{ "version": "0.1", "preparedOn": "2026-10-19", "referenceIntensityHours": 47.25, "intensityExponent": 1, "defaultBudget": 100, "defaultSelected": [ "amf", "fistula" ], "entries": [ { "id": "amf", "slug": "amf-malaria-prevention", "name": "Malaria prevention", "report": "/opportunities/amf-malaria-prevention/", "source": "/opportunities/downloads/amf-future-v0.1.json", "modelVersion": "0.1", "dataVersion": "0.1", "reviewed": "2026-10-11", "basis": "Donation to AMF · 2026 grant reference", "scope": "Gross young-child acute illness prevented; net-related harms unestimated.", "window": "Three years after net distribution", "windowNote": "The campaign horizon stays at three years. Course days below describe each avoided illness, not how long nets last.", "evidence": "Published GiveWell grant model, extended to unknown future allocations using WSI assumptions. The reference grant is already funded.", "fields": [ { "key": "costMultiplier", "label": "Delivery cost relative to the reference", "default": 1, "min": 0.1, "max": 10, "note": "WSI scenario choice. 1× uses the reference grant-equivalent cost; 2× doubles it.", "kind": "multiplier" }, { "key": "effectMultiplier", "label": "Future effect retained", "default": 0.75, "min": 0, "max": 1, "note": "WSI judgment applied to an already adjusted grant model. Covers burden, prevention and allocation; no extra additionality factor.", "kind": "percent" }, { "key": "nonfatalDays", "label": "Ordinary illness: days", "default": 4, "min": 0, "max": 7, "note": "WSI whole-course assumption. Up to seven days, the published higher scenario.", "kind": "number" }, { "key": "nonfatalIntensity", "label": "Ordinary illness: average intensity", "default": 3, "min": 0, "max": 10, "note": "WSI judgment, averaged over all hours including sleep and periods of relief.", "kind": "number" }, { "key": "fatalDays", "label": "Fatal illness: days", "default": 4, "min": 0, "max": 7, "note": "WSI whole-course assumption. Fatal illness replaces the ordinary course for those cases.", "kind": "number" }, { "key": "fatalIntensity", "label": "Fatal illness: average intensity", "default": 5, "min": 0, "max": 10, "note": "WSI judgment, averaged over all hours including sleep and periods of relief.", "kind": "number" } ], "formula": "Prevented episodes and direct deaths scale with spending × retained effect ÷ cost multiplier. USU = [(episodes − direct deaths) × ordinary days × intensity + direct deaths × fatal days × intensity] × 24 ÷ 47.25.", "model": { "id": "amf-future", "version": "0.1", "checkedOn": "2026-10-11", "nextFundingReview": "2026-11-10", "title": "AMF malaria prevention: provisional future-funding estimate", "costBasis": "USD 1,000 received by AMF, using a grant-equivalent cost basis with source co-funding and displacement assumptions. Payment fees and tax effects excluded.", "population": "Young-child acute malaria. Source under-five population with ages 1-59 months mortality proxy.", "benefitHorizon": "Three years following a distribution. Future locations and distribution dates unassigned.", "source": { "title": "GiveWell ITN CEA [DRC 2027-29], 2026 public model", "url": "https://docs.google.com/spreadsheets/d/1ud2BUyRTxOMK2DgI8XM0SeDQLjv7snCacluPpkoaB-0/edit?gid=1266854728", "retrievedOn": "2026-10-11", "workbookSHA256": "45a0cd15b4fda5046fa3ed5826ffb49d09db72113d25aa99848a29a470b5b1d9", "sheet": "Main CEA", "column": "K (DRC)", "grantStatus": "Approved May 2026; already funded. Used only as an analytical reference." }, "grantURL": "https://www.givewell.org/research/grants/Against-Malaria-Foundation-ITN-Campaigns-in-DRC-in-2027-2029-May-2026", "allocationURL": "https://www.againstmalaria.com/Distribution_Allocations.aspx", "donationURL": "https://www.againstmalaria.com/Donation.aspx", "sourceFacts": [ { "cell": "Main CEA!H8", "label": "Grant size", "value": 276000000.0 }, { "cell": "Main CEA!K16", "label": "Total spending by all contributors", "value": 291589543.3 }, { "cell": "Main CEA!K99", "label": "Indirect malaria deaths per direct malaria death", "value": 0.5687 }, { "cell": "Main CEA!K110", "label": "Total deaths averted among people under age 5", "value": 64397.05782 }, { "cell": "Main CEA!K128", "label": "Malaria cases averted among people under age 5 in the 3-year period following a distribution", "value": 7395818.973 }, { "cell": "Main CEA!K244", "label": "Total supplemental grantee-level adjustment", "value": -0.12 }, { "cell": "Main CEA!K245", "label": "Leverage and funging adjustment for counterfactual impact estimates", "value": -0.1143789556 }, { "cell": "Main CEA!K246", "label": "Overall adjustment for program outputs", "value": -0.2206534809 }, { "cell": "Main CEA!K250", "label": "Total supplemental intervention-level adjustment affecting lives saved", "value": -0.01 }, { "cell": "Main CEA!K252", "label": "Overall adjustment for program outcomes", "value": -0.2284469461 }, { "cell": "Main CEA!K255", "label": "Total nets distributed that wouldn't have been distributed otherwise", "value": 45908948.61 }, { "cell": "Main CEA!K259", "label": "Total lives saved that wouldn't have been saved otherwise", "value": 67412.87916 } ], "futureScenarios": { "lower": { "effectMultiplier": 0.5, "costMultiplier": 1.25, "label": "Lower" }, "central": { "effectMultiplier": 0.75, "costMultiplier": 1, "label": "Central" }, "higher": { "effectMultiplier": 1, "costMultiplier": 0.8, "label": "Higher" } }, "judgments": [ "Apply K246 proportionally to acute cases. GiveWell publishes it as a program-output adjustment, not a separate adjusted case estimate.", "Apply K252 to young-child direct deaths and retain K99 direct-to-indirect ratio after adjustments. This is a WSI decomposition.", "Future effect multipliers 0.50/0.75/1.00 and cost multipliers 1.25/1.00/0.80 are WSI scenario choices, not measured portfolio averages or confidence limits.", "Central effect is reduced 25% from the DRC reference because DRC is an unusually high-burden setting and future allocations are unknown. The exact discount is judgment, not an estimated country ratio.", "Effect multiplier jointly represents differences in burden, realized prevention and allocation from the already-adjusted reference. Cost multiplier varies the grant-equivalent resources required for that benefit.", "Public net donations are provisionally treated as having the same impact per dollar as the reference grant after its co-funding and other-funder adjustments. Future delivery and co-funding must materialize. Do not additionally multiply by the full-cost/net-price ratio.", "Shared malaria courses v0.1 and 47.25 intensity-hours per USU are WSI assumptions. Fatal courses replace ordinary courses." ], "formulas": { "referenceCasesPerBudget": "K128 * (1 + K246) * budgetUSD / H8", "referenceDirectDeathsPerBudget": "K110 / (1 + K99) * (1 + K252) * budgetUSD / H8", "futureCasesOrDeaths": "referenceValue * effectMultiplier / costMultiplier", "usu": "((cases - directDeaths) * nonfatalDays * 24 * nonfatalIntensity + directDeaths * fatalDays * 24 * fatalIntensity) / 47.25" }, "fundingSnapshot": { "status": "Provider-reported program-level funding need", "checkedOn": "2026-10-11", "url": "https://www.againstmalaria.com/AMFFundingGap.aspx", "pageSHA256": "8505bd13ffaa0fd11f34d5c90f8e89a68e0e810b5e35659ce79fb00dc9f255a0", "immediateGapUSD": 43830000, "overallGapRoundedUSD": 219000000, "availableToCommitRoundedUSD": 