We Struggle So Hard For Each Breath That We Take

So, I recently read Elizabeth Pisani's excellent book The Wisdom of Whores, in which she spends a good deal of time talking about how she and her colleagues did a bang-up job of snookering donor countries into adequately funding AIDS programs, and then, despite their good intentions, failed to spend that money on programs that actually lowered the incidence of HIV/AIDS. So, when I was browsing through a site I've linked to before, GiveWell, this page stood out to me. They give their top rating to exactly four out of 136 charities they've rated:

We believe charities that are truly and reliably changing lives are the exception, not the rule.

Some of the heavy-hitters they list as "Not Recommended" include UNICEF, World Vision, and the Grameen Foundation. To be clear, I don't think this means that those organizations do no good work. But it does mean 1) there's a good chance the work they're doing is having no effect 2) there's a good chance that some of their work is having a negative effect 3) there's a very good chance no one knows if certain programs work 4) should we be in a position to provide help or money to someone near or far, we should not be surprised if we make a hash of it, and should simply try to learn from our mistakes.