Evidence Action

Evidence Action scales low-cost health interventions that improve the wellbeing of hundreds of millions of people in Africa and Asia. The organization currently has four programs: Safe Water Now, Deworm the World, Equal Vitamin Access, and Syphilis-Free Start. Evidence Action’s Accelerator drives new program development, refining high-potential and cost-effective interventions.

Their demonstrated impact includes:

  • Providing access to safe drinking water, which has saved more than 15,000 lives of children under 5 and averted over 3 million diarrhea cases in young children. 
  • Helping governments deliver over 2 billion deworming treatments in the last decade, which is estimated to produce $23B in productivity gains.
  • Reaching over 515 million people globally with interventions since their founding.

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Key Strengths: Evidence, Scale

Multidimensional Poverty Index Indicators: Mortality, Drinking water, Sanitation

Other Key Outcomes: Child development

Recent Expense Budget: US$32,000,000

Year Founded: 2013

Operating in
9
countries
9M
people given access to clean water
195M
children reached with deworming treatment in 2023, for $0.50 per treatment
35M
children reached with supplements to prevent anemia
1,300
newborn lives saved through maternal syphilis screening and treatment
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The problem: scaling impactful interventions

In order to tackle extreme poverty at the level it exists, how do we bridge the gap between identifying evidence-based, cost-effective interventions that work and successfully scaling them up to improve the lives of millions?

The solution: expertise

Evidence Action’s mission is to be a world leader in scaling evidence-based and cost-effective programs to reduce the burden of poverty. Evidence Action takes evidence from rigorous research and uses their expertise in program delivery to design and implement interventions that have an impact on hundreds of millions of lives.

Evidence Action was incubated by Innovations for Poverty Action (IPA), a highly respected poverty research network. (IPA is another of The Life You Can Save’s recommended organizations).

Children waiting in line for Evidence Action deworming pills

How Evidence Action works

Evidence Action operates four programs, plus their Accelerator: Safe Water Now, Deworm the World, Equal Vitamin Access, and Syphilis-Free Start.

Safe Water Now

Every year, 1 million people die from diarrhea caused by unsafe drinking water, sanitation, and hand hygiene — and 525,000 of those deaths being children under five. [1] Safe Water Now provides access to safe drinking water to millions of people in communities across Kenya, Uganda, Malawi, and India. The program is based on rigorous research that shows water treatment reduces under-five deaths by 25%, and is delivered through two complementary water treatment solutions:

  1. Chlorine dispensers: Evidence Action has a network of 52,000+ chlorine dispensers across rural communities in Africa. Maintained by over 100,000 local community volunteers, the dispensers are installed directly at water sources and enable safe water at the turn of a single valve.
  2. In-line chlorination: For communal piped water systems — often found in peri-urban and urban communities — Evidence Action installs in-line chlorination devices directly on water tanks. As water flows, it’s automatically chlorinated in the correct dose.

Safe Water Now’s focus on human-centered design – requiring little to no behavioral change from the end user – yields chlorine adoption rates that are up to five times higher than other water treatment solutions and are sustained over time. [2]

Three woman treating their water with chlorine with a dispenser from Evidence Action.

Deworm the World

There are more than 913 million children at risk for parasitic worm infections like soil-transmitted helminths and schistosomiasis. [3] These worms interfere with nutrient absorption and cause malnourishment, anemia, and impaired mental and physical development; they also prevent children from attending school, which impacts their future success in life.

Deworm the World works with governments to implement large-scale school-based deworming programs Deworm the World has helped contribute to significant declines in worm prevalence in Kenya, and evidence from India indicates that success in reducing prevalence is being achieved there as well.

Deworm the World has helped governments deliver over 2 billion treatments, including 195 million in 2023.

Syphilis-Free Start

Maternal syphilis causes more stillbirths and infant deaths than HIV, yet it’s easily preventable — with an inexpensive dual HIV/syphilis test and a single shot of penicillin. 

