Elie Hassenfeld: [00:00:00] Hi, this is Elie Hassenfeld. I'm GiveWell's co-founder and CEO. Today I am speaking with Natalie Crispin, who leads GiveWell's work on vaccines. Philanthropic funding for vaccines is really interesting because finding programs to support isn't straightforward. Vaccines are so effective that a lot of philanthropic funding already goes to vaccines, and so the challenge for us is identifying substantial gaps in funding that we can fill to deliver vaccines that are needed and improve health. So I hope that our conversation today illustrates the kind of work that we do to find cost-effective programs that help people in low-income countries. And then I hope it also illustrates how GiveWell's research has evolved and improved in just the last few years. 

GiveWell is most known for our Top Charities, and in the past, a majority of our research time focused on those Top Charities. Because of this, we organized our research team into these buckets: the Top Charities group and also everything else.

Today we still go deep on Top Charities and a lot of our funding goes to Top Charities, but the majority of the time that [00:01:00] our research team spends is on other investigations. So that's looking for and supporting programs that are not Top Charities. I want to give a little history just to explain where we are today and how it fits into where we've come from.

So to enable us to do more of this work on non–Top Charities in 2023, three years ago we reorganized the research team into cause-specific units. So now we have a team that focuses on vaccines and also nutrition and water, malaria, and more. And this reorganization has enabled us to find more cost-effective programs that we're excited to support. We've also increased the size of our team, so three years ago, we were approximately 30 people on our research team. Today, we're nearly 60. So we've specialized and we've also roughly doubled our capacity from where we were just three years ago. And so this year, in 2026, with a bigger team and a team that's building expertise in important areas, we're able to be broader and also deeper than we were even as [00:02:00] recently as three years ago.

One of the outcomes this has enabled is it's given us the opportunity to move from being solely what you might call a passive grant maker to an active grant maker. I'll explain what those terms mean.

When GiveWell got started, our idea was let's just look for the most cost-effective organizations that exist. We want to look out at the world and have them apply and then direct funds to great programs that we can find. Over time, with this additional capacity and specialization, we're in a better position to go out to the world and say, you know, we think, for example, this particular approach to increasing vaccination can be very cost-effective. That's something we do today and that's more active grant making.

So we're going to talk about all of that with Natalie today. I'm especially excited to have this conversation with Natalie Crispin because Natalie is GiveWell's longest tenured staff member after me. She's been here [00:03:00] since 2009, and I think it's especially fitting to have this conversation with you, Natalie, because you can shed light on vaccines work today, but also how GiveWell's research has evolved over the past nearly 20 years. So Natalie, thanks for joining this conversation.

Natalie Crispin: Thanks, Elie. Happy to be here.

Elie Hassenfeld: Let's just start by sharing kind of the big picture. What's the state of vaccine funding today, and you know, especially in light of aid cuts by the US government last year. And then we can talk a little bit about how that informs the approach you take to grant making and what that means for the work we're doing in 2026.

Natalie Crispin: Great. So yeah, at its very basic: Vaccines are very effective. There's a lot of evidence behind the idea that vaccines reduce causes of mortality, and have been a big piece of why child mortality across the world and particularly in low- and middle-income countries in the last few decades has really plummeted.

There are some challenges to delivering vaccinations. They [00:04:00] often involve needles. Not all vaccines, but most vaccines involve needles. So you need some amount of skill to deliver them. It's a fairly complex schedule where you need multiple doses of many of the vaccines, you're trying to deliver them at young ages, and ensure that children are getting them at the appropriate ages so that they're protected when they're at higher risk.

And they need to be kept at a certain temperature range, which can be very challenging in places that have limited access to electricity. However, really they've been an incredible success story where rates of vaccination are really high in a lot of places, and even some of the most challenging places to work in.
And so is really a strong foundation to build on. There's also a lot of room for improvement in places where coverage may only be half of what we see in some of the more wealthy countries. So, yeah, I think it's a really interesting [00:05:00] area, a place where there can be a lot of cost-effective work.

