{
  "name": "cases",
  "description": "Historical case studies, including failures.",
  "license": "CC BY 4.0. Cite “Charitology (charitology.org)”.",
  "generated": "2026-10-26",
  "data": [
    {
      "id": "carnegie-libraries",
      "path": "/record/case-studies/carnegie-libraries/",
      "title": "Carnegie’s public libraries",
      "summary": "Andrew Carnegie paid for more than 2,500 library buildings on one condition, that each town keep its library running with public money. The gift built the buildings, and the towns’ commitment made them last.",
      "kind": "success",
      "era": "1881–1917",
      "place": "United States, Scotland and other countries",
      "depth": 3,
      "lessons": [
        "A matching condition can turn a one-time gift into a permanent institution. Carnegie paid for the building, and the town promised to pay for the library every year after.",
        "Simple, standard terms let a small office run thousands of grants. One application form set the same conditions for every town.",
        "A program that defers to local power inherits local exclusions. Who counts as “the community” decides who a community gift serves."
      ],
      "conditions": [
        "short-horizon",
        "missing-voice"
      ],
      "sources": [
        {
          "title": "Andrew Carnegie’s Library Legacy: A Timeline",
          "url": "https://carnegie.org/article/andrew-carnegies-library-legacy/",
          "publisher": "Carnegie Corporation of New York (renamed the Andrew Carnegie Foundation in 2026)",
          "year": 2025
        },
        {
          "title": "Carnegie Libraries",
          "url": "https://encyclopediaofarkansas.net/entries/carnegie-libraries-6466/",
          "publisher": "John Spurgeon, Encyclopedia of Arkansas"
        },
        {
          "title": "The Roots of Community: project overview",
          "url": "https://aquila.usm.edu/rocpartners/",
          "publisher": "Matthew R. Griffis, University of Southern Mississippi"
        },
        {
          "title": "Knowledge Access: The Effects of Carnegie Libraries on Innovation",
          "url": "https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3629299",
          "publisher": "Enrico Berkes and Peter Nencka, SSRN working paper",
          "year": 2020
        },
        {
          "title": "Knowledge Access: The Effects of Carnegie Libraries on Innovation, seminar abstract",
          "url": "https://memento.epfl.ch/event/knowledge-access-the-effects-of-carnegie-libraries",
          "publisher": "EPFL Virtual Innovation Seminar",
          "year": 2020
        }
      ],
      "review": "draft",
      "body": "## What happened\n\nAndrew Carnegie, the steel magnate, made his first library gift in 1881, to Dunfermline in Scotland, where he was born. By the time the last grants for library buildings were made in 1917, he and the Carnegie Corporation of New York had given some $56 million for 2,509 public libraries. According to the corporation, 1,681 of those buildings went up in the United States, in 1,412 communities.\n\nThe grants came with conditions. A town had to show that it needed a library, provide the site, keep the library free to all and promise yearly support equal to 10 percent of the grant, paid for by local taxes. Carnegie wrote that a free library was the best gift, “provided the community will accept and maintain it as a public institution.” His secretary, James Bertram, ran the program through one standard application form, the “Schedule of Questions,” and steered towns toward model floor plans. Money was released in stages as the building went up.\n\nThe libraries lasted. The Encyclopedia of Arkansas reports that more than half were still operating in the 21st century. In a working paper, the researchers Enrico Berkes and Peter Nencka compared towns that got a Carnegie library with towns that were approved for one but never built it, and found that patenting rose in the library towns over the next 20 years.\n\nThe program also followed local custom. Matthew Griffis, who directs a research project on Carnegie’s segregated libraries, writes that in most Southern communities, white attitudes dismissed the need for any library service for Black residents. He counts only eleven communities in the whole country that opened libraries for African Americans through Carnegie’s program.\n\n## Where it sits in the system\n\nThe buildings were bricks. The lasting change was a rule: towns taxed themselves to run a free public library. That is **structure** (level 3) on the [depth scale](/method/#depth). It is also a counterexample to the [Short Horizon](/diagnosis/short-horizon/). Carnegie paid the one-time cost, and the gift was built to outlive him because the community took over the running costs.\n\nThe design gave towns a voice in a narrow sense. A library came only if local leaders asked for it and agreed to pay for it. But the people who decided were the people who held local power. Where Black residents were shut out of public life, the program worked within segregation, and the few libraries it funded for African Americans were separate ones. This is the [Missing Voice](/diagnosis/missing-voice/) in a different form: a gift that answers to “the community” serves whoever the community’s gatekeepers count.\n\n## What carries over\n\nPair capital with a commitment to running costs, so the gift doesn’t die when the giver stops paying. Keep the terms simple enough to run at scale. And before relying on local consent, ask whose consent it is. Carnegie’s own philosophy of giving is in [The Gospel of Wealth](/record/traditions/the-gospel-of-wealth/)."
    },
    {
      "id": "dare",
      "path": "/record/case-studies/dare/",
      "title": "D.A.R.E.’s original curriculum",
      "summary": "Police officers teaching children to resist drugs became the most widely used school drug prevention program in the United States. Rigorous evaluations of the original curriculum found little or no effect on drug use, and the program eventually replaced it.",
      "kind": "failure",
      "era": "1983–2013",
      "place": "United States",
      "depth": 2,
      "lessons": [
        "Popularity and evidence can run on separate tracks for decades. The program stayed dominant while rigorous studies found small or no effects.",
        "How a lesson is taught can matter as much as what it says. In a 1994 comparison, interactive programs that built social skills did better than D.A.R.E.’s officer-led lessons.",
        "An evaluation changes nothing until it reaches the people who decide what gets funded.",
        "An organization can change course on evidence and say so. D.A.R.E. now states on its own history page that the original curriculum had little long-term effect."
