Direct Relief, No. 5 on Forbes’ 2024 Top 100 Charities list, quickly delivers medical supplies. World Food Kitchen, No. 82, shows up with the food.
By William P. Barrett, Senior Contributor
In late September, as Hurricane Helene unleashed record floods on the Appalachian region of western North Carolina, killing more than 100 and causing an estimated $50 billion in damage, Americans turned to their phones and laptops for the latest updates—and to donate millions to numerous reputable charities, including a state-approved disaster fund run by United Way. On streaming platform Twitch, gamers began raising money for Direct Relief, which was already rushing extra medical supplies and cash to free clinics and community health centers in Helene-hit areas. Within days, Chef José Andrés’ World Food Kitchen had set up a hub in Asheville, N.C., to distribute food and drinkable water, both in short supply.
Though it remains a tiny part of overall charitable giving, disaster relief has grabbed the public’s attention as images of suffering from fire and floods in the U.S. and wars and earthquakes abroad fill the news and social media. Over the past two years, at 826 companies served by third-party giving platform Benevity, three of the top five recipients of workers’ donations were charities associated with relief efforts: the Red Cross (across all countries and chapters), Doctors Without Borders (across all countries), and Palestine Children’s Relief Fund. Giving by those under age 30 skewed even more heavily to relief, an analysis for Forbes of a subset of those companies shows.
But along with generosity, disasters also bring out fraudsters ready to exploit these charitable urges. The National Consumers League says charity scams nearly doubled in 2023, an increase it links to record breaking natural disasters. After the North Carolina floods, law enforcement authorities issued the standard warnings and advice: Don’t respond to unsolicited phone calls, emails or texts asking you to give and don’t open any attachments or links in emails and texts—-they could be phishing attempts or be directing you to fake charities impersonating real ones.
Here’s one way to play it safe if you’re moved to donate after a disaster: Give to the organizations on the new Forbes list of America’s Top 100 Charities, ranked by private donations received. All are legitimate charities.
Direct Relief, No. 5 on this 26th edition of our list, is one of the most respected and older organizations in the disaster relief business. A returnee to the list this year, and the youngest charity on it, is World Central Kitchen, at No. 82; since its founding in 2010, it has served hundreds of millions of meals to those affected by both natural disasters and wars, including in Gaza, Lebanon and Israel. About a quarter of the charities on the Forbes list report they engage in disaster relief—though the degree to which they do so varies.
Among other list members with significant disaster activities in the U.S. or abroad: Americares, American National Red Cross, Catholic Relief Services, CARE USA, Christian Broadcasting Network’s Operation Blessing, Doctors Without Borders USA, Matthew 25: Ministries, Samaritan’s Purse, Save the Children Federation and World Vision. (You can view the full roster of 100 charities and details about their finances here.)
A 75-year-old Santa Barbara, California-based organization founded by an Estonian immigrant businessman, Direct Relief may pump more aid into disaster relief in the U.S. and abroad than any other charity on the new Forbes list, depending on who’s counting and how. In the year ended June 30, 2024, it received $2.4 billion in medical supply and cash donations and reckons it used $775 million of that to aid victims of, among other tragedies, the Maui, Hawaii forest fires, the earthquake along the Syria/Turkey border, wars in Gaza, Ukraine and Sudan, and hurricanes and floods in the U.S. and abroad. The rest went to providing non-disaster medical supply aid to ongoing projects in 50 countries on five continents.
Yes, those numbers pale in comparison to the dollars government bodies, such as the Federal Emergency Management Agency, pour into disaster assistance. But charities can be nimble, particularly when it comes to marshalling private resources and supplies quickly.
Thomas E. Tighe, a former Peace Corps official who has headed Direct Relief for 24 years, says the key to disaster aid is “a rapid scaling up of activity.” It also helps to have experience, critical mass and familiarity with an area. If a hurricane looms, Direct Relief notifies authorities in advance if it thinks it can help.
Long before Helene hit, Direct Relief was active in the region providing medical supplies for charitable care, so it knew the lay of the land. Post-storm, it dramatically stepped-up deliveries of drugs and supplies to stock medical facilities and accommodate folks suddenly displaced without needed items. So far, Direct Relief has provided $12 million in supplies and $375,000 in cash grants to clinics, with more aid on the way. Among the goods: insulin, EpiPen anti-allergic reaction devices and even personal hygiene kits containing essential basics like soap and toothpaste. Most of the material was delivered from Direct Relief’s large Santa Barbara warehouse by FedEx, which donated its services. The warehouse is “about the size of a typical Costco store,” Tighe says. (Direct Relief also has warehouses in Mexico and the Netherlands.)
Similarly, Direct Relief was already working in Ukraine on COVID-19 relief when the Russian invasion began in February 2022, and stayed to deal with the overwhelming health issues. Tighe figures Direct Relief has sent $1.5 billion worth of medicines and goods to Ukraine since the start of the war. One of the grim items it has supplied: body bags, to improve public hygiene. Tighe, 64, has made a dozen trips to Ukraine himself. Though he’ll be stepping down at the end of this year, the hands-on Tighe was in Ukraine again this month.
Most of Direct Relief’s donations come in the form of “gift-in-kind” pharmaceuticals and medical supplies from corporations. (That’s common for relief charities.) But in 2024 it also got $74 million in crucial cash from a donor base that includes more than 200,000 small contributors. “Cash donations spike during emergencies,” Tighe observes.
