The GiveWell Blog

GiveWell donors supported more than direct delivery: AMF and new net research

Supporters of the Against Malaria Foundation in recent years may have had even more impact than they expected.

The Against Malaria Foundation (AMF) is a GiveWell top charity because we believe its program to distribute insecticide-treated nets prevents people from dying of malaria. AMF-supported net distributions are incredibly cost-effective; we estimate that a $2,000-3,000 donation averts one death.[1] AMF’s work is important in and of itself to fund.

Not all AMF donations, however, just support typical net distributions. In recent years, AMF supported research on a new type of insecticide-treated net, the piperonyl butoxide (PBO) net. This research itself (i.e., researcher time, equipment, and administrative costs) was funded by a small number of AMF donors who explicitly agreed to support it. The research was conducted on nets that were contributed by a broad group of AMF donors.

Preliminary data suggest that PBO nets are more effective at preventing malaria than standard insecticide-treated nets in areas where mosquitoes have developed insecticide resistance. We think it is likely that AMF sped up the completion of a large-scale, high-quality study of these new nets.

We’re thrilled to recommend charities that contribute research in the fields in which they operate. AMF doesn’t just prevent deaths from malaria by distributing nets—it has improved our and others’ understanding of which nets can work best in the future. This post is to share this story with our donors, whose contributions make this work possible.

Summary

In this post, we’ll discuss:

  • Insecticide resistance and the potential of PBO nets. (More)
  • AMF’s role in PBO net research. (More)

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Our recent visit to Burkina Faso

GiveWell staff recently visited Burkina Faso to meet with staff of one of our top charities, Malaria Consortium’s seasonal malaria chemoprevention (SMC) program, and observe its work. Through its SMC program, Malaria Consortium distributes preventative anti-malarial medication at a time of year when it is needed most.

As I write below, GiveWell donors have directed more than $37 million to Malaria Consortium over the last 18 months at our recommendation. We expect that this will provide preventative treatments to 4.8 million children and avert over 16,000 deaths. We’re so appreciative of the support of our community in enabling this tremendous impact.

We originally sent a version of the following message to supporters of Malaria Consortium’s SMC program in late August. We received positive feedback on this message and decided to share it more broadly on our blog. We plan to publish more information about the 2019 Burkina Faso site visit in the future.

Hello from Burkina Faso!

I’m here on a site visit of Malaria Consortium, one of our recommended charities, to see its malaria prevention program in action.

This visit helped me relate more deeply to the program by getting to know some of the people who run it and some of the people who benefit from it. I wanted to share my experience with you.

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Why we don’t use subnational malaria mortality estimates in our cost-effectiveness models

Summary

We recently completed a small project to determine whether using subnational baseline malaria mortality estimates would make a difference to our estimates of the cost-effectiveness of two of our top charities, the Against Malaria Foundation and Malaria Consortium. We ultimately decided not to include these adjustments because they added complexity to our models and would require frequent updating, while only making a small difference (a 3-4% improvement) to our bottom line.

Though this post is on a fairly narrow topic, we believe this example illustrates the principles we use to make decisions about what to include in our cost-effectiveness model.

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Revisiting the evidence on malaria eradication in the Americas

Summary

  • Two of GiveWell’s top charities fight malaria in sub-Saharan Africa.
  • GiveWell’s valuations of these charities place some weight on research by Hoyt Bleakley on the impacts of malaria eradication efforts in the American South in the 1920s and in Brazil, Colombia, and Mexico in the 1950s.
  • I reviewed the Bleakley study and mostly support its key findings: the campaigns to eradicate malaria from Brazil, Colombia, and Mexico, and perhaps the American South as well, were followed by accelerated income gains for people whose childhood exposure to the disease was reduced. The timing of these events is compatible with the theory that rolling back malaria increased prosperity.

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Nothing But Nets

In 2014, we prioritized Nothing But Nets (http://nothingbutnets.net) as a potential GiveWell top charity because it funds insecticide-treated nets to prevent malaria, one of our priority programs. In early 2014, we contacted Nothing But Nets to explain our process and to invite it to apply for a recommendation. Nothing But Nets provided brief responses to…

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Giving cash versus giving bednets

We recently published a new review of GiveDirectly, a “standout” charity that gives cash directly to poor people in Kenya. As we were going through the process of discussing and vetting the new review, I found myself wondering how I would defend my preference to donate to distribute insecticide-treated bednets (ITNs) against a serious advocate…

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