A holistic strategy to alleviate poverty—called the Graduation Program—can help the world’s poorest households “graduate” from extreme poverty into sustainable standards of living, according to a recent study carried out by an international consortium (Banerjee A et al. Science. 2015;348[6236]:1260799).

From 2007 to 2014 the researchers tested this program, enrolling more than 20 000 participants in 6 countries—Ethiopia, Ghana, Honduras, India, Pakistan, and Peru. They conducted randomized controlled trials in villages associated with extreme poverty (defined as living on US $1.25 a day or less). Within these villages, the researchers identified the poorest of the poor and assigned half the participants to the program and half to a control group. Participants in the program received a 1-time transfer of assets to generate income; skills training on how to manage the asset; food or cash support in times of emergency; coaching to reinforce skills, build confidence, and address challenges; access to a savings account; and for all but 1 site, access to health care, health education, or both.

The intervention increased income and revenues in the treatment group, benefits that were sustained 1 year after the end of the program. Based on pooled results, those enrolled in the program had more assets and savings, spent more time working, went hungry on fewer days, and had improved health and lowered stress, although the intent-to-treat effects across these measures varied by country. The estimated benefits were overall higher than the costs in 5 of the 6 sites.