And also a place where you need to make sure that you're being additive to what's already happening. There are some very large funders in vaccination. Governments contribute a lot to their own vaccination programs, and Gavi is a large multinational organization that brings together large amounts of funding from donor governments to supply, mostly to supply the vaccines, subsidize the vaccines that countries buy, as well as to support the delivery systems.

And Gavi has seen some cuts in the last year with the US announcing that they weren't going to pledge to Gavi. And that has left them in a position where they are asking countries to cut back on what external support they're going to get. So, that's where we are today. It's dynamic. We're waiting to see how some of that plays out, but definitely an interesting space to [00:06:00] be looking at.

Elie Hassenfeld: Yeah. So one of the things I've always thought about vaccines since the beginning is, on one hand, you listed out a lot of challenges with delivering vaccines, but in the scope of all the things that we can do to improve health in low-income countries, like these challenges are in some sense relatively limited relative to the challenges that exist in many other programs. I mean, even something like malaria nets, which GiveWell has provided a lot of support for over the years, you have to replace a malaria net every couple years. People have to use it every night. The insecticide in the net that kills mosquitoes can degrade, or mosquitoes can develop resistance. The nets themselves can develop holes and the nets need to be used on a consistent basis over time to get the effect. Where in the case of childhood vaccines, it's, you know, one or some small number of doses at one stage in life that then confers lifelong protection, or at least long-term protection.

And so, you know, for these reasons, vaccines are, they have challenges, but in the scheme of things like really [00:07:00] powerful. They're also relatively cheap and they're effective at preventing diseases that are deadly. And I think for some of those reasons, there was a large amount of global funding that came in.

You know, you mentioned Gavi as the largest funder of vaccines. And I think that has just always made it challenging for us at GiveWell to find ways to take the money that donors are giving us and then turn it into, you know, more people receiving vaccines. You know, that's been a big challenge for us over time.

And so I think a lot of what we're going to talk about today is ways in which we're trying to approach that particular challenge. But before I dive into that, I'm curious, with aid cuts, which, you know, we talked a lot about over the past year. How much do you think that that picture is changing? Meaning, to what extent does it seem to you like supply of vaccines is now likely to be a big gap? Where in the past, like that was not the primary gap. And by supply of vaccines, I mean, purely having the money to purchase the vaccines so [00:08:00] that countries could deliver them.

Like, is that, has something changed there? And if so, by how much?

Natalie Crispin: Yeah, it's a good question. I think largely the money to buy the vaccines is still going to be there. So Gavi is prioritizing that—the US was 13%, something like that, of Gavi's funding, so some of the impact on vaccine supply and aid cuts has been cushioned by the fact that there are many donors. And then Gavi is choosing to cut back in areas that are not the core vaccine supply. There are going to be exceptions to this, so Gavi is looking at having two categories of vaccines, one being core vaccines and the other being discretionary vaccines. And some of the things in the discretionary pot, either countries won't be scaling up as quickly as they were expecting [00:09:00] to, or there's a possibility that they might have to scale back, which would be, I think, unprecedented in vaccination to have to take vaccines out of a schedule. So I think, for that reason, it's less likely to happen.

But particularly malaria vaccines are new. They're relatively expensive. So many vaccines are under a dollar or two per dose. Malaria vaccines are more like $3 a dose for some of the less expensive ones. And you need four to complete the series, which is the most of any vaccine.

We're looking at that. I think there are potential ways that that could be mitigated, but I think we'll know more later this year.

Elie Hassenfeld: And I guess, you know, one of the benefits of your being in a position and our vaccines team being in a position to focus completely on vaccines in your daily work is you can stay in touch with the people in the vaccines [00:10:00] community on the funding side, the organizations that are delivering programs. And if something changes and there is, you know, a need for vaccine supply or what have you, your connections will mean that you'll hear about what's happening on a pretty regular basis.