      ],
      "conditions": [
        "missing-feedback-loop",
        "silence-about-failure"
      ],
      "sources": [
        {
          "title": "How effective is drug abuse resistance education? A meta-analysis of Project DARE outcome evaluations",
          "url": "https://doi.org/10.2105/ajph.84.9.1394",
          "publisher": "Susan T. Ennett, Nancy S. Tobler, Christopher L. Ringwalt and Robert L. Flewelling, American Journal of Public Health 84(9)",
          "year": 1994
        },
        {
          "title": "Project DARE: no effects at 10-year follow-up",
          "url": "https://doi.org/10.1037/0022-006X.67.4.590",
          "publisher": "Donald R. Lynam and colleagues, Journal of Consulting and Clinical Psychology 67(4)",
          "year": 1999
        },
        {
          "title": "Project D.A.R.E. Outcome Effectiveness Revisited",
          "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC1448384/",
          "publisher": "Steven L. West and Keri K. O’Neal, American Journal of Public Health 94(6)",
          "year": 2004
        },
        {
          "title": "History",
          "url": "https://dare.org/history/",
          "publisher": "D.A.R.E. America"
        }
      ],
      "review": "draft",
      "body": "## What happened\n\nD.A.R.E., short for Drug Abuse Resistance Education, began in 1983 as a partnership between the Los Angeles Police Department and the Los Angeles Unified School District. Police officers taught a 17-lesson curriculum to elementary school students. A nonprofit, D.A.R.E. America, was founded in 1989 to oversee the program, and it spread quickly across the country and abroad. By 1994 it was the most widely used school-based drug prevention program in the United States.\n\nThe evaluations were consistent:\n\n- **1994.** Susan Ennett and colleagues pooled the results of eight rigorous evaluations, a method called meta-analysis, and found D.A.R.E.’s short-term effect on drug use was small, and smaller than that of interactive programs focused on social skills.\n- **1999.** Donald Lynam and colleagues followed 1,002 young people who had received either D.A.R.E. or standard drug education in sixth grade. At age 20 there were few differences in drug use or attitudes, and in no case did the D.A.R.E. group do better.\n- **2004.** A meta-analysis of 11 studies by Steven West and Keri O’Neal found an extremely small effect that was not statistically significant. They described D.A.R.E. as the country’s largest school-based prevention program in federal spending.\n\nThe program changed, slowly. The model was substantially revamped in 2001 with help from a $13.6 million grant from the Robert Wood Johnson Foundation. D.A.R.E. later adopted a different curriculum, keepin’ it REAL, built on interactive small-group learning instead of lectures, for middle schools in 2008 and elementary schools in 2013. D.A.R.E.’s own history page says independent evaluations of the original curriculum in the 1990s found “minimal long-term influence on drug use,” and that a later pilot curriculum did not show positive results.\n\n## Where it sits in the system\n\nThe aim was **prevention** (level 2) on the [depth scale](/method/#depth). The lesson is about the system around it. The evidence was public by 1994, yet a decade later the program was still the country’s largest school-based prevention program in federal spending. Charitology’s reading is that the people closest to the program could see children engaged in class and a police officer in the school, while drug use years later stayed out of view. That is the [Missing Feedback Loop](/diagnosis/missing-feedback-loop/): the signal that mattered never reached the people choosing what to fund.\n\nThe ending runs against the [Silence About Failure](/diagnosis/silence-about-failure/). D.A.R.E. now says in public what didn’t work, including a curriculum of its own that failed a pilot. That kind of candor is what the [Failure Archive](/record/failure-archive/) hopes to make normal.\n\n## What carries over\n\nFund evaluation early, and decide in advance what result would change the plan. When a well-loved program turns out not to work, keep the relationships and the delivery system, and change the content. Whether the new curriculum works as delivered is a question for the same kind of evaluation."
    },
    {
      "id": "green-revolution",
      "path": "/record/case-studies/green-revolution/",
      "title": "The Green Revolution",
      "summary": "Foundation-funded crop research gave farmers high-yield wheat and rice, and cereal harvests in the developing world roughly tripled. The gains were uneven, and some of the costs, from falling water tables to narrower diets, showed up decades later.",
      "kind": "mixed",
      "era": "1943–2000",
      "place": "Mexico, South and Southeast Asia, and other developing regions",
      "depth": 3,
      "lessons": [
        "Research that every farmer can use is a public good. Funding the institutions that keep producing it can change a whole food system, not one farm at a time.",
        "Measuring success in one unit, tons of grain, hid costs that were counted in other units, such as water, soil, diets and who was left out.",
        "Many of the harms grew from the rules around the technology, such as subsidies that encouraged overuse of inputs. The same tool does more or less damage depending on the policies it arrives with.",
        "Costs that arrive decades later are easy to leave out of a success story. Long-horizon work needs long-horizon accounting."
      ],
      "conditions": [
        "single-lens",
        "short-horizon"
      ],
      "sources": [
        {
          "title": "Green Revolution: Impacts, limits, and the path ahead",
          "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3411969/",
          "publisher": "Prabhu L. Pingali, Proceedings of the National Academy of Sciences 109(31)",
          "year": 2012
        },
        {
          "title": "Photo Essay: Mexico and the Launch of the Green Revolution",
          "url": "https://resource.rockarch.org/story/photo-essay-mexico-and-the-launch-of-the-green-revolution/",
          "publisher": "Liesel Vink, Rockefeller Archive Center",
          "year": 2019
        },
        {
          "title": "Norman Borlaug, Facts",
          "url": "https://www.nobelprize.org/prizes/peace/1970/borlaug/facts/",
          "publisher": "NobelPrize.org"
        },
        {
          "title": "India groundwater",
          "url": "https://news.uci.edu/2009/08/12/india-groundwater",
          "publisher": "University of California, Irvine, on Rodell, Velicogna and Famiglietti in Nature 460",
          "year": 2009,
          "note": "Reports a satellite study finding that northern India lost more than 109 cubic kilometers of groundwater between 2002 and 2008, mainly to irrigation pumping."
        }
      ],
      "review": "draft",
      "body": "## What happened\n\nIn 1943 the Rockefeller Foundation began a farm research program with Mexico’s government. Mexico supplied the research station, and the foundation paid the scientists. One of them, the plant pathologist Norman Borlaug, bred dwarf wheat suited to Mexican conditions, and by 1956 Mexico was self-sufficient in wheat. In the mid-1960s he brought dwarf wheat to India and Pakistan, where production rose sharply. The Rockefeller and Ford foundations also built the International Rice Research Institute in the Philippines, which opened in 1960 and bred the high-yield rice IR-8. A 1968 speech called the movement a “Green Revolution,” and in 1970 Borlaug received the Nobel Peace Prize.\n\nThe scale of the result is hard to overstate. In a 2012 review, Prabhu Pingali of the Bill & Melinda Gates Foundation reports that cereal production in the developing world tripled over about 50 years, while the population more than doubled and farmland grew by only about 30 percent. The review cites estimates that without the new crop varieties, food production in developing countries would have been almost 20 percent lower and world food and feed prices 35 to 65 percent higher. In Asia, each 1 percent rise in crop productivity has been estimated to cut the number of poor people by 0.48 percent.\n\n## Where it sits in the system\n\nOn the [depth scale](/method/#depth) this is **structure** (level 3). The work changed the institutions that produce food. The early research centers in Mexico and the Philippines grew into a permanent international network for crop research.\n\nIt is mixed because the ledger has more than one column, and Pingali’s own review documents the other columns. The gains were concentrated in irrigated, high-rainfall areas. Poorer rain-fed regions and women farmers gained less. By 1998 modern varieties covered 82 percent of the planted area in Asia but only 27 percent in Africa. Diets gained calories but often lost variety. Overuse of fertilizer, pesticides and water degraded soils and polluted water, harms Pingali attributes mostly to subsidies and price policies rather than to the seeds themselves. In northern India, a satellite study found groundwater falling fast between 2002 and 2008, mainly because of pumping for irrigation.\n\nSeen through one lens, yield, this is among the great successes in history. Seen through others, such as the environment, future generations or fairness, the picture is more complicated. That gap is the [Single Lens](/diagnosis/single-lens/). The costs that came due decades later are the [Short Horizon](/diagnosis/short-horizon/).\n\n## What carries over\n\nPaying for public research, and for the institutions that keep it going, can change a whole system. The same reach means the side effects are system-sized too. Count every column of the ledger before calling the result, and keep counting after the headlines move on. How much harms to future people should weigh against gains today is [Open Problem 13, Discounting the Future](/open-problems/discounting-the-future/)."
