Look around Caitlin Tulloch's home in Oakland, California, and it's clear that the world outside the U.S. has made an impression on her.
"This is a really lovely piece of embroidery that I bought in a town called Mae Hong Son in Thailand," she says, gesturing to a red tapestry woven through with geometric forms. She has other textiles, too — from Guatemala, Indonesia, Kenya, Laos and Uzbekistan. Some she's purchased in person while abroad. Others she's received as gifts.
On her office door is a little gold placard that her husband had made for her. It reads: "Caitlin Tulloch, Grand Poobah of Cost Effectiveness."
Tulloch is an economist. And cost effectiveness is what she has focused on for more than a decade. She uses data to work towards the biggest humanitarian bang for the buck: saving more lives, educating more children and lifting more people out of poverty as affordably and effectively as possible.
This is the work she'd been doing while on staff at USAID since 2023 when, earlier this year, DOGE and the Trump administration began pausing and then shutting down thousands of the agency's contracts. Funding for most of the foreign aid agency's programs evaporated almost overnight.
"It was all very confusing," recalls Tulloch. "But in a very, very short period of time, what USAID had historically been doing was just wiped off the map."
Tulloch was let go and reinstated by the agency multiple times before ultimately resigning. It was around that time that she and several colleagues, some of whom had been laid off, went on to create a special kind of matchmaking service. They call themselves Project Resource Optimization (PRO).
The idea was simple — out of the ashes of the dismantling of much of U.S. foreign assistance, Tulloch and her team would guide philanthropists who want to help but are uncertain how to do so. They would offer advice on where to invest their money for the biggest impact.
A most important spreadsheet
Here's how this effort got started.
At first, when USAID was being decimated and Tulloch and her coworkers watched their efforts go up in smoke, she says there was "a large community of people processing a lot of grief."
They managed to find ways to take care of one another, even at a distance. The daily texts of cat pictures began in February.
"I think we just needed things to smile at," says Tulloch. "It actually became a very nice routine amongst our team. If something bad would happen, they would be like, 'Well, we need a thread of everyone's pets.' "
Pretty soon, Tulloch started contemplating what to do next. "Thinking about what I can do with my skill set to take care of people, improve human welfare," she says.
And then, in late February, she got a couple of phone calls from two well-heeled foundations that she'd interacted with previously and that support groups overseas. They were grappling with a conundrum. In a world where the U.S. has now largely retreated from its commitment to foreign aid, they wanted to know how to donate their money to have the greatest impact on saving lives. Of the thousands of programs the agency once supported at a level of some $35 billion, which should these foundations help fund?
"All of a sudden, people are saying, 'Out of all of that, if I have $2 million, if I have $5 million, what should I pick up?,' " Tulloch recalls.
She decided this was the perfect project to focus on. So she and several colleagues went to ForeignAssistance.gov and downloaded a spreadsheet listing all the foreign aid programs that USAID had been funding. It amounted to 22,724 commitments.
"They're tagged by country and by sector and by purpose and by implementing partner and by funding source," says Tulloch. When an NPR reporter visited her in April, she called up the spreadsheet that she and her team assembled to track all these fields and scrolled through the document that now satisfyingly consumes her life.
There are basic sanitation programs in Ghana, tuberculosis control initiatives in Malawi, STD control projects in Nepal, and on and on. Line after line after line.
"Each of these represents an obligation in a particular country," Tulloch says. "It's like a heat map of what was being done, where."
Tulloch and her small team applied a series of filters to the spreadsheet, trying to hone in on the programs that were the most cost effective and that had the potential to save the most lives. For instance, they removed projects focused on improving the work environment or fostering biodiversity. "Not because those were bad objectives," she says, "but simply because that wasn't the focus of this initiative." They also filtered geographically, focusing on lower income countries.
"And we were still at 2,000 rows and $9 billion," she says. She thought to herself, "I don't know what else to filter out here. It's really a terrible set of decisions."
They then waded through the descriptions for all 2,000 rows and reached out to numerous programs around the world to make sure their funding had indeed been withdrawn — and if so, how urgent their unfinished work was. PRO sent out a survey that asked the program staff to check off which proven lifesaving interventions they were currently delivering and to how many people. Things like emergency food assistance, syphilis detection and treatment, the spraying of insecticide on home surfaces to kill the mosquitoes that spread malaria, and more. PRO then conducted a quick check on the efficiency of that delivery to come up with their short list.
So far, the team has 54 projects totaling almost $96.5 million that they call "Urgent and Vetted."
A match made in Mali
When Tulloch first surveyed this list, one "row" leapt to the front of the line. "It's a project in Mali that was delivering treatment for acute malnutrition for children, mostly under 5," she says, along with other health issues. The work was being done by the global NGO Alliance for International Medical Action (ALIMA) in the middle of an ongoing civil war affecting most of the country.
"So in these conditions, [the people are] unable to produce food," says Dr. Geoffray Kakesi Mambweni through an interpreter. He runs the Mali arm of the ALIMA group. "They're unable to harvest. They're unable to travel because of all these risks that are present."
