I helped hundreds of unemployed people with their job search as COO of School of Hard Knocks.
We had a training module called “the difference between a dream and a plan”.
A dream is saying you want to run a bar in Spain some day. A plan is learning Spanish, understanding the licensing laws, saving up a deposit and scouting locations. Many attendees had the former and almost none had the latter.
I’m reminded of this by global health ‘scaling plans’. Ultra Philanthropy’s Mid-Stage Global Health Fund, which I manage, aims to bring a cost-effective health intervention to scale by 2029, so I assess a lot of them.
We usually talk about scale as a question of ambition and money. These organisations have plenty of ambition, and I expect the Funding Anthropalypse will soon give them enough money.
What’s missing is a proper plan to scale - one with professional management and leadership in it. We need more Managing Directors and Chiefs of Staff.
What’s wrong with most scaling models?
Scaling models often sell funders a dream. A typical one looks like this:
2026: team of 15 - 2 co-founders, an ops associate and 12 frontline delivery staff in-country. About as cost-effective as a GiveWell Top Charity.
2027: team of 29 - 2 co-founders, an ops associate, a Director of Operations and 25 frontline staff. A bit less cost-effective, but still above the bar.
2031: team of 106 - 2 co-founders, a Director of Operations, an ops associate, a finance associate and a Head of Monitoring, Evaluation and Learning (MEL), plus 100 frontline staff. Cost-effectiveness will be 10x a GiveWell Top Charity.
2036: team of 314 - 2 co-founders, a Director of Operations, a Director of Finance, a Director of MEL and 3 juniors per director, plus 300 frontline staff. Cost-effectiveness will be 150x a GiveWell Top Charity.
This sets off alarm bells.
First, the GiveWell Top Charities are incredibly hard to beat. Any model predicting you’ll beat them by two orders of magnitude is probably overstating your effectiveness or understating your real costs (in my experience, usually both).
Second, I’ve seen many, many organisations whose plan reads ‘... infinity’, almost always 5+ years out. I am always suspicious of a plan where cost-effectiveness dramatically increases at a point far enough in the future that no one will check.
When those deadlines arrive, very few have hit their goal. Usually, this is because consistent delivery, team coordination and accurate monitoring all get harder as you expand, and so you need to add more bodies (and therefore more costs). There are very few roles that allow one person to oversee far more goods or services without being overburdened.
I think this copies the tech scaling model, where a single repeatable product can serve hundreds, then thousands, then millions of people. Healthcare almost never works like this. A software product can serve its millionth user with the same codebase, but you can’t serve a million people without more nurses.
Third, these models assume the co-founders can manage a much bigger staff, usually while doing their own work and most of the fundraising and strategy. The founders become the bottleneck, lacking either the time or the talent to do everything expected of them.
If you’re a donor, treat any plan that reaches huge scale without expanding its back-office staff with great scepticism. A scaling plan without new senior hires in it is a dream with a budget attached.
Instead, we want to see reasonable hiring triggers, a clear idea of the founders’ roles and a thought-through future org chart.
What should charity founders do day-to-day?
Founders have several jobs no one else can do - defining the vision and strategy, and securing the money and people to make it happen.
But the cost-effectiveness world pushes us to keep overheads as low as possible. So co-founders, often smart generalists, often end up ‘teaching themselves’ the next thing that needs doing: bookkeeping, MEL, designing their randomised controlled trial (RCT).
This is usually a false economy. You can do the basics, but the second you need to add a million contraceptive doses to your accounting inventory, you’re frantically asking Claude and hoping its advice is kosher.
Autodidact founders scaling back-office functions is usually a mistake. It costs their time, produces errors and takes them away from work that only a founder can do.
Rule of thumb: if it’s a profession and not your core skillset, buy the expertise, from a consultant, a firm or a new hire.
This shows up most often in finance, operations, HR, MEL - but also, the most neglected of all, people management.
What do Managing Directors and Chiefs of Staff actually do?
Running organisations and teams is a profession.
I’ve built staff teams twice, at School of Hard Knocks and One for the World, so I can say from experience: managing people well is incredibly difficult. It was consistently the hardest and most time-consuming part of my work.
A randomised trial in Indian textile firms also found that adopting structured management practices raised productivity by 17% in the first year. These were for-profit manufacturers, so adjust accordingly, but also see Nick Allardice’s writing for sector-relevant material.
The title varies - Managing Director, Chief of Staff, COO, Executive Director, CEO, even Founders’ Associate - but the impact is the same: it pays to hire someone to make the organisation function.
Managing Directors run the project, directing people and systems, so the founder can concentrate on strategy, fundraising and externally representing the organisation.
Chiefs of Staff focus on delivery, keeping people on the right priorities and on schedule. They specialise in seeing a plan through from conception to completion.
Most founders aren’t actually selected for their capacity to run a team or direct people’s work. They excel at articulating a vision and convincing people to back it.
So why don’t more founders hire these roles?
