UP Matrix ScorecardLast updated: June 2026
Spiro
Spiro has delivered well during its pilot and is now experimenting with technical assistance to state health departments, which would turbocharge its scale. They have already received a GiveWell grant and the Global Fund is an obvious payer-at-scale. A strong bet.
Overall Rating
Cost Effectiveness Rating
Cost Effectiveness Rationale14xGiveWell Benchmark
Our RecommendationBuy
Key Information
Overview
Spiro conducts household screening and treatment for tuberculosis in Pakistan, offering on-the-spot treatment for children under 5 in a single visit.
RegistrationUS
Turnover (USD)$597k
StageEarly mid-stage
Countries ActivePakistan
54321Intervention Evidence QualityOrganisation Evidence QualityPotential for ScalePayer-at-scale InterestFit for Global Health Fund
The UP Index™3.4 / 5
Pathways to Scale
Payer-at-scale Interest
Government Adoption
Franchise/Replication (by other NGOs)
Commercial Revenue
Impact Metrics
Death prevented (per $1M at scale)255
ConfidenceMedium
Cost per DALY averted$46
Total annual reach9,800 cases treated
International Evidence
Intervention Evidence QualityRationale: Single RCT
MediumQuasi-Experimental
Single RCT
Multiple RCTs
Meta-Analysis
Implementation Evidence
Organisation / Programme Evidence QualityRationale: Successful pilot
MediumPilot Study
Quasi-Experimental
Single RCT
Multiple RCTs