> Do you have any pointers to organizations which have a higher hit rate than Gates foundation?

I think there are a couple that are significantly better, e.g. Doctors Without Borders, who run an extremely targeted operation with low overhead (you can find spending breakdown in their annual reports). They also explicitly limit the amount of funding they accept from governments/etc. such that they remain politically neutral. I'm sure there are others in the same category.

"Do you have any pointers to organizations which have a higher hit rate than Gates foundation?"

- It's true they have the capital that spreads far and wide compared to most others. No doubt.

"What are you basing the following on? -> "Their process has been to spray and pray. No active involvement, no process optimisation, no impact metric monitoring etc.""

- Conversations with individuals that work at the foundation.

GiveWell, Watsi.