Tag Archives: Malaria Consortium

IPTi for malaria: a promising intervention with likely room to scale

Intermittent preventive treatment in infants (IPTi) for malaria provides preventive antimalarial medicine to children under 12 months old. It is among the most promising programs we’ve identified in our active pipeline of new interventions. Not only does IPTi appear to be highly effective at reducing clinical malaria, it’s also underutilized (more below), and the population it targets is especially vulnerable to malaria. That implies potential to open up large amounts of room for more funding if IPTi begins to be used more widely—our crude estimate is between $50 million and $200 million globally once it’s scaled—which is something we’re increasingly thinking about as we aim to direct $1 billion in cost-effective funding by 2025.
In September 2021, we recommended a small grant to Malaria Consortium and PATH to assess the feasibility and cost-effectiveness of implementing IPTi at national scale in two countries. This grant was the result of an atypical process for us: because we don’t know of any organizations currently implementing IPTi, we issued a request for information to several charities that we thought might be good candidates to do so (more below). We’re hopeful that this scoping exercise will answer some of our many open questions about IPTi, and that this intervention continues to look promising as we learn more.
What is IPTi?
Intermittent preventive treatment in infants (IPTi) for malaria is a program that distributes preventive antimalarial medicine (usually sulfadoxine-pyrimethamine, or SP) to infants, regardless of whether they have malaria, during routine immunization services. A Cochrane meta-analysis of 12 randomized controlled trials (RCTs) found that IPTi reduced cases of clinical malaria by 30%.[1]
IPTi appears effective enough that the World Health Organization (WHO) began recommending it 12 years ago, in 2010.[2] However, our research has identified only one country, Sierra Leone, that has integrated IPTi into its routine national health care practice.[3] We think this neglectedness is due in part to potentially surmountable logistical factors, such as the need to coordinate work between national malaria control programs and national immunization programs.[4] Other barriers to implementation have included the way WHO guidelines identified which settings are appropriate for IPTi[5] (though we understand from speaking with other organizations in the malaria space that these guidelines are currently under revision), and challenges with administering previously available formulations of SP.[6]
Why we’re excited about it

Effectiveness –

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Our recommendations for giving in 2021

You can have a remarkable impact by supporting cost-effective, evidence-based charities.
Just looking at the approximately $100 million[1] GiveWell had discretion to grant in 2020—a subset of all the money we directed to the charities we recommend—the impact of our donors is impressive. We estimate these grants will:

Save more than 24,000 lives
Treat over 6 million children with a full course of antimalarial medication
Provide vitamin A supplementation to over 8.6 million children
Deliver over 4.4 million long-lasting insecticide-treated nets (LLINs) to protect against malaria
Vaccinate 118,000 children
Treat over 11.4 million children for parasitic worms

We’re grateful for your support and interest in our work, and we’re excited to share our recommendations and updates on our recent research. We hope you consider donating to some of the truly outstanding charities we recommend.


We continue to recommend the same excellent top charities.
Our top recommendation: GiveWell’s Maximum Impact Fund
GiveWell’s evolving role
How our research teams have increased our room for more funding

Our top charities team identified many more cost-effective funding opportunities in 2021.
Our new interventions team identified a number of promising new program areas to support.
We finalized three initial focus areas for high-leverage work within public health regulation and investigated grants in each of those areas.

Updates to our impact estimates
Giving unrestricted funding
How to give efficiently
Ways to learn more

We continue to recommend the same excellent top charities.
The nine charities we recommend are high-impact, cost-effective, and backed by evidence and our rigorous analysis. This year, our top charities list remains unchanged.
While our list of recommendations is the same, we have made major strides in our research identifying new giving opportunities within our top charities. We expect to direct about $300 million to our top charities in 2021, compared to about $180 million in 2020. More detail on this below.
We’ve also made major strides in identifying new opportunities that are as cost-effective as current top charities, and expect to grant about $130 million to new interventions this year. We expect to continue that work in 2022.
Our top recommendation: GiveWell’s Maximum Impact Fund
Our Maximum Impact Fund remains our top recommendation for donors who want to do as much good as possible with their gift. As always, we take no fees, and grant from our Maximum Impact Fund on a quarterly basis to the opportunities where we believe additional donations will help the most.
Cost-effectiveness varies

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Initial thoughts on malaria vaccine approval

The World Health Organization (WHO) recently recommended the widespread use of the malaria vaccine RTS,S/AS011We’ll use “RTS,S” as shorthand in this post. jQuery(‘#footnote_plugin_tooltip_13408_1_1’).tooltip({ tip: ‘#footnote_plugin_tooltip_text_13408_1_1’, tipClass: ‘footnote_tooltip’, effect: ‘fade’, predelay: 0, fadeInSpeed: 200, delay: 400, fadeOutSpeed: 200, position: ‘top right’, relative: true, offset: [10, 10], }); for children. It provides an additional, effective tool to fight malaria. This is great news!
We’ve been following this vaccine’s development for years and, in the last few months, have been speaking with organizations involved in its development and potential wider rollout.
Our work on RTS,S (and other malaria vaccines) is ongoing, and we might significantly update our views in the near future. But because we’ve been following its progress, we’re sharing some initial thoughts.
In brief