    },
    {
      "id": "haiti-earthquake-reconstruction",
      "path": "/record/case-studies/haiti-earthquake-reconstruction/",
      "title": "Rebuilding Haiti after the 2010 earthquake",
      "summary": "Billions of dollars poured into Haiti after the 2010 earthquake, almost all of the relief aid through international organizations. In 2015 ProPublica and NPR reported that the American Red Cross had raised nearly half a billion dollars and built six permanent homes. The Red Cross said it had helped millions of Haitians in other ways.",
      "kind": "failure",
      "era": "2010–2015",
      "place": "Haiti",
      "depth": 1,
      "lessons": [
        "Giving that follows the news arrives in a burst, mostly without research, and attention fades long before rebuilding is done.",
        "Money raised for one disaster is, in practice, tied to that place and to the group that raised it. When land titles, partners and government capacity take years to sort out, a large earmarked sum can outrun the ability to spend it well.",
        "Aid that goes around local institutions leaves them no stronger. Almost all relief aid went to international agencies and organizations rather than through Haitian ones.",
        "Counting people helped is not the same as measuring what changed. Without project-level spending and results, big claims can’t be checked by anyone."
      ],
      "conditions": [
        "story-bias",
        "restriction-reflex",
        "missing-voice",
        "measurement-gap"
      ],
      "sources": [
        {
          "title": "How the Red Cross Raised Half a Billion Dollars for Haiti and Built Six Homes",
          "url": "https://www.propublica.org/article/how-the-red-cross-raised-half-a-billion-dollars-for-haiti-and-built-6-homes",
          "publisher": "Justin Elliott (ProPublica) and Laura Sullivan (NPR)",
          "year": 2015
        },
        {
          "title": "American Red Cross Responds to Latest ProPublica and NPR Coverage",
          "url": "https://www.redcross.org/about-us/news-and-events/press-release/american-red-cross-responds-to-latest-propublica-and-npr-coverag.html",
          "publisher": "American Red Cross",
          "year": 2015
        },
        {
          "title": "Give aid directly to Haitian institutions to build back better, says UN report",
          "url": "https://news.un.org/en/story/2011/06/379512",
          "publisher": "UN News, on a report by the Office of the UN Special Envoy for Haiti",
          "year": 2011
        },
        {
          "title": "Haiti: Where Has All the Money Gone?",
          "url": "https://www.cgdev.org/publication/haiti-where-has-all-money-gone",
          "publisher": "Vijaya Ramachandran and Julie Walz, Center for Global Development",
          "year": 2012
        },
        {
          "title": "Real Time Charitable Giving",
          "url": "https://www.pewresearch.org/internet/2012/01/12/real-time-charitable-giving/",
          "publisher": "Aaron Smith, Pew Research Center",
          "year": 2012
        }
      ],
      "review": "draft",
      "body": "## What happened\n\nThe earthquake that struck Haiti in January 2010 drew a wave of giving. Americans gave an estimated $43 million by text message alone. In a Pew survey of those text donors, most had heard about the appeal on television, and half gave the moment they heard. By 2012, the Center for Global Development counted almost $6 billion in official aid disbursed and an estimated $3 billion more in private donations to charities.\n\nThe American Red Cross raised nearly half a billion dollars. In June 2015 ProPublica and NPR reported that it had built six permanent homes in all of Haiti. The Red Cross said it had provided homes to more than 130,000 people. The reporters found that count included people who got short-term rental aid, temporary shelters or construction training. A housing project in the Campeche neighborhood, for which an internal proposal estimated about 700 homes, built none. The Red Cross said it could not secure land rights. The reporters also described internal documents on staffing problems and, for one $5.4 million shelter project, layers of overhead that left about 60 percent for the work itself.\n\nThe Red Cross published a response the same day. It said donors’ money had built and run eight hospitals and clinics, helped stem a cholera outbreak, provided clean water and sanitation, and moved more than 100,000 people out of tents into safer housing. When land for new homes wasn’t available, it said, it paid for rental subsidies, repairs and retrofits. It said 90 percent of its Haiti staff were Haitian and criticized what it called the reporting’s “lack of balance, context and accuracy.”\n\n## Where it sits in the system\n\nRebuilding homes is **repair** (level 1) on the [depth scale](/method/#depth). The lessons are about the channels the money took, and they reach far beyond one organization.\n\n- **Attention.** The money followed the headlines ([Story Bias](/diagnosis/story-bias/)). In a 2012 Pew survey of text donors, 58 percent were following the rebuilding “not too closely” or not at all.\n- **Restriction.** Money given for Haiti was, in effect, committed to Haiti and to the group that raised it, even where land disputes and government delays, the obstacles the Red Cross itself cited, made building slow ([the Restriction Reflex](/diagnosis/restriction-reflex/)).\n- **Local voice.** About 99 percent of relief aid after the quake went to international agencies, the Red Cross movement and international charities and contractors, according to the UN Special Envoy’s office, which urged donors to work through Haitian institutions instead ([the Missing Voice](/diagnosis/missing-voice/)).\n- **Measurement.** The Center for Global Development found few evaluations of what aid in Haiti had delivered, and called for spending and results to be published ([the Measurement Gap](/diagnosis/measurement-gap/)).\n\n## What carries over\n\nBefore giving after a disaster, ask who is already working there, how much of the money will reach local organizations and how results will be reported. See the [Disaster Response Guide](/tools/disaster-response-guide/) and [Open Problem 8, the Optimal Restriction](/open-problems/the-optimal-restriction/)."
    },
    {
      "id": "hookworm-campaign",
      "path": "/record/case-studies/hookworm-campaign/",
      "title": "The hookworm campaign in the American South",
      "summary": "A five-year, $1 million Rockefeller commission surveyed hundreds of Southern counties, treated more than 400,000 people for hookworm and pushed for sanitary privies. Hookworm was not eradicated, but school enrollment and literacy rose most where infection had been worst.",
      "kind": "success",
      "era": "1909–1914",
      "place": "Southern United States",
      "depth": 3,
      "lessons": [
        "Measuring the problem first gave the campaign a baseline. County surveys before treatment, and resurveys after, showed whether the work was paying off.",
        "A time-limited funder can leave something permanent by working through public agencies. State and local governments took over some of the work as the commission wound down.",
        "Treating infected people repairs the damage, while privies and shoes stop new infections. Treatment alone lets a parasite come back.",
        "A name can overpromise. The commission was for “eradication,” and hookworm was reduced, not eliminated."