136350000, "programsSeekingFundingRoundedUSD": 180190000, "pipelineTable": [ [ "", "Distribution Proposal", "# Nets", "Cost/net", "Cost of nets", "Non-netcosts", "Monitoring cost per net", "Monitoringcosts", "Total cost", "Balance", "% funded", "Able to befunded?" ], [ "A", "Programme 1", "15.10m", "$2.00", "-$30.20m", "-$0.00m", "$0.15", "-$2.27m", "-$32.47m", "103.89m", "100", "Yes" ], [ "A", "Programme 2", "15.10m", "$0.00", "-$0.00m", "-$16.60m", "$0.00", "-$0.00m", "-$16.60m", "87.29m", "100", "Yes" ], [ "P", "Programme 3", "9.60m", "$2.00", "-$19.20m", "-$0.00m", "$0.20", "-$1.92m", "-$21.12m", "66.17m", "100", "Yes" ], [ "P", "Programme 4", "10.00m", "$2.00", "-$20.00m", "-$0.00m", "$0.20", "-$2.00m", "-$22.00m", "44.17m", "100", "Yes" ], [ "P", "Programme 5", "11.20m", "$2.00", "-$22.40m", "-$0.00m", "$0.20", "-$2.24m", "-$24.64m", "19.53m", "100", "Yes" ], [ "P", "Programme 6", "12.70m", "$2.00", "-$25.40m", "-$0.00m", "$0.20", "-$2.54m", "-$27.94m", "-$8.41m", "70", "Partial" ], [ "P", "Programme 7", "16.10m", "$2.00", "-$32.20m", "-$0.00m", "$0.20", "-$3.22m", "-$35.42m", "-$43.83m", "0", "" ], [ "Σ", "89.80m", "", "-$149.40m", "-$16.60m", "", "-$14.19m", "-$180.19m", "" ] ], "limitations": [ "Source marked Currently updating and retains older background text. Values are a dated snapshot, not a live balance or independent funding audit.", "The detailed table places the remaining gap in two anonymous provisional programs. Countries and campaign dates are not public in that table.", "Rounded source components do not exactly reconcile. No extra calculation precision is implied.", "No campaign reservation, earmarking agreement or direct organizational confirmation. The DRC reference grant is already funded." ] }, "exclusions": [ "Ages 5 and older", "Indirect deaths", "Long-term complications", "Income effects", "Caregiver distress and bereavement", "USU for death itself or lost life-years", "Net-related adverse effects are unestimated" ], "interpretation": "Provisional WSI program-level scenario, not a GiveWell USU estimate, portfolio forecast, observed impact or verified effect of a particular donation. Gross acute-malaria benefit only. Scenario outcomes are not statistical bounds; actual impact can fall outside them or be much lower if delivery or additionality fails.", "profiles": { "version": "0.1", "referenceIntensityHours": 47.25, "hoursPerDay": 24, "profiles": { "lower": [ 2, 2, 2, 3 ], "central": [ 4, 3, 4, 5 ], "higher": [ 7, 4, 7, 7 ] }, "scope": "Complete acute nonfatal and fatal malaria courses; provisional time-average intensities. Death itself and bereavement excluded." }, "calculation": { "modelVersion": "0.1", "checkedOn": "2026-10-11", "budgetUSD": 1000, "costBasis": "USD 1,000 received by AMF, using a grant-equivalent cost basis with source co-funding and displacement assumptions. Payment fees and tax effects excluded.", "referenceGrant": { "episodesPrevented": 20.88371656703365, "directDeathsPrevented": 0.11475796589439394, "centralUSUAverted": 127.7575428731728 }, "scenarios": { "lower": { "effectMultiplier": 0.5, "costMultiplier": 1.25, "label": "Lower", "episodesPrevented": 8.35348662681346, "directDeathsPrevented": 0.04590318635775757, "nonfatalEpisodesPrevented": 8.307583440455703, "nonfatalDays": 2, "nonfatalIntensity": 2, "fatalDays": 2, "fatalIntensity": 3, "nonfatalUSUPerEpisode": 2.0317460317460316, "fatalUSUPerEpisode": 3.0476190476190474, "nonfatalUSUAverted": 16.87889968854492, "fatalUSUAverted": 0.13989542509030878, "usuAverted": 17.01879511363523 }, "central": { "effectMultiplier": 0.75, "costMultiplier": 1, "label": "Central", "episodesPrevented": 15.662787425275239, "directDeathsPrevented": 0.08606847442079546, "nonfatalEpisodesPrevented": 15.576718950854444, "nonfatalDays": 4, "nonfatalIntensity": 3, "fatalDays": 4, "fatalIntensity": 5, "nonfatalUSUPerEpisode": 6.095238095238095, "fatalUSUPerEpisode": 10.158730158730158, "nonfatalUSUAverted": 94.94381074806518, "fatalUSUAverted": 0.87434640681443, "usuAverted": 95.8181571548796 }, "higher": { "effectMultiplier": 1, "costMultiplier": 0.8, "label": "Higher", "episodesPrevented": 26.104645708792063, "directDeathsPrevented": 0.14344745736799241, "nonfatalEpisodesPrevented": 25.961198251424072, "nonfatalDays": 7, "nonfatalIntensity": 4, "fatalDays": 7, "fatalIntensity": 7, "nonfatalUSUPerEpisode": 14.222222222222221, "fatalUSUPerEpisode": 24.88888888888889, "nonfatalUSUAverted": 369.2259306869201, "fatalUSUAverted": 3.570247827825589, "usuAverted": 372.7961785147457 } }, "interpretation": "Provisional WSI program-level scenario, not a GiveWell USU estimate, portfolio forecast, observed impact or verified effect of a particular donation. Gross acute-malaria benefit only. Scenario outcomes are not statistical bounds; actual impact can fall outside them or be much lower if delivery or additionality fails." } } }, { "id": "fistula", "slug": "fistula-repair", "name": "Fistula repair", "report": "/opportunities/fistula-repair/", "source": "/opportunities/downloads/fistula-repair-v0.1.json", "modelVersion": "0.1", "dataVersion": "0.1", "reviewed": "2026-10-12", "basis": "Donation to Fistula Foundation · future-cost allowance", "scope": "Gross later physical and emotional relief; surgical harms unestimated.", "window": "Postoperative days 91–365", "windowNote": "Up to 275 days within this window. No benefit is extrapolated beyond the first year.", "evidence": "Reported spending and a small follow-up cohort inform the model. Cost, additional care and lasting relief remain provisional.", "fields": [ { "key": "cost", "label": "Cost allowance per procedure", "default": 1500, "min": 0.01, "max": 1000000, "note": "WSI allowance, informed by 2025 organization-wide expenses. Not the provider’s direct patient cost or a verified marginal cost.", "kind": "money" }, { "key": "eligible", "label": "Eligible fistula share", "default": 0.8, "min": 0, "max": 1, "note": "WSI approximation from the reported case mix; perineal-tear repair benefits excluded.", "kind": "percent" }, { "key": "additional", "label": "Additional treatment share", "default": 0.75, "min": 0, "max": 1, "note": "WSI assumption about distinct courses that would otherwise not occur within the credited year.", "kind": "percent" }, { "key": "lasting", "label": "Share with lasting relief", "default": 0.65, "min": 0, "max": 1, "note": "WSI proxy informed by a small cohort. Continence is not a direct measure of suffering.", "kind": "percent" }, { "key": "intensity", "label": "Average intensity reduction", "default": 2, "min": 0, "max": 10, "note": "WSI judgment, averaged over all hours including sleep and periods of relief.", "kind": "number" }, { "key": "days", "label": "Days of relief counted", "default": 275, "min": 0, "max": 275, "note": "WSI assumption within postoperative days 91–365. Shortening this window does not reduce treatment cost.", "kind": "number" } ], "formula": "Courses with lasting relief = spending ÷ cost × eligible share × additional share × lasting-relief share. USU = those courses × relief days × average intensity reduction × 24 ÷ 47.25.", "model": { "version": "0.1", "id": "fistula-foundation-repair", "name": "Fistula repair with Fistula Foundation", "checkedOn": "2026-10-12", "costBasis": "USD received by Fistula Foundation, provisionally mapped to future delivery using a