Malaria kills around 600,000 people annually. Children under five years old in Africa account for about 70% of all malaria deaths worldwide, and around 11% of total malaria deaths are in the Democratic Republic of the Congo (DRC).[1]
As part of our ongoing efforts to scale our research and funding to direct much more money where it can do extraordinary good, GiveWell recently made its largest grant ever: $276 million to fund the purchase and distribution of malaria nets in DRC through the Against Malaria Foundation (AMF).[2] This grant, which we announced earlier this week via our podcast, is being funded by Coefficient Giving and donations to GiveWell’s Top Charities Fund.[3]
We estimate this grant will lead to the distribution of around 92 million insecticide-treated nets (ITNs), 46 million of which we think would not otherwise be distributed, and will avert approximately 67,000 deaths.
The research we conducted as part of this grant investigation led us to two key decisions:
First, this grant is much larger than our past funding for nets in DRC, enabling the purchase of nets for use across all 26 provinces of DRC from 2027 through 2029 and covering $60 million in distribution costs.[4]
Second, the funding will shorten the time between regular net distributions to provide additional protection against malaria in up to five provinces with higher malaria burden.
Looking back to move forward
Making such a large grant required an intensive grant investigation process, beginning with an analysis of one of our past grants to AMF for insecticide-treated nets in DRC. In that analysis, we drew on multiple independent data sources, funded qualitative interviews to gather more information, and conducted a novel empirical analysis to deepen our confidence. Those findings fed into our investigation for this grant, where we were able to do more and deeper research than we had in past investigations, increasing our confidence, especially in three areas:
How effective are insecticide-treated nets at reducing cases of malaria?
How many children are contracting and dying from malaria in specific areas of DRC?
How long do the nets provide protection against malaria infections?
These three questions were central to our decision making for this grant, as each informs a key parameter in our cost-effectiveness analysis. GiveWell focuses on identifying the programs that save or improve lives the most per dollar, so that the limited amount of funding available can make the greatest difference. We do that by creating cost-effectiveness analyses of the programs we evaluate.
We used a recent Demographic and Health Survey in DRC as a key data source for