Take care when helping good causes

There is no shortage of social problems, innovative ideas to tackle them and people with substantial sums of money to help. Bringing all three together to produce the most efficient result is another matter.

A new generation of wealthy people, many of whom made fortunes while they were unusually young from technology, are turning their energies earlier in life towards giving some of their money to good causes. They include Mark Zuckerberg, the Facebook founder, who an­nounced this year that he and his wife Priscilla Chan will donate $3bn to biomedical research, and Pierre Omidyar, the eBay co-founder who set up the Omidyar Network.

Their relative youth makes them more able and willing to start giving earlier than previous philanthropists. But in other ways many of this generation are less innovative than they may think, either in their approach to identifying new projects or to introducing better measurements of impact and success. Peabody, Rowntree, Ford and Carnegie were at least as strategic in their day.

Many are motivated by personal experiences and sentiments in deciding what to support. Michael Bloomberg has been inspired by his work on gun control and education.

That means some wish to take the lead in projects rather than work in co-operation with others. They may be put off projects if other donors have already provided support and “own” them.

Critics express concern that donors prefer to establish their own organisations and be the largest single donor, rather than working in partnership with others for established projects. The result can be the reinvention of ideas that have already failed, neglect of those known to work and a substantial bottleneck of fledgling innovations that lack the finance to be rigorously tested.

But there is a persistent need for new technology, as the Financial Times highlighted when it showcased innovations around pregnancy and birth in its Maternal and Child Health special report. One is the Odón device, a simple, low-cost way to ease difficult births, which is still under development. Yet existing, lower-tech approaches linked to people more than equipment are also highly effective, such as “kangaroo care”, involving constant skin-to-skin contact between mothers and premature newborns and reducing the need for costly incubators.

The most successful projects typically work at scale. Small pilots may appear effective but even if they have unusually rigorous data to demonstrate results, success may be the result of exceptional circumstances and individuals, which cannot be easily replicated.

Even projects with proven impact at a bigger scale often fail to win adoption across regions, countries or borders. Without a sustainable source of income, from individuals or governments, they are frequently doomed to fail. Philanthropy can support innovation, but the longer term often requires support from the state, which may prove difficult if the approach does not match political priorities.

When the FT’s Maternal and Child Health report looked at innovations meriting further examination, each project already had some funding, management teams in place and evidence of impact. All need different types of support from other backers to be sustained, scaled up or copied.

Innovation in funding is as important as in products and interventions. Living Goods, a non-profit organisation, uses a franchise model in eastern Africa to support local people working to improve health, far from clinics, pharmacies and professional staff.

In Kwara state in Nigeria, a subsidised health insurance scheme gives those on the lowest incomes access to good-quality care. In Kenya, long-term managed equipment service contracts ensure manufacturers are required to train staff and maintain machines operating near-continuously as a condition of payment. Such approaches also have the merit of being largely developed in, by and for lower-income countries.

Ultimately, they may have lessons for those trying to innovate in philanthropy in richer countries too.