rounded organization-wide expense allowance per procedure; not a verified marginal cost or full societal cost.", "sourceFacts": { "reportedDirectPatientCostUSD": 624, "reportedDirectPatientCostIncludes": [ "surgery", "postoperative care", "physical rehabilitation" ], "totalExpenses2025USD": 24023353, "programExpenses2025USD": 20604972, "managementExpenses2025USD": 1533442, "fundraisingExpenses2025USD": 1884939, "surgeries2025": 19577, "reportedPerinealTearCaseShare": 0.2, "clinicalCohortBaselineN": 60, "clinicalCohort12MonthN": 58, "clinicalCohortNoUrinaryIncontinence3Months": 0.61, "clinicalCohortNoUrinaryIncontinence12Months": 0.672 }, "sharedAssumptions": { "referenceIntensityHours": 47.25, "intensityExponent": 1, "fistulaShare": 0.8, "creditedDays": 275, "creditedWindow": "Postoperative days 91 through 365 inclusive. No early or later benefit credit; perioperative harms remain unestimated.", "fistulaShareBasis": "WSI approximation from the reported 20% perineal-tear share. Assumes the remaining 80% is eligible fistula care; future mix is unverified. Tear-repair benefits remain outside this model.", "intensityBasis": "A single average reduction across physical and emotional suffering. WSI judgment, not a conversion from disability weights, depression scores or a measured USU survey. Averages include sleep and periods of relief.", "additionalCourseBasis": "WSI assumption about the share translating into distinct additional treatment courses that otherwise would not occur within the credited year. Allows for repeat procedures, other funding and delayed allocation. This is not a measured causal effect.", "lastingReliefBasis": "Provisional proxy informed by one small Ugandan follow-up cohort. Continence does not establish freedom from suffering. The chosen intensity reduction allows residual distress; partial relief in other courses is unestimated." }, "scenarios": { "lower": { "label": "Lower", "costPerProcedureUSD": 2000, "additionalCourseShare": 0.5, "lastingReliefShare": 0.5, "averageIntensityReduction": 1 }, "central": { "label": "Central", "costPerProcedureUSD": 1500, "additionalCourseShare": 0.75, "lastingReliefShare": 0.65, "averageIntensityReduction": 2 }, "higher": { "label": "Higher", "costPerProcedureUSD": 1000, "additionalCourseShare": 1, "lastingReliefShare": 0.8, "averageIntensityReduction": 3 } }, "fundingSnapshot": { "status": "donations_accepted_gap_unverified", "checkedOn": "2026-10-12", "remainingFundingGapUSD": null, "verifiedMarginalCostUSD": null, "nextCampaign": null, "basis": "Official general donation page and September 2026 Uganda network announcement. Active operations and expansion do not establish an unfilled budget or the allocation of a new gift.", "recheckDue": "2026-11-11" }, "donationURL": "https://fistulafoundation.org/donate/", "sources": [ { "id": "F1", "title": "Fistula Foundation: FAQs", "url": "https://fistulafoundation.org/about/faqs/", "locator": "How much does it cost to treat obstetric fistula?; Can perineal tears be treated?", "role": "Reported direct cost and approximate case mix", "checkedOn": "2026-10-12" }, { "id": "F2", "title": "Fistula Foundation: 2025 audited financial statements", "url": "https://fistulafoundation.org/wp-content/uploads/2019/03/Fistula-2025-Audited-Statements.pdf", "locator": "Statements of Activities, printed page 3 (PDF page 6), 2025 total expenses", "role": "Organization-wide expense context; not a marginal-cost estimate", "checkedOn": "2026-10-12" }, { "id": "F3", "title": "Fistula Foundation: 2025 results", "url": "https://fistulafoundation.org/news/advances-womens-global-health/", "publishedOn": "2026-03-26", "role": "Reported annual surgical volume, including related childbirth injuries", "checkedOn": "2026-10-12" }, { "id": "F4", "title": "El Ayadi et al. (2019): Trajectories of physical and psychosocial health after fistula repair", "url": "https://onlinelibrary.wiley.com/doi/full/10.1111/tmi.13178", "doi": "10.1111/tmi.13178", "locator": "Table 2 and discussion; 60-woman Ugandan longitudinal cohort", "role": "One-year outcome context, not a controlled donation-impact study or a current portfolio average", "checkedOn": "2026-10-12" }, { "id": "F5", "title": "Fistula Foundation: Uganda treatment network launch", "url": "https://fistulafoundation.org/news/fistula-treatment-network-uganda/", "publishedOn": "2026-09-03", "role": "Current program activity; not proof of a remaining funding gap", "checkedOn": "2026-10-12" } ], "interpretation": "Gross later relief within the first postoperative year. All future cost, attribution, outcome and intensity factors are provisional WSI assumptions. Results are illustrative scenarios, not confidence intervals, a verified donation return, a complete net-benefit estimate or a lower bound. Actual additional benefit can be zero. Different scope and horizon from the AMF analysis; no charity ranking follows.", "exclusions": [ "suffering during the first 90 days, including surgical recovery", "surgical complications and other adverse effects", "benefits after the first postoperative year", "partial benefits in courses outside the lasting-relief fraction", "severe perineal-tear repair benefits", "deaths prevented", "income and caregiver effects", "bereavement" ], "calculation": { "modelVersion": "0.1", "checkedOn": "2026-10-12", "budgetUSD": 1000, "costBasis": "USD received by Fistula Foundation, provisionally mapped to future delivery using a rounded organization-wide expense allowance per procedure; not a verified marginal cost or full societal cost.", "historicalExpensePerProcedureUSD": 1227.1212647494508, "sharedAssumptions": { "referenceIntensityHours": 47.25, "intensityExponent": 1, "fistulaShare": 0.8, "creditedDays": 275, "creditedWindow": "Postoperative days 91 through 365 inclusive. No early or later benefit credit; perioperative harms remain unestimated.", "fistulaShareBasis": "WSI approximation from the reported 20% perineal-tear share. Assumes the remaining 80% is eligible fistula care; future mix is unverified. Tear-repair benefits remain outside this model.", "intensityBasis": "A single average reduction across physical and emotional suffering. WSI judgment, not a conversion from disability weights, depression scores or a measured USU survey. Averages include sleep and periods of relief.", "additionalCourseBasis": "WSI assumption about the share translating into distinct additional treatment courses that otherwise would not occur within the credited year. Allows for repeat procedures, other funding and delayed allocation. This is not a measured causal effect.", "lastingReliefBasis": "Provisional proxy informed by one small Ugandan follow-up cohort. Continence does not establish freedom from suffering. The chosen intensity reduction allows residual distress; partial relief in other courses is unestimated." }, "scenarios": { "lower": { "label": "Lower", "costPerProcedureUSD": 2000, "additionalCourseShare": 0.5, "lastingReliefShare": 0.5, "averageIntensityReduction": 1, "supportedProcedureEquivalents": 0.5, "additionalTreatmentCourses": 0.2, "coursesWithLastingRelief": 0.1, "reliefDays": 27.5, "usuAverted": 13.968253968253968, "directDeathsPrevented": null }, "central": { "label": "Central", "costPerProcedureUSD": 1500, "additionalCourseShare": 0.75, "lastingReliefShare": 0.65, "averageIntensityReduction": 2, "supportedProcedureEquivalents": 