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[Added August 27, 2014: GiveWell Labs is now known as the Open Philanthropy Project.]

As part of our work on GiveWell Labs, we retained Dr. Steven Phillips as a consultant to source giving opportunities in malaria control/elimination.

This post lays out:

• The work that Dr. Phillips did for us in order to source giving opportunities. More
• Why we undertook this project in partnership with Dr. Phillips. We are not currently moving forward with the giving opportunities sourced; this is a function not of the quality of the opportunities (many of which appear potentially strong to us) but of how our strategic priorities have evolved. More
• What we learned from this project about giving opportunities in this area, as well as about the practice of sourcing giving opportunities more generally. More
• Brief summaries of the giving opportunities. More

About Dr. Phillips: Dr. Phillips serves or has served on the Boards and Advisory bodies of the following organizations: Malaria No More, Net Impact, the World Economic Forum’s Global Health Advisory Board, advisor to the United Nations Special Envoy for Malaria, the Harvard School of Public Health’s Leadership Council and the advisory panels of Medicines for Malaria Ventures, the UCSF Global Health Group, Episcopal Relief and Development’s “NetsforLife” Initiative, the World Bank Malaria Booster Program, the Strategic Advisory Group of the Global Business Coalition on HIV/AIDS, TB and Malaria, the World Health Organization Special Programme for Research and Training in Tropical Diseases (TDR) Strategic Alliances Advisory Group. He was also a Private Sector Advisory Board representative to the Global Fund for AIDS, TB and Malaria, and a private sector representative on the board of Roll Back Malaria.

The projectBefore he began this project, Dr. Phillips categorized giving opportunities in malaria as (a) research and development of new drugs, vaccines and technologies, (b) program delivery or operations research, and (c) advocacy to increase awareness of and funding directed to malaria. We agreed with Dr. Phillips to focus his work on (b), program delivery and operations research.

Dr. Phillips communicated with many prominent organizations (e.g., President’s Malaria Initiative, Center for Disease Control, Population Services International, Malaria no More among others) that focus on malaria asking for giving opportunities. We agreed with Dr. Phillips that Good Ventures would consider providing funding to the opportunities, depending on their fit with our broader priorities in GiveWell Labs.

Why we worked on thisWe decided to undertake this project because:

• As of September 2013 (when we began this project), we felt that deeply investigating a cause and likely making some grants within it was necessary in order to learn. At that point, malaria control was one of the top contenders for a cause we would focus on and make grants in. (More in our September 2013 GiveWell Labs update.) Since then, we have begun grantmaking in labor mobility and criminal justice reform (two of the other causes mentioned in that post). At the same time, we have been reflecting on how best to approach causes in the broad area of “foreign aid” and as of early 2014, are still considering how best to move forward. (More in our March 2014 annual review and plan post for GiveWell Labs.)
• Our approach to identifying giving opportunities is non-traditional and we sought the experience of someone like Dr. Phillips, who has significant experience working (a) on malaria programming, (b) grantmaking/identifying giving opportunities, and (c) malaria in the broader context of global health and international development assistance. In addition to the interest in malaria specifically, we also hoped to improve our understanding of the process of finding giving opportunities.

We felt that we learned important things on both of the above points (more below).

Ultimately, we decided not to move forward with funding the opportunities Dr. Phillips identified. This is not a function of the quality of the ideas Dr. Phillips received, but is due the fact that we’re not yet at a point where we are prepared to commit significant funding and staff time to malaria (more in our recent review and plan for GiveWell Labs). We plan to revisit these proposals if and when we choose to commit more thoroughly to this area.

What we learnedDr. Phillips advised us not to ask participating organizations to publish the full details of the ideas they proposed; instead, we summarize the key things we learned below.

