Global Health Fund Deep Dive 2026

Severe acute malnutrition (SAM) is one of the leading killers of young children in Nigeria. According to Taimaka, in Gombe State alone, roughly 3% of children under five suffer from it at any given time. Yet fewer than two in ten children nationally receive any treatment. The problem is not that treatment is impossible. It is that the dominant model has always been too expensive and too hospital-dependent to reach the children who need it most.

Taimaka was founded to change that. They have redesigned the community-based management of acute malnutrition (CMAM) so that it can be delivered at scale by trained community health workers rather than doctors and nurses, at an average cost of $94 per child treated. That is more than a 50% reduction on legacy approaches, which Taimaka estimates cost $251 or more per child.

Taimaka is scaling rapidly, targeting 35,000 cases treated by 2027.

Taimaka's model works in three connected stages. First, community mobilisers and local leaders travel door to door through target communities, screening children for malnutrition using mid-upper arm circumference (MUAC) measurements. MUAC below a threshold of 11.5cm indicates severe acute malnutrition. Children who screen positive are referred directly to Taimaka outpatient clinics located within government primary healthcare facilities.

Second, trained community health workers, equipped with a digital triage tool that standardises assessment and ensures consistent quality of care, take over. For uncomplicated SAM cases, children receive ready-to-use therapeutic food (RUTF), antibiotics, and vaccinations across a course of six to ten weekly outpatient visits. RUTF is a high-energy, fortified, peanut-based paste that requires no preparation, no clean water, and can be administered at home between visits. Taimaka has also piloted the OptiMA approach, which uses MUAC measurements to progressively reduce RUTF dosage as a child improves, allowing more children to be reached with the same supply.

Third, for children presenting with complications — severe infections, poor appetite, dangerous oedema — Taimaka transports them to inpatient care centres where doctors and nurses stabilise their condition before returning them to outpatient follow-up.

CMAM is a WHO-endorsed intervention with a strong mechanistic rationale: RUTF directly addresses the caloric and micronutrient deficits that cause SAM, and the outpatient model dramatically increases coverage compared to hospital-based care. According to GiveWell, analysis of observational data estimates that SAM treatment reduces all-cause mortality by approximately 60%.

Taimaka's programme data shows a recovery rate of 95%. GiveWell estimates the programme's cost-effectiveness at approximately 9× its benchmark and anticipates this will improve as the programme scales and cost-per-child falls further.

Taimaka's programme has treated over 12,000 children to date, with an estimated 253 to 706 lives saved. The programme achieves a recovery rate of 95%. GiveWell estimates a cost of approximately $4,300 to prevent a death through Taimaka's programme, ranking it among the most cost-effective child survival interventions available to donors.

Safe water is one of the most neglected areas in global health funding. According to GiveWell, most large funders focus on water infrastructure rather than water treatment, leaving a critical and underfunded gap that Evidence Action is well positioned to fill.

The Life You Can Save notes that every year more than one million people die from diseases caused by unsafe drinking water, and 525,000 of those deaths are children under five. Waterborne diseases including cholera, typhoid, and diarrhoeal illness are largely preventable through a simple, proven intervention: water treatment. Yet for the two billion people globally who lack access to safely managed drinking water, that intervention remains out of reach.

Evidence Action's Safe Water Now programme provides access to safe drinking water to millions of people across Kenya and Uganda.

Rigorous research has shown that water treatment reduces under-five child mortality from all causes by more than 20%.

Safe Water Now delivers chlorine treatment directly to water points at no cost to families, through two complementary approaches.

The first is a network of around 18,000 bright blue chlorine dispensers installed directly at community water sources across rural areas not served by municipal systems. The mechanism is simple: a community member places their bucket under the dispenser, turns a valve to release the correct dose of chlorine, and fills their bucket with water. The chlorine disinfects during the walk home. By the time they arrive, the water is safe to drink. Dispensers are maintained by a vast network of elected community volunteer promoters who encourage use and report when refills or repairs are needed. Evidence Action's circuit rider team delivers supplies by motorcycle, reaching even remote dispensers and addressing faults within 72 hours.

The second approach is in-line chlorination, used in peri-urban and urban communities with communal piped water systems. Devices are installed directly on water storage tanks, automatically chlorinating water at the correct dose as it flows through.

This human-centred design is a core reason the programme works. According to Evidence Action, chlorine adoption rates through dispensers are up to five times higher than other water treatment interventions, a finding from Michael Kremer's original research. Programme adoption is monitored through unannounced household visits that test water for chlorine residual: a direct measure of whether families are actually benefiting.