Natalie Crispin: Yeah, that's been a big benefit of the reorganization into these subject matter–specific areas is that we both have more people, more time to focus on these areas, and a specific mandate to focus on these areas. And so, as you mentioned before, we used to organize into Top Charities and everything else. That made sense at the time because the question was how do we operate in a different way? How do we find things in a different way? And that had sort of that unifying question.

Over time, we found that we were having a lot of grants in a particular area but weren't sort of concentrating that expertise. And so we moved more [00:11:00] into organizing by cause area. And we've seen a lot of benefits from that. In the vaccination space, I went from managing the Top Charities team with a similar number of people that I now have working on vaccination with me. And it just feels like we can do so much more in that space because of that.

And talking to other funders, implementers, experts, has been a real benefit. Just being able to test some of the assumptions, talking to people and realizing I was assuming something, I was thinking about something in some way. But actually there was some underlying assumption there that was not true. And that happens now way more often than I think it did before. And then being able to spend more time and talk to more people about generating new ideas for things we could do, testing them out, and just getting to be more exploratory in the vaccination space.

Elie Hassenfeld: The big picture with vaccines is they're really effective. They're [00:12:00] relatively cheap, and there's a lot of funding that is supporting their delivery. And so the challenge for us is identifying areas where there are substantial gaps in funding that we can fill to deliver vaccines that are needed and improve health. And so, yeah, like Natalie, how are you thinking about this challenge, and what are some of the areas where you expect additional funding to do a lot of good via vaccines?

Natalie Crispin: This will be a little bit stylized, but when you look at a place that has particularly low vaccination rates and you ask people, as we have been, what are the bottlenecks here? Why aren't we getting higher coverage rates? We hear a lot of the same things over and over again. So people live far from health facilities where vaccines are delivered. There's not funding for vaccinators to go out and do outreach, which is a common strategy for reaching more children who [00:13:00] may not be as close to health facilities. There may be problems with the cold chain. There may be some people who are hesitant about vaccines, aren't sure about the benefits, and are wary of the side effects.

So when we look at that picture, we think, okay, what are the things that seem most likely to bridge that gap? Some of the work that we've done in the past was around incentives, so providing compensation to parents, to caregivers who brought their children to the health facilities since they had to take time out of their income-generating activities, as well as pay for transportation to get to the health facilities.

And then, also thinking about this outreach strategy, which is common, is done across most places. However, also has challenges because it is fairly resource intensive to get people to go from the facilities to the communities where children are [00:14:00] and particularly the communities where there's high rates of children missing vaccines because they're further out.

And so, in trying to build out a set of programs that we think might be particularly cost-effective, we've made a push recently on the vaccination outreach piece. So, we ran a request for proposals last year. We're going to run another one in the next couple of months. And, asking organizations to bring us more specific ideas of how they can supplement what's already happening with outreach and reach more children, get coverage rates up, and then separately funding a set of coverage surveys that are going to take a read before and then several times during the program to say, is this program in fact resulting in higher coverage rates?

Elie Hassenfeld: I want to go through these different categories that you mentioned and kind of talk through some of the grants you made and also some of the programs you're considering. So that's in areas like outreach, cold chain, [00:15:00] incentives, maybe other. But before we get there, you know, we went from vaccines are great, it's hard to find opportunities, to a few like specific strategies that you could employ to increase vaccines. And, you know, some of that I guess came from speaking with people, you know, asking people like, well, what are the obstacles to vaccinations? So that's one pathway.

I'm also curious to just compare, because you've been at GiveWell for a long time, and so compare how we learned about vaccine programs in the past versus what we're doing today. You know, like you said, we've done some work on incentives. You know, a Top Charity of ours is an organization called New Incentives, and they give small cash incentives to caregivers to encourage parents to bring their kids to childhood vaccine appointments. And that alleviates some of the obstacles. And one of the reasons that we supported that program, that New Incentives settled on that program, is that there was a fair bit of randomized controlled evidence demonstrating that vaccine incentives can increase vaccine [00:16:00] utilization among families. So that was a very good fit for us.