Evidence Action helps governments bring low-cost syphilis screening and treatment to pregnant women through antenatal care clinics. Working with health ministries, with the goal of transitioning full responsibility to governments in 5-7 years, Syphilis-Free Start has had impressive results so far in Liberia – screening coverage increased from <7% to nearly 70% as of December 2023.

Syphilis-Free Start has helped 320,000 pregnant women be screened for syphilis and over 5,400 syphilis-positive pregnant women be treated; and it has averted 2,300+ adverse birth outcomes – including saving over 1,300 lives.

Evidence Action is now expanding the program into Zambia and Cameroon.

Equal Vitamin Access

Iron deficiency anemia affects millions of children and adolescents and is a leading cause of malnutrition and disability. Evidence shows that weekly iron and folic acid (IFA) supplements are highly effective in combating anemia.

Through its Equal Vitamin Access program, Evidence Action supports governments in providing weekly iron and folic acid treatments to millions of children and adolescents. 

This program launched in India in 2019, and expanded to Malawi in 2024. In India, which carries 33% of the global anemia burden, Evidence Action helped state governments increase the number of children reached with weekly supplementation by nearly three-fold – to over 35 million – between 2019 and 2023, all for an average of just $0.50 per child per year.

Evidence Action’s Accelerator

Evidence Action’s Accelerator drives new program development. It’s a rigorous six-stage process through which they identify and pressure-test evidence-backed interventions. The Accelerator focuses on “ready to scale” solutions within health and nutrition, with the goal of building the next generation of Evidence Action programs. [4]

What makes Evidence Action so effective

Broad reach and potential for scale

Safe Water Now provides 10 million people access to clean water, while Deworm the World has helped deliver over 2 billion treatments to children. [5] [6]

Proven adoption rates

Safe Water Now maintains a high average user adoption rate of 62% for chlorine dispensers. This is an outstanding result in the world of water and sanitation for point-of-collection products.

Cost-effectiveness

Safe Water Now delivers access to safe water for less than $1.50 per person per year. Deworm the World and Equal Vitamin Access provide treatments for less than $0.50 per treatment on average – and as low as $0.05 for deworming in India!

Compounding impact

A randomized controlled trial in Kenya found that children who received deworming had a 25% reduction in school absenteeism, when compared to those who did not. Following those same children two decades later, the researchers found that receiving two to three additional years of deworming increased their income by 13% and consumption by 14%.

Evidence Action’s accountability and sustainability

Evidence Action is a model of non-profit transparency. The organization makes its documents publicly available and publishes its reports and data. Notably, when programs prove to not be effective, Evidence Action recognizes and shares outcomes, and alters its programs accordingly. One such example was No Lean Season, which received acclaim and support after initial promising results. In its dedication to ongoing proof and accountability, Evidence Action continued to pressure-test the program for scalable robustness, and when the evidence proved to be disappointing, the organization publicized the new findings and halted funding. Subsequently, operational challenges combined with the disappointing evidence led to the closure of No Lean Season. As Vox observed, “We’d benefit enormously from a nonprofit sector in which every charity was as careful and honest as Evidence Action.”

“We’d benefit enormously from a nonprofit sector in which every charity was as careful and honest as Evidence Action.” — Vox

Recognition for Evidence Action

Evidence Action’s Deworm the World and Safe Water Now programs are the direct result of the work of Michael Kremer and Esther Duflo, two of the winners of the 2019 Nobel Prize in Economic Sciences. [12] Evidence Action’s Deworm the World is recommended by rigorous evaluator GiveWell, and The Jameel Poverty Action Lab lists school-based deworming as a “best buy” in terms of education and health. [13] [14]

In July 2018, GiveWell awarded a Good Ventures-funded incubation grant of $5.1 million to Evidence Action Beta (now the Accelerator) “to create a program dedicated to developing potential GiveWell top charities by prototyping, testing, and scaling programs which have the potential to be highly impactful and cost-effective.” Evidence Action’s Accelerator will take forward this work.