Chlorination is proven to kill the bacteria and pathogens that cause waterborne disease. Kremer's landmark study, drawing on 15 randomised controlled trials across low and middle income countries, found water treatment to be one of the most cost-effective child survival interventions available. The WHO endorses chlorination. Safety concerns are minimal. Chlorine provides residual protection for up to three days after treatment. The dispenser model was tested against a range of competing water treatment interventions and achieved by far the highest sustained uptake.

The Life You Can Save recognises Evidence Action as one of the world's most effective charities and GiveWell estimates this programme to be five times as cost-effective as its benchmark.

Evidence Action notes that from 2013 to 2024, Safe Water Now averted over 15,000 deaths among children under five and more than four million cases of diarrhoea. The programme currently reaches nearly 10 million people with access to safe water across Kenya, Malawi and Uganda, at under $1.70 per person per year.

The best organisations in global health do not just follow the evidence when it confirms what they hoped. They follow it when it is hard. In 2026, Evidence Action published a full transparency report after independent evaluations — first in Kenya, then in Uganda and Malawi — found that far fewer people were using the dispensers than its monitoring had indicated. Their response was immediate: they commissioned independent surveys, overhauled their monitoring protocols, and made the decision to wind down operations in Malawi and scale back in Uganda over a 24-month transition, concentrating resources where the evidence best supports impact. Once that transition completes, Evidence Action expects to reach an estimated 2.8 million people across Kenya and Uganda — a smaller but better-verified footprint. According to GiveWell, the programme remains roughly five times as cost-effective as its benchmark.

Malaria kills around 625,000 people every year, and 70% of those deaths are children under five (Against Malaria Foundation). It is one of the leading causes of childhood death on the continent and one of the most preventable. AMF funds and distributes long-lasting insecticide-treated bed nets (LLINs) to households across some of the world's most malaria-affected regions, working directly with national malaria programmes to ensure every net reaches the people who need it most. To date, AMF has funded over 370 million nets, protecting more than 666 million people.

100% of public donations go directly towards purchasing nets.

GiveWell notes that AMF's model is built around targeting precisely, distributing accountably, and monitoring rigorously, while funding net purchase and leveraging government and partner infrastructure for distribution.

Before any campaign, AMF conducts or funds detailed pre-distribution registration surveys, which map every household in the target area, recording the number of sleeping spaces and existing nets to calculate the exact number of LLINs required. This household-level precision minimises waste and maximises coverage.

Distribution itself is run by national malaria control programmes and partner organisations, often using smartphones to record GPS-verified household data in real time. According to GiveWell, AMF funds the procurement of the nets — typically at a cost of $4 to $6 per net including distribution — while government partners fund operational costs, creating a highly leveraged model.

After distribution, AMF commissions independent post-distribution monitoring surveys at regular intervals, typically at 6, 12, 18, and 24 months. Independent field teams visit randomly sampled households to check whether nets are present, hanging over sleeping spaces, and in usable condition. This data is published publicly and used to refine future distributions.

The evidence for LLINs is among the strongest in global health. According to GiveWell, there is strong evidence from randomised controlled trials that LLIN distributions can be expected to reduce malaria incidence and child mortality. Distributions are targeted to countries with known malaria risk and modelled against local malaria burden data to ensure impact is concentrated where it is greatest.

GiveWell estimates it costs approximately $3,000 to $8,000 to avert a death through AMF's distributions, making it one of the most cost-effective life-saving interventions available to donors. AMF focuses a significant and growing proportion of its distributions on the Democratic Republic of Congo, the country with the second highest number of malaria cases in the world and where malaria is the leading cause of death.

Malaria remains one of the most underfunded disease areas relative to its burden. GiveWell, The Life You Can Save and Giving What We Can have all continuously recognised AMF as a top charity.

According to Against Malaria Foundation, AMF has funded over 370 million nets to date, protecting more than 666 million people. GiveWell estimates the cost per net including distribution at $4 to $6.

Vitamin A is critical to children's growing bodies and brains (Helen Keller International). It strengthens vision, prevents blindness, and builds children's immune systems so they are strong enough to fight routine childhood illnesses like diarrhoea, measles, malaria, and pneumonia. These illnesses can quickly end a child's life if they do not have enough vitamin A.

According to GiveWell, between 25% and 36% of preschool-aged children in countries where HKI is active are affected by vitamin A deficiency — a rate the WHO classifies as a severe public health problem. As noted by The Life You Can Save, an estimated 100,000 children die each year from vitamin A deficiency related causes.