But I'm especially curious like, where did these ideas come from and would we have been able to do this five years ago? And if not, why not? How would this have looked five years ago?

Natalie Crispin: I think one of the key differences came from, as you were saying, looking in the academic literature, finding what programs were classified as "programs," studied as a program, studied in multiple places and found to be effective in a wide variety of contexts.

And GiveWell supported a lot of those programs. There's a lot to recommend them because they are so scalable and often they're things that are very basic and so it can be very cheap. And then in the vaccination space, now we've shifted to asking ourselves, "What's missing to make this system reach more people?" rather than starting with specific program types. And we still want things that have evidence or that we could generate evidence to [00:17:00] show how effective they're being and decide whether or not to continue funding them. But in the case of vaccination, that led us to understand things like the planning work that goes into figuring out who's being missed by the system and what it would take to reach them, the additional funds for vaccinators or motorbikes or boats to help them get to the places that aren't getting the same levels of coverage as the ones that might be closer to the health facility.

Because of the nature of the vaccination space where coverage is pretty high in general, you don't want a blanket approach like we might do for seasonal malaria chemoprevention where people are not accessing this service outside of these broad campaigns. You need more of a specific targeted approach so that understanding of how the system works, what's missing, sort of naturally leads to a certain kind [00:18:00] of intervention. And that intervention doesn't necessarily have like an academic literature behind it.

There's a few studies. They're in pretty different contexts and they don't quite look like this is a program with a very specific set of activities. It's more like, here's a gap you need to fill in a specific system. And so now we're trying to sort of fill that evidence base in what might be a less rigorous but more practical way where we're trying this program in a bunch of different places. We're doing these before and after surveys. We are looking at variations on the program. We're asking for a unified set of monitoring indicators so we can compare across programs. And I think, well, we're hypothesizing, we're trying that that is an approach that will help us decide what to scale up.

Elie Hassenfeld: I want to get into examples, but it's really interesting to think about this in the context of, I don't know, like how GiveWell research has worked over time. Like in some ways, vaccines just didn't fit [00:19:00] well into our historical approach to doing research.

I mean, we found a few cases, like New Incentives, and years ago we supported an organization called Village Reach. But the situation with vaccines is it's—this might be overly simplified so you can tell me if this is wrong—but it's so well funded that it is difficult to find these like huge programs with large amounts of randomized evidence behind them. That just like doesn't exist in the same way for vaccines, but because of all the benefits we talked about even though some large portion of the funding gap is taken care of, it can be really cost-effective to fill in additional money, at the margin on top of all the funding that already exists.

And then the approach that we took historically just doesn't work well for vaccines because, sure, you could imagine an RCT run on the boat-delivering vaccine organization and the specialized backpack approach. You know, maybe you could have like a combination of the approaches, even then, to [00:20:00] your point, there's so much geographic variation in what it takes to reach a place, what the immunization rates are, that the idea of the kind of randomized control trials that you would do for seasonal malaria chemoprevention, like how effective is that in a given broad geography that we talked about recently in these conversations, it's just is different for vaccines. It's like a much more targeted approach.

And so, I don't know, like it feels to me like we literally could not have done this five years ago with the structure we had and with the capacity we had. Like we were, we were doing what we could with the size of team that we had, and now we're in a position where we can go much further and, you know, look at these targeted approaches and evaluate them in their location, you know, on their own merits, which I think is, I don't know, like a really interesting way to see how our growth and evolution on research is enabling us to find opportunities that we literally could not have found in the past. We would not have been able to. Yeah, I don't know. Do you agree with that framing? Like, what do you think?

