Global Public Health · 10 Interventions

The Lives
We Can Save

The world has made extraordinary progress against premature death. But millions more people are still dying from causes we know how to prevent, at costs far lower than we spend on almost anything else.

This site focuses on the ten best-documented mortality-reducing public health interventions. In many of these cases, a dollar can be directly traced to a life saved. It does not cover the broader landscape of quality-of-life improvements, mental health, disability, or non-communicable disease management: only interventions where mortality impact has been rigorously quantified.

📖 What is a DALY? A Disability-Adjusted Life Year measures years of healthy life lost — one DALY equals one year of healthy life lost to disease or premature death. The WHO considers interventions below $1,000/DALY highly cost-effective in low-income settings. Several interventions here cost as little as $2–6/DALY.
The world is much better.

Ten public health measures, including vaccines, oral rehydration therapy, antiretroviral treatment, and clean water have collectively transformed human survival. The ten interventions tracked here now save an estimated every year.

Impact of 10 Life-Saving Public Health Interventions

Toggle between annual impact, cumulative lives saved, and cost-effectiveness.

Source: WHO · Lancet 2024 · GiveWell 2024 · DCP3 · Our World in Data

The world can be made much better.

The same interventions that have already saved millions are still not reaching everyone who needs them. An estimated per year are within reach at current coverage targets.

Coverage Progress — Current vs. Full Potential

Each bar shows what fraction of the achievable impact is currently being realised.

Source: WHO · Our World in Data · GiveWell 2024

Additional Lives Saveable per $1 Million Invested

Where can additional dollars save the most lives? Central estimate = $1M ÷ √(cost_low × cost_high).

Source: GiveWell 2024 · DCP3 · Geometric mean of published cost-per-life bounds

💰 How Much Impact Can You Have?

Enter a donation amount and choose an intervention to see your estimated impact, with cost-effectiveness data from GiveWell, DCP3, and The Life You Can Save.

The central estimate uses the geometric mean of published low/high cost-per-life bounds — appropriate because cost-effectiveness ranges span multiplicative uncertainty.

Ten Interventions in Detail

Click any card to expand its full description, statistics, historical trend, and source links.

All Ten Interventions at a Glance

Click column headers to sort.

Intervention ↕ Lives / Year ↕ Total Saved ↕ Additional / Year ↕ Pediatric % ↕ Cost / DALY ↕ Cost / Life ↕ Period

Sources & Methods

All numbers on this page are drawn from peer-reviewed literature, international health agency databases, and the published evaluations of GiveWell and The Life You Can Save. Where multiple estimates exist, we report the range and note uncertainties. This section documents primary sources and key methodological choices.

Mortality & Disease Burden

  • Immunization (50 years): Hollingsworth et al. (2024). "Vaccine-preventable deaths averted, 1974–2024." The Lancet. Full text ↗
    154 million lives saved over 50 years of EPI. Measles alone: 93.7M of total.
  • Immunization (modelled, 2000–2030): Toor et al. / Vaccine Impact Modelling Consortium (2021). "Lives saved with vaccination for 10 pathogens across 112 countries." eLife. Full text ↗
    50 million deaths averted 2000–2019; 97 million projected by 2030 (80–120M 95% CI). 21 mathematical models using standardised demographic and coverage inputs.
  • Malaria: WHO World Malaria Report 2024. ↗
    597,000 deaths in 2023; 76% children under 5. 11.7M lives saved since 2000 through scale-up of ITNs, ACTs, and IRS.
  • HIV/AIDS: UNAIDS Global AIDS Update 2024. ↗ · WHO HIV Data ↗ · KFF Global HIV/AIDS ↗ · PEPFAR ↗
    630,000 AIDS-related deaths in 2024; 40.8M PLHIV globally, 31.6M on ART (77%); 1.3M new infections/year; 44.1M cumulative deaths since epidemic began. PEPFAR: 26M lives saved, 5.5M babies born HIV-free, $120B+ cumulative funding, 20.6M on treatment. 87% know status, 89% of those on treatment, 94% virally suppressed. Global HIV funding: $18.7B available vs $21.9B needed by 2030. HAART development in 1996 (ACS landmark) produced 60–80% decline in AIDS/death/hospitalization rates.
  • Water & Sanitation: WHO/UNICEF Joint Monitoring Programme (JMP). ↗ · JMP 2017 Report ↗
    829,000 deaths/year from unsafe drinking water; 1.4M/year from poor sanitation and hygiene. JMP 2017: 844M lacked basic drinking water, 2.3B lacked basic sanitation, 892M practised open defecation (2015 baseline). Only 71% of global population had safely managed drinking water.
  • Tuberculosis: WHO Global TB Report 2024. ↗ · TB Alliance ↗
    1.25M deaths in 2023; WHO estimates 75M lives saved since 2000 through DOTS and related programs. 2.7M TB cases undiagnosed annually. TB Alliance\'s BPaL regimen (2019) cut drug-resistant TB treatment from 18+ months to 6 months.
  • Oral Rehydration Therapy: GBD / WHO / UNICEF diarrheal disease estimates; Nalin et al. (1978). The Lancet.
    438,000 under-5 diarrheal deaths in 2021 (GBD). ORS reduces diarrheal mortality by up to 93% (Lancet 1978).
  • Tobacco: WHO Global Health Observatory / IHME Global Burden of Disease. ↗ · Gates Foundation ↗
    8M+ deaths/year attributable to tobacco; 1.2B users globally (down from 1.38B in 2000). 22M deaths averted 2008–2014 by MPOWER policies. WHO FCTC ratified by 182 countries. Gates Foundation: $498M committed since 2008 to tobacco control in 30+ countries. Global smoking prevalence declined from 32.7% (2000) to ~18% (2022).