VAS is underfunded globally: GiveWell notes that reductions in UNICEF vitamin A supplementation (VAS) funding have left significant gaps in countries such as Nigeria, Niger, and Guinea, and that HKI's funding would likely not be replaced by other actors in its absence.

A single capsule of vitamin A given to children twice a year for the first five years of their lives can save their sight and lives. (HKI)

HKI provides funding to governments to deliver VAS campaigns for preschool age children aged 6 to 59 months in sub-Saharan Africa. Alongside funding, HKI provides technical assistance on planning, training of distributors, and promoting awareness of each campaign, and conducts monitoring to understand how many children are reached.

HKI delivers through multiple channels depending on context. In Kenya, they support multiday community events reaching four times as many children as standard delivery. In Senegal, they partner with the Ministry of Health, clinics, and community leaders to integrate vitamin A into routine healthcare visits. In Nepal, they train community health workers who go door to door in remote villages.

The case for vitamin A supplementation traces back to pioneering research spearheaded by HKI itself. A study conducted with Dr. Alfred Sommer of the Johns Hopkins Bloomberg School of Public Health found that vitamin A could both prevent blindness and decrease the risk of childhood mortality by nearly a third. HKI notes that this became one of the most important breakthroughs in 20th century global public health.

According to GiveWell, there is strong evidence from randomised controlled trials that VAS reduces child mortality — with an estimated reduction of 4% to 12% depending on location — and VAS is one of the most cost-effective programmes that donors can support. It is very cheap to deliver, at around $1 per capsule, including delivery costs. And beyond preventing deaths, VAS is likely to provide additional benefits including increased income in later life, vision protection, and costs averted from treating illness.

GiveWell estimates that it costs between approximately $1,000 and $8,500 to avert a death through HKI-supported VAS campaigns, varying by country. This equates to being approximately 9 to 59 times as effective as its benchmark. GiveWell and The Life You Can Save have recognised HKI as a top charity.

In 2025, HKI distributed more than 94.4 million capsules of vitamin A. According to The Life You Can Save, HKI's annual impact includes supporting 388,000 families with education and tools to grow, prepare, and sell vitamin A-rich foods, and providing 32 million children under the age of five with two doses of vitamin A.

An estimated 40% of deaths of children under five in Nigeria are from vaccine-preventable diseases (New Incentives). Routine childhood vaccines are available for free at government clinics in northern Nigeria, yet according to GiveWell, vaccination rates in the states where New Incentives works range from just 39% to 68% — among the lowest in the world.

The barrier is not medicine. It is access. Caregivers face real costs in reaching clinics: transport, time away from work, the opportunity cost of a day. New Incentives addresses this with a simple idea: small cash transfers to caregivers who bring their children in for vaccination, paired with community awareness-raising and work with government to reduce vaccine stockouts.

Every 20 seconds, someone dies from a disease that could have been prevented by a vaccine.

New Incentives runs a conditional cash transfer programme in northern Nigeria, working in partnership with nine state governments (GiveWell).

New Incentives delivers three connected activities. First, it raises awareness about the benefits of childhood vaccinations through community mobilisation. Second, it provides cash incentives at government clinics after children receive vaccinations — caregivers receive approximately $9.50 in total across six routine immunisation visits (GiveWell). Third, it helps improve the vaccine supply chain to ensure enough vaccines are available at clinics.

New Incentives' programme was tested through an independent randomised controlled trial run by IDinsight. According to New Incentives, the RCT found a 108% increase in full vaccination coverage, a 62% increase in timely measles vaccination, and a 180% increase in the proportion of clinics avoiding vaccine stockouts — up from around 10% of clinics to over a quarter.

According to GiveWell, the programme leads to a substantial increase in vaccination rates of 9 to 18 percentage points depending on location, at a cost of approximately $18 per child enrolled. GiveWell estimates it costs roughly $1,500 to $6,000 to avert a death in areas where New Incentives works, making it one of the most cost-effective programmes they fund. GiveWell's qualitative assessment of New Incentives is described as very strong, even compared to their other top charities — noting that New Incentives stands out for its dedication to identifying, responding to, and being transparent about issues it faces.

Vaccination in northern Nigeria is one of the most underfunded areas in global child health. New Incentives is one of GiveWell's top charities.

Between January and November 2023, New Incentives enrolled 1.39 million infants in its program (GiveWell). According to New Incentives, the programme has served 6.79 million infants, issued 29.8 million cash transfers after verifying vaccinations, and encouraged over 103.9 million vaccinations. The programme maintains an 85.79% retention rate through the full vaccination cycle.