Natalie Crispin: That [00:21:00] seems right to me. Like vaccination outreach was not on our radar. We weren't thinking about it as a program. We weren't taking this portfolio approach of making a series of grants that was going to help us figure out which of those to then take forward. And I think it's, yeah, just it's exciting to be in this part of the evolution where we are now finding a bunch of new things. Things that might be even more cost-effective than some of the things that we've done before. And, being able to sort of round out the types of programs we're able to consider.

Elie Hassenfeld: Yeah. Okay. This is great. So let's actually try to talk about some of the things that you're excited about. You've talked a lot about vaccination outreach. Maybe we can go through some of the, you know, one grant that GiveWell has made in that area to make it really concrete. Like, what is this? How does it work? You know, why is it promising? And, you know, maybe the always important question, what could go wrong? Or, you know, what could you be wrong about in this area that could make it less cost-effective than you think?

Natalie Crispin: We made four grants so [00:22:00] far for vaccination outreach. We're planning more in 2026. One of the ones that we've made recently is, parts of the province in DRC called Congo Central. The data that we've looked at there indicates that only about half of children are receiving each vaccine.

So there's different rates for different vaccines, but on average it's about half for each vaccine. And the government officials, other funders, and others that we talked to while considering this grant thought that some of the biggest challenges to getting coverage up here were long distances between communities and health facilities. The lack of funding for vaccination teams to plan and carry out these outreach sessions. And so the grant will provide access and training to mapping tools that will enable vaccinators to better target where to go out to. They'll pay community health workers to collect information on children in their [00:23:00] community to ask who is and not vaccinated, to then send that information digitally to health facilities, and then the grant will also pay for transportation for vaccination teams to go out and reach the communities who are identified through this data collection as at higher need.

We're then making a second grant to a separate organization to do baseline and follow-up coverage surveys to see if the coverage rates go up. We're projecting an 11 percentage point increase in vaccination coverage, which would be significant. This is supposed to be a pretty intense project, but it does not require that this project get to anything like a hundred percent coverage to be at the cost effectiveness level that we've estimated it at, so we hope that's realistic.

I think it's a really exciting grant because we think it could be a replicable approach, and something like a million and a half children are born every year in provinces in DRC where [00:24:00] coverage is similar or lower than what we think is happening in Congo Central.

So the idea is that if this program has a result similar or better to what we think it might, then we could scale it up, or other funders could scale it up, and it could absorb maybe tens of millions of dollars a year in DRC for something that's, you know, potentially highly cost effective. It is quite expensive per child. So we're hoping that over time it could reduce. And we also think that because there is some existing outreach work, there's a risk that this could more replace what's already happening rather than be additive to it. Another challenge is around the digital data collection. We think that this is potentially a really important and exciting innovation. Well, innovation might be too strong. It's a tool that has been used in many places and can do a lot. [00:25:00] But it can be really challenging in a context where there's limited connectivity, where the community health workers using it may have been trained in other systems, where they may have to be duplicating records in digital and paper systems in order to meet all the different requirements. So that's a piece that we're gonna also be looking at closely.

Elie Hassenfeld: Okay. And so I just want to kind of get anchored on this. So, we have this roughly 10% expected increase in vaccination coverage—it sounds like that's really the core measure of success in this program. So, you know, again, very roughly going from about 50% coverage to about 60% coverage. I imagine that that estimate is not very precise. Like we wouldn't be shocked to learn that we doubled that, we wouldn't be shocked to see that it ended up being half as much. But that is in some ways the level we would need to reach in order to see this grant as cost-effective, or sufficiently cost-effective that we would keep supporting it. Is that all basically [00:26:00] right?

Natalie Crispin: Yes. I'll caveat a little bit by saying we actually think that this particular grant, its direct benefits, is lower than our bar. And the reason why we made the grant was because we think it can teach us about whether a something like 10 percentage point increase is feasible in this context, can give the partner who's going to carry this out, the Clinton Health Access Initiative, or CHAI, will give them experience with implementing this.

