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If you only had $100 to spare in your budget, you’d want to spend it the best way possible.
The same is true for governments looking to bring vital health or sanitation services to more people. As the CEO of the nonprofit Evidence Action, Kanika Bahl works to disrupt traditional international development to help find, fund, and scale the approaches that drive outsize impact for every dollar spent. The result: effective and efficient poverty interventions that reach millions around the world.
Bahl’s experience in business, microfinance, and emerging markets finance — including at the nonprofits Clinton Health Access Initiative and Results for Development — influences the approach she takes at Evidence Action. “I take the lens of an investor,” she told me. “Whether that’s a country government or an international donor with very scarce resources, I ask myself what allocation offers the highest ‘return’ for every dollar spent in terms of buying better health, nutrition, improved income.”
Sometimes a program can be effective but isn’t reaching nearly as many people as it could. That’s where Evidence Action comes in, working with governments to scale programs that have been proven to have high potential to change lives.
Health, nutrition, and sanitation are their current focus areas, but they’re also looking for any cost-effective intervention. Bahl describes these programs as the “lowest-hanging fruit” in international development — the actions that are life-saving, cheap, and easy to implement in partnership with governments, but that people just aren’t doing yet.
To borrow language from the tech industry, Evidence Action works as an accelerator for these cost-effective ideas, taking an almost VC approach to development work. Evidence Action screens potentially high-impact interventions for cost-effectiveness and scalability over six “funnel” stages, only letting the most promising ideas go through each stage. Just 2 percent make it to the final scaling stages, to then hopefully be implemented or expanded by the governments of multiple countries.
“What we’re trying to do is find the unicorns of international development,” Bahl said.
Evidence Action has indeed found some unicorns. The organization’s Dispensers for Safe Water and Deworm the World programs have reached hundreds of millions of people globally with chlorinated water and deworming pills, respectively; the results have been profiled (and scrutinized) by Vox.
One of their newest programs screens and treats maternal syphilis. In any given year, about a million pregnant women have active syphilis, and more than a third of these infections can impact the child: early births, deaths (both stillbirth and within the first month of being born), and severe disability. Testing and treatment is fast and cheap, but rarely done. So Evidence Action partnered with the Liberian government to test for both HIV and syphilis, which only costs $0.35 more than testing for HIV alone. Now, 67 percent of women have been screened for syphilis, rather than 6 percent.
With many of these programs, Bahl said, it’s important to have “governments in the driver’s seat.” The path to scale is ultimately through the government, but Evidence Action can help put a foot on the pedal.