      ],
      "conditions": [
        "measurement-gap",
        "short-horizon",
        "symptom-trap"
      ],
      "sources": [
        {
          "title": "Disease and Development: Evidence from Hookworm Eradication in the American South",
          "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3800113/",
          "publisher": "Hoyt Bleakley, Quarterly Journal of Economics 122(1)",
          "year": 2007
        },
        {
          "title": "Photo Essay: The Rockefeller Sanitary Commission and the American South",
          "url": "https://resource.rockarch.org/story/the-rockefeller-sanitary-commission-and-the-south/",
          "publisher": "Liesel Vink, Rockefeller Archive Center",
          "year": 2019
        },
        {
          "title": "Hookworm Eradication",
          "url": "https://encyclopediaofarkansas.net/entries/hookworm-eradication-2233/",
          "publisher": "Rebecca Haden, Encyclopedia of Arkansas"
        }
      ],
      "review": "draft",
      "body": "## What happened\n\nHookworm larvae live in soil polluted by human waste and burrow in through the skin, often through bare feet. Infected children are often listless, anemic and stunted. In 1909 John D. Rockefeller gave $1 million to create the Rockefeller Sanitary Commission for the Eradication of Hookworm Disease, a five-year effort across eleven Southern states.\n\nThe commission started by measuring. It surveyed hundreds of counties and found that, on average, about 40 percent of school-age children were infected. Then it went to work: traveling dispensaries gave free treatment, lecturers and exhibits taught doctors, teachers and families to recognize the disease, and the campaign pushed for sanitary privies at schools and churches. It treated more than 400,000 people. In Arkansas, children were required to wear shoes to school, and meetings took on a carnival air, with testimonials, singing and refreshments.\n\nThe commission closed at the end of 1914. State governments had increased their own anti-hookworm spending as it wound down, and the newly founded Rockefeller Foundation carried the model abroad. Resurveys found infection had fallen by about 30 percentage points across the infected areas.\n\nHookworm was not eradicated. But the economist Hoyt Bleakley found that counties with more infection before the campaign saw bigger gains afterward in school enrollment, attendance and literacy. Following those children into adulthood, he found a substantial gain in income.\n\n## Where it sits in the system\n\nThe campaign worked at several depths at once. Treatment was **repair** (level 1). Privies and shoes were **prevention** (level 2). Its lasting effect, the Rockefeller Archive Center notes, was to set a model for public health by building services into state and local government. That is **structure** (level 3) on the [depth scale](/method/#depth), and it is why a commission with a five-year life could have effects that lasted.\n\nIt is also an early answer to the [Measurement Gap](/diagnosis/measurement-gap/). Because the commission surveyed before it treated, it knew where the problem was worst and could check its own progress. Nobody had to guess. And it avoided the [Symptom Trap](/diagnosis/symptom-trap/) by pairing treatment with the sanitation that stops reinfection.\n\n## What carries over\n\nMeasure the problem before you treat it, and plan for who will carry on the work when you stop. A short-lived funder can leave behind a permanent public capacity if it builds through the institutions that will remain. Be careful with words like “eradication” unless eradication is really on the table."
    },
    {
      "id": "ice-bucket-challenge",
      "path": "/record/case-studies/ice-bucket-challenge/",
      "title": "The ALS Ice Bucket Challenge",
      "summary": "In the summer of 2014 a viral video challenge raised $115 million for the ALS Association, which turned the money into research grants, clinics and advocacy. It is a case of attention-driven giving that funded lasting work, and a reminder that attention picks causes by what spreads, not by need.",
      "kind": "mixed",
      "era": "2014–2024",
      "place": "United States and online worldwide",
      "depth": 1,
      "lessons": [
        "Attention can raise a fortune in a single summer, but it chooses causes by what spreads, not by the size or neglect of the need.",
        "A windfall does the most good when it is turned into things that keep working, such as research teams, clinics and trained people.",
        "Self-reported impact needs independent checks. The 10-year evaluation leaned on a grantee survey that only about a quarter of grantees answered.",
        "A campaign total can’t say whether the money was new giving or giving moved from other causes. That counterfactual is the question that matters most and is the hardest to answer."
      ],
      "conditions": [
        "story-bias",
        "measurement-gap"
      ],
      "sources": [
        {
          "title": "The ALS Ice Bucket Challenge",
          "url": "https://www.als.org/ibc",
          "publisher": "The ALS Association"
        },
        {
          "title": "ALS Association Ice Bucket Challenge Impact Evaluation Report",
          "url": "https://www.als.org/sites/default/files/2024-08/ALS_IBC10_Impact_Report.pdf",
          "publisher": "Joshua Schnell and colleagues, RTI International",
          "year": 2024
        }
      ],
      "review": "draft",
      "body": "## What happened\n\nIn the summer of 2014, people around the world filmed themselves dumping buckets of ice water over their heads and challenged their friends to do the same and give to the fight against amyotrophic lateral sclerosis (ALS), also called Lou Gehrig’s disease. The ALS Association credits Anthony Senerchia, Pete Frates and Pat Quinn with launching the movement. It says 17 million people took part and the challenge raised $115 million for the association.\n\nA 10-year evaluation by RTI International, published by the association in 2024, describes where the money went. From 2013 to 2024 the association awarded $154.7 million in 560 research grants. Grantees reported new genes, biomarkers and treatment targets, and close to 80 percent of those who answered a survey said the funding let them expand their ALS research. The association says the number of multidisciplinary ALS clinics has more than doubled since 2014, from 100 to more than 220. Federal research money grew too: NIH funding for ALS research nearly tripled between 2011–2013 and 2021–2023, adjusted for inflation, while the NIH budget as a whole grew about 21 percent. The evaluators say that attributing this growth specifically to the association is beyond the scope of their study.\n\n## Why it’s mixed\n\nThe money was real and so was the research. But the way it arrived is not a model for how giving should choose causes. ALS got a viral moment that most diseases never get, and nothing in the challenge compared ALS with other needs. The windfall came once. RTI calls it a “once-in-a-generation phenomenon.”\n\nThe evidence on impact is also thinner than the totals suggest. The grantee survey had a 27 percent response rate, a limitation the report itself flags. And most care for people living with ALS is still palliative, the evaluators note.\n\n## Where it sits in the system\n\nThe money worked at several depths. Clinic care is relief, research aims at treatments, which on the [depth scale](/method/#depth) is **repair** (level 1), and advocacy for federal funding works on structure. The way the money was raised is a clear case of [Story Bias](/diagnosis/story-bias/): a fun, social, shareable act, attached to one cause. The way its impact is reported shows the [Measurement Gap](/diagnosis/measurement-gap/), where outputs such as grants, papers and clinics are counted, while the outcome that matters most, years of life for people with ALS, is much harder to measure.\n\n## What carries over\n\nWhen attention brings a windfall, put it into capacity that lasts and commission evaluation that doesn’t rely on the people funded. And ask the question no campaign total answers: did this money add to the world’s giving or move it from somewhere else? That is [Open Problem 4, the Counterfactual Problem](/open-problems/the-counterfactual-problem/)."
    },
    {
      "id": "one-laptop-per-child",
      "path": "/record/case-studies/one-laptop-per-child/",
      "title": "One Laptop per Child",
      "summary": "A nonprofit started by MIT Media Lab faculty set out to give schoolchildren around the world low-cost laptops of their own, and governments bought hundreds of thousands. In Peru children used computers far more but did no better in math or language, and in Uruguay reading and math scores did not improve.",
      "kind": "mixed",
      "era": "2005–2014",
      "place": "Peru, Uruguay and other countries",
      "depth": 3,
      "lessons": [
        "Delivering a thing is not the same as delivering what the thing is for. The laptops reached children, and better test scores did not follow.",
        "Test the theory of change before scaling it. The big evaluations reported after governments had already bought laptops for whole school systems.",
        "What you measure shapes what you learn. Peru’s evaluation found no effect on test scores and inconclusive gains in general thinking skills, and observers disagreed about which outcomes mattered most.",
        "Randomizing during a national rollout is what made these lessons knowable. That choice deserves as much attention as the results."
