You seem to be considering only the U.S. government. The Scandinavian countries have done quite well in combating poverty. While the U.S. government has not eradicated poverty it was government programs that ensured that people were fed at decent levels in the U.S. and it was government programs that ensured the eradication, for the most part, of a host of a number of diseases that used to be endemic amongst poor people.

The problem with reliance on hyperlocal philanthropies means that location A may be populated by selfish jerks who given nothing to the least of their brethren while location B does.