• This project successfully sourced promising giving opportunities. Were we to have decided to commence grantmaking in malaria, we likely would have moved forward with a number of these projects. Had we tried to source these giving opportunities on our own, we would likely have struggled to do so (or spent an unreasonable amount of time trying to do so); because of Dr. Phillips’s subject-matter knowledge and relationships with people in the sector, he was able to source giving opportunities relatively easily, requiring limited time investment from GiveWell staff. In the future, we may undertake a similar process for causes in which we are aiming to make grants.
• Unrelated to Dr. Phillips’s project, we have been investigating the hypothesis that data is underinvested in in the malaria sector (one set of conversation notes here, more forthcoming). We formed this theory based on our top charities work and our impressions that there is a lack of information available regarding questions such as (a) how long do LLINs last in the field; (b) what are the impacts of insecticide resistance on LLIN-effectiveness; and (c) to what extent does covering a proportion of a community (e.g., 50%) with LLINs confer protective benefits to the entire area, among others. Dr. Phillips was acting independently of this internal research project; nevertheless, half of the ideas he received (14/27) focused on data (10) or evaluation (4), which we take as some support for our hypothesis.
• Four of the ideas proposed to Dr. Phillips could be considered as part of GiveWell’s traditional work on finding and recommending top charities. We intend to add these to our list of opportunities to consider in the future.

We also continued to experience the challenge of working in a field (philanthropy) where limited information is publicly available. Ideally, we’d like to have 20+ proposals for each cause we’d consider committing to (as we now do for malaria delivery and operational research) and use those proposals as a major input into the causes we would ultimately choose. Unfortunately, this data set does not exist and we don’t believe it’s feasible to create it.

It seems to us that organizations are happy to engage with a funder when funding is reasonably likely to result (as it was in the case of this project) but would be less likely to do so as the odds of receiving funding fell. Were we to try to solicit proposals across the spectrum of foreign aid, that would likely require many projects of the type Dr. Phillips conducted, and we don’t believe organizations would be willing to participate in our process given the low probability that they would receive funding.

Proposal summariesWe are not publishing the full details of each proposal we received. Instead, we post brief summaries of each proposal, without the name of the organization that proposed it, and our categorization of the project.

We include proposals only from those organizations who have agreed to participate and have kept other proposals confidential.

We categorize each project as:

• Data
• Evaluation
• Delivery (i.e., rolling out evidence-backed programs)
• Elimination
• Other

Proposal topics:

Data

• Combining multiple data sources, including SMS authentication codes for antimalarial drugs, to map malaria prevalence and treatment.
• Field testing a low-cost device to detect substandard and counterfeit malaria medications.
• Developing a device for use in the field to diagnose malaria via molecular assays.
• Research to determine why children who died from malaria did not receive effective treatment.
• Developing a practical field diagnostic test to monitor and improve the performance of indoor residual spraying of organophosphates.
• Developing an extension to malaria database management software used by national control programs. The extension would help the control programs synthesize and visualize the data managed by the software to inform decisions about control activities.

Evaluation

• Evaluating service delivery mechanisms for seasonal malaria chemoprevention and advising national malaria control programs on implementing seasonal chemoprevention.
• Evaluating the use of local materials to improve housing in order to prevent the entry of mosquitoes.
• Randomized controlled trial to determine the safety and efficacy of a novel malaria vaccine candidate.

Delivery

• Instituting high-quality malaria testing and treatment within a franchise of private clinics.
• Expanding a program to work with plantations to provide malaria protection and case management to migrant plantation workers. These workers are at uniquely high risk for contracting and transmitting malaria, so providing them with malaria care is important to achieving malaria elimination.
• Adding indoor residual spraying to a strategic package of program interventions against malaria in an African setting with high levels of malaria transmission.
• Funding community health workers in remote villages to travel to households in order to seek out and treat malaria cases.

Elimination

• Formalizing a partnership among Latin American and Caribbean countries to work towards malaria elimination by sharing data and coordinating control efforts.
• Creating and supporting malaria elimination leadership teams in two countries.
• Assembling a team of malaria field experts to provide technical assistance to a number of national malaria programs pursuing elimination.
• Employing village health workers and engaging community leaders to achieve zero deaths from malaria and to begin working towards elimination at the community level.
• Eliminating malaria in a small island community.

Other

• Developing and testing a digital board game to teach villagers about malaria prevention and treatment.
• Advocating to recipient country leaders to request that Global Fund grants target funds to malaria as opposed to HIV or TB.
• Raising funds from the public for malaria treatment.