      ],
      "conditions": [
        "measurement-gap",
        "story-bias"
      ],
      "sources": [
        {
          "title": "Annan presents prototype $100 laptop at World Summit on Information Society",
          "url": "https://news.mit.edu/2005/laptop-1116",
          "publisher": "MIT News",
          "year": 2005
        },
        {
          "title": "Technology and Child Development: Evidence from the One Laptop per Child Program",
          "url": "https://www.aeaweb.org/articles?id=10.1257/app.20150385",
          "publisher": "Julian Cristia, Pablo Ibarrarán, Santiago Cueto, Ana Santiago and Eugenio Severín, American Economic Journal, Applied Economics 9(3)",
          "year": 2017
        },
        {
          "title": "The Impact of a One Laptop per Child Program on Learning: Evidence from Uruguay",
          "url": "https://www.iza.org/publications/dp/8489/the-impact-of-a-one-laptop-per-child-program-on-learning-evidence-from-uruguay",
          "publisher": "Gioia De Melo, Alina Machado and Alfonso Miranda, IZA Discussion Paper 8489",
          "year": 2014
        },
        {
          "title": "Evaluating One Laptop Per Child (OLPC) in Peru",
          "url": "https://blogs.worldbank.org/en/education/olpc-peru2",
          "publisher": "Michael Trucano, World Bank Blogs",
          "year": 2012
        }
      ],
      "review": "draft",
      "body": "## What happened\n\nIn November 2005, at the World Summit on the Information Society in Tunis, United Nations Secretary-General Kofi Annan unveiled the first working prototype of a “$100 laptop,” alongside Nicholas Negroponte, cofounder of the MIT Media Lab. The machine came from One Laptop per Child, a nonprofit created by Media Lab faculty to give schoolchildren and their teachers a personal, connected computer. It was rugged, ran on very little power and could share one internet connection across many machines. Governments would buy the laptops, and schools would hand them out, one per child.\n\nGovernments did buy. Peru ran the largest deployment, with a commonly reported 902,000 laptops. Uruguay’s Plan Ceibal was, according to the economists who studied it, the only deployment to cover a whole country.\n\nThen came the evaluations. In Peru, a team led by researchers at the Inter-American Development Bank ran a randomized evaluation in 318 rural primary schools. After 15 months, treatment schools had gone from about one computer for every eight students to more than one each, and children used computers far more at school and at home. But the study found no effect on math or language test scores, and only inconclusive evidence of gains in general thinking skills. In Uruguay, economists found the program had no effect on math or reading scores in its first two years, possibly because students mainly used the laptops in class to search the internet.\n\nReactions split on what the results meant. Michael Trucano of the World Bank called the habit of handing out hardware first “classic worst practice,” and also asked whether standardized tests were measuring the right things.\n\n## Where it sits in the system\n\nThe program aimed at **structure** (level 3) on the [depth scale](/method/#depth): changing what every school gives every child. But a new input changes the structure of learning only if it changes what produces learning, such as what children do in class and how teachers teach. The evaluations suggest that, on its own, it didn’t.\n\nThis is the [Measurement Gap](/diagnosis/measurement-gap/) in its classic form: [outputs and outcomes](/record/encyclopedia/outputs-and-outcomes/) are different things. Laptops delivered were the output. Learning was the outcome. A bold, simple promise, unveiled at a world summit, made the output easy to sell ([Story Bias](/diagnosis/story-bias/)). The randomized evaluation during Peru’s rollout is the reason anyone knows the difference.\n\n## What carries over\n\nWrite down the [theory of change](/record/encyclopedia/theory-of-change/), the chain from what you deliver to the change you want, and test its weakest link at small scale before buying for a whole country. Decide in advance which outcomes count, so a disappointing result can’t be explained away and a promising one isn’t missed."
    },
    {
      "id": "oral-rehydration-therapy-spread",
      "path": "/record/case-studies/oral-rehydration-therapy-spread/",
      "title": "How oral rehydration therapy spread",
      "summary": "A drink of clean water, sugar and salt can save a child from dying of diarrhea. After it was used to treat refugees during a 1971 cholera outbreak, it spread through health programs and door-to-door teaching, while child deaths from diarrhea fell from an estimated 4.6 million a year in 1980 to about 1.5 million by 2000.",
      "kind": "success",
      "era": "1971–2000",
      "place": "Bangladesh, India and worldwide",
      "depth": 0,
      "lessons": [
        "The cheapest fix can be one of the biggest. Oral rehydration salts cost a few cents per treatment.",
        "Putting treatment in families’ hands, not only in clinics, is what let it reach millions. That meant convincing doctors that people with little training could give it.",
        "Checking whether people can really do what they were taught is part of the intervention. Years after BRAC’s campaign, researchers tested the solutions mothers made at home.",
        "Relief at scale is not a lesser good. A treatment that meets the need today, everywhere, can save more lives than far more ambitious programs."
      ],
      "conditions": [
        "missing-voice",
        "measurement-gap"
      ],
      "sources": [
        {
          "title": "Reducing deaths from diarrhoea through oral rehydration therapy",
          "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC2560623/",
          "publisher": "Cesar G. Victora, Jennifer Bryce, Olivier Fontaine and Roeland Monasch, Bulletin of the World Health Organization 78(10)",
          "year": 2000
        },
        {
          "title": "Miracle cure for an old scourge",
          "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC2636196/",
          "publisher": "Bulletin of the World Health Organization 87(2)",
          "year": 2009
        },
        {
          "title": "The status of ORT (oral rehydration therapy) in Bangladesh: how widely is it used?",
          "url": "https://doi.org/10.1093/heapol/12.1.58",
          "publisher": "A. Mushtaque R. Chowdhury, Fazlul Karim, Sanjit K. Sarkar, Richard A. Cash and Abbas Bhuiya, Health Policy and Planning 12(1)",
          "year": 1997
        },
        {
          "title": "Diarrhoeal disease, fact sheet",
          "url": "https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease",
          "publisher": "World Health Organization",
          "year": 2024
        }
      ],
      "review": "draft",
      "body": "## What happened\n\nFor most of history, diarrhea killed mainly through dehydration, draining the body of water and salts. Oral rehydration salts, a mix of clean water, sugar and salt, are absorbed in the small intestine and replace what is lost. A treatment costs a few cents.\n\nThe formula came out of years of studies in Kolkata and Dhaka. In 1971, during a cholera outbreak among refugees from what is now Bangladesh, Dilip Mahalanabis of the Johns Hopkins center in Kolkata treated patients at Bangaon, India, with the solution, dispensed from drums. He and Dhiman Barua of the World Health Organization had to persuade a skeptical medical profession that people with little training could give it. In 1978 Barua set up WHO’s program to control diarrheal diseases. After oral rehydration therapy was introduced in 1979, it quickly became the cornerstone of diarrhea control programs. The Lancet called it “potentially the most important medical advance” of the century.\n\nIn Bangladesh, the nonprofit BRAC took it door to door. Between 1980 and 1990 it taught more than 12 million mothers to make the solution at home with common salt and unrefined brown sugar. In 1993 researchers revisited more than 9,000 households and tested solutions made by a sample of mothers. More than 70 percent of mothers could make one that was chemically safe and effective, and many of them had been very young during the campaign. The solution was used in 60 percent of recent bouts of diarrhea.\n\nWorldwide, deaths of children under five from diarrhea fell from an estimated 4.6 million in 1980 to about 1.5 million by 2000. Oral rehydration played a significant part, though not the only one.\n\n## Where it sits in the system\n\nOn the [depth scale](/method/#depth) this is **relief** (level 0). It treats the illness in front of you and does not stop diarrhea from happening. That is the point of the case: depth describes, it doesn’t grade, and relief delivered everywhere saved millions of lives.\n\nThe spread is a counterexample to the [Missing Voice](/diagnosis/missing-voice/). The breakthrough was trusting families, not only doctors, to deliver care. And it shows the [Measurement Gap](/diagnosis/measurement-gap/) from both sides. Researchers in Bangladesh tested what mothers could actually do, while a 2000 review of the global record found that patchy data and differing definitions of the therapy made trends hard to track.\n\n## What carries over\n\nSimple, cheap, taught at home and checked: that combination carried a relief treatment to millions of families. Relief does not end the need, though. Diarrhea still kills around 443,832 children under five a year, according to WHO, and preventing it takes safe water, sanitation, handwashing and rotavirus vaccines. See the [Intervention Database entry](/record/interventions/oral-rehydration-therapy/)."
