"...if you subscribe to the belief that all lives are created equally -- and your giving is aimed at saving human lives or reducing suffering -- your donations will almost always yield greater returns when given (to reputable organizations) internationally.
...understanding just how little can save a life might make you reconsider your charitable giving. NYU philosophy professor Peter Unger ends his 1996 book, Living High and Letting Die, with a calculation that a $200 donation could help ensure a child lives through its most vulnerable years, from age 2 to 6, in the developing world. Much more recently, the folks at GiveWell, an independent charity evaluator, estimated that their top-rated international charity averts a child death for every donation of $200 to $600. You would be hard-pressed to find a local charity that could actually save a life with a similarly sized gift."