0.6666666666666666, "additionalTreatmentCourses": 0.4, "coursesWithLastingRelief": 0.26, "reliefDays": 71.5, "usuAverted": 72.63492063492063, "directDeathsPrevented": null }, "higher": { "label": "Higher", "costPerProcedureUSD": 1000, "additionalCourseShare": 1, "lastingReliefShare": 0.8, "averageIntensityReduction": 3, "supportedProcedureEquivalents": 1.0, "additionalTreatmentCourses": 0.8, "coursesWithLastingRelief": 0.6400000000000001, "reliefDays": 176.00000000000003, "usuAverted": 268.19047619047626, "directDeathsPrevented": null } }, "interpretation": "Gross later relief within the first postoperative year. All future cost, attribution, outcome and intensity factors are provisional WSI assumptions. Results are illustrative scenarios, not confidence intervals, a verified donation return, a complete net-benefit estimate or a lower bound. Actual additional benefit can be zero. Different scope and horizon from the AMF analysis; no charity ranking follows." } } }, { "id": "friendship", "slug": "friendship-bench", "name": "Depression relief", "report": "/opportunities/friendship-bench/", "source": "/opportunities/downloads/friendship-bench-v0.2.json", "modelVersion": "0.1", "dataVersion": "0.2", "reviewed": "2026-10-19", "basis": "Donation for Friendship Bench Zimbabwe adult care", "scope": "Gross psychological relief; treatment harms unestimated.", "window": "Assumed days 91–180 after starting care", "windowNote": "Up to 90 days. The six-month screening endpoint does not establish continuous relief throughout this interval.", "evidence": "A historical trial screening difference is translated into a relief scenario. Especially exploratory; current evidence is under reassessment.", "fields": [ { "key": "cost", "label": "Cost allowance per client", "default": 50, "min": 0.01, "max": 1000000, "note": "WSI allowance informed by historical delivery costs, not a verified current marginal cost.", "kind": "money" }, { "key": "additional", "label": "Additional eligible care share", "default": 0.5, "min": 0, "max": 1, "note": "WSI assumption combining adult eligibility, allocation and whether care would happen anyway.", "kind": "percent" }, { "key": "retained", "label": "Trial effect retained", "default": 0.5, "min": 0, "max": 1, "note": "WSI transfer assumption applied to a 36.2 percentage-point screening difference. Zero models no additional effect.", "kind": "percent" }, { "key": "intensity", "label": "Average intensity reduction", "default": 1, "min": 0, "max": 10, "note": "WSI judgment about psychological suffering. No validated conversion from screening scores to USU.", "kind": "number" }, { "key": "days", "label": "Days of relief counted", "default": 90, "min": 0, "max": 90, "note": "WSI assumption within days 91–180. Costs do not fall when fewer days of benefit are counted.", "kind": "number" } ], "formula": "Additional improved screening outcomes = spending ÷ cost × additional eligible care share × 0.362 × trial effect retained. USU = those outcome equivalents × relief days × intensity reduction × 24 ÷ 47.25.", "model": { "version": "0.2", "id": "friendship-bench-zimbabwe", "name": "Depression relief with Friendship Bench Zimbabwe", "checkedOn": "2026-10-12", "checkedTimezone": "UTC", "evidenceStatus": "exploratory", "costBasis": "USD received for Friendship Bench Zimbabwe work, provisionally mapped to future care using a broad allowance per client. Not a verified marginal cost, an earmarked treatment purchase or an estimate for the global organization.", "sourceFacts": { "trialYearPublished": 2016, "trialRandomizedParticipants": 573, "trialClinics": 24, "depressionThresholdControl": 0.499, "depressionThresholdIntervention": 0.137, "thresholdMeaning": "PHQ-9 at least 11 at six months; secondary screening outcome in adults initially screening positive for common mental disorders. Not a confirmed diagnosis or direct suffering measurement.", "fixedAnnualCostUSD": 170419, "variableCostPerClientUSD": 3.37, "annualClients2020": 12364, "costPriceYear": 2019, "costPerspective": "Historical payer cost across program and city health resources; annualized scale-up, infrastructure, screening and treatment. Includes modeled and anticipated inputs.", "laterRuralTrialParticipants": 516, "laterRuralTrialFinding": "Greater SSQ-14 improvement at months 3, 6 and 9, but not 12; no difference in PHQ-9 score changes at measured follow-ups.", "annual2025MonitoringEnrolled": 13864, "annual2025MonitoringCompleteClinicalData": 3009, "annual2025MonitoringHasConcurrentControl": false, "reportedClientsQ12026": 88436 }, "sharedAssumptions": { "referenceIntensityHours": 47.25, "intensityExponent": 1, "creditedDays": 90, "creditedWindow": "Assumed days 91 through 180 after starting care. A six-month endpoint does not establish 90 days of continuous relief. Earlier and later benefits are unestimated.", "endpointProxyBasis": "Treat the scaled between-group difference in depression-screening status as additional improved-outcome equivalents. This is a WSI bridge to a relief scenario, not an observed count of durable recoveries or a validated USU mapping.", "deliveryBasis": "Share of spending assumed to translate into additional adult care resembling the reference population. Combines age and setting eligibility, allocation and whether care would happen anyway. Not a measured program share.", "effectBasis": "Retain only a selected fraction of the old urban trial difference to allow for fewer sessions, changed delivery and mixed evidence across settings. This factor is distinct from whether a donation brings additional eligible care.", "intensityBasis": "One average reduction in psychological suffering across the credited hours, including sleep and periods of relief. WSI judgment; no conversion from PHQ-9, SSQ-14, DALYs or WELLBYs." }, "scenarios": { "lower": { "label": "No added effect", "costPerClientUSD": 50, "additionalEligibleCareShare": 0.5, "trialEffectRetained": 0, "averageIntensityReduction": 1 }, "central": { "label": "Central", "costPerClientUSD": 50, "additionalEligibleCareShare": 0.5, "trialEffectRetained": 0.5, "averageIntensityReduction": 1 }, "higher": { "label": "Higher", "costPerClientUSD": 25, "additionalEligibleCareShare": 0.75, "trialEffectRetained": 0.75, "averageIntensityReduction": 2 } }, "fundingSnapshot": { "status": "donation_page_available_gap_unverified", "checkedOn": "2026-10-12", "remainingFundingGapUSD": null, "verifiedMarginalCostUSD": null, "confirmedAllocation": null, "basis": "Official Zimbabwe donation page and Q1 2026 activity report. Public activity and solicitation do not establish current unmet budget, next allocation or additional treatments.", "recheckDue": "2026-11-11" }, "donationURL": "https://www.friendshipbenchzimbabwe.org/donate", "sources": [ { "id": "B1", "title": "Chibanda et al. (2016): randomized trial in Harare", "url": "https://pubmed.ncbi.nlm.nih.gov/28027368/", "doi": "10.1001/jama.2016.19102", "locator": "Abstract: six-month PHQ-9 threshold proportions, 13.7% versus 49.9%", "role": "Historical trial reference; reported absolute proportions, not an adjusted absolute effect", "checkedOn": "2026-10-12" }, { "id": "B2", "title": "Healey et al. (2022): economic analysis of Friendship Bench