addressing questions of interest to policymakers and its experts have been prominently featured in the media. There are a few reasons why we have not prioritized it in our own research. For one thing, the profile of the center has risen considerably as a result of the pandemic and we are unsure what additional funding would make possible in the short term (notably, the center does not have an active appeal on its website and actually suggests other organizations for donations instead). In addition, the center's track record in providing high-quality advice does not appear to be unblemished; we noted that its experts explicitly [recommended against wearing DIY masks](https://uk.news.yahoo.com/please-not-diy-surgical-mask-103200517.html) in early March (a position reversed by the end of the month) and were [not discouraging people from pressing ahead with travel plans](https://www.jhsph.edu/covid-19/questions-and-answers/your-covid-19-questions-answered.html) as late as March 6, advice that may have led to costly decisions and missed opportunities during a period when infections were rapidly increasing.

**Also considered**
-------------------

Other organizations we considered included Partners in Health, PATH, CARE, the Food and Agricultural Organization of the United Nations (FAO), [EpidemicForecasting.org](http://epidemicforecasting.org/), IDInsight, Y-RISE, Center for Disaster Philanthropy, GiveDirectly (for its US-focused Project 100 campaign), the Emergent Fund's People's Bailout, National Domestic Workers Alliance, Meals on Wheels, Feeding America/World Central Kitchen, and United Way. While we have elected not to pursue these options at this time, we believe they are all doing relevant work and intend to track their activities periodically as bandwidth permits. Complete analysis of all organizations considered is available [here](https://bit.ly/COVIDgiving).

Certain of these merit mention for donors with specific preferences or priorities that may be different from ours. For example, the [Center for Disaster Philanthropy's COVID-19 Response Fund](https://disasterphilanthropy.org/cdp-fund/cdp-covid-19-response-fund/) is a good option for donors who want to make a single donation to cover a wide range of interventions globally. For donors interested in helping vulnerable populations in the US, the [Feeding America/World Central Kitchen partnership](https://www.gofundme.com/f/americasfoodfund) looks attractive on the basis of scale of impact and fast implementation. For US-focused donors with very strong social justice values, the [Emergent Fund's People's Bailout](https://www.emergentfund.net/covid-19) could be an intriguing option.

If an organization doesn't appear anywhere in this blog post, it's possible we are not aware of it, or it's possible we were but decided not to investigate it in depth.

**Opportunities we wish we'd found more of**
--------------------------------------------

Based on our analysis of the big picture, and the important levers we identified, we felt there were a number of "gaps" in the landscape that we wished we could support, but we could not quickly find as many strong organizations dedicated towards those efforts as we would've hoped to see. (Such organizations may exist, in which case we'd love to hear about them.)

*   **PPE manufacturing & logistics.** We are aware of a number of US-based and international PPE donation and distribution efforts; however, we did not find much that was focused on making sure that there exists enough PPE to distribute in the first place. Demand for all kinds of items is through the roof and the supply chain is [struggling to keep pace](https://www.adb.org/sites/default/files/publication/579121/ppe-covid-19-supply-chains-bottlenecks-policy.pdf). We would love to be able to find charitable candidates for scaling up PPE manufacturing and logistics.
*   **Advocacy to drive global engagement by the US government.** The US has been conspicuously absent from many of the most consequential international efforts to coordinate distribution of vaccines, treatments, and diagnostics to the world's population. Global access to these goods is in the US's national interest since an active pandemic anywhere is a threat to health everywhere. However, it was difficult to find any organizations actively working to organize support for these interventions in Congress or other relevant channels. (Note: the [ONE campaign](https://www.one.org/us/take-action/oneworld/?utm_source=homepage&source=homepage&utm_medium=referral&utm_campaign=covid19) was brought to our attention very recently and we might investigate it in a future update.)
*   **Supporting fast/early contact tracing for lower-income countries.** When case numbers are small, contact tracing seems to be one of the most effective and _cost_-effective strategies in controlling an outbreak ([Juneau et al.](https://www.medrxiv.org/content/10.1101/2020.04.20.20054726v1.full.pdf)); however, it has diminishing returns with scale (see [guidance from Africa CDC](https://africacdc.org/download/guidance-on-contact-tracing-for-covid-19-pandemic/)) and thus becomes too expensive for lower-income countries when case numbers get too high. Lower-income countries that cannot afford expensive lockdowns are particularly in need of cheaper interventions, and contact tracing could fill that role _only_ _if_ it is done swiftly enough. We would like to find candidates that are helping lower-income countries deploy early contact tracing. Big NGOs might do this, but we couldn't quickly find out. The [TCN coalition](https://tcn-coalition.org/) coordinates organizations working on mobile contact tracing, but we didn't see a specific focus on poorer regions without Apple/Android phones.
*   **South & Southeast Asia**. This may simply be a reflection of our existing networks and knowledge base, but we were able to find many more promising options focused on beneficiaries in Africa than in other parts of the Global South. It's important to remember that India alone has more people than the _entire continent_ of Africa, and the region is home to many other densely populated countries like Bangladesh, Pakistan, and Indonesia. We would be grateful to learn about more systematic interventions focused on this part of the world.

