Footnotes for "GiveWell donors supported more than direct delivery: AMF and new net research" | GiveWell
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You are hereHome » Footnotes for "GiveWell donors supported more than direct delivery: AMF and new net research"
Footnotes for "GiveWell donors supported more than direct delivery: AMF and new net research"
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[1] See "Bednets" tab, 2019 GiveWell Cost-Effectiveness Analysis — Version 6 (public), cell C81. $100,000/48 = $2,083.33. In other words, we expect one death to be averted for every marginal $2,083 spent on AMF's LLIN distributions. In general, our cost-effectiveness analyses are simplified models that rely on many difficult judgment calls and inputs for which limited data is available. To reflect the imprecision of the model, we provide a range, rather than a single estimate, and round to the thousands, arriving at the estimated $2,000 to $3,000 we share in the post. [2] "An insecticide-treated net (ITN) is a net (usually a bed net), designed to block mosquitoes physically, that has been treated with safe, residual insecticide for the purpose of killing and repelling mosquitoes, which carry malaria." (GiveWell, Mass Distribution of Long-Lasting Insecticide-Treated Nets (LLINs), last updated March 2018) [3] "Insecticide resistance (defined broadly as any ways in which populations of mosquitoes adapt to the presence of insecticide-treated nets (ITNs) in order to make them less effective) is a major threat to the effectiveness of ITNs. Insecticide resistance seems to be fairly common across sub-Saharan Africa, and it seems that resistance is increasing." (GiveWell, Insecticide Resistance and Malaria Control, Last Updated November 2019) [4] "Our very rough best guess (methodology described in more detail below) is that ITNs are roughly one-third less effective in the areas where the Against Malaria Foundation is working than they would be in the absence of insecticide resistance. ITNs remain a highly cost-effective intervention after incorporating this discount." (GiveWell, Insecticide Resistance and Malaria Control, Last Updated November 2019) [5] "The implications of current levels of insecticide resistance for the effectiveness of ITNs are unclear. There are no high-quality studies that estimate the impact of insecticide resistance on ITNs’ effectiveness, partly because of ethical restrictions on testing ITNs via new randomized controlled trials (RCTs). Experts generally seem to argue that ITNs remain highly effective in most locations, but this conclusion seems to be based on low-quality information." (GiveWell, Insecticide Resistance and Malaria Control, Last Updated November 2019) [6] "PBO nets are a newer type of net incorporating piperonyl butoxide (PBO) alongside the standard pyrethroid insecticide used in other nets. PBO is a synergist which inhibits the metabolic enzymes that grant immunity in mosquitoes." (GiveWell, Insecticide Resistance and Malaria Control, Last Updated November 2019) [7] "In September, 2015, a WHO expert group reviewed the evidence for PBO long-lasting insecticidal nets to define their deployment. Despite awaiting for more conclusive evidence from community randomised controlled trials (RCTs) with epidemiological outcomes, WHO, nevertheless, has recommended a small rollout in specific situations." (Protopopoff et al. 2018, pg. 1579) [8] "We did a cluster RCT of four groups using a two-by-two factorial design. The RCT started on March 1, 2014. The post-intervention assessment period was initially planned for 18 months (from Jan 1, 2015, to June 30, 2016) and was subsequently extended on our request to the funding agency to 24 months (from Jan 1, 2014, to Dec 31, 2016) to enable further assessment of the PBO long-lasting insecticidal net (figure 1). The study area was Muleba district of the Kagera region in northwest Tanzania, and comprised 40 villages." (Protopopoff et al. 2018, pg. 1579) [9] "In 2017, WHO granted – on an exceptional basis – a conditional policy recommendation for pyrethroid-PBO ITNs. The recommendation was developed based on findings from one trial in Tanzania and will remain conditional until data from at least one more trial conducted over 2 years have confirmed the enhanced impact on malaria that was demonstrated in the first study." (World Health Organization, New types of insecticide-treated nets, January 15, 2020) [10] Our assessment relies on the senior members of our research staff who led our investigation into PBOs and AMF. [11] "AMF plans to fund at least one, and possibly two, studies on insecticide resistance. One of these studies will be conducted by the Liverpool School of Tropical Medicine with the 2015 Nord Ubangi distribution. We have now seen a preliminary research proposal for this study. The study will include: Measurements of species abundance, resistance prevalence and level, and the effect of PBO (an insecticide) on insects’ mortality at baseline and at a 1-year post-distribution follow-up