scale-up", "url": "https://doi.org/10.1136/ebmental-2021-300317", "publicCopyURL": "https://prevention-collaborative.org/wp-content/uploads/2024/05/Economic-threshold-analysis-of-delivering-a-tasksharing-treatment-for-common-mental-disorders.pdf", "locator": "Table 2, printed page 51; payer perspective and 2019 USD in methods", "role": "Historical cost context, not a current marginal donation price", "checkedOn": "2026-10-12" }, { "id": "B3", "title": "Haas et al. (2023): randomized trial in rural Zimbabwe", "url": "https://pubmed.ncbi.nlm.nih.gov/37440230/", "doi": "10.1001/jamanetworkopen.2023.23205", "locator": "Abstract: SSQ-14 and PHQ-9 results at 3, 6, 9 and 12 months", "role": "Evidence that results differ across populations and outcomes", "checkedOn": "2026-10-12" }, { "id": "B4", "title": "Friendship Bench Zimbabwe: 2025 annual report", "url": "https://drive.google.com/file/d/1jcoxqvNNTnkIsByD-dSK-u0gnaQzUYCQ/view", "locator": "Printed pages 12-13: follow-up cohort and limitations; not the current USU effect input", "role": "Recent monitoring, with incomplete follow-up and no concurrent comparison group", "checkedOn": "2026-10-12" }, { "id": "B5", "title": "Friendship Bench Zimbabwe: Q1 2026 impact report", "url": "https://drive.google.com/file/d/1LzxwolHr_aaM9F7-X-uzb20bYUlmi4jJ/view", "locator": "Printed page 9: clients seen; page 17: funding invitation", "role": "Current operations and request for support, not verified remaining need", "checkedOn": "2026-10-12" }, { "id": "B6", "title": "Friendship Bench Zimbabwe: evolution of the program", "url": "https://www.friendshipbenchzimbabwe.org/post/the-evolution-of-friendship-bench-two-decades-of-community-led-mental-health-care-in-zimbabwe", "role": "Transition toward government delivery and technical assistance; broader populations", "checkedOn": "2026-10-12" }, { "id": "B7", "title": "Happier Lives Institute (2025): mid-year charity update", "url": "https://www.happierlivesinstitute.org/report/2025-mid-year-charities-update-hlis-first-mid-year-charities-update-and-how-were-changing-the-way-we-keep-donors-informed/", "locator": "Friendship Bench section: historical routine attendance averaging 1.12 of 6 possible sessions", "role": "Evaluator's original implementation analysis; not assumed to measure 2026 attendance", "checkedOn": "2026-10-12" }, { "id": "B8", "title": "Happier Lives Institute (16 October 2026): recommendation paused", "url": "https://www.happierlivesinstitute.org/2026/10/16/friendship-bench-recommendation-paused/", "checkedOn": "2026-10-19", "role": "Current evaluator status, data-access limitations and methodological reassessment; no new numerical effect estimate." } ], "interpretation": "Exploratory gross psychological relief over an assumed 90 days. Costs, additional delivery, transfer of trial results, duration and intensity are WSI choices. A screening threshold is not a direct suffering measure. Scenarios are not confidence bounds or a ranking. Actual additional benefit can be zero; treatment harms and deaths prevented are unestimated. General donation allocation to matching Zimbabwe adult care is not verified.", "exclusions": [ "benefits in the first 90 days or after day 180", "adolescent and non-Zimbabwe benefits", "benefits outside the selected depression-screening proxy", "treatment harms", "suicides or other deaths prevented", "physical illness outcomes", "caregiver and income effects", "bereavement add-ons" ], "calculation": { "modelVersion": "0.1", "checkedOn": "2026-10-12", "budgetUSD": 1000, "costBasis": "USD received for Friendship Bench Zimbabwe work, provisionally mapped to future care using a broad allowance per client. Not a verified marginal cost, an earmarked treatment purchase or an estimate for the global organization.", "referenceAbsoluteDifference": 0.362, "historicalPayerCostPerClientUSD": 17.15348430928502, "sharedAssumptions": { "referenceIntensityHours": 47.25, "intensityExponent": 1, "creditedDays": 90, "creditedWindow": "Assumed days 91 through 180 after starting care. A six-month endpoint does not establish 90 days of continuous relief. Earlier and later benefits are unestimated.", "endpointProxyBasis": "Treat the scaled between-group difference in depression-screening status as additional improved-outcome equivalents. This is a WSI bridge to a relief scenario, not an observed count of durable recoveries or a validated USU mapping.", "deliveryBasis": "Share of spending assumed to translate into additional adult care resembling the reference population. Combines age and setting eligibility, allocation and whether care would happen anyway. Not a measured program share.", "effectBasis": "Retain only a selected fraction of the old urban trial difference to allow for fewer sessions, changed delivery and mixed evidence across settings. This factor is distinct from whether a donation brings additional eligible care.", "intensityBasis": "One average reduction in psychological suffering across the credited hours, including sleep and periods of relief. WSI judgment; no conversion from PHQ-9, SSQ-14, DALYs or WELLBYs." }, "scenarios": { "lower": { "label": "No added effect", "costPerClientUSD": 50, "additionalEligibleCareShare": 0.5, "trialEffectRetained": 0, "averageIntensityReduction": 1, "supportedClientEquivalents": 20.0, "additionalEligibleClients": 10.0, "additionalImprovedOutcomes": 0.0, "reliefDays": 0.0, "usuAverted": 0.0, "directDeathsPrevented": null }, "central": { "label": "Central", "costPerClientUSD": 50, "additionalEligibleCareShare": 0.5, "trialEffectRetained": 0.5, "averageIntensityReduction": 1, "supportedClientEquivalents": 20.0, "additionalEligibleClients": 10.0, "additionalImprovedOutcomes": 1.81, "reliefDays": 162.9, "usuAverted": 82.74285714285715, "directDeathsPrevented": null }, "higher": { "label": "Higher", "costPerClientUSD": 25, "additionalEligibleCareShare": 0.75, "trialEffectRetained": 0.75, "averageIntensityReduction": 2, "supportedClientEquivalents": 40.0, "additionalEligibleClients": 30.0, "additionalImprovedOutcomes": 8.145, "reliefDays": 733.05, "usuAverted": 744.6857142857142, "directDeathsPrevented": null } }, "interpretation": "Exploratory gross psychological relief over an assumed 90 days. Costs, additional delivery, transfer of trial results, duration and intensity are WSI choices. A screening threshold is not a direct suffering measure. Scenarios are not confidence bounds or a ranking. Actual additional benefit can be zero; treatment harms and deaths prevented are unestimated. General donation allocation to matching Zimbabwe adult care is not verified." }, "modelVersion": "0.1", "evidenceReviewedOn": "2026-10-19", "revisionNote": "Evidence-status update only. Numerical assumptions and calculations from model 0.1 are unchanged.", "evaluatorUpdate": { "organization": "Happier Lives Institute", "announcedOn": "2026-10-16", "checkedOn": "2026-10-19", "status": "recommendation_paused_pending_reassessment", "reasons": [ "Restrictions on access to recent monitoring data in Zimbabwe", "Methodology update, including how different sources of evidence are weighted" ], "expectedUpdateBy": "2026-11-30", "url": "https://www.happierlivesinstitute.org/2026/10/16/friendship-bench-recommendation-paused/", "interpretation": "A reassessment, not a finding of ineffectiveness. No revised numerical effect estimate provided. HLI fundraising is paused; the announcement says direct giving remains possible." } }, "notice": "HLI paused its recommendation