One reason is status. Founders want to stay at the top of the org chart. When I see a founder with 10 direct reports, it’s often because they want to remain ‘above’ all the directors and heads of functions.
That doesn’t mean they should direct everyone’s work personally. Managing Directors and Chiefs of Staff let founders keep their status without spending most of their time on line management. Hiring an MD is a ‘silent promotion’ - it frees founders to do the strategy, vision and fundraising that only they can do.
I’ve been that hire twice. School of Hard Knocks’ founder took me on as their first employee; One for the World’s volunteer founders hired me as the first full-time Executive Director while they stayed on the board, and we grew revenue 7x in 4 years. Both times, the founders kept the vision and the status, and the organisations grew because someone was paid to run them.
As a founder, ask yourself: “How will this project run when I only personally know one third of the staff?” It might seem fanciful, but it’s entirely plausible that every grantee of our Mid-Stage Fund gets to $10m revenue in the next 3 years. At that point, the founders will have hired only a fraction of the team and will probably see the whole organisation together once or twice a year. This is a significant organisational change.
A second reason is fear of bureaucracy. Tech readers will hear this as ‘manager mode’, the thing ‘founder mode’ warns against. But that failure belongs to product companies; delivery charities fail the other way, with the vision intact but the service late or substandard.
How should donors think about overheads?
The biggest blocker may be the optics of overheads. We built this problem as donors. For more than 15 years, the sector has being trying to educate donors against using low overheads as a proxy for cost-effectiveness, mostly unsuccessfully.
This is why I focus on cost-effectiveness in my own advising. A low overhead rate only tells you about costs. Cost-effectiveness assesses costs and outcomes together. If squeezing overheads also squeezes what the charity delivers - and, past a point, it usually does - the saving is false.
Most cost-effective organisations only make sense at scale. Their unit economics may not even work while small. The goal is to grow until they can compete with the most cost-effective charities in the world.
Nothing can scale without investing in its infrastructure.
An organisation may not have the budget or scale to hire a senior executor yet, but it can still set triggers for when it should. Triggers protect against both failure modes: hiring too early and overloading the budget, or overstretching the current team and hiring only when something breaks.
I’d go further: scale can solve your overhead rate, but a low overhead rate can’t take you to scale. Imagine a senior Managing Director at US$200,000 per year. At $1m revenue, that’s 20% of the budget. At $10m, it’s 2%, and no one minds any more.
But cap your overheads too brutally at $1m (or, especially, $3m-$5m revenue) and you’ll probably never reach the scale the project was set up to achieve. You’ll end up in one of the many valleys of death: burnt-out staff, failure to fundraise enough, or a serious implementation error because you couldn’t properly monitor the frontline work. If you’re really unlucky, you might discover that error during your first RCT, and disappointing findings will dog you for years.
What should we do to help organisations scale effectively?
For donors: scrutinise your grantees’ plans to scale (or hire an advisor - talk to us for a free recommendation). Ask for the org chart in 3 years’ time and what the founders aim to be doing. Look out for anyone managing more than 8 direct reports (ideally no more than 5).
Be deeply sceptical of any organisation that says it can scale dramatically with a minimalist leadership and back-office team. (Be especially sceptical of anyone claiming their cost-effectiveness will go from ‘competitive’ to ‘orders of magnitude better than New Incentives’.)
Most importantly, make it explicit that you’ll pay for overhead - and that you’re less likely to fund organisations that don’t plan for it.
For founders: turn your scaling dream into a serious plan. Set hiring triggers in advance and map your operations, finance, HR and MEL needs as you grow. Budget a line for an MD, a Chief of Staff or both before you need it. Then get someone who’s scaled something to red-team the plan.
For talented people: I hope many more of these roles are hired in the next year. If you’re organised, ruthless at delivering and can manage people, put yourself forward. A great first step is joining High Impact Professionals’ talent directory, so organisations can find you. (They also have an Impact Accelerator Program starting soon.) I think a lot of $1m organisations are about to become $10m organisations, and you can help them do it.
Sources of support
A quick non-exhaustive list:
For advisors and evaluators who can vet scaling organisations, ask us for a recommendation or consider a scaling-focused fund (e.g. DIV, ours).
For organisations, Mulago Foundation knows a lot about scaling in development. I’ve also seen useful, thoughtful materials from Spring Impact, though I don’t know their work well enough to endorse it.
For prospective hires, High Impact Professionals and Ambitious Impact are great entry points for talent.
The Funding Anthropalypse can buy programmes at ten times the scale. The cheapest thing it buys is the people who turn those dreams into plans.
Jack Lewars is the founder of Ultra Philanthropy, an independent advisory that helps major donors give for maximum impact, and is the fund manager of its Mid-Stage Global Health Fund. He advises donors giving up to nine figures a year, and is Chair of Trustees at High Impact Athletes. Talk to him about your giving.
I used Claude to help structure my thoughts and to suggest improvements and flag gaps, as well as for proofreading; all views, primary drafting and final edits are mine.