This vaccine is a promising addition to the set of tools available to fight malaria, but it’s not a panacea. We expect long-lasting insecticide-treated nets (LLINs) and seasonal malaria chemoprevention (SMC)—interventions provided through two of the programs we currently recommend—to continue to be important in the fight against malaria in the near term.2

The parts of the WHO news release that we have bolded indicate that RTS,S should be used with existing malaria control interventions:

“WHO Director-General Dr Tedros Adhanom Ghebreyesus [said,] ‘Using this vaccine on top of existing tools to prevent malaria could save tens of thousands of young lives each year.’”
“WHO recommends that in the context of comprehensive malaria control the RTS,S/AS01 malaria vaccine be used for the prevention of P. falciparum malaria in children living in regions with moderate to high transmission as defined by WHO.”
Similarly, Gavi’s news release states: “The vaccine will be a complementary malaria control tool to be added to the core package of WHO-recommended measures for malaria prevention. This includes the routine use of insecticide-treated bed nets, indoor spraying with insecticides, malaria chemoprevention strategies, and the timely use of malaria testing and treatment.”
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Simple comparisons of potential costs and effectiveness of RTS,S and SMC suggest that SMC could be more cost-effective (see below). But there are lots of unknowns about RTS,S that could change that.
We are actively looking into whether there are promising funding opportunities in this space.

For the time being, this news

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Our recommendations for giving in 2020

You can have a major, positive impact today by choosing to support organizations backed by strong evidence: our top charities.
We recommend the nonprofits that offer the most impact per dollar we’re aware of. In fact, we estimate that you can save a life by donating $3,000-$5,000 to our top recommendation.[1]
If you’re a longtime donor, you’ll recognize most of this year’s top charities. You may even wonder why our list hasn’t changed much. However, a tremendous amount of research—truly thousands of hours—has been done to ensure that these organizations continue to meet our high standards. And although there are many familiar names, one is entirely new: New Incentives.
We’re proud to share our recommendations and grateful to you for considering supporting them. We hope you’ll read on!

In this post, we’ll cover:

How to give in 2020
Our work on COVID-19
Key research updates
Introducing New Incentives
Giving to GiveWell’s operations
How to give efficiently
Ways to learn more

How to give in 2020
Our nine top charities are the best opportunities we’ve found for donors to save or improve lives.
We conduct an intense, monthslong assessment of each top charity before determining it can be added to our list. All top charities meet our high standards for evidence of effectiveness, cost-effectiveness, and transparency. We believe they will use donations well.
However, our work to ensure that our top charities meet our standards isn’t the end of our process. We continually assess where funding is most needed within our list of top charities. Donors can support the highest-priority needs by giving to our Maximum Impact Fund.
The Maximum Impact Fund is our top recommendation for donors who want to do as much good as possible with their gift. We regularly make grants from the Maximum Impact Fund to our top charities. We direct these grants where we believe they will achieve the most good at the time they’re given.
Our top charities’ funding needs constantly change. For example, a top charity might identify an opportunity to work in a new country that requires more funding than it has on hand. Another might receive a large grant that fills its immediate funding needs. We continually monitor these changes and re-prioritize our top charities’ needs.
Giving to the Maximum Impact Fund is the best way to take advantage of our latest research and to ensure your

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Why we’re excited to fund charities’ work a few years in the future

We recently spoke with someone who wanted to donate to a GiveWell top charity. They were interested in getting the funding “out the door” and to program participants as quickly as possible.
But our top choice for funding today is Malaria Consortium’s seasonal malaria chemoprevention program—for work it expects to complete in 2022.[1] The potential donor was puzzled. Shouldn’t we prioritize an organization that needs the money sooner?
We often recommend donations today that support programs a few years from now. This probably diverges from many people’s intuitions about getting funding out the door as soon as possible.
Three key reasons why funding today leads to more impact in the future
1. Upfront coordination and planning increases charities’ impact.
Highly effective charities tend to spend a lot of time preparing before they implement their programs.
The Against Malaria Foundation (AMF) is a GiveWell top charity that supports the distribution of insecticide-treated nets, primarily in sub-Saharan Africa. These nets are hung over sleeping spaces and prevent mosquitoes from biting and transmitting potentially deadly malaria. AMF says the ideal lead time for its work is 23 months.[2] During that time, it takes the following steps:

Choosing a location: AMF decides where it should direct funding to have the greatest impact. It considers malaria prevalence, the number of people in need of nets, and whether partner organizations can conduct distributions according to AMF requirements.[3]
Negotiating an agreement: AMF and the country’s national malaria program negotiate a net distribution agreement and seek government approval.[4]
Ordering nets: AMF negotiates with net manufacturers to place an order for nets suited to local needs, which may vary in size, color, and insecticide.[5]
Producing, shipping, and transporting nets: Nets are manufactured and shipped to regional warehouses.[6]
Visiting households: AMF’s partners visit households to determine how many nets are needed.[7]

Some of these steps are practical requirements for conducting a distribution, such as ordering and shipping nets to the relevant location. Other steps increase the impact of the distribution. Though 23 months may seem like a long lead time, it enables AMF to coordinate with in-country groups, identify the highest-need areas, order the quantities and types of nets that are most suitable for those areas, and select partners that can conduct high-quality distributions and monitoring. We believe that the overall impact of donations is much greater than they would be if

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