Cost-Effectiveness Estimates

  • Primary framework: Disease Control Priorities, 3rd edition (DCP3). ↗
    Authoritative synthesis of cost-per-DALY and cost-per-life estimates. TB DOTS cited as ~$2–8/DALY — among the most cost-effective medical interventions documented.
  • GiveWell cost-effectiveness models (2023–2024): ↗
    Used for AMF (nets), Malaria Consortium (SMC), HKI (Vitamin A), New Incentives (vaccination incentives). GiveWell publishes full models with assumptions.
  • Vitamin A (VAS): Imdad A, Mayo-Wilson E, Haykal MR, et al. (2022). "Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age." Cochrane Database of Systematic Reviews Issue 3, Art. No.: CD008524. ↗
    47 RCTs, 1,223,856 children across 19 countries. All-cause mortality: RR 0.88, 95% CI 0.83–0.93 (high-certainty evidence, 19 trials, 1,202,382 children). Diarrhea mortality: RR 0.88, 95% CI 0.79–0.98 (high certainty). Also reduces diarrhea incidence by 15% (RR 0.85), measles incidence by 55% (RR 0.45), and Bitot\'s spots by 58% (RR 0.42). VAD affects 190 million children under 5 globally. GiveWell estimates VAS is 9–59× WHO cost-effectiveness threshold.
  • Vitamin A (GiveWell grant): GiveWell grant to Nutrition International for VAS renewal in Chad (September 2024). ↗
    Example of GiveWell\'s direct grantmaking model for VAS delivery in high-burden settings. Nutrition International (nutritionintl.org) is the world\'s largest VAS implementer.
  • Water chlorination (historical): Cutler & Miller (2005). "The Role of Public Health Improvements in Health Advances: The Twentieth-Century United States." Demography 42(1):1–22. ↗ NBER Working Paper No. 10511. ↗
    Clean water responsible for ~50% of overall mortality decline, ~75% of infant mortality reduction, and ~2/3 of child mortality reduction in 13 major US cities 1900–1936. Social rate of return >23:1; cost ~$500/life-year saved (2003 dollars). Waterborne diseases fell from 25% of infectious disease deaths in 1900 to near zero by 1936.
  • Water treatment (meta-analysis): Kremer, Luby, Maertens, Tan & Więcek (2022). "Water Treatment and Child Mortality: A Meta-analysis and Cost-effectiveness Analysis." BFI Working Paper 2022-26. ↗
    Meta-analysis of 15 RCTs (25,300 participants): 28–30% reduction in under-5 all-cause mortality (Peto OR 0.72, 95% CI 0.55–0.92; Bayes OR 0.70, 95% CrI 0.49–0.93). Expected reduction in new implementation: 25%. Cost per DALY averted ~$40 for chlorine dispensers — approximately 45× below 1×GDP threshold. Funded by GiveWell.
  • Water chlorination (RCT): Kremer et al. (2022). NBER Working Paper 29447. ↗
    Kenya RCT: chlorine dispensers reduced child mortality by 63–67%.
  • Tobacco tax: Ngo et al. (2021). Nature Medicine. ↗
    A universal $1/pack tax increase could prevent 15M deaths over 10 years and reduce global smokers by 66 million.
  • AMR mortality: Murray et al. (2022). The Lancet.
    1.27M deaths directly attributable to drug-resistant infections in 2019; 10M/year projected by 2050 without action.

