In the first quarter of 2018, we received $2.96 million in funding for making grants at our discretion. In this post we discuss:
- The decision to allocate the $2.96 million to the Against Malaria Foundation (AMF) (70 percent) and the Schistosomiasis Control Initiative (SCI) (30 percent).
- Our recommendation that donors give to GiveWell for granting to top charities at our discretion so that we can direct the funding to the top charity or charities with the most pressing funding need. For donors who prefer to give directly to our top charities, we continue to recommend giving 70 percent of your donation to AMF and 30 percent to SCI to maximize your impact.
Allocation of discretionary funds
The allocation of 70 percent of the funds to AMF and 30 percent to SCI follows the recommendation we have made, and continue to make, to donors. For more discussion on this allocation, see our blog post about allocating discretionary funds from the previous quarter.
We also considered the following possibilities for this quarter:
Helen Keller International (HKI) for stopgap funding in one additional country
We discussed this possibility in our blog post about allocating discretionary funds from the previous quarter. After further discussing this possibility with HKI, our understanding is that (a) the amount of funding needed to fill this gap will likely be small relative to the amount of GiveWell-directed funding that HKI currently holds, and (b) we will have limited additional information in time for this decision round that we could use to compare this new use of funding to HKI’s other planned uses of funding. We will continue discussing this opportunity with HKI and may allocate funding to it in the future. Our current expectation is that we will ask HKI to make the tradeoff between allocating the GiveWell-directed funding it holds to this new opportunity and continuing to hold the funds. Holding the funds gives the current programs more runway (originally designed to fund three years) and gives HKI more flexibility to fund highly cost-effective, unanticipated opportunities in the future. We believe that HKI is currently in a better position to assess cost-effectiveness of the opportunities it has than we are, while we will seek to maximize cost-effectiveness in the longer run by assessing HKI’s track record of cost-effectiveness and comparing that to the cost-effectiveness of other top charities.
We remain open to the possibility that HKI will share information with us that will lead us to conclude that this new opportunity is a better use of funds than our current recommendation of 70 percent to AMF and 30 percent to SCI. In that case, we would allocate funds from the next quarter to fill this funding gap (and could accelerate the timeline on that decision if it were helpful to HKI).
Evidence Action’s Deworm the World Initiative for funding gaps in India and Nigeria
We spoke with Deworm the World about two new funding gaps it has due to unexpected costs in its existing programs in India and Nigeria.
In India, the cost overruns total $166,000. Deworm the World has the option of drawing down a reserve of $5.5 million (from funds donated on GiveWell’s recommendation). The reserve was intended to backstop funds that were expected but not fully confirmed from another funder. Given the small size of the gap relative to the available reserves, our preference is for Deworm the World to use that funding and for us to consider recommending further reserves as part of our end-of-year review of our top charities’ room for more funding.
In Nigeria, there is a funding gap of $1.7 million in the states that Deworm the World is currently operating in. Previous budgets assumed annual treatment for all children, and Deworm the World has since become aware of the existence of areas where worm prevalence is high enough that twice per year treatment is recommended. Our best guess is that AMF and SCI are more cost-effective than Deworm the World’s Nigeria program (see discussion in this post). It is possible that because additional funding would go to support additional treatments in states where programs already operate, the cost to deliver these marginal treatments would be lower. We don’t currently have enough data to analyze whether that would significantly change the cost-effectiveness in this case.
Deworm the World also continues to have a funding gap for expansion to other states in Nigeria. We wrote about this opportunity in our previous post on allocating discretionary funding.
Malaria Consortium for seasonal malaria chemoprevention (SMC)
We continue to see a case for directing additional funding to Malaria Consortium for SMC, as we did last quarter. Our views on this program have not changed. For further discussion, see our previous post on allocating discretionary funding.
What is our recommendation to donors?
We continue to recommend that donors give to GiveWell for granting to top charities at our discretion so that we can direct the funding to the top charity or charities with the most pressing funding need. For donors who prefer to give directly to our top charities, we are continuing to recommend giving 70 percent of your donation to AMF and 30 percent to SCI to maximize your impact. The reasons for this recommendation are the same as in our previous post on allocating discretionary funding.
This is a general question about the effectiveness of AMF, not specifically about this blog post.
I have read elsewhere that recipients of donated insecticide-treated bednets often use them as fishing nets instead. I have even read that this is so common that it is causing depletion of fish stocks in some places.
I have read on this website that the effectiveness of insecticide-treated bednets is judged largely based on the reduction in the overall death rate (not based on the reduction in the number of deaths attributed to malaria) and that the reduction in the overall number of deaths somehow exceeds the number of deaths in which malaria is the official cause of death.
How do we know that the way that insecticide-treated bednets save lives has anything to do with malaria at all?
Maybe the reason that the death rate drops is because of increased consumption of fish, which is high in protein, omega-3’s, etc., so it prevents death from malnutrition, heart disease, etc.
If the nets are saving lives by preventing death from protein-deficiency, that’s great. But nets without insecticide would work just as well, at a lower cost.
But if overfishing by those who receive the nets is leaving fewer fish for everyone else, and causing fish to go extinct in some places, then it’s really counterproductive in the long run.
How do we know that this isn’t what is happening, and that the nets really are having a net positive benefit?
Thanks for your question and apologies for the slow response!
We wrote about the possibility of people using insecticide-treated nets for fishing here. In summary, we don’t believe this is something that impacts a meaningful proportion of the Against Malaria Foundation (AMF)’s work, and see the issue of not having nets to prevent malaria as a more serious problem.
We rely heavily on evidence from randomized controlled trials of insecticide-treated nets in our recommendation of the program. We understand that in those trials, intensive measures were taken to confirm that the nets were actually being hung and used properly; we discuss these here. Thus, we think it is reasonable to believe that the measured reduction in child mortality was largely due to the nets’ use as intended, rather than other factors. The trials also found significant effects on malaria-related measures (see discussion of key trials here).
We understand that the intensive techniques used to verify that nets were being hung and used properly in these small-scale trials would be impractical to use in a large-scale distribution of the sort that AMF carries out. Still, AMF also monitors its work by visiting a proportion of households who receive nets every six months for 2.5 years after a distribution to check on whether the nets have been hung as well as their condition. We described AMF’s monitoring process in detail here (the visits I mentioned are referred to as “post-distribution check-ups” at the link). Although we do believe AMF’s monitoring has some shortcomings (discussed here; see here for more information about work we’re doing with IDinsight to better understand and improve this monitoring), we think it generally creates a strong case that nets are received by the intended recipients and hung over sleeping spaces.
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