And then, there's two ways that we could end up wanting to do more of this program, even though it's currently estimated below our bar. One is it could exceed our expectations and then another is it could be trialed in this location and then expanded to other places. Congo Central is actually about average or slightly above average for coverage rates in DRC, and we're starting there because it's a somewhat more feasible, [00:27:00] relatively easy to work in area, and then get the experience and potentially go to areas where it's a little bit harder to work in, but more potential for impact because coverage is starting lower.

Elie Hassenfeld: And so I guess this is one of the challenges that just comes with doing, you know, more of this supporting programs to grow and even supporting programs that are not currently operating in exactly this way, which is, we don't know what will happen. And so our attitude is, this has a lot of potential. It has a lot of potential to have more of an impact than our quote best guess. Also, we could learn other things that would enable us to make better decisions in the future. And so a lot of what we'll do in the future is going to be dependent on, you know, what we learn from supporting this particular grant.

Natalie Crispin: Yeah, and I think back to when we decided to support the randomized control trial of New Incentives, and we came really close to not making that grant. We thought it was likely below our bar, but we thought it was worth learning and seeing. Maybe it was above our [00:28:00] bar. Now we think it's one of the most cost-effective programs we've ever funded.

Elie Hassenfeld: Yep. And then I just think it's interesting here to think about the stakes of this grant. Like you said that there's something like a million and a half children born in DRC in provinces with coverage similar or lower than Congo Central.

And so the stakes are very high. As far as we know, there aren't other funders, or you should tell me, but there isn't a lot of funding coming in trying to do the thing that we are doing here by finding these obstacles and then alleviating them. And so the imperative to engage and to try to learn to deliver funding effectively in provinces like this in DRC is that there are so many children born every year who are not getting the vaccines that they need. And so we're trying to learn what we can so that we can serve them.

Natalie Crispin: Right. Yeah, there definitely are other funding sources that are trying to do similar things, but it's a massive problem and declining global resources for this sort of work. So we think there's a gap.

Elie Hassenfeld: I wonder if we can just touch on one of the other areas that you mentioned as potentially [00:29:00] interesting, which is the supply chain or the cold chain. You know, this is like a very different kind of approach to increasing vaccination rates. So, you know, we've done incentives, which is making it easier for caregivers or incentivizing caregivers to bring children for vaccines. And then outreach is the set of activities that we just described. And then cold chain supply chain, it's like really getting in there to the logistics of vaccine distribution. And so, yeah, I'd love it if you could just say more about where you're at on this one and what you found, what you're seeing, and what some of your major questions are.

Natalie Crispin: We're at an earlier stage in understanding this space. We have the general impression that cold chain and supply chains are functioning reasonably well in delivering vaccines to health facilities. However, we commissioned a report in 2025 on what had been the impact of US aid cuts. So this was before Gavi cuts, which are coming through now, and was just about the bilateral aid [00:30:00] programs funded by the US. The researchers were talking to district level, health facility level people involved in the vaccine delivery system, and they were talking about reduced funds for outreach, reduced funds for staff. They were also talking about some of the cold chain maintenance and the push-and-pull system of getting vaccines out to health facilities and how either they had seen degradations in those already or they were fearful of them because there was no longer a funding stream for cold chain maintenance or things like that.

And so that will keep changing as governments and other funders react to the funding cuts and fill in, in some places potentially, or have to move funding further out from those needs. And I think that's an area that we want to get more into, make some early grants in, and understand what are the best [00:31:00] approaches here and where's the highest need. So we're thinking about some potential grants in that category later this year.

Elie Hassenfeld: And then a category you didn't mention, but I know we've done a lot of work on, and it overlaps with, you know, a large part of GiveWell's work is focused on malaria and malaria vaccines. GiveWell has provided a huge amount of support to malaria via malaria nets at the Against Malaria Foundation, seasonal malaria chemoprevention via Malaria Consortium. Vaccines are now a program that can be supported. And would just love if you could talk a little bit more about the kind of work that we've done, that you've seen and are thinking about with malaria vaccines.