Charity Evaluator Notes

  • GiveWell Top Charities (2024): Against Malaria Foundation, Malaria Consortium, Helen Keller International, New Incentives. These are the only four currently recommended organisations. GiveWell discontinued its "Standout Charity" tier in October 2021. ↗
  • The Life You Can Save (TLYCS): Recommends ~23 charities across health, education, and economic empowerment. All four GiveWell top charities are also TLYCS-recommended. TLYCS has a broader mandate and does not apply GiveWell's strict cost-per-DALY filter. ↗
  • Gavi, the Vaccine Alliance: GiveWell reviewed Gavi in 2011–2018 and concluded that private donations would not produce additional impact because institutional donors (governments, Gates Foundation) already fully fund Gavi's programs. GiveWell explicitly notes their analysis predates COVID-19 and the funding landscape may have changed. ↗
  • Evidence Action — Dispensers for Safe Water: GiveWell committed $64.7M in 2022 but declined to renew Kenya funding in August 2024 after independent surveys found actual program reach (~2M people) was ~40% below projections (~4.7M), and the program fell below GiveWell's rising cost-effectiveness threshold (~10× cash benchmark). This case led GiveWell to invest more heavily in independent data verification across all grants.
  • Stop TB Partnership: Was a GiveWell top charity in 2009 (praised for coverage requirements, spot-check audits, public non-compliance disclosures). No longer recommended: GiveWell found that marginal private funding would flow to MDR-TB programs rather than first-line DOTS treatment, with uncertain cost-effectiveness.
  • MSF (Médecins Sans Frontières): Not a GiveWell top charity. GiveWell previously awarded "Special Recognition" for MSF's exceptional transparency — unusually, MSF published honest accounts of underperforming programs including a failed China TB effort. That recognition page is now marked outdated.
  • Evidence Action — Deworm the World Initiative: A GiveWell top charity. Treats 280M+ children annually for soil-transmitted helminths and schistosomiasis. While deworming's mortality impact is debated, long-term follow-up studies show significant economic returns (20% increase in adult earnings). Evidence Action also operates multiple other evidence-based programs.
  • International Rescue Committee (IRC): Not a GiveWell top charity but a major cross-category health implementer operating in 40+ countries, particularly in crisis and conflict settings. IRC's health programs span immunization, malaria, nutrition, and WASH. Their cost-effectiveness is harder to assess than single-intervention charities, but they reach populations that other organizations cannot.
  • Nutrition International: GiveWell direct grant recipient for VAS delivery. World's largest vitamin A supplementation implementer, reaching children across 60+ countries. Received GiveWell grants for programs in Chad, Nigeria, and other high-burden countries. nutritionintl.org
  • TB Alliance: Non-profit drug development organization that developed the BPaL regimen for drug-resistant TB. Not reviewed by GiveWell (R&D focus). tballiance.org
  • Global Action to End Smoking: Formerly the Foundation for a Smoke-Free World. Funds harm reduction research and cessation programs. Not reviewed by GiveWell. globalactiontoendsmoking.org

Methodology

  • Cost-per-life calculator: Uses the geometric mean of published low/high cost-per-life bounds. This is appropriate because cost-effectiveness ranges span multiplicative uncertainty (e.g., $500–$5,000) rather than additive uncertainty — the geometric mean ($1,581) is less biased than the arithmetic mean ($2,750).
  • "Additional lives reachable": Difference between lives saved at current coverage and lives that would be saved at full (or WHO target) coverage, holding all other variables constant. A rough approximation — real-world marginal costs typically increase as coverage approaches 100%.
  • Pediatric shares: Derived from intervention-specific literature. Immunization: WHO/UNICEF data + Lancet 2024. Malaria: WHO Malaria Report (76% U5). HIV: UNAIDS data (~8% of deaths are children under 15). Vitamin A: 100% (programme targets children under 5 by definition).
  • Historical trend data: Global aggregates from WHO GHO, UNAIDS, WHO/UNICEF JMP, IHME Global Burden of Disease. Values are estimates; methodologies have changed over time (interpret long-run trends as directional, not precise).
  • DALYs: Disability-Adjusted Life Years from DCP3 and WHO cost-effectiveness databases. The WHO defines interventions below $1,000/DALY as highly cost-effective in low-income settings; several interventions here are $2–8/DALY.
  • Framing: Based on Max Roser's essay "The world is awful. The world is much better. The world can be much better."
Important caveats: Numbers on this page aggregate across geographies, time periods, and methodologies with different assumptions. Cost-effectiveness estimates can vary 10–100× depending on country, implementation quality, and counterfactual assumptions. Lives-saved estimates involve substantial modelling uncertainty — note the 95% credible intervals where cited (e.g., the VIMC immunization estimate of 97M has a CI of 80–120M). This page is best interpreted as indicating orders of magnitude of impact, not precise accounting. Consult primary sources before making significant decisions.