“Beyond the GiveWell Podcast: Fortify Health’s Lessons from Scaling” by Tony Senanayake

TL;DR GiveWell has published a podcast, looking back on their investments in iron fortification and their 8.2 million dollars grant to Fortify Health in 2021. When the grant was made, the projected cost-effectiveness was 5x cash transfers we delivered and estimated 12x. We want to share what this looked like from the inside. Over three years, our team scaled from reaching fewer than half a million people to more than 20 million, while roadblocks in our government engagement strategy forced a pivot. This post is about what we learned over the last 3+ years of scaling a public health intervention, the mistakes we made and the learnings we hope will be useful for funders, implementers and supporters. We are seeking approximately $1 million over the next two years to unlock the government channel, where we believe the next order of magnitude of impact lies. We would welcome your support. 1. Background GiveWell has just published a podcast discussing their thinking about iron fortification and our work at Fortify Health. In it they discuss their lookback on their 2021, 8.2 million dollars grant to Fortify Health along with their decision to continue their support of our work with [...] --- Outline: (00:12) TL;DR (01:11) 1. Background (03:00) 2. About Fortify Health (03:04) 2.1. The problem (04:03) 2.2. Our solution (05:22) 2.3. What we are building toward (06:29) 3. Private Miller Partnerships - from .5 to 20 Million people reached (07:17) 3.1. What drove the improvement: within our control (08:43) 3.2. What drove the improvement: outside our control (09:51) 4. Our government partnership story (11:47) 5. What we learned (11:51) Theme 1: Build the foundations before the pressure arrives (13:52) Theme 2: Know what to measure, and be honest when you cannot (16:51) Theme 3: Scale and sustainability are not the same (19:28) Theme 4: It's hard to know when to pivot your strategy (22:53) 6. Transferable Lessons for Others (22:58) For implementers (23:51) For funders and supporters (24:52) For those considering working in this space (25:29) 7. Help us support millions more people --- First published: May 25th, 2026 Source: --- Narrated by TYPE III AUDIO .