Faced with a $1.9 million shortfall after USAID pulled funding, GiveWell evaluated whether to support ALIMA’s critical healthcare programs in conflict-affected Cameroon. Despite challenges in measuring impact—especially in unstable regions with mobile populations and spotty data—the team conducted a thorough cost-effectiveness analysis. They weighed interventions like syphilis testing against maternal mortality prevention, ultimately finding syphilis screening more efficient per dollar spent. While data limitations raised doubts, firsthand accounts from local health leaders confirmed the program's vital role. After balancing urgency with evidence, GiveWell approved the full grant to sustain essential services, marking a rare but necessary departure from their usual timeline to prevent immediate harm.