Direct Relief manages to bring in a steady flow of money without spending much on fundraising. One low-cost giving channel Tighe has been cultivating for a decade: gamers on Amazon’s Twitch and on other streaming platforms. (Direct Relief often uses Tiltify, a third-party fundraising platform, to encourage and facilitate the gamers’ giving campaigns.) In the fiscal year ending in June, Direct Relief received $1 million in cash from the gaming community, including Twitch users. With this fiscal year less than half over, Twitch-originated cash donations alone are about $500,000.
Charities like Direct Relief that depend on gift-in-kind donations also tend to have high financial efficiencies, especially when it comes to fundraising. It spent only $3 million last fiscal year, giving it a fundraising efficiency ratio—the percent of donations remaining after subtracting fundraising costs—that rounds to 100%. It doesn’t get any higher.
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Unlike the receipt of cash, gift-in-kind valuations, and therefore overall efficiencies, can be subject to manipulation by charities. But Direct Relief has long had a reputation for using conservative valuations. In 2011, a Forbes expose revealed that a number of U.S. nonprofits were accepting massive donations of deworming medicine pills that could be bought on world markets for a few cents a pill and listing them on their financial statements as donations worth as much as $16.25 per pill. That was a deceptive 81,000% mark-up that artificially improved calculated financial efficiency ratios. Direct Relief valued the same pills at an honest 3.2 cents each.
Especially in recent years, disaster relief domestically and abroad has become a fashionable charitable cause. But it remains a tiny slice of the charitable pie. Patricia McIlreavy, president of the Center for Disaster Philanthropy, a 14-year-old Washington, D.C.-based nonprofit that advises donors, says less than 2% of all charitable expenditures go toward that objective. Disaster relief efforts “don’t get enough money, period,’’ she says.
As in the world of business, brand names in charity are built over years and have resonance. Collectively, private donations to the 100 entries on the Forbes list rose at more than double the rate of donations to all nonprofits combined. In their latest fiscal years—generally ending in 2023—the top 100 took in record private contributions of $63.7 billion, up 4.1% from the year-earlier period. Giving USA Foundation, which tracks philanthropy, reckons that private contributions to all of the country’s estimated two million nonprofits rose by only 1.9% in 2023 to $557.2 billion. That means the Forbes 100 alone accounted for a full one-ninth of that sum.
For the third straight year, No. 1 on our list was Feeding America, which shot to the top after Covid 19 mass layoffs and later inflation focused attention on food insecurity in America. The Chicago-based umbrella for several hundred food banks around the country reported private contributions of $4.9 billion for the fiscal year ending June 30, 2023, up 15%. No. 2 again was Good 360. For the year ending December 31, 2023, the Alexandria, Va.-based clearinghouse that routes donated corporate gift-in-kind products to charities listed $3 billion in donations received, up 14%.
St. Jude Children’s Research Hospital moved up a click to No. 3. With just a single location, the Memphis institution raised $2.6 billion in a year ending June 30, 2024, a 5% increase. Knocked down one notch to No. 4 was United Way Worldwide. The Alexandria, Va.-based network of more than 1,100 legally separate nonprofits emphasizing paycheck deductions had been the nation’s largest charity for years until 2022, despite a steady decline due to the rise of specific-cause charities and alternative workplace giving platforms. For the year ending June 30, 2024, United Way received donations of $2.6 billion, a 2% drop.
The donation cutoff for this year’s roster—No. 100—rose 4% to $194 million. That spot went to Father Flanagan’s Boys’ Home, the Nebraska-based organization that caters to at-risk children and families in a number of states.
The Forbes top-charity list is based on the value of private donations received in the latest reporting period, and excludes revenue from government support, fees for services or investment earnings. Since the list is designed to inform would-be donors in the general public, we don’t look at colleges and other academic institutions soliciting specifically for themselves, on the theory their donations come primarily from their own alumni. We also avoid religious institutions, since they are not required to disclose financial information and most don’t. (A notable exception is No. 6 Salvation Army, which is technically a church.) Read more here about our methodology for compiling the list and how this can help you evaluate any charity you consider supporting.
Some 28 of the 100 nonprofits on our list reported total compensation of more than $1 million for at least one employee, up from 25 last year. The top compensated employee at each averaged $1.34 million, a healthy 8% increase over the year before. (Direct Relief CEO Tighe earned less than half the average, at $619,337.)
As in past years, the highest paid were chief executives of large nonprofit hospital/medical operations. Tops: Steven J. Corwin, who received $12.9 million as CEO of New York-Presbyterian Hospital, which returned to the Forbes list after an absence of several years. Next was Rod Hochman, paid $12.1 million heading Providence St. Joseph Health, a Renton, Wash.-based network of hundreds of health facilities under a variety of names in seven Western states. Third was Kenneth Davis of New York’s Mount Sinai Health Systems, at $6.9 million.
Besides New York-Presbyterian and World Central Kitchen, there are five other newcomers or returnees to the list. They are, in alphabetical order: Big Brother Big Sisters of America (No. 66), Christian Appalachian Project (No. 98), Hadassah, the Women’s Zionist Organization of America (No. 84), Metropolitan Opera Association (No. 85) and Teach for America (No. 95). They replaced Barack Obama Foundation, Breakthrough T1D (formerly JDRF), Combined Jewish Philanthropies, Conservation International Foundation, Covenant House, El Pasoans Fighting Hunger Food Bank and North Texas Food Bank.
The full list of the Top 100 Charities is here. A fuller description of our methodologies and how donors can use the data with other information to help evaluate any charity is here.