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Direct Relief has been ranked as the fifth largest charity in the United States and one of the most effective stewards of private donations, according to Forbes’ 2024 annual list of the 100 Top U.S. Charities, which ranks organizations by private donations.
“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,” Forbes stated.
Forbes awarded Direct Relief a perfect score of 100% for charitable commitment, reflecting the proportion of expenses allocated directly to its charitable mission, and 100% for fundraising efficiency, highlighting the organization’s minimal fundraising costs relative to private donations.
In fiscal year 2024, which ended on June 30, Direct Relief delivered more than $2.4 billion in humanitarian aid, including $770 million in medical aid for victims of natural disasters, war, and civil conflicts in locations such as North Carolina, Maui, Ukraine, the Middle East, Haiti, and Sudan.
Direct Relief’s impact also included providing targeted financial support for projects such as funding mobile medical clinics, prosthetics clinics in Ukraine, and search and rescue teams in California.
Forbes highlighted Direct Relief’s leader role in disaster response, noting that it “may pump more aid into disaster relief in the U.S. and abroad than any other charity on the new Forbes list.”
Top Ten Charities in the US – 2024
| Rank | Organization Name | Industry | Private Donations ($) | Total Revenue ($) | Fundraising Efficiency (%) | Charitable Commitment (%) |
|---|---|---|---|---|---|---|
| 1 | Feeding America | Domestic Needs | $4.91 B | $5.16 B | 99 | 98 |
| 2 | Good 360 | International Needs | $3.04 B | $3.06 B | 100 | 100 |
| 3 | St. Jude Children’s Research Hospital | Medical | $2.57 B | $3.79 B | 84 | 70 |
| 4 | United Way Worldwide | Domestic Needs | $2.49 B | $3.56 B | 87 | 85 |
| 5 | Direct Relief | International Needs | $2.37 B | $2.38 B | 100 | 100 |
| 6 | Salvation Army | Domestic Needs | $2.3 B | $4.78 B | 89 | 83 |
| 7 | Habitat for Humanity International | International Needs | $2.02 B | $3.08 B | 91 | 84 |
| 8 | Americares | International Needs | $1.54 B | $1.56 B | 99 | 98 |
| 9 | Goodwill Industries International | Domestic Needs | $1.48 B | $8.24 B | 99 | 77 |
| 10 | Boys & Girls Clubs of America | Youth | $1.36 B | $2.83 B | 89 | 79 |
Forbes. “The 100 Largest U.S. Charities.” Forbes, 2024, www.forbes.com/top-charities/list/.
Leading Position Among California and International Charities
Among the 100 largest U.S. charities recognized by Forbes in 2024, Direct Relief stands out as the largest among the six headquartered in California, emphasizing its leadership in a state renowned for philanthropy.
Top California Charities by Size – 2024
| Rank | Organization Name | Industry | Private Donations ($) | Total Revenue ($) | Fundraising Efficiency (%) | Charitable Commitment (%) | Based in California |
|---|---|---|---|---|---|---|---|
| 1 | Direct Relief | International Needs | $2.37 B | $2.38 B | 100 | 100 | x |
| 2 | Shriners Hospitals for Children | International Needs | $547 M | $1.98 B | 71 | 75 | x |
| 3 | Cedars-Sinai Health System | Domestic Needs | $426 M | $8.78 B | 95 | 89 | x |
| 4 | Entertainment Industry Foundation | Health | $321 M | $325 M | 91 | 90 | x |
| 5 | City of Hope | Medical | $280 M | $4.73 B | 85 | 82 | x |
| 6 | Second Harvest of Silicon Valley | Domestic Needs | $262 M | $294 M | 97 | 95 | x |
Forbes. “The 100 Largest U.S. Charities.” Forbes, 2024, www.forbes.com/top-charities/list/
Globally, Direct Relief is ranked as the second-largest charity in the “International Needs” category, underscoring its ability to address complex global challenges and deliver impactful humanitarian aid across diverse regions.
