Smarter Strategizing Could Help Grant Makers Go to Bat for Global Health

Talk about Moneyball is everywhere. It’s not just the buzz about the film as Oscar voting gets under way but also how the movie’s tale of statistical empiricism vanquishing decades of conventional wisdom can apply to business and education. Now it’s time to think about how it applies to philanthropy.

The big insights of Moneyball—that careful analysis of data, smart allocation of resources, and the pursuit of undervalued strategies can create a great baseball team—have broad and important relevance for grant makers. Even better than in the world of baseball, applying the ideas to the nonprofit world leaves no losers but lots of winners, including schools, the poor, the environment, global health, and many other areas of philanthropic endeavor.

Michael Lewis, the well-known financial writer, coined the term “moneyball” when he wrote a book about how the Oakland A’s, despite a payroll of just $40-million in 2002, used statistics to figure out how to outplay the average major-league team, which had a $70-million payroll. That was a monumental achievement at a time when the New York Yankees paid players a total of $125-million a year.

In the foundation world, the Bill & Melinda Gates Foundation often plays the role of the Yankees. In the mid-1990s, when Bill and Melinda Gates decided to undertake efforts to improve health care in developing countries, everyone thought they could essentially pay for everything that needed to be done. Overwhelmed by the financial heft that Gates brought, many foundations concluded that global health no longer belonged in their portfolios. What they missed, of course, was what Moneyball teaches us: There are many ways, some counterintuitive, to get big hits solving health and other social problems.

At a time when foundations must spread their money further to care for the 7 billion people now living on our planet, it is more important than ever to figure out how to do more with less.

Already social entrepreneurs are showing us how to accomplish this goal. By creating solar LED lights and clean cookstoves, they are transforming efforts to fight poverty around the world. But foundations are frequently not at the forefront of those efforts. Through the judicious application of Moneyball techniques, they can once again become the leaders of large-scale social change.

One place for some big wins would be for more foundations to return to making grants for global health.

For a relatively small investment, foundations could support treatment for neglected tropical diseases such as intestinal worms and make a huge difference not just in health but also in the economic progress of people in poor countries. Data back up the big effects that these tiny investments could make, but few foundations have shown any interest in taking action.

Providing children in the developing world with vitamins, iron, iodine, and other important nutrients shows similar results and costs similarly little—but again, good data, little action.

Adults in poor countries are contracting the same health problems as those in rich ones, such as heart disease, strokes, and diabetes. Such diseases will become bigger killers in the developing world in our lifetimes than infectious diseases, yet efforts to curb them are not on the agenda.

Look deeper to understand what is causing these problems—the failures of the health-care system—and you would struggle to find a foundation trying to improve the situation.

Such gaps occur even though so many have witnessed the profound achievements foundations have made when they apply innovative strategies to global health.

Just a decade ago, as the HIV/AIDS pandemic raged, it became clear that annually hundreds of thousands of children had been infected with HIV by their mothers. At the time, as many 40 percent of pregnant women in Botswana were infected with HIV. Mother-to-child transmission was rampant, but scientists had identified an inexpensive, short-course drug regimen that could cut such rates by at least a half, with the potential to save hundreds of thousands of children from HIV infection each year.

Armed with these data and spurred by a constellation of actors—activists, academics, and doctors—several foundation leaders decided to pay for a project to prevent mother-to-child-transmission of HIV. Because of this approach, millions of healthy children have been born to mothers with HIV. That’s an example of how Moneyball theories can make a difference.

So how can an intrepid 21st-century foundation play Moneyball? Here’s a quick sketch of what I’ve learned working in Rwanda for a decade and studying the example of foundation work to fight AIDS among children.

Collect more data. Closely examine where a disease is spreading. Extrapolate the trends for the future. Get the data from reliable sources—governmental and nongovernmental, competitors and allies. If the data do not exist, commission research. If the data are imperfect, use proven statistical techniques to make it as reliable as necessary.

Find the best groups to support. Identify the collaborative and cross-disciplinary efforts, the social entrepreneurs, and the innovative organizations that are contributing to measurable social change. Help them grow.

Intuition matters. Even as you use available (and often imperfect) data to craft upstart programs, don’t abandon your instincts. The richest data are no substitute for hard-won wisdom: Data simply inform and bolster the very human process of integrating into a coherent strategy a vast sea of disparate ideas from many colleagues over years or perhaps decades of experience.

In Moneyball, baseball managers vie for and trade players to build the ideal competitive organization; in the philanthropic analog, grant makers can rally other donors, grantees, people affected by a social problem, and a cross-section of experts to build high-impact programs.

Foundations can indeed be the innovative leaders in social change, placing bets that pay off by producing great results for relatively small sums. But more important is the final score: the lives saved, kids educated, environments conserved, and cities revitalized. Don’t wait for spring-training time, foundations. Get in the game.