One of the most successful programs run by Kakesi's team of 109 people is providing young kids a fortified peanut-based paste called Plumpy'Nut that is extraordinarily effective in treating malnutrition. "Many of these children would be dead at this stage without this kind of a program," he explains.
That's why his team was distressed when, earlier this year, the U.S. government asked them to suspend their work so that an evaluation could be conducted. Kakesi says they were subsequently told by USAID to fire their staff and liquidate their supplies, including fuel and medicines. It wasn't clear whether USAID would restore their award. Ultimately, it was reinstated but the funding will only last until July. And ALIMA wasn't confident the grant would be renewed at that point.
A US State Department spokesperson wrote in an email to NPR: "USAID's grant with ALIMA in Mali is active and running," and added, "We will continue to make changes as needed."
"We didn't want ALIMA to be in a position of stop, start, stop, start funding," says Tulloch. "There is still a cliff coming. And there was still an interruption in funds being paid in the meantime that was preventing ALIMA from doing their work."
This instability is part of the broader foreign aid landscape that she and her colleagues are now navigating. "We have been chasing a moving target since day one," she says. "It is inherently a very volatile environment in which to be making decisions."
The PRO team determined that with a relatively small investment, the program could sustain its distribution of life-saving nutritional support to thousands of women and children, independent of U.S. funding decisions. If ALIMA waited too long, however, Tulloch and her colleagues felt it would be almost impossible to resume, given the challenges of operating in a war zone.
So PRO called up the Boston-based CRI Foundation, which funds global health development work in Africa and said they should act now and contribute to the Mali project. PRO was transparent about the possible resumption of USAID funds and the unlikely chances of a grant renewal in July. The possible downside of waiting was just too great in their estimation.
"And so we're now in this kind of matchmaking role," says Tulloch.
Kara Weiss, the foundation's executive director, was excited to hear about the opportunity in Mali. Her team had been wondering where to invest once the U.S. cut foreign aid. It had all seemed so impenetrable. So they reached out to other foundations and former USAID colleagues to figure out what to do, which led them to Tulloch.
"To have someone come to you and say, 'Well, we're just gonna go through the entire portfolio and get some answers,' like, yes, please," Weiss says. "It's been a remarkably helpful initiative."
The foundation wound up contributing $2.5 million to the Mali program — about half of what the group used to receive from USAID over a two year period. Still, the new influx of funds will allow ALIMA to extend some of its most pressing work in the country through mid-2026, independent of a grant renewal by the U.S. government.
"I think it's clear that private philanthropy is not going to be able to fill all the gaps," says Weiss. "But what we can do is staunch the bleeding, keep projects functioning so that it's possible for local organizations or local governments to take them over."
Tulloch agrees. "If we all wait until all of the dust settles, it's going to be a worse outcome that we're going to arrive at than if people take some of these bets right now," she says. She has found that not all donors are comfortable with contributing to an ecosystem characterized by such uncertainty, but the CRI Foundation was willing to take that risk.
In the meantime, ALIMA was thrilled with the news. "When I was able to inform our teams who are out in the field that we had finally secured financing," says Kakesi, "it was just so much joy. So this financing really gave us hope. And at the same time, we did have to prioritize because this is indeed more limited funding."
He says his team will spend the money in the neediest regions of the country.
A closing window
Una Osili, the associate dean at Indiana University's Lilly Family School of Philanthropy, finds PRO's matchmaking effort innovative and essential.
"No single actor can solve the scale of problems that the world has to deal with," she says, "whether that's in health care, education, agriculture, energy. And increasingly, we think about blended finance models as well as new forms of capital." Such funds might come from governments, the private sector and philanthropic interests across the Global North and Global South, she argues.
Osili brings up a standard critique of private global development philanthropy — that it tends to operate at a small scale and does so with minimal coordination with government agencies. By contrast, in her view, the PRO project is harnessing the reams of data that the U.S. government has accumulated over the years to rectify a key "information asymmetry" that often plagues donors who don't know how best to make a difference.
In addition, Osili says philanthropy's key advantage is that it's freed from the constraints that bind other entities, including governments. "Private donors don't have to respond to election cycles," says Osili. "They can work in real time, so philanthropy has flexibility, agility and the ability to essentially experiment."
The Mali program is one of now 13 matches that the PRO team has helped facilitate so far. And PRO, which is now being paid for its efforts by the think tank Center for Global Development, has a singular focus — securing funding for as many programs as they can on that Urgent and Vetted shortlist.
This matchmaking process, says Tulloch, "is not intended to be a long-term thing. I think we expect to do this for another four or five weeks. After that, the projects in our database will all largely have closed down. This is very time sensitive."
That's because the window for restarting de-funded projects is closing. Staff will soon go elsewhere, supplies will dry up. Tulloch knows well that most of the projects in that spreadsheet of hers will flatline.
"There's no justice in any of this," she says, "that anybody should have to be sitting here and filtering a spreadsheet in this way as the means of making decisions of such consequence. Not everybody's going to make it."
"This is not about getting everything we want, making things whole again," Tulloch admits. "I would like to make the world a better and slightly more just place for other people. And that's something we can do, even if it doesn't fix everything."
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