Top International Charities by Size – 2024
| Rank | Organization Name | Industry | Private Donations ($) | Total Revenue ($) | Fundraising Efficiency (%) | Charitable Commitment (%) |
|---|---|---|---|---|---|---|
| 1 | Good 360 | International Needs | $3.04 B | $3.06 B | 100 | 100 |
| 2 | Direct Relief | International Needs | $2.37 B | $2.38 B | 100 | 100 |
| 3 | Habitat for Humanity International | International Needs | $2.02 B | $3.08 B | 91 | 84 |
| 4 | Americares | International Needs | $1.54 B | $1.56 B | 99 | 98 |
| 5 | Compassion International | International Needs | $1.28 B | $1.34 B | 87 | 80 |
| 6 | MAP International | International Needs | $1.01 B | $1.02 B | 99 | 99 |
| 7 | United States Fund for UNICEF | International Needs | $0.84 B | $0.85 B | 90 | 89 |
| 8 | World Vision | International Needs | $0.84 B | $1.51 B | 86 | 89 |
| 9 | Doctors Without Borders USA | International Needs | $0.75 B | $0.78 B | 86 | 87 |
| 10 | Convoy of Hope | International Needs | $0.63 B | $0.64 B | 96 | 93 |
Forbes. “The 100 Largest U.S. Charities.” Forbes, 2024, www.forbes.com/top-charities/list/
2024 Charity Ratings
Beyond its Forbes ranking, Charity Navigator, the nation’s leading nonprofit evaluator, awarded Direct Relief an overall 100% charity rating for 2024, marking its 14th consecutive Four-Star rating. This distinction underscores the organization’s commitment to excellence, accountability, and measurable impact.
Charity Navigator also recognized Direct Relief as one of the Best Humanitarian Relief Charities of 2024, highlighting its responses to Hurricane Helene, Hurricane Milton, and humanitarian crises in Sudan and Ukraine. These lists identify organizations that are “extraordinarily effective at what they do, giving you the chance to support a cause where you’ll have an impact.”
Direct Relief has also earned an A+ rating from CharityWatch, the highest grade awarded by the independent watchdog.
Humanitarian Impact in 2024
In 2024, Direct Relief advanced its global humanitarian mission with the following accomplishments:
- Delivering Lifesaving Medicines: Distributed over 380 million defined daily doses of medicine to more than 2,300 healthcare facilities across 90 countries and all 50 U.S. states.
- Hurricane Responses: Responded to Hurricanes Beryl, Helene, and Milton, providing financial support and essential medicines to over 90 healthcare providers across impacted states, including Florida, Georgia, North Carolina, South Carolina, Tennessee, Texas, and Virginia.
- Middle East Humanitarian Aid: Provided $299 million in medical aid to regions including Gaza, Egypt, Israel, Lebanon, Syria, and Yemen. This included nearly 150 tons of medical supplies, valued at more than $32 million, addressing critical health needs such as cancer treatment, diabetes care, cardiac conditions, and water purification.
- Support for Ukraine: Delivered $322 million in medical aid to Ukraine in 2024, bringing the total since 2022 to 2,600 tons, valued at $1.4 billion. Current initiatives focus on rehabilitation, mental health, mobile care, and energy resilience for healthcare facilities.
Policies on Donor Funds and Valuation of In-Kind Donations
Direct Relief ensures that no donor funds are used for fundraising expenses. Such costs—averaging just 2% of cash revenue—are covered entirely by earnings from a generous bequest, ensuring that 100% of donor contributions directly support humanitarian programs.
As an organization funded exclusively by private charitable contributions, Direct Relief does not accept government support. Its operational efficiency is bolstered through strategic partnerships with businesses and nonprofit organizations.
The majority of donations received and distributed by Direct Relief are in-kind contributions of medicine and medical supplies, valued at wholesale cost. These contributions form the largest share of the organization’s annual revenue.
Direct Relief’s long-standing support for locally run facilities providing essential health services to underserved communities has enabled it to expand its reach and strengthen fragile health systems globally, marking an unparalleled level of impact in its 76-year history.