on 16 October 2026 pending reassessment. This is not a finding of ineffectiveness. The numerical model has not been revised." }, { "id": "trichiasis", "slug": "trichiasis-surgery", "name": "Eye-pain relief", "report": "/opportunities/trichiasis-surgery/", "source": "/opportunities/downloads/trichiasis-surgery-v0.1.json", "modelVersion": "0.1", "dataVersion": "0.1", "reviewed": "2026-10-17", "basis": "Program costs · 2025 USD planning proxy", "scope": "Later eye-pain relief minus assumed recovery pain; incomplete benefit and harm coverage.", "window": "Postoperative days 91–365, less early recovery pain", "windowNote": "Up to 275 days of later relief. Recovery pain is deducted separately even if later relief is zero.", "evidence": "A coalition planning-cost proxy and longitudinal cohort support context. Additional relief and recovery pain are WSI judgments.", "fields": [ { "key": "cost", "label": "Cost per completed surgical course", "default": 315, "min": 0.01, "max": 1000000, "note": "WSI midpoint of a sector planning-cost range, used as a surgery proxy. Not a current provider quotation.", "kind": "money" }, { "key": "intensity", "label": "Average later intensity reduction", "default": 0.5, "min": 0, "max": 10, "note": "WSI average across all treated patients, including incomplete response. Do not multiply by a second success rate.", "kind": "number" }, { "key": "days", "label": "Later relief days counted", "default": 275, "min": 0, "max": 275, "note": "WSI assumption within postoperative days 91–365. Shorter relief leaves the full course cost unchanged.", "kind": "number" }, { "key": "recoveryDays", "label": "Recovery pain: days", "default": 7, "min": 0, "max": 14, "note": "WSI allowance, not an observed study mean. Up to 14 days, the published lower-benefit scenario.", "kind": "number" }, { "key": "recoveryIntensity", "label": "Recovery pain: average intensity", "default": 2, "min": 0, "max": 10, "note": "WSI treatment-pain allowance. Full complications and other treatment burdens remain unestimated.", "kind": "number" } ], "formula": "USU = spending ÷ course cost × (later relief days × intensity reduction − recovery days × recovery intensity) × 24 ÷ 47.25. A negative result means the counted treatment pain exceeds the counted relief.", "model": { "modelVersion": "0.1", "preparedOn": "2026-10-17", "budgetUSD": 100, "currencyYear": 2025, "estimateType": "Illustrative program-cost scenario; not an estimated return on a current donation", "population": "Adults with trachomatous trichiasis receiving an additional completed surgical treatment course; Ethiopian outcome evidence provisionally applied to a broader planning-cost reference.", "counterfactual": "No additional surgery in the credited year. Assumed average relief is relative to the care patients would otherwise receive, including self-care. This counterfactual was not measured by the longitudinal study.", "referenceIntensityHours": 47.25, "intensityExponent": 1, "creditedDays": 275, "creditedWindow": "Postoperative days 91 through 365 inclusive. Earlier disease-pain relief is uncredited; a separate early treatment-pain allowance is deducted.", "scope": "Later eye-pain relief minus an assumed early treatment-pain burden. Incomplete pain balance, not total net benefit.", "reportedEvidence": { "study": { "source": "T1", "year": 2017, "enrolledAdults": 1000, "followedAtOneYear": 980, "painReportedBeforePercentApprox": 99, "painReportedAtOneYearPercent": 33.7, "design": "Longitudinal surgical cohort with comparison participants without trichiasis, not surgery versus untreated trichiasis. Operations were randomized between techniques." }, "cost": { "sources": [ "T2", "T3" ], "baseCostUSD": 180, "implementationUplift": [ 0.5, 1.0 ], "derivedPlanningCostUSD": [ 270, 360 ], "currencyYear": 2025, "caveat": "Coalition planning average for TT management, which includes surgery and epilation. Not an audited surgery-only cost or a current provider quotation." }, "funding": { "source": "T3", "publicationYear": 2025, "estimatedGapUSD": [ 105000000, 140000000 ], "estimatedCases": 390000, "countries": 13, "currentUnfundedBalanceVerified": false, "allocationOfNewDonationVerified": false } }, "choices": { "costUnitBridge": "Use the coalition management cost as a proxy for one completed patient surgical course, including required eye care. Do not double count bilateral patients. Actual surgery mix, repeat procedures and full partner costs need confirmation.", "intensity": "WSI judgment about average attributable relief across all treated patients and all hours, including sleep, incomplete response and recurrence. Not derived from symptom percentages or a calibrated USU survey. No extra success-rate multiplier.", "duration": "WSI judgment; the one-year observation does not measure relief throughout the 275-day interval.", "recovery": "WSI allowance for additional treatment pain, applied to every modeled course. Days and intensity are not study estimates and do not fully price complications.", "additionality": "Conditional on additional completed surgical courses. No donor-allocation or marginal funding factor is estimated." }, "scenarios": { "lower": { "label": "Lower", "costPerCourseUSD": 360, "averageIntensityReduction": 0.25, "recoveryDays": 14, "recoveryIntensity": 3, "courseEquivalents": 0.2777777777777778, "laterReliefUSU": 9.700176366843033, "recoveryBurdenUSU": 5.925925925925926, "selectedPainBalanceUSU": 3.7742504409171076 }, "central": { "label": "Central", "costPerCourseUSD": 315, "averageIntensityReduction": 0.5, "recoveryDays": 7, "recoveryIntensity": 2, "courseEquivalents": 0.31746031746031744, "laterReliefUSU": 22.171831695641217, "recoveryBurdenUSU": 2.2574955908289245, "selectedPainBalanceUSU": 19.914336104812293 }, "higher": { "label": "Higher", "costPerCourseUSD": 270, "averageIntensityReduction": 1, "recoveryDays": 3, "recoveryIntensity": 1, "courseEquivalents": 0.37037037037037035, "laterReliefUSU": 51.734273956496175, "recoveryBurdenUSU": 0.5643738977072311, "selectedPainBalanceUSU": 51.16990005878894 }, "no_relief": { "label": "No lasting relief", "costPerCourseUSD": 315, "averageIntensityReduction": 0, "recoveryDays": 7, "recoveryIntensity": 2, "courseEquivalents": 0.31746031746031744, "laterReliefUSU": 0.0, "recoveryBurdenUSU": 2.2574955908289245, "selectedPainBalanceUSU": -2.2574955908289245 } }, "unestimated": [ "Non-pain vision benefits", "Relief before day 91 or after year one", "Full burden of complications and repeat surgery", "Psychological and family effects", "Deaths prevented", "Marginal donation allocation and displacement of other funding" ], "sources": [ { "id": "T1", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5686479/", "accessedOn": "2026-10-17" }, { "id": "T2", "url": "https://a.storyblok.com/f/274450/x/d97c5236fb/appendices-ictc-2025-gap-analysis.pdf", "accessedOn": "2026-10-17" }, { "id": "T3", "url": "https://a.storyblok.com/f/274450/x/6d34d2c7e8/closing-the-gap-ictc-2025-gap-analysis-report_042125.pdf", "accessedOn": "2026-10-17" }, { "id": "T4", "url": "https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001136", "accessedOn": "2026-10-17" }, { "id": "T5", "url": "https://www.sightsavers.org/contact-us/frequently-asked-questions/", "accessedOn": "2026-10-17" } ], "interpretation": "Assumption scenarios, not confidence intervals, measured cost-effectiveness