[Review] How to Be Great at Doing Good: Why Results Are What Count and How Smart Charity Can Change the World

There are more than 1.5 million nonprofits in the United States, and in 2013 over 62 million Americans volunteered nearly 7.7 billion hours to charitable causes. Given these statistics, you might think we were well on our way to a world in which caring people are significantly improving the lives of people in need. According to the World Bank, however, more than a billion people globally live in extreme poverty, and each year over 2.6 million children die of hunger-related causes. It's enough to make one wonder whether charity does any good.

In How to Be Great at Doing Good: Why Results Are What Count and How Smart Charity Can Change the World, animal rights activist Nick Cooney offers an antidote to such cynicism in the form of a "complacency-shattering guidebook for anyone who wants to actually change the world, whether as a donor, a volunteer, or a nonprofit staffer." 

In the book, Cooney addresses the misconceptions that persistently prevent donors and volunteers from "succeeding" in their charitable endeavors. He tells us, for example, that most people see charity as

a warm, fuzzy thing and that as long as our intentions are good we should be applauded. We are not taught to think rigorously about our approach. We are not taught how to succeed at doing good, or even that success is what matters. So we aren't in the habit of making calculated decisions when it comes to doing good....

But what do we mean by "success"? "The measure of success for charities," Cooney writes, is not an "up or down vote on whether they are making the world a better place." The question is, or should be, how much good can a charity accomplish. It's not a revolutionary — or even new — idea, but if pursued to its logical conclusion, it requires donors, volunteers, and nonprofit practitioners to make some tough decisions. If we really want to change the world and include as many individuals as possible in that change, we need to completely rethink the way we do our work.

For nonprofits to become more efficient, Cooney argues, they first need to establish a "bottom line" that reflects their "cost per good done." It could be something like the "cost per HIV infection prevented," or "the cost per ton of greenhouse gas emissions prevented." Not that establishing such metrics is easy. A study by the Center for Effective Philanthropy found that "even among the largest foundations...only 8 percent had any data whatsoever that showed how successful they'd been at achieving a defined goal." 

Cooney uses Habitat for Humanity, which works to provide "decent housing to as many people as possible," to illustrate what this might look like in practice. Habitat, which mostly operates in the United States but also has operations in developing countries, could lower its "cost per" by shifting even more of its activities to developing countries, where building costs are much lower. If it did so, the question for the organization then would become how "to balance the fact that overseas construction has a dramatically lower 'cost per family housed' with the fact that donors might reduce their giving as a higher and higher percentage of [Habitat's] work [took place] abroad." Cooney's answer is to "shift more and more construction overseas until the number of families the organization was able to house began to drop." He understands, of course, that the organization is unlikely to follow his advice, for any number of reasons: change is hard; it's easier for people to empathize with those in need in their own communities; charities have little appetite for risk, especially when it comes to their revenue.

If shifting more of its programming abroad presents Habitat with multiple challenges, Cooney believes other organizations need to make even more drastic changes. He cites the Make-A-Wish Foundation as an example of a charity that could accomplish its goal — to alleviate the suffering of children with life-threatening illnesses — far more efficiently, and to make his point he contrasts it with the Schistosomiasis Control Initiative (SCI), which treats schistosomiasis, a debilitating but easily preventable tropical disease. Through its activities, the Make-A-Wish Foundation makes sick children happier for a few days, whereas treating schistosomiasis in regions where it is endemic prevents a lifetime of debilitating chronic illness for a far greater number of children. In fact, it costs SCI less than a dollar per child to treat the disease, while Cooney estimates that Make-A-Wish spends $19,000 "per sick child made temporarily much happier."

If Make-A-Wish really wanted to succeed at its goal of helping children, he argues, it could allocate a percentage of its budget to treating diseases such as schistosomiasis. And if that resulted in a falloff in donations from an American public that is less interested in funding children's health initiatives in Africa than in granting wishes for dying children here at home — well, so be it; the measurable increase in lives changed for the better would be worth it. Indeed, in Cooney's view, every year the Make-A-Wish Foundation decides not to make such a change, it "[condemns] to a lifetime of debilitation" thousands of children it could have otherwise saved from a preventable disease.

"While a significant shift in program funding like this may have to be rolled out slowly," he adds, "in practical terms it is very doable." What's more, it's been done before by the likes of the YMCA and the American Cancer Society. Make-A-Wish officials might argue that such a change would come at the expense of the organization's brand identity and the goodwill it has built up over decades of operation. Cooney will have none of it, arguing that maintaining a "consistent [brand] identity" is far less important, and less urgent, than helping as many sick children as possible.

Furthermore, if our main priority is to make the world a better place, he writes, then we all need to recognize that we have an important role to play in incentivizing nonprofits to become more efficient. For Cooney, that means supporting organizations that prioritize a lower "cost per" over a "consistent identity, setting up a free-market-style competition among organizations that further drives down their costs and results in more people who need help being helped." Donors also need to spend more time researching a charity's effectiveness — although such an approach is not without problems. The biggest, of course, is that the data needed to determine nonprofit effectiveness is hard to come by. While overhead costs are easy enough to find (through sites like GuideStar and Charity Navigator), overhead has little to do with effectiveness. An organization can spend an exorbitant amount on overhead while still maintaining a low "cost per good done" if it carries out its programming efficiently. Cooney's solution to the problem is for nonprofits to work harder to provide data that demonstrates their effectiveness — and for funders and donors to incentivize nonprofits to do that.

The bigger problem, however, is that not all charity work is created equal. Indeed, for Cooney, charity is a zero-sum game. If one donates to a local arts organization instead of to the Seva Foundation, which works to prevent blindness in twenty countries, he or she is in effect "condemning" people to blindness. The idea that "it's all needed" or that all charitable dollars are well spent rings hollow when one considers the extreme levels of suffering in the world. And that means we need to prioritize our giving, because "each of us has a very limited amount of time, money, and energy to devote to charity."

It's an idea that many readers of his book will object to. Likewise, Cooney's insistence that "bias" is what causes people to not support the most cost-effective program — that is, the program that helps the greatest number of people for the least amount of money, regardless of where those people live or other needs closer to home — will be rejected by many who see investments in one's community as both critical and appropriate. Who could blame residents of America's poorest cities, for example, for wanting to donate to local programs, even if doing so is less "cost-effective" in the global scheme of things?

These are relatively minor objections, however, to Cooney's otherwise compelling arguments. For those committed to making the world a better place, How to Be Great at Doing Good is a book that deserves to be read and widely discussed.

Mirielle Clifford is an editorial assistant at Foundation Center in New York. For more great reviews, visit our Off the Shelf section.