V. Addendum: Should you prioritize COVID response over other EA priorities?
===========================================================================

We've written this post primarily for the benefit of donors who have _already_ decided to focus on COVID-19 for their own reasons. We have not made it a priority to analyze the relative value of COVID-related donations as compared to other issues or causes. This post should _not_ be seen as taking any position for/against prioritizing COVID-19 over other issues or causes.

That said, we know this question is top of mind for many EAs, and we wanted to offer some brief thoughts on it here.

Evaluating the relative cost-effectiveness of "COVID-themed" vs. "non-COVID-themed" donations is more difficult than if these were wholly separable topics/areas. Instead, the effects of the pandemic itself are intertwined with both donors' actions and the work of the organizations they support in several ways. (This intertwinement seems less pronounced for cause areas such as AI x-risk, and more pronounced for cause areas such as global health and pandemic preparedness).Some of these entwined interactions point _against_ prioritizing COVID:

*   Donors and other funders are facing immense pressure to step up their giving and direct attention towards this pandemic. As a result, anti-malaria and other global health interventions [may be even more underfunded than usual](https://www.ft.com/content/f4557f2c-2464-46bd-a844-d08cadc3da59https://www.axios.com/bill-gates-foundation-coronavirus-2ca13a93-2067-49e0-9be2-3c0ee289ffd0.html) as a result, not only today but potentially for several years.

Some interactions point _in favor of_ prioritizing COVID:

*   The tremendous global disruption set in motion by the pandemic could be harmful to other work that EAs consider important (for example, [supply chain disruptions may disrupt access to malaria control tools](https://www.healthpolicy-watch.org/combined-impact-of-covid-19-and-malaria-could-be-catastrophic-warns-leading-research-group/)), such that working to resolve the root cause of the disruption may be one of the most effective ways to allow the most important work to get back on track.

*   See GiveWell blog post "[The impact of COVID-19 on GiveWell’s plans](https://blog.givewell.org/2020/03/26/the-impact-of-covid-19-on-givewells-plans/)" for more on impacts and disruptions.

*   An improved response to this crisis may translate into better preparedness for future pandemics.
*   GiveWell donors motivated by the promise of guaranteed impact from intensely vetted, cost-effective charities must accept that the current environment marks a significant departure from the conditions under which those interventions were shown to work well.

*   Note that in [GiveWell's EA Forum post on April 23](https://forum.effectivealtruism.org/posts/stoidt2ajFA76Liuv/three-grants-in-response-to-the-covid-19-pandemic) about COVID-19 grants, they recommend that individual donors still give to the normal recommended charities.

These factors point to a complicated picture that we have not undertaken to disentangle here. Overall, while we would _not_ go so far as to suggest that EAs redirect their giving away from effective charities they already support, we do feel there are strong reasons for EAs to consider COVID-specific giving. Moreover, the situation is so quickly evolving that there is not yet an established consensus about what is most effective to do, so we believe it is important that individual EAs take up the mantle of thinking carefully about what they think is best to do in the current unusual times, rather than exclusively deferring to the opinion of trusted voices in the EA world.

(For another EA Forum post which has a different take, see [COVID-19 response as XRisk intervention](https://forum.effectivealtruism.org/posts/BdMWoQ95EKTpKxmB7/covid-19-response-as-xrisk-intervention))