International charity

Donors can have large impact -- saving a life for a few thousand dollars -- when giving internationally.1
Some programs (largely health-related) have strong track records of success; others have often failed to achieve strong results. (More)
Our top charities are:

The Against Malaria Foundation
The Schistosomiasis Control Initiative

*Data from Victora, Cesar G. et al. 2003. Applying an equity lens to child health and mortality: More of the same is not enough. The Lancet 362: 233-241.
International aid is a promising cause, but also a challenging one. It's promising in that it involves helping the world's lowest-income people, so even a small gift can make a major difference in someone's life.2 However, it's also the case that international aid involves a completely different part of the world. The distance makes it very hard for you as a donor to really tell what an organization's doing or hold it accountable.
How do charities help?
Because the need is so vast, charities run a wide variety of programs. Most programs focus on health (aiming to prevent or treat conditions like HIV/AIDS, malaria, or deaths during childbirth), poverty reduction (aiming to increase individuals' income and standard of living through programs like microfinance, agricultural training, or introducing new technologies), education (aiming to provide expanded and improved educational opportunities for youth), or disaster relief.3 We've primarily reviewed charities working in the above areas. Charities also pursue many other goals that we haven't yet considered as carefully, such as empowering women through programs focused on increasing cultural sensitivity and advocating to developing-world governments for changes in policy and/or funding allocations. If you're interested in an area we haven't covered yet, please contact us and let us know.
What are the challenges of finding a great international charity?
Though the need is vast, it's difficult to find a great charity that will use your donation well. Many approaches to helping people in the developing world have spotty track records and/or histories of failure.4 At the same time, the best approaches have had a huge impact.5
Many charities' programs don't have a track record of success
Large international charities often run many different types of programs. For example, UNICEF (possibly the biggest and best-known international charity) runs some programs that have great track records of success (such as vaccination or salt iodization programs),6 but also programs without a track record (such as constructing wells or working to achieve gender equality).7 When you give to UNICEF, you're supporting the organization as a whole, both the projects with strong track records and those without. Even when a donation restriction is formally honored, the donation can often be effectively unrestricted (more at our discussion of fungibility as well as at this blog post). Few charities focus on programs with strong track records.8 The charities that work on programs with strong track records (like distributing nets to prevent malaria 9) often work on many other things too, and charities that only run one program often choose an approach that doesn't have much evidence behind it.
What difference does your donation make?
Even when you give to a charity running a strong program, your donation may not result in more people helped. For example, some charities focus on providing surgeries to children suffering from birth defects (like a cleft lip or palate), elderly people who are blind because they can't afford a cataract operation, or young women with a condition called obstetric fistula. As long as charities can show that they only use expert surgeons to perform these operations and that they monitor surgical complications and success rates, it's likely that the surgeries are helping people. However, we have yet to find a surgery charity where we can be confident that they use additional donations to help additional individuals. That's because we're concerned about a limited supply of expert surgeons in many countries, and feel that training new surgeons may be a difficult endeavor.10 The issue of limited trained capacity applies to any charity whose work depends on the availability of skilled labor, whether it's focused on surgery, malaria diagnosis, HIV treatment, or a wide variety of other programs.
Where should you give?
We think that health is the strongest area for individual donors.11 We urge donors not just to focus on the problems they care most about, but also to consider whether they - as donors - can make a difference in these problems. For health, we believe the answer is yes; for other sectors we believe it is often no. Our top international charities are:

Against Malaria Foundation: AMF provides long-lasting insecticide-treated nets (to protect against mosquitoes that transmit malaria) to other organizations, which then distribute them in developing countries.
Schistosomiasis-Control-Initiative: SCI assists African governments with treatment of neglected tropical diseases.
For more charities, see our full list of recommended international charities.
1. See http://www.givewell.org/recommended-charities#WhatdoyougetforyourdollarAnoverview

2. We estimate that the best international charities can save a life for as little as $200-$1000. In the U.S. it is much more expensive to make a difference. See our cost-efficiency comparison of our top international and U.S. causes.

3. We've evaluated over 750 international charities. Summaries of what we've learned and links to more information are at our developing-world health overview, our developing-world poverty reduction overview, and our developing-world education overview.

4. There are a number of examples of ways in which well-intentioned projects may fail to achieve desired results. Building wells may fail to reduce water-related illness (detailed analysis here); agriculture programs in Africa have failed to increase crop yields; programs providing textbooks and other supplies have failed to raise students' test scores; and many other developing-world education programs have weak, if any, evidence of success.

5. Most successful projects are in the area of health and include such large-scale successes as the eradication of smallpox and the dramatic reduction of infant mortality in Africa (see our developing-world health overview). For a full list of health programs that have been rigorously shown to save lives and reduce suffering, see our summary of proven health programs.

6. The evidence for the positive impact of vaccination programs is at our full review of immunization coverage expansion programs. For an example of success with salt iodization, see Chapter 15 (PDF) of: Levine, Ruth. 2007. Case studies in global health: Millions saved. Sudbury, MA: Jones and Bartlett.

7.
UNICEF. 2010. Immunization. http://www.unicef.org/immunization/index_coverage.html (accessed May 8, 2010). PDF "printout" available at http://www.givewell.org/files/ExternalWebsites/Unicef/UNICEF-Immunization.pdf
UNICEF. 2010. Nutrition. http://www.unicef.org/nutrition/index_iodine.html (accessed May 8, 2010). PDF "printout" available at http://www.givewell.org/files/ExternalWebsites/Unicef/UNICEF-Nutrition.pdf
UNICEF. 2010. Water, Sanitation and Hygiene. http://www.unicef.org/wash/index_watersecurity.html (accessed May 8, 2010). PDF "printout" available at http://www.givewell.org/files/ExternalWebsites/Unicef/UNICEF-WatSan.pdf
UNICEF. 2010. Gender equality. http://www.unicef.org/gender/index_action.html (accessed May 8, 2010). PDF "printout" available at http://www.givewell.org/files/ExternalWebsites/Unicef/UNICEF-Gender.pdf

8. We've evaluated over 750 international charities. Fewer than 30 either published impact reports of their own programs or focused on programs that had strong external evidence of effectiveness.

9. See our detailed analysis of insecticide-treated net distribution programs for more information.

10. For a more detailed discussion on the issue of limited capacity and questions to ask a surgery charity before making a donations see our developing-world surgery overview.

11. More at our developing-world health overview as well as a 2011 blog post.