    },
    {
      "id": "playpumps",
      "path": "/record/case-studies/playpumps/",
      "title": "PlayPumps",
      "summary": "A merry-go-round that pumped water as children played drew $16.4 million in pledges and wide celebrity support. Field reports later found many pumps broken, unused or slower than the hand pumps they replaced, and the backers stopped the rollout and said so publicly.",
      "kind": "failure",
      "era": "2005–2010",
      "place": "Southern Africa",
      "depth": 2,
      "lessons": [
        "A story can outrun the evidence. The picture of children playing while water flowed raised millions and a 4,000-pump target before independent field assessments came in.",
        "Bad news traveled slowly. Field partners saw breakdowns early and a 2007 UNICEF assessment raised concerns, but the report stayed internal, and the first public acknowledgment came in 2009.",
        "When the people who will use a technology don’t choose it, mismatches follow. In some places a PlayPump replaced a hand pump that delivered more water per hour.",
        "Stopping a program and explaining why, in public, is how the field learns. It works best when it happens early."
      ],
      "conditions": [
        "story-bias",
        "missing-feedback-loop",
        "missing-voice",
        "silence-about-failure"
      ],
      "sources": [
        {
          "title": "Southern Africa: Troubled Water",
          "url": "https://www.pbs.org/frontlineworld/stories/southernafrica904/",
          "publisher": "Amy Costello, FRONTLINE/World, PBS",
          "year": 2010
        },
        {
          "title": "Timeline: The PlayPump Trail",
          "url": "https://www.pbs.org/frontlineworld/stories/southernafrica904/timeline_tw.html",
          "publisher": "FRONTLINE/World, PBS",
          "year": 2010,
          "note": "Summarizes the 2007 UNICEF assessment, the 2008 report for Mozambique’s government, PlayPumps International’s 2009 letters and Jean Case’s 2010 letter."
        },
        {
          "title": "The PlayPump: What Went Wrong?",
          "url": "https://news.climate.columbia.edu/2010/07/01/the-playpump-what-went-wrong/",
          "publisher": "Daniel Stellar, State of the Planet, Columbia Climate School",
          "year": 2010
        }
      ],
      "review": "draft",
      "body": "## What happened\n\nThe PlayPump was a children’s merry-go-round attached to a water pump. As children spun it, it pumped groundwater into a storage tower, and advertising on the tower was meant to pay for upkeep. Its founder, Trevor Field, had installed hundreds across South Africa and its neighbors, and in 2000 the World Bank recognized the technology for innovation. FRONTLINE/World profiled it in 2005, and the story helped build enthusiasm among donors.\n\nIn September 2006, at the Clinton Global Initiative, Laura Bush, Bill Clinton and the philanthropists Jean and Steve Case announced $16.4 million to install PlayPumps across sub-Saharan Africa: $10 million from the U.S. government, $5 million from the Case Foundation and $1.4 million from the MCJ Foundation. A new nonprofit, PlayPumps International, set out to install 4,000 pumps by 2010, and celebrities joined the fundraising.\n\nTrouble showed up in the field. Save the Children, a partner, heard on site visits that pumps were breaking down and that some communities were rejecting them. By late 2009, only 42 of its 80 planned pumps in Mozambique had been installed, and 13 of those were working properly. A 2007 UNICEF assessment in South Africa, Mozambique and Zambia raised concerns about safety, maintenance and effectiveness and recommended installing PlayPumps only at schools, but the report was not released publicly. A 2008 report for Mozambique’s government noted the technology’s merits but found installation and maintenance problems. No advertisers had come forward in rural areas to pay for upkeep, and the pumps delivered less water per hour than the hand pumps they had often replaced.\n\nIn September 2009 PlayPumps International acknowledged “challenges” and temporarily suspended new installations. It gave its remaining pumps to the charity Water for People, and in 2010 it stopped raising money for the technology. Jean Case published a personal letter on the Case Foundation’s website about what the foundation had learned. FRONTLINE/World, whose first story had helped make the pump famous, broadcast its own follow-up investigation in June 2010.\n\n## Where it sits in the system\n\nClean water for a village is **prevention** (level 2) on the [depth scale](/method/#depth). What failed was not the goal but the system around it. A vivid image drew money faster than evidence could ([Story Bias](/diagnosis/story-bias/)). Problems seen in the field took years to reach donors ([the Missing Feedback Loop](/diagnosis/missing-feedback-loop/)). Some communities rejected the pumps, and some lost hand pumps that had worked better, a sign that the people who would use the water were not the ones deciding what to install ([the Missing Voice](/diagnosis/missing-voice/)). And a critical assessment stayed internal while fundraising went on ([the Silence About Failure](/diagnosis/silence-about-failure/)).\n\n## What carries over\n\nPilot and measure before scaling, ask users before installing, and treat early warnings from field partners as data. The public admission at the end is the behavior a healthy system should reward, and the [Failure Archive](/record/failure-archive/) exists to make such admissions normal and early. What would make it so is [Open Problem 9, the Failure Commons](/open-problems/the-failure-commons/)."
    },
    {
      "id": "polio-eradication",
      "path": "/record/case-studies/polio-eradication/",
      "title": "The campaign to eradicate polio",
      "summary": "Since 1988 a global partnership has cut wild polio cases by more than 99 percent and eradicated two of the three wild strains. The original deadline was the year 2000, and the last stretch has proved the hardest.",
      "kind": "mixed",
      "era": "1985–present",
      "place": "Worldwide",
      "depth": 4,
      "lessons": [
        "A precise goal with a shared scoreboard, zero cases, has held governments, agencies and a volunteer movement together for decades.",
        "A civic network can be funder, fundraiser and advocate at once. Rotary helped start the effort, and its members have contributed more than $2.7 billion.",
        "The last 1 percent can be harder than the first 99. A deadline set at the start rarely survives the hardest places.",
        "Program data can look better than reality. Independent audits are how a campaign finds out what its own numbers miss."