or full uncertainty bounds. Effects may be zero or negative. Cannot rank against WSI gross-benefit donation scenarios." } }, { "id": "podoconiosis", "slug": "podoconiosis-foot-care", "name": "Preventing painful foot attacks", "report": "/opportunities/podoconiosis-foot-care/", "source": "/opportunities/downloads/podoconiosis-foot-care-v0.1.json", "modelVersion": "0.1", "dataVersion": "0.1", "reviewed": "2026-10-18", "basis": "Program costs · assumed 2026 USD", "scope": "Gross acute attacks avoided; chronic symptoms and treatment burdens unestimated.", "window": "First year of supported foot care", "windowNote": "One full year of care. Attack duration below changes each avoided course, not the funded year.", "evidence": "A randomized trial supplies the attack-rate difference. The current US-dollar delivery cost is an unverified WSI assumption.", "fields": [ { "key": "cost", "label": "Cost per participant-year", "default": 200, "min": 0.01, "max": 1000000, "note": "WSI planning assumption. Historical PPP international dollars are not treated as current US dollars.", "kind": "money" }, { "key": "retained", "label": "Trial effect retained", "default": 0.5, "min": 0, "max": 1, "note": "WSI transfer assumption applied to 4.5 fewer attacks per person-year. No extra success multiplier.", "kind": "percent" }, { "key": "days", "label": "Days per avoided attack", "default": 3, "min": 0, "max": 5, "note": "WSI assumed whole course; WHO describes 3–5 bedbound days. Lower values allow you to test shorter exposure.", "kind": "number" }, { "key": "intensity", "label": "Average attack intensity", "default": 3, "min": 0, "max": 10, "note": "WSI judgment, averaged over all hours including sleep and periods of relief.", "kind": "number" } ], "formula": "Avoided attacks = spending ÷ annual care cost × 4.5 × trial effect retained. USU = avoided attacks × days per attack × intensity × 24 ÷ 47.25.", "model": { "modelVersion": "0.1", "preparedOn": "2026-10-18", "budgetUSD": 100, "estimateType": "Illustrative program-cost scenario; gross acute benefit", "currency": "USD", "currencyYear": 2026, "currencyBasis": "Nominal planning assumptions chosen in October 2026; not a conversion of historical ETB or PPP international dollars.", "population": "Adults with persistent podoconiosis lymphoedema, similar to participants in the northern Ethiopian GoLBeT trial.", "counterfactual": "No additional comparable supported foot-care package during the credited first year.", "referenceIntensityHours": 47.25, "intensityExponent": 1, "creditedYears": 1, "assumedDaysPerAttack": 3, "reportedEvidence": { "trial": { "source": "P1", "participants": 696, "interventionAttackRatePerPersonYear": 19.4, "controlAttackRatePerPersonYear": 23.9, "absoluteAttackRateReduction": 4.5, "absoluteReduction95CI": [ 3.8, 5.1 ], "endpoint": "Acute dermatolymphangioadenitis attacks per person-year; intention-to-treat analysis with available diaries." }, "historicalCost": { "source": "P2", "ETBPerParticipant": 2419, "suppliesETB": 529, "deliveryETB": 1890, "internationalDollarsPPP2016": 314, "isUSD": false, "included": "Trial-based first-year provider delivery, supplies and training; imperfect separation from research costs.", "useInModel": "Context only. Not substituted for a current US-dollar price." } }, "choices": { "cost": "US$200 per additional adult supported for a full year is an illustrative WSI budget assumption, not a verified price. US$100 and US$300 test sensitivity. Intended provider scope: supplies, training, supervision, follow-up, transport and administration; household costs excluded.", "effectRetention": "Retain 50% of the trial absolute attack-rate reduction centrally, with 25% and 100% scenarios. A judgment about transfer to a future similar program, not a measured success probability. No further adherence or success multiplier.", "duration": "Three days per avoided attack is an assumed course, not an arithmetic mean measured by the trial. WHO describes acute attacks causing 3–5 bedbound days. No benefit from shortening remaining attacks is added.", "intensity": "Average intensity 3 on the WSI 0–10 scale, across all hours of each assumed attack including sleep and milder periods. WSI judgment, not a validated clinical mapping. Alternatives 2 and 4.", "additionality": "Conditional on paying for additional full-year care that would otherwise not occur. No claim about what a new unrestricted donation purchases.", "harms": "Treatment burdens and adverse effects are unestimated. Headline is gross avoided acute suffering, not complete net benefit." }, "scenarios": { "lower": { "label": "Lower", "costPerParticipantYearUSD": 300, "effectRetention": 0.25, "intensity": 2, "outputsPer100USD": { "participantYearEquivalents": 0.3333333333333333, "attacksAverted": 0.375, "acuteDaysAverted": 1.125, "grossUSUAverted": 1.1428571428571428, "deathsPrevented": null, "netUSU": null } }, "central": { "label": "Central", "costPerParticipantYearUSD": 200, "effectRetention": 0.5, "intensity": 3, "outputsPer100USD": { "participantYearEquivalents": 0.5, "attacksAverted": 1.125, "acuteDaysAverted": 3.375, "grossUSUAverted": 5.142857142857143, "deathsPrevented": null, "netUSU": null } }, "higher": { "label": "Higher", "costPerParticipantYearUSD": 100, "effectRetention": 1, "intensity": 4, "outputsPer100USD": { "participantYearEquivalents": 1.0, "attacksAverted": 4.5, "acuteDaysAverted": 13.5, "grossUSUAverted": 27.428571428571427, "deathsPrevented": null, "netUSU": null } }, "no_effect": { "label": "No effect", "costPerParticipantYearUSD": 200, "effectRetention": 0, "intensity": 3, "outputsPer100USD": { "participantYearEquivalents": 0.5, "attacksAverted": 0.0, "acuteDaysAverted": 0.0, "grossUSUAverted": 0.0, "deathsPrevented": null, "netUSU": null } } }, "deathsPrevented": null, "netUSU": null, "remainingFundingGapUSD": null, "unestimated": [ "Chronic swelling and discomfort", "Psychological and stigma-related relief", "Caregiver effects", "Treatment harms and burden of daily self-care", "Household costs and patient time", "Benefits beyond year one", "Shortening attacks that still occur", "Deaths prevented" ], "sources": [ { "id": "P1", "title": "Negussie et al. (2018): GoLBeT randomized trial", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6562300/", "use": "Primary attack-rate effect, Table 2; trial design and limitations. DOI: 10.1016/S2214-109X(18)30124-4." }, { "id": "P2", "title": "Hounsome et al. (2019): GoLBeT economic evaluation", "url": "https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007780", "use": "Costing methods, Table 1 and intervention-cost results. Historical ETB and 2016 PPP international dollars, not current US dollars." }, { "id": "P3", "title": "WHO (2023): Podoconiosis fact sheet", "url": "https://www.who.int/news-room/fact-sheets/detail/podoconiosis-(non-filarial-lymphoedema)", "use": "Condition, painful acute attacks and care context. Does not supply a USU intensity." }, { "id": "P4", "title": "Footwork International: current work and 2026–2031 strategy", "url": "https://www.footwork.international/", "use": "Reviewed 18 October 2026. Active public initiative and donation route; no verified current delivery price or remaining funding gap." } ], "interpretation": "Scenarios are illustrative assumptions, not confidence limits or a ranking. Fractional participant-years represent