Natalie Crispin: I think this is a super interesting area. It's a very interesting point in the cycle because 2025 was a very big year for introducing malaria vaccines into countries' schedules of infant routine immunizations. And now the vast majority of countries that have high [00:32:00] malaria rates have introduced malaria vaccines, which means it's at least in a part of the country, they're delivering vaccines.

A few years back, GiveWell was making some grants in the space of helping with this introduction process, buying doses for areas that were the comparator areas for a pilot project, providing technical assistance to national governments as they worked out how to retrain health workers adapt supply chains, those sort of things, to get the system to start providing those vaccines.

Now the needs I think are shifting, and so one of the big areas of need is in just getting coverage up. So where they're offered but not enough children are getting them or completing the four-dose schedule. And these are doses that are not intended to be given at the ages when parents have traditionally [00:33:00] brought their children for vaccinations. So it's extra times that parents have to make the trip to a health facility. So we do think vaccination outreach, as we've been talking about, will be helpful for that sort of increasing coverage across the board. And I think malaria vaccines will particularly benefit from that because there's quite a bit of sort of catch up, as you might think of it, to be done in that work.

And then I think there's a question going forward whether buying the doses will be a bottleneck. Gavi is having to give countries budgets of how much they can spend on the vaccine support that they get from Gavi. And countries may have to decide about what they're going to do as far as slowing down their scale up, which may leave high-burden areas uncovered, or potentially even reducing their scale. As I mentioned before, that would be, I think, unprecedented in vaccination. So that is something we're talking to other groups about [00:34:00] and figuring out if we think there could be a funding gap in the future. But it's a little early in the process for that.

Elie Hassenfeld: Yeah. Thanks so much, Natalie. This has all been, you know, really interesting to me. I learned a lot from this conversation. I feel like we only covered maybe a quarter of what I was hoping to in our time, but there's certainly a lot more on vaccines that we're doing than we were able to talk about. Anything else you want to add or share before we wrap up?

Natalie Crispin: I guess I'd just say that compared to, say, five or 10 years ago, the thing that feels like it's changed most is the number of people I get a chance to work with and ideas that come out of that just leads to more assumptions questioned, more ideas available, and I think better decisions that I feel more confident in.

So, it's just a really exciting time to be at GiveWell, to get to work with the colleagues that I do, and having the opportunity to build these connections with others in the space and understand what we're getting wrong more quickly and more frequently than we did. [00:35:00] So that's what I'm feeling particularly excited about and just happy to be part of this transition as we keep figuring it out.

Elie Hassenfeld: Thank you so much, Natalie. This has been great.
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Hey, this is Elie again. I hope that this conversation really helped illustrate how GiveWell of today is operating differently and better than we were in the past. You know, I think Natalie put it well when she said that the way we used to approach it is we'd start with a program and say, "What do we need to do to make this program reach more people?"

And now instead we're able to ask a different question, which is, "Here's a problem: Vaccines aren't reaching enough people in the Democratic Republic of Congo. What programs could reach them? What evidence exists? And then what could we do to support more evidence, to identify cost-effective ways to help people in need?"

We are, I think, clearly in a position to find things we couldn't have with the approach we were taking in the past. So we're finding more. And [00:36:00] then, because of the size and scope of our team, can go deeper and, you know, in my opinion, make better decisions about the grants that we're making than we ever could before.

I hope this conversation focused on vaccines is interesting in and of itself, but also it's just one example of the work that our research team is doing in so many areas, including nutrition, water, livelihoods, malaria, and more. So I hope this was able to shed some light on one area of our work.
As always, if you have feedback or questions, please send them to info@givewell.org. And if you are interested in supporting our work, we would appreciate it. Every additional donation helps us do more. And you can donate at givewell.org. Thank you so much.