Tag Archives: World Health Organization

Why GiveWell funded the rollout of the malaria vaccine

Since our founding in 2007, GiveWell has directed over $600 million to programs that aim to prevent malaria, a mosquito-borne disease that causes severe illness and death. Malaria is preventable and curable, yet it killed over 600,000 people in 2021—mostly young children in Africa.[1]
Following the World Health Organization’s approval of the RTS,S/AS01 malaria vaccine (RTS,S) in late 2021,[2] GiveWell directed $5 million to PATH to accelerate the rollout of the vaccine in certain areas of Ghana, Kenya, and Malawi. This grant aimed to enable these communities to gain access to the vaccine about a year earlier than they otherwise would, protecting hundreds of thousands of children from malaria.[3]
Although we’re very excited about the potential of the RTS,S malaria vaccine to save lives, it isn’t a panacea. We still plan to support a range of malaria control interventions, including vaccines, nets, and antimalarial medicine.
In this post, we will:

Explain how we found the opportunity to fund the malaria vaccine
Discuss why we funded this grant
Share our plan for malaria funding moving forward

Identifying a gap in vaccine access
In October 2021, we shared our initial thoughts on the approval of the RTS,S malaria vaccine by the World Health Organization (WHO). At that point, we weren’t sure whether the vaccine would be cost-effective and were not aware of any opportunities for private donors to support the expansion of vaccine access.
In the following months, our conversations with PATH, a large global health nonprofit that we’ve previously funded, revealed that there might be an opportunity to help deploy the vaccine more quickly in certain regions. PATH had been supporting the delivery of the vaccine in Ghana, Kenya, and Malawi as part of the WHO-led pilot—the Malaria Vaccine Implementation Program (MVIP)–-since the pilot began in 2019.[4] In order to generate evidence about the effectiveness of the vaccine, randomly selected areas in each country received the vaccine during the early years of the pilot, while “comparison areas” would receive the vaccine at a later date, if the vaccine was recommended by the WHO.[5]
Once the vaccine had received approval from the WHO, the WHO and PATH believed there was an opportunity to build on the momentum and groundwork of the pilot to roll out the vaccine to the comparison areas as soon as possible. However, the expectation at the time

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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.
So:

For the time being, this news

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