Chiming in to add a bit more detail. I lead the malaria team at GiveWell. As Isabel said, our headline recommendations haven't changed and we're excited to continue recommending SMC and bednet programs as top charities, and making grants in areas such as malaria vaccines and perennial malaria chemoprevention.
The episode of The Daily claims that the mosquitos are winning. The mosquitos are a formidable adversary, but I don't believe they are winning.
Between 2000 and 2015, there were big gains in driving down malaria deaths. Since 2015 malaria deaths have plateaued and the WHO reports that deaths ticked up in 2020 and 2021 when services were disrupted due to Covid. But the big picture is that the world has made a lot of progress in controlling malaria and the most important tools continue to deliver large impacts for modest costs.
One of the biggest threats, if not the biggest, to maintaining and extending those gains is lack of funding. The Global Fund to fight AIDS, Tuberculosis, and Malaria is the largest funder of malaria control in Africa by far. In its last fundraising round (for 2023-2025), it was only able to raise slightly more than it had available in the prior three years (allowing for $13.1 billion vs. $12.7 billion to be allocated to programs, or 3% more). With population growth and inflation, that funding will cover less in the next three years than it did in the last three.
In addition to maintaining coverage of programs that have had large impacts, there are new tools now available that could combat mosquito resistance and drive malaria down further if funding is available to deploy them. A couple of key ones:
Bednets with chlorfenapyr. These nets add a second insecticide and have beenfound to be meaningfully more effective than the most commonly used nets. Though currently more expensive than the most commonly used nets, their greater benefits outweigh the greater costs in most parts of Africa. Chlorfenapyr nets are beginning to be deployed in Africa at a large scale, including in net distributions funded by GiveWell via AMF.
Malaria vaccines. The R21 vaccine was recommended by the WHO this year. There have been concerns about the cost of malaria vaccines. R21 will likely be around half the price per dose of the RTS,S vaccine that was recommended by WHO in 2022. Gavi, the Vaccine Alliance, will be supporting rollout of malaria vaccines and we're looking into ways to leverage that funding for quicker or higher quality rollout, as we have supported before.
Our malaria team is on the lookout for the most cost-effective ways to combat malaria for the available resources, and that could include anything from supporting evidence generation to advocating for more global funding for malaria, getting high coverage of existing tools, or supporting governments in the rollout of new innovations.
(The Daily also discussed malaria outbreaks in cities due to the importation of the A. stephensi mosquito to Africa from Asia. It's possible that this is a mosquito that is winning, by threatening urban populations which have been at lower risk of malaria. But little is known about the trajectory of the impact of these mosquitoes on malaria cases and deaths. At this point, we can largely only speculate as to what additional malaria control programs may be needed in the future due to the spread of A. stephensi and what impact such programs would have compared to using the resources on malaria programs protecting rural communities. Our current understanding is that the most pressing needs are to fund data collection. We're talking to experts about whether there are funding gaps and assessing whether to fund them.)
Chiming in to add a bit more detail. I lead the malaria team at GiveWell. As Isabel said, our headline recommendations haven't changed and we're excited to continue recommending SMC and bednet programs as top charities, and making grants in areas such as malaria vaccines and perennial malaria chemoprevention.
The episode of The Daily claims that the mosquitos are winning. The mosquitos are a formidable adversary, but I don't believe they are winning.
Between 2000 and 2015, there were big gains in driving down malaria deaths. Since 2015 malaria deaths have plateaued and the WHO reports that deaths ticked up in 2020 and 2021 when services were disrupted due to Covid. But the big picture is that the world has made a lot of progress in controlling malaria and the most important tools continue to deliver large impacts for modest costs.
One of the biggest threats, if not the biggest, to maintaining and extending those gains is lack of funding. The Global Fund to fight AIDS, Tuberculosis, and Malaria is the largest funder of malaria control in Africa by far. In its last fundraising round (for 2023-2025), it was only able to raise slightly more than it had available in the prior three years (allowing for $13.1 billion vs. $12.7 billion to be allocated to programs, or 3% more). With population growth and inflation, that funding will cover less in the next three years than it did in the last three.
In addition to maintaining coverage of programs that have had large impacts, there are new tools now available that could combat mosquito resistance and drive malaria down further if funding is available to deploy them. A couple of key ones:
Our malaria team is on the lookout for the most cost-effective ways to combat malaria for the available resources, and that could include anything from supporting evidence generation to advocating for more global funding for malaria, getting high coverage of existing tools, or supporting governments in the rollout of new innovations.
(The Daily also discussed malaria outbreaks in cities due to the importation of the A. stephensi mosquito to Africa from Asia. It's possible that this is a mosquito that is winning, by threatening urban populations which have been at lower risk of malaria. But little is known about the trajectory of the impact of these mosquitoes on malaria cases and deaths. At this point, we can largely only speculate as to what additional malaria control programs may be needed in the future due to the spread of A. stephensi and what impact such programs would have compared to using the resources on malaria programs protecting rural communities. Our current understanding is that the most pressing needs are to fund data collection. We're talking to experts about whether there are funding gaps and assessing whether to fund them.)