      ],
      "conditions": [
        "fragmentation",
        "measurement-gap",
        "short-horizon"
      ],
      "sources": [
        {
          "title": "Global eradication of poliomyelitis by the year 2000 (resolution WHA41.28)",
          "url": "https://www.archive.polioeradication.org/wp-content/uploads/2016/07/19880513_resolution-2.pdf",
          "publisher": "World Health Assembly",
          "year": 1988
        },
        {
          "title": "Poliomyelitis, fact sheet",
          "url": "https://www.who.int/news-room/fact-sheets/detail/poliomyelitis",
          "publisher": "World Health Organization",
          "year": 2025
        },
        {
          "title": "History of Polio: Key Milestones & Global Eradication",
          "url": "https://polioeradication.org/about-polio/history-of-polio/",
          "publisher": "Global Polio Eradication Initiative"
        },
        {
          "title": "Partners",
          "url": "https://polioeradication.org/who-we-are/partners/",
          "publisher": "Global Polio Eradication Initiative"
        },
        {
          "title": "Update on the ongoing public health emergencies of international concern: poliomyelitis (EB/SCHEPPR/8/2)",
          "url": "https://apps.who.int/gb/scheppr/pdf_files/SCHEPPR8/EB_SCHEPPR8_2-en.pdf",
          "publisher": "World Health Organization, report by the Director-General",
          "year": 2026
        }
      ],
      "review": "draft",
      "body": "## What happened\n\nIn 1985 Rotary International launched PolioPlus, its program to end polio. In May 1988 the World Health Assembly committed the World Health Organization to eradicating polio by the year 2000, which launched the Global Polio Eradication Initiative. That year there were an estimated 350,000 cases in more than 125 countries where the virus was endemic. The partnership grew to include WHO, Rotary, the U.S. Centers for Disease Control and Prevention, UNICEF, the Gates Foundation and Gavi, among others. Rotary members alone have contributed more than $2.7 billion, and more than a million of them have volunteered.\n\nThe results are enormous. Wild polio cases have fallen by more than 99 percent. Wild poliovirus type 2 was declared eradicated in 2015 and type 3 in 2019. Every WHO region except the Eastern Mediterranean has been certified free of wild polio, Africa most recently, in 2020.\n\n## Why it’s mixed\n\nThe year-2000 deadline passed long ago. Wild poliovirus type 1 still circulates in Afghanistan and Pakistan, which had reported 39 cases for 2025 by the end of the year, down from 99 in 2024, with a backlog of samples still untested. A second problem comes from the oral vaccine itself. Its weakened virus can regain the ability to cause paralysis and spread where too few children are vaccinated. There were 202 such vaccine-derived cases in 2025, down from 463 in 2024. WHO links them to insecurity, displacement and large numbers of unvaccinated children. A newer oral vaccine is much less likely to revert.\n\nMeasurement has been hard too. In late 2025 an independent audit in Karachi found that the program’s data did not give an accurate picture of campaign quality, that coverage was being overestimated and that more children were being missed than the data showed. Funding has tightened, and the partnership adopted a leaner plan for 2026.\n\n## Where it sits in the system\n\nEradication removes a disease for good, which makes it **source** work (level 4) on the [depth scale](/method/#depth), like the eradication of [smallpox](/record/case-studies/smallpox-eradication/). Until the last virus is gone, though, every vaccination round is prevention that has to be repeated.\n\nThe campaign is also a working answer to [Fragmentation](/diagnosis/fragmentation/). Very different organizations share one target and one scoreboard. The Karachi audit shows the [Measurement Gap](/diagnosis/measurement-gap/) inside even a data-rich program, and four decades of work is a long test of funders’ patience against the [Short Horizon](/diagnosis/short-horizon/).\n\n## What carries over\n\nA shared, measurable goal can hold a coalition together for a generation. The last steps of an eradication campaign happen in the hardest places, so funders need patience, flexible money and outside checks on the numbers. A program that is 99 percent finished is not finished."
    },
    {
      "id": "rosenwald-schools",
      "path": "/record/case-studies/rosenwald-schools/",
      "title": "The Rosenwald schools",
      "summary": "A Black educator and a Chicago businessman started a program that built nearly 5,000 schools for Black children in the segregated rural South, with local communities and governments paying most of the cost. Economists later found the schools explain a large share of that era’s gains in Black education.",
      "kind": "success",
      "era": "1912–1932",
      "place": "Rural South, United States",
      "depth": 3,
      "lessons": [
        "Matching grants can multiply a gift and build ownership. Over time the fund’s share of a school’s cost fell from about a quarter to 10 to 15 percent, with local people and governments paying the rest.",
        "In a system that tends to redirect money away from the people it is meant for, funding things that are hard to divert, like buildings, desks and books, protects the gift.",
        "Matching has a cost too. Communities that could not raise their share could be turned down, so a match can favor the places that need help least.",
        "A fund built to spend itself out can move fast and avoid outliving its purpose."
      ],
      "conditions": [
        "parked-money",
        "missing-voice"
      ],
      "sources": [
        {
          "title": "The Impact of Rosenwald Schools on Black Achievement",
          "url": "https://www.chicagofed.org/-/media/publications/working-papers/2009/wp2009-26-pdf.pdf",
          "publisher": "Daniel Aaronson and Bhashkar Mazumder, Federal Reserve Bank of Chicago working paper 2009-26, published in the Journal of Political Economy 119(5)",
          "year": 2011
        },
        {
          "title": "Julius Rosenwald and the Rosenwald Schools Act of 2020 (Public Law 116-336)",
          "url": "https://www.congress.gov/116/plaws/publ336/PLAW-116publ336.htm",
          "publisher": "U.S. Congress",
          "year": 2021
        },
        {
          "title": "Rosenwald Fund Schools (1912-1932)",
          "url": "https://www.blackpast.org/african-american-history/rosenwald-fund-schools-1912-1932/",
          "publisher": "Holly Roose, BlackPast.org",
          "year": 2011
        },
        {
          "title": "Julius Rosenwald’s Crusade",
          "url": "https://www.philanthropyroundtable.org/magazine/julius-rosenwalds-crusade/",
          "publisher": "Peter M. Ascoli, Philanthropy magazine (Philanthropy Roundtable)",
          "year": 2006,
          "note": "The author is Rosenwald’s grandson and biographer."
        }
      ],
      "review": "draft",
      "body": "## What happened\n\nIn the early 1900s, schools for Black children in the rural South were badly underfunded by white-run county boards. In 1930 the average county still spent 39 cents per person on salaries in Black schools for every dollar it spent in white schools. Booker T. Washington, the principal of the Tuskegee Institute in Alabama, sought Northern donors to build better schools, and Julius Rosenwald, the Chicago businessman who built Sears, Roebuck, agreed to help. After six pilot schools near Tuskegee around 1913 and 1914, the program spread across the South. Between 1912 and 1932 it helped build 5,357 schools and related buildings, such as teachers’ homes and workshops, in 15 states.\n\nThe fund’s rule, as the economists Daniel Aaronson and Bhashkar Mazumder summarize it, was to help “only where help was wanted.” Rosenwald money came only if Black residents and local governments put in money too, and together they paid most of the cost. The fund set standards for light, ventilation and sanitation, and it required desks, blackboards and books. It concentrated on physical things that county boards could not easily shift to white schools.\n\nIt worked. Aaronson and Mazumder found that rural Black students with access to a Rosenwald school completed more than a full extra year of schooling, with gains in literacy and test scores too. They estimate the schools explain close to 40 percent of the narrowing of the Black-white education gap in the South for children born between 1910 and 1925. The gains were largest in the most disadvantaged counties.\n\nThe building program ended in 1932, the year Rosenwald died. He had required his fund to spend all its money within 25 years of his death, and the Julius Rosenwald Fund dissolved in 1948.\n\n## Where it sits in the system\n\nOn the [depth scale](/method/#depth) this is **structure** (level 3). Each school was a building, but the deal changed what county school systems built and paid for, because public money and upkeep were part of the match. Requiring local demand and contributions also put the community, not the donor, at the start of every project, the opposite of the [Missing Voice](/diagnosis/missing-voice/).\n\nIn a 1929 essay Rosenwald wrote, “I am opposed to gifts in perpetuity for any purpose.” His fund is an early answer to what Charitology calls [Parked Money](/diagnosis/parked-money/).\n\nThe program worked inside segregation rather than against it. Washington’s strategy of putting education and economic progress first brought deep conflict with W. E. B. Du Bois and the NAACP. The schools show what building within the system achieved, not whether challenging it directly would have achieved more.\n\n## What carries over\n\nMatching can multiply money and build ownership, but it can also screen out the poorest places, so a match needs a plan for those who can’t meet it. A fund with an end date has to spend where it can do good now. How fast philanthropic money should be spent is [Open Problem 12, the Payout Question](/open-problems/the-payout-question/)."
