Direct Relief Secures Top 5 Spot on Forbes’ List of Largest U.S. Charities in 2023, Mobilizes $2.26 Billion in Humanitarian Medical Aid  


Ratings Awards

Medical aid from Direct Relief bound for Turkey. (Lara Cooper/Direct Relief)

Direct Relief is the fifth largest charity in the United States in 2023, according to Forbes Magazine’s newly released annual list of the 100 largest U.S. charities, by private donations. The humanitarian medical aid group mobilized a record $2.26 billion in private contributions in its 2023 fiscal year that ended June 30.

Five Largest U.S. Charities in 2023 – Forbes

RankNameCategoryPrivate DonationsTotal RevenueFundraising EfficiencyCharitable Commitment
1 Feeding AmericaDomestic$4.27 B$4.36 B99%98%
2Good 360International$2.67 B$2.69 B100%100%
3United WayDomestic$2.6 B$3.51 B88%85%
4St. Jude Children’s Research HospitalMedical$2.46 B$3.3 B84%70%
5Direct ReliefInternational$2.26 B$2.27 B100%99%
Source: Forbes (

Direct Relief, which is funded entirely by private charitable contributions and does not accept government support, prioritizes operational efficiency through strategic partnerships with businesses and organizations. The vast majority of the donations it receives and distributes consist of in-kind donations of medicine and medical supplies. These contributions, valued at their wholesale cost, comprise the predominant share of the organization’s annual revenue.

Forbes awarded Direct Relief a score of 99% for charitable commitment (how much of a charity’s total expenses go directly to the charitable purpose) and 100% on fundraising efficiency (the percent of private donations remaining after deducting fundraising costs).

Forbes also ranked California-based Direct Relief as the largest of the six California charities included in its 2023 list.

Largest California Charities in 2023 – Forbes

RankNameCityStatePrivate DonationsTotal RevenueFundraising EfficiencyCharitable Commitment
1Direct ReliefSanta BarbaraCalifornia$2.26 B$2.27 B100%99%
2Shriners Hospitals for ChildrenPasadenaCalifornia$561 M$474 M76%77%
3Cedars-Sinai Health SystemLos AngelesCalifornia$432 M$8.67 B95%89%
4Entertainment Industry FoundationLos AngelesCalifornia$412 M$410 M98%96%
5Second Harvest of Silicon ValleySan JoseCalifornia$283 M$294 M98%95%
6City of HopeDuarteCalifornia$229 M$3.38 B81%80%
Source: Forbes (

Direct Relief, one of the world’s largest channels for humanitarian medical assistance to underserved communities and survivors of disasters, also ranks as the second largest charity in the “International Needs” category, according to Forbes.

10 Largest International Charities in 2023 – Forbes

RankNameCategoryPrivate DonationsTotal RevenueFundraising EfficiencyCharitable Commitment
1Good 360International$2.67 B2.69 B100%100%
2Direct ReliefInternational$2.26 B$2.27 B100%99%
3Habitat for Humanity InternationalInternational$1.54 B$2.36 B90%82%
4AmericaresInternational$1.35 B$1.36 B99%98%
5Compassion InternationalInternational$1.16 B$1.19 B87%81%
6United States Fund for UNICEFInternational$959 M$1.07 B92%90%
7World VisionInternational$912 M$1.4 B90%89%
8Doctors Without Borders USAInternational$678 M$670 M85%83%
9Catholic Relief ServicesInternational$674 M$1.45 B94%94%
10Task Force for Global HealthInternational$658 M$738 M100%98%
Source: Forbes (

Direct Relief in 2023

Doctors, midwives, community health workers, and other health professionals working in public-benefit health organizations around the world rely on Direct Relief to equip them with the medical resources they need to care for any patient, without regard to politics, religion, or ability to pay.

In its 2023 fiscal year, Direct Relief provided assistance in the form of essential medications, a broad range of medical supplies, and financial support in response to requests from healthcare providers and other local organizations across 88 countries and 55 US states and territories. The 2,900 tons of medical essentials provided by Direct Relief included 534 million defined daily doses of specifically requested medications, vaccines, insulin, and biologic therapies. The organization also provided $77 million in financial assistance through grants for a variety of emergency response and public-health related purposes.

In 2023, Direct Relief once again sustained and expanded existing programs while also responding to humanitarian emergencies globally. The organization’s continuing response to the war in Ukraine – now exceeding $1.5 billion in humanitarian assistance – remains the largest mobilization of medical resources in Direct Relief’s history.

Direct Relief’s longstanding approach of supporting locally run facilities providing essential health services to underserved communities has enabled the organization to distribute more medicine and supplies and strengthen fragile health systems in more places than ever before in its 75-year history. 

Since January 1, 2023, Direct Relief has:

  • Donated insulin to 40,332 children with Type 1 diabetes in 32 countries.
  • Provided more than 460,000 doses of lifesaving naloxone to health centers, free clinics, community organizations and harm reduction groups in the U.S.
  • Delivered critical rare disease therapies to treat more than 600 patients in 17 countries.
  • Launched projects to provide resilient energy solutions to 41 healthcare facilities in California, Florida, Louisiana, and North Carolina, projected to yield an estimated $4.3 million in cost savings annually.
2023 Charity Ratings

In addition to its top ranking from Forbes, Direct Relief earned a four-star rating from Charity Navigator, America’s largest independent charity evaluator.

This recognition marks Direct Relief’s 13th consecutive four-star rating and the first time it has been evaluated in Charity Navigator’s Impact & Results beacon, where its 100% rating contributed to an overall perfect score across the key nonprofit performance indicators Charity Navigator assesses.

Direct Relief also retains an A+ rating from Charity Watch, the highest score given by the independent charity watchdog.

Direct Relief, which receives no government funding and is supported entirely from charitable contributions, has a longstanding commitment to efficiency and frugality in all its organizational activities, including fundraising activities.

Direct Relief’s revenue includes both gifts of medications and other medical commodities and cash. Direct Relief believes it important to note that revenue associated with medical product contributions obviously may not be used for fundraising purposes, and that its modest fundraising expenses average about 2 percent of its total cash revenue. The organization pays all such fundraising expenses with earnings from a generous bequest, which means that zero percent of donated funds are used for the organization’s fundraising activities.

To learn more, please read the Direct Relief 2023 Impact Report.

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