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Tl;dr

doebem’s latest research identifies the distribution of portable micromembrane water filters as a top donation opportunity in Brazil. This solution demonstrates a cost of USD 306 per DALY and USD 12.5k per life saved, making it 5-10 times more cost-effective than other evaluated options and achieving 40% of the cost-effectiveness of GiveWell’s top charities.

Context

Over the past few months, we have shared significant progress from doebem on this forum, aiming to encourage effective giving in Brazil and maximize the social impact of donations (see: doebem's new phase presentationcause prioritization study; research methodology).

Today, we're thrilled to share with the Effective Altruism community our first recommendation in this new institutional phase, which also marks the full implementation of our research process.

After prioritizing and conducting an in-depth study on the issue of access to clean water — examining it through the lenses of importance, neglectedness, and tractability — and mapping dozens of organizations operating in Brazil, we evaluated four solutions with strong evidence of effectiveness in regions where water insecurity is a major challenge. Our conclusion is that the best donation opportunity to address this problem is the distribution of portable micromembrane filters by the Projeto Saúde e Alegria.

About the Donation Opportunity

These micromembrane filters use advanced technology, with 0.1μm ultrafiltration nanotubes capable of removing up to 99% of harmful microorganisms from the water. Currently, the filters are imported, with a total unit cost, including logistics, of approximately USD 39. Each filter can serve a family of five and, due to the high sediment and organic matter content in the local water, has a lifespan of two and a half years.

This solution is crucial for the community served, as despite being in the Amazon, a region abundant in water resources, the available water is unsuitable for human consumption. Furthermore, these communities are located in a state with some of the highest percentages of the population without access to basic sanitation and clean water in the country, with more than half the population in this situation. The project also focuses on rural and riverside communities, among Brazil's most socially vulnerable communities. You can find more on water insecurity in this study conducted by doebem.

doebem's institutional assessment of Projeto Saúde e Alegria showed very positive results, highlighting the organization’s legitimacy (over 40 years of work in close collaboration with communities, the government, and third-sector organizations), its openness to external audits, and its institutional sustainability. Additionally, they have demonstrated the capacity to strategically absorb and effectively use new resources by expanding the distribution of filters, thus reducing the still significant unmet demand in the region.

About the Cost-Effectiveness Analysis

Alongside the mentioned data on filter characteristics and organizational credentials, our cost-effectiveness analysis incorporates demographic, morbidity and mortality, and income data from the region where the solution is implemented. We also used robust evidence on the impact of filters on reducing diarrhea prevalence as well as the role of water security in improving outcomes in work and education indicators. Estimated impacts from these studies were calibrated to account for contextual differences between the studied solutions and Projeto Saúde e Alegria’s filter solution. This calibration involved analyzing secondary data and conducting iterative reviews within the doebem team. Finally, we ran a sensitivity analysis to understand how qualitative shifts in results might occur; notably, no significant changes were observed.

Conclusion

Our cost-effectiveness analysis concluded that the social return of these filters is 65 times their cost. Additionally, USD 306 equals 1 DALY or USD 12.5k per life saved. In comparison, this solution proved to be 5x to 10x more cost-effective than other opportunities evaluated by doebem. Furthermore, in terms of cost per life saved, these portable filters are 40% as cost-effective as GiveWell's top charities.

Our initial hypothesis when embarking on doebem's new phase — marked by increased institutionalization, professionalization, and local research — was that the best donation opportunities in Brazil would be around 15% as effective as top global charities. Thus, this first result exceeded our expectations, leaving us excited to share it with the Effective Altruism community and promote it to further strengthen effective giving in Brazil.

Ongoing Research and Opportunities

In parallel, doebem is also evaluating other donation opportunities for the cause of adequate food access, whose in-depth study has been completed and is currently in the translation stage. It will be shared in English soon. We are also conducting research on the third and final priority cause identified in our study: non-communicable diseases. We will share the findings in this forum as soon as these research efforts are finalized.

Information about this new donation opportunity is systematized in this publication. Feel free to read and share it with anyone you think might be interested. Also, if you're attending EA Global: Boston 2024, feel free to add me on Swapcard, invite me for a quick chat, or stop me in the halls—I’d be glad to talk more about the findings of this research!

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