averages across full-year care packages, not delivery of partial courses. No organization has endorsed this model." } }, { "id": "palliative", "slug": "palliative-pain-relief", "name": "Relieving cancer pain", "report": "/opportunities/palliative-pain-relief/", "source": "/opportunities/downloads/palliative-pain-relief-v0.1.json", "modelVersion": "0.1", "dataVersion": "0.1", "reviewed": "2026-10-18", "basis": "Program costs · assumed 2026 USD", "scope": "Gross physical pain relief; medication harms and other care benefits unestimated.", "window": "One funded seven-day care window", "windowNote": "Up to seven days per funded patient-week. Further weeks require further funding; no automatic duration extension.", "evidence": "Clinical research supports potential pain relief. Both the current care cost and average additional relief are WSI assumptions.", "fields": [ { "key": "cost", "label": "Cost per patient-week", "default": 40, "min": 0.01, "max": 1000000, "note": "WSI allowance for medicines, clinical care, transport and administration. Not a provider quotation.", "kind": "money" }, { "key": "intensity", "label": "Average additional intensity reduction", "default": 1, "min": 0, "max": 10, "note": "Already averages sleep, nonresponse, interruptions and shortened exposure. Hours after death contribute zero. Do not apply another success factor.", "kind": "number" }, { "key": "days", "label": "Days of relief counted per funded week", "default": 7, "min": 0, "max": 7, "note": "Test counting less than the full week; cost per funded week stays fixed. Default already averages shortened exposure in the intensity reduction.", "kind": "number" } ], "formula": "Funded patient-week equivalents = spending ÷ weekly cost. USU = patient-weeks × counted days × average additional intensity reduction × 24 ÷ 47.25.", "model": { "modelVersion": "0.1", "preparedOn": "2026-10-18", "budgetUSD": 100, "estimateType": "Exploratory program-cost scenario; gross physical pain relief", "currency": "USD", "currencyYear": 2026, "currencyBasis": "Nominal WSI planning assumptions chosen in October 2026. No verified current provider quote or inflation conversion.", "population": "Adults with inadequately controlled moderate or severe cancer pain receiving additional clinically supervised palliative care in Uganda. Not all hospice patients.", "counterfactual": "Pain that would be experienced with care otherwise available during the same funded week. The assumed reduction is additional to that care, not a before-and-after trial difference.", "referenceIntensityHours": 47.25, "intensityExponent": 1, "daysPerFundedWeek": 7, "reportedEvidence": { "source": "H1", "reviewStudies": 62, "reviewParticipants": 4241, "participantsWithNoWorseThanMildPain": 362, "participantsWithThatOutcomeReported": 377, "useInModel": "Supports potential for cancer-pain relief only. The 362/377 proportion is not multiplied into the model: it is not an additional effect versus no comparable care." }, "choices": { "cost": "40 USD per patient-week is a provisional WSI allowance for medicines, clinical assessment, follow-up, transport and administration. It is not a price quoted by Hospice Africa Uganda. Alternatives of 20 and 80 USD test halving and doubling this unknown; household costs and patient time excluded.", "intensityReduction": "1 point on the WSI 0–10 scale, averaged across all 168 hours and all funded eligible patient-weeks, relative to otherwise available care. Includes milder periods, sleep, interruptions, nonresponse and shortened exposure. Hours after death contribute zero. Not a validated mapping from clinical pain scores.", "duration": "Credit one seven-day budget window only. Fractional patient-weeks are accounting equivalents, not a recommendation to stop care after a week. Repeated weeks need new funding and evidence that the assumed relief continues.", "additionality": "Program budget must enable additional care. No extra success, adherence or mortality factor is multiplied into the already averaged intensity reduction. No claim about marginal unrestricted donations.", "harms": "Medication side effects and treatment burdens remain unestimated. This is gross pain relief, not complete net benefit." }, "scenarios": { "lower": { "label": "Lower", "costPerPatientWeekUSD": 80, "averageIntensityReduction": 0.5, "outputsPer100USD": { "patientWeekEquivalents": 1.25, "fundedPatientDayEquivalents": 8.75, "grossUSUAverted": 2.2222222222222223, "deathsPrevented": null, "netUSU": null } }, "central": { "label": "Central", "costPerPatientWeekUSD": 40, "averageIntensityReduction": 1, "outputsPer100USD": { "patientWeekEquivalents": 2.5, "fundedPatientDayEquivalents": 17.5, "grossUSUAverted": 8.88888888888889, "deathsPrevented": null, "netUSU": null } }, "higher": { "label": "Higher", "costPerPatientWeekUSD": 20, "averageIntensityReduction": 2, "outputsPer100USD": { "patientWeekEquivalents": 5.0, "fundedPatientDayEquivalents": 35.0, "grossUSUAverted": 35.55555555555556, "deathsPrevented": null, "netUSU": null } }, "no_effect": { "label": "No additional relief", "costPerPatientWeekUSD": 40, "averageIntensityReduction": 0, "outputsPer100USD": { "patientWeekEquivalents": 2.5, "fundedPatientDayEquivalents": 17.5, "grossUSUAverted": 0.0, "deathsPrevented": null, "netUSU": null } } }, "deathsPrevented": null, "netUSU": null, "remainingFundingGapUSD": null, "unestimated": [ "Other symptom relief", "Psychological and spiritual support", "Caregiver relief and bereavement", "Medication harms and treatment burden", "Household costs and patient time", "Relief beyond the funded week", "Deaths prevented" ], "sources": [ { "id": "H1", "title": "Wiffen, Wee and Moore (2016): Oral morphine for cancer pain", "url": "https://www.cochrane.org/evidence/CD003868_oral-morphine-cancer-pain", "use": "Original Cochrane review: evidence of analgesia, study limitations and adverse effects. DOI: 10.1002/14651858.CD003868.pub4. Not a causal estimate of this Ugandan program or a USU calibration." }, { "id": "H2", "title": "WHO (2020): Palliative care", "url": "https://www.who.int/news-room/fact-sheets/detail/palliative-care", "use": "Scope of palliative care and its place alongside other treatment. Reviewed 18 October 2026." }, { "id": "H3", "title": "Hospice Africa Uganda: Holistic Palliative Care", "url": "https://hospice-africa.org/en/services/holistic-palliative-care", "use": "Provider description of clinical care, outreach and patient support. Reviewed 18 October 2026; does not establish our cost or intensity assumptions." }, { "id": "H4", "title": "Logie and Harding (2005): Evaluation of Uganda’s morphine access program", "url": "https://link.springer.com/article/10.1186/1471-2458-5-82", "use": "Primary implementation study: prescribing, supply and follow-up barriers. Historical evidence, not a current price or outcome estimate." }, { "id": "H5", "title": "Hospice Africa: official donation options", "url": "https://www.hospice-africa.org/en/donate", "use": "Official local and international support routes checked 18 October 2026. Allocation and remaining funding gap unverified." } ], "interpretation": "All quantitative cost and USU-effect inputs are WSI assumptions. Scenarios are not confidence intervals, guarantees or a ranking. No organization has endorsed this model. Pain relief does not imply cure or a death prevented." } } ] }