The GiveWell Blog

Growing GiveWell’s Largest Research Area: Malaria

Despite significant progress fighting malaria over the past few decades, the disease still kills around 600,000 people annually. Malaria is a leading cause of death globally, especially for young children in Africa, who make up around 70% of all malaria deaths worldwide.

While malaria prevention has long been a focus for GiveWell, the growing capacity and specialized expertise on our malaria team are allowing us to take on this challenge now in a way that would not have been possible even a few years ago.

Over our nineteen-year history, GiveWell has directed more than $1 billion in donations to malaria prevention programs that we estimate will save more than 235,000 lives. This is primarily through two core programs:

  • Seasonal malaria chemoprevention (SMC), which provides preventive antimalarial medication to young children during the months when malaria is mostly likely to be transmitted. We have directed more than $500 million to support SMC, most via Malaria Consortium’s SMC program, one of our Top Charities.
  • Insecticide-treated nets, which are typically hung over beds or other sleeping spaces to provide protection from mosquitoes at night. We have directed more than $600 million to support net campaigns, most via Against Malaria Foundation, another of our Top Charities.

GiveWell’s overall research team has doubled in size over the past few years. Our malaria research team is the largest of our research teams, with 15 people collectively devoting more than 20,000 hours each year to our expanded efforts.

With this growth, we are working to reduce malaria deaths even further by (1) funding evidence to improve our future grantmaking decisions for core malaria prevention programs, (2) identifying ways to increase coverage of our core programs, and (3) expanding our portfolio beyond our core programs.

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More than a Spoonful of Medicine

What does it take to prevent malaria? Some of the programs GiveWell recommends might sound straightforward—for example, seasonal malaria chemoprevention (SMC) programs provide antimalarial drugs to young children—but the process of accomplishing this is not simple at all.

Below, we offer a post from Malaria Consortium that describes the many complex steps required to carry out an SMC campaign. See our reports for more information about the evidence for SMC and about Malaria Consortium’s SMC program.

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Our recommendations for giving in 2022

We wrote back in July that we expected to be funding-constrained this year. That remains true as we approach the end of the year, putting us in the unusual position of leaving impact on the table.

We’ve set a goal of raising $600 million in 2022, but our research team has identified $900 million in highly cost-effective funding gaps. That leaves $300 million in funding gaps unfilled. By donating this year, you can help us not only meet but exceed our goal—and say yes to more excellent opportunities to save and improve lives.

Additionally, our giving guidance for donors has changed this year. For the first time, our top recommendation is to give to our new All Grants Fund, which we allocate to any need that meets our cost-effectiveness bar. We think it’s the best bet for donors who want to support the most promising opportunities we’ve found to help people, regardless of program or location. And it reflects our current views on how we can best meet our goal of maximizing global well-being—by taking advantage of every path to impact, whether that’s funding top charities, seeding and scaling newer programs, or funding research.

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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. It’s also underutilized, 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. 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.

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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 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

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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/AS01 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.

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