By Marie Dao and Camille Berger, 14 February 2025. Reading time: 10 min.
When we make a donation, we’re trying to make the world a better place. But how do we know whether our generosity is really having a significant impact? Many people say: “The important thing is to act” or “I prefer not to look at the figures”. Yet ignoring the effectiveness of our donations potentially means helping fewer people than we could. So we have a moral responsibility to measure and compare.
In his essay “The Moral Imperative Toward Cost-Effectiveness in Global Health”, published by the Center for Global Development, Toby Ord explores why assessing the impact of donations is essential, particularly in the field of global health.
Toby Ord is a philosopher at Oxford University, known for his work on effective altruism. In this article, he highlights a disturbing fact: some charitable interventions can be up to 100 times more effective than others, meaning that an optimised donation could save or improve many more lives than a donation made without rigorous evaluation.
According to Ord, cost-effectiveness analysis is essential. It compares different interventions in terms of the number of lives saved or improved per euro spent. This analysis is to be distinguished from cost-benefit analysis, which is based on what each recipient is prepared to pay individually, and which therefore over-values the preferences of the wealthy. Cost-effectiveness analysis, on the other hand, is impartial in this respect.
Cost-effectiveness analysis helps to see what benefit could be produced in a causal way if this money were spent on different interventions – for example, saving a thousand lives or saving ten thousand lives. The only comparison that is made is between these benefits. The question of whether or not it is worth spending the budget to save ten thousand lives is not part of the analysis.
With a budget of €25,000, we could either train and provide a guide dog for one person in Europe [1], or fund surgery to cure more than 1,000 people of blindness in developing countries [2]. Far from saying that funding a guide dog is “bad”, this comparison illustrates a key point: our resources are limited. If we want to increase our impact, we have to take these differences in effectiveness into account.
We are spontaneously inclined to give on the basis of emotion rather than analysis. We favour causes that touch us personally or that are featured prominently in the media. But the real impact of a donation is not measured by the strength of the emotion it generates, but by its practical effectiveness.
Not measuring effectiveness means risking investment in solutions that help little, while others can save or transform lives on a massive scale.
If we have the power to help 10 or 100 times as many people with the same amount of money, shouldn’t we care? Some would say that the important thing is to act, regardless of the measurable impact. But if we were in charge of allocating a public health or humanitarian relief budget, we wouldn’t do it willy-nilly: we’d try to save as many lives as possible.
When we give, we have the same duty. Our generosity is precious, and for it to have the greatest possible effect, it is essential to adopt a rigorous and informed approach .
Find out about the measurable impact of charities:
Some organisations, such as GiveWell, analyse the effectiveness of charities. Mieux Donner uses these comparisons to recommend charities where your donation can have the greatest possible impact.
Compare costs and effectiveness:
As in the case of the guide dog, each euro donated can have a very different impact depending on how it is used.
Take into account the differences in costs between countries:
Interventions in low-income countries can be much more effective in terms of lives improved or saved.
It’s true that some charities are difficult to quantify. However, this does not make the task impossible:
Measuring and comparing the impact of our donations is not a matter of cold rationality, but one of justice and moral responsibility. If we really want to help as much as possible, we need to assess the concrete effects of our choices and adjust our generosity accordingly. In the end, a well-chosen donation can transform many more lives than we can imagine.
[1] https://www.chiens-guides-idf.fr/prix-chien-guide/
[2] Recalculated from The Moral Imperative towards Cost-Effectiveness, whose initial reference is Cook et al. (2006), p. 954. ‘Their figure is $7.14 per surgery and with a 77% cure ratio’
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