    },
    {
      "id": "scared-straight",
      "path": "/record/case-studies/scared-straight/",
      "title": "Scared Straight",
      "summary": "Programs that brought at-risk teenagers into prisons to be confronted by inmates spread across the United States on the strength of a documentary. Randomized trials found they increased later offending, yet versions of the programs carried on for decades.",
      "kind": "failure",
      "era": "1970s–2010s",
      "place": "United States and other countries",
      "depth": 2,
      "lessons": [
        "Success stories without a comparison group can’t show that a program works. The original documentary reported that 16 of 17 teenagers stayed out of trouble for three months, and compared them with no one.",
        "A program can feel right, cost almost nothing and still cause harm. Only randomized comparisons revealed it.",
        "Evidence of harm does not stop a program by itself. In one case, negative results ended the evaluation instead of the program.",
        "The more dramatic, cheap and intuitive a program is, the faster it spreads, so those are the programs most in need of testing."
      ],
      "conditions": [
        "story-bias",
        "measurement-gap",
        "missing-feedback-loop"
      ],
      "sources": [
        {
          "title": "Scared Straight and Other Juvenile Awareness Programs for Preventing Juvenile Delinquency, a systematic review",
          "url": "https://doi.org/10.4073/csr.2013.5",
          "publisher": "Anthony Petrosino, Carolyn Turpin-Petrosino, Meghan E. Hollis-Peel and Julia G. Lavenberg, Campbell Systematic Reviews 2013:5",
          "year": 2013,
          "note": "A free copy is held by the University of Tübingen repository at https://publikationen.uni-tuebingen.de/xmlui/handle/10900/64695"
        },
        {
          "title": "Justice Department Discourages the Use of “Scared Straight” Programs",
          "url": "https://ojjdp.ojp.gov/sites/ojjdp/files/pubs/news_at_glance/234084/topstory.html",
          "publisher": "Office of Juvenile Justice and Delinquency Prevention, OJJDP News @ a Glance",
          "year": 2011
        }
      ],
      "review": "draft",
      "body": "## What happened\n\nIn the 1970s, inmates serving life sentences at a New Jersey prison started a program to scare at-risk and delinquent teenagers away from crime. The teenagers visited the prison and sat through aggressive presentations about prison life, often with exaggerated stories of violence. A television documentary that aired in 1978 reported that 16 of the 17 teenagers it followed stayed law-abiding for three months afterward, a 94 percent success rate. There was no comparison group. The program was copied in more than 30 jurisdictions, and Congress held hearings on it.\n\nIt is easy to see why it spread. The idea is deterrence, which matches a common intuition about how to stop crime. It was cheap, too: one Maryland version cost less than a dollar per participant.\n\nThen the evidence came in. A randomized trial of the New Jersey program, published in 1982, reported that participants were more likely to be arrested than similar teenagers who didn’t take part. In 2013 a Campbell Collaboration review led by Anthony Petrosino pooled the results of randomized trials run over 25 years in eight jurisdictions. Across them, the programs made later offending more likely: the odds rose by a factor of about 1.6 to 1.7. “Doing nothing would have been better than exposing juveniles to the program,” the authors wrote.\n\nThe programs didn’t stop. The review notes that when a California version produced negative results, the response was to end the evaluation, not the program. A 2011 television series, *Beyond Scared Straight*, revived interest. That year two senior U.S. Justice Department officials wrote publicly that the department did not support such programs, and Maryland and California suspended theirs. The department’s juvenile justice office added that bringing court-involved youth into contact with adult inmates could violate federal law.\n\n## Where it sits in the system\n\nThe aim was **prevention** (level 2) on the [depth scale](/method/#depth): stopping crime before it happened. Its failure is a lesson about the system’s signals. A documentary carried the story further than any data could ([Story Bias](/diagnosis/story-bias/)). The people who saw the program in action, such as inmates, staff, parents and viewers, saw what happened in the room, not arrest records a year later ([the Missing Feedback Loop](/diagnosis/missing-feedback-loop/)). And before-and-after counts without a comparison group looked like evidence when they weren’t ([the Measurement Gap](/diagnosis/measurement-gap/)).\n\n## What carries over\n\nGood intentions and a plausible theory are not evidence. A [randomized controlled trial](/record/encyclopedia/randomized-controlled-trials/) was the only thing that showed this program was doing harm. See the myth [If a program sounds logical, it works](/record/myths/if-a-program-sounds-logical-it-works/), and for the wider question of when help hurts, [Open Problem 20, When Charity Harms](/open-problems/when-charity-harms/)."
    },
    {
      "id": "smallpox-eradication",
      "path": "/record/case-studies/smallpox-eradication/",
      "title": "The eradication of smallpox",
      "summary": "A coordinated global campaign ended a disease that had killed people for thousands of years. It remains the only human disease ever eradicated.",
      "kind": "success",
      "era": "1967–1980",
      "place": "Worldwide",
      "depth": 4,
      "lessons": [
        "A precise, shared goal (zero cases) let thousands of organizations and governments coordinate around one measurable target.",
        "Surveillance and ring vaccination, which meant finding cases and vaccinating everyone around them, beat trying to vaccinate everyone everywhere. Learning which approach worked mattered as much as the money.",
        "Eradication can end recurring disease and treatment, while preparedness and safe handling of laboratory stocks still need support."
      ],
      "conditions": [
        "fragmentation",
        "short-horizon"
      ],
      "sources": [
        {
          "title": "Smallpox",
          "url": "https://www.who.int/health-topics/smallpox",
          "publisher": "World Health Organization"
        },
        {
          "title": "Smallpox: A Great and Terrible Scourge, “Success”",
          "url": "https://nlm.nih.gov/exhibition/smallpox/sp_success.html",
          "publisher": "U.S. National Library of Medicine"
        },
        {
          "title": "The WHO and the Eradication of Smallpox",
          "url": "https://origins.osu.edu/read/who-and-eradication-smallpox",
          "publisher": "Origins, Ohio State University"
        }
      ],
      "review": "draft",
      "body": "## What happened\n\nEfforts to eliminate smallpox go back to the 1950s, and in 1967 the World Health Organization launched an intensified eradication program. Alongside widespread vaccination, teams increasingly found each case and vaccinated the people around it, an approach called surveillance and containment. The last naturally occurring case was recorded in Somalia in 1977. On 8 May 1980 the World Health Assembly declared smallpox eradicated.\n\n## Why it’s a source-level case\n\nEradication ended naturally occurring smallpox. WHO still oversees laboratory stocks, research on vaccines and treatments, and emergency preparedness, so the disease has not disappeared from public health budgets. On the depth scale Charitology describes the end of natural transmission as a **source** (level 4) outcome for one disease. The campaign was a feat of [coordination](/diagnosis/fragmentation/) as much as of medicine.\n\n## What carries over\n\nFew problems can be eradicated the way a virus with no animal host can. But the campaign shows what a precise shared goal, honest measurement and a willingness to change methods mid-course can do."
    }
  ]
}