Rob Mather: Against Malaria Foundation — What we do, How we do it, and the Challenges

This tran­script of an EA Global talk, which CEA has lightly ed­ited for clar­ity, is cross­posted from effec­tivealtru­ You can also watch the talk on YouTube here.

The Against Malaria Foun­da­tion is one of the most effec­tive global health char­i­ties in the world, and the sin­gle most com­mon dona­tion tar­get for EA Sur­vey re­spon­dents (as of 2018). What makes this or­ga­ni­za­tion so spe­cial? How do they ap­proach their work, and what challenges do they face? CEO Rob Mather an­swers these ques­tions in this talk from EA Global 2018: Lon­don.

The Talk

I’m go­ing to try and cover what we do and how we do it, but I use the words im­pact and ac­countabil­ity a lot in what we do. They’re themes that you will see that run through what we talk about, be­cause ev­ery char­ity re­ally, our fo­cus is to have im­pact. And par­tic­u­larly de­liv­er­ing that for us means fo­cus­ing on ac­countabil­ity, be­cause the devil is in the de­tail. It’s not easy to raise money, but it’s not where you mess up. You mess up on de­liv­ery, on op­er­a­tions. So that’s re­ally where our fo­cus lies.

1100 Rob Mather

You guys can read the num­bers. I hope you can see the num­bers at the back more quickly than I can say them. But I think we all un­der­stand that malaria is a hu­man­i­tar­ian is­sue. The num­bers are pretty fright­en­ing. When I first came across malaria it was be­cause I heard that seven jumbo jets full of chil­dren un­der five died from malaria ev­ery day. And that re­ally struck me. Not only does it par­tic­u­larly af­fect chil­dren un­der five, but preg­nant women who have a com­pro­mised im­mune sys­tem when they’re preg­nant are also par­tic­u­larly vuln­er­a­ble.

We fo­cus on Sub-Sa­haran Africa, be­cause that’s where 90% of the cases of malaria and where most of the deaths oc­cur. But it’s not just a hu­man­i­tar­ian is­sue. If you’re sick with malaria then you can’t teach, you can’t farm, you can’t func­tion. And that means you’re not a con­struc­tive or pro­duc­tive mem­ber of so­ciety. And so malaria is a drain on the economies of all of these coun­tries that are af­fected. So if the hu­man­i­tar­ian doesn’t get you like it got me, then I hope the eco­nomic com­po­nent would get you in­stead. If we put $1 mil­lion into fight­ing malaria effec­tively and effi­ciently, then we will im­prove the GDP of the coun­try or the con­ti­nent, I should say, by $12 mil­lion. A 12 to 1 re­turn is a pretty good offer, even if you’re not per­suaded by the hu­man­i­tar­ian el­e­ment.

1100 Rob Mather (1)

Un­for­tu­nately, there’s no silver bul­let. There is no vac­cine. Lots of re­search go­ing on, and we all keep our fingers crossed that they’ll find some­thing. Vac­ci­na­tion re­search and gene drives are a big hope, and we all hope fer­vently that some­thing comes of them, but for now it doesn’t ex­ist. So to pick up on the un­der fives, if I in­vited you all down to Heathrow Air­port and you saw this, we’d all say, “Hang on a minute. This is slaugh­ter.” And this is daily, re­mem­ber, so it is a big is­sue that we ab­solutely need to do some­thing about.

1100 Rob Mather (2)

And a big part of the solu­tion, not the only solu­tion, but a big part of the solu­tion is nets. They cost $2. They pro­tect two peo­ple each. And, there­fore, given that the fe­male mosquito that is preg­nant and wants to re­pro­duce needs a blood meal to re­pro­duce bites be­tween 10:00 at night and 2:00 in the morn­ing, that is some­thing ter­rific we have on our side. It means that we can cover peo­ple when they sleep, and we can pro­tect them me­chan­i­cally. We also cover these nets with in­sec­ti­cide. We’re putting nets in very challeng­ing en­vi­ron­ments: they’re house­holds but they’re not houses. So in­evitably, these nets be­come ripped, they be­come torn, they have holes in them. But for­tu­nately, the mosquitoes don’t do a red ar­rows ma­neu­ver through a hole. They land on the net and mi­grate to the hole, and when they pick up in­sec­ti­cide it kills them. The fact that mosquitos typ­i­cally feed be­tween 10:00 at night and 2:00 in the morn­ing is a re­ally good char­ac­ter­is­tic that we can ex­ploit here.

And the im­pact is dra­matic. We’re talk­ing about whether it’s 600 nets or 1,000 nets or 400 nets, it de­pends on the malaria bur­den, but we’re talk­ing about low thou­sands of dol­lars equals one death averted, and broadly it’s 1,000 cases of malaria pre­vented for ev­ery per­son that dies, the mor­tal­ity to mor­bidity ra­tio. This is an ex­traor­di­nary im­pact. And graph­i­cally that’s what we see.

1100 Rob Mather (4)

We see prior to putting nets in place you have the top graph, the sea­son­al­ity, rainy sea­sons and dry sea­sons, hap­pens more or less im­me­di­ately, so within weeks. It’s not as easy as just hand­ing out nets and say­ing, “Right, we’re done.” Ed­u­ca­tion is in­volved and there’s sus­tained effort, but broadly speak­ing any ma­jor health ini­ti­a­tive where you’d have a 10% de­cline na­tion­wide is dra­matic. So if we can in­tro­duce 40% or 50% de­cline, you can see this is in the sen­sa­tional cat­e­gory of what we can achieve.

How AMF Got Started

So just a minute or so on how I started. I shame­lessly called 250,000 of my best friends and said, “Would you like to swim?” And they all said yes. In fact, the truth is that I failed be­cause I was try­ing to get a mil­lion peo­ple to swim, but I’m not go­ing to count that as true failure re­ally. And very much the spirit be­hind this was, as I said to Michael Phelps, “What I’d like you to do in front of the cam­era is just say, ‘I would like you to swim. It doesn’t mat­ter how fast I swim. When I swim I count as one per­son. And if you swim you count as one per­son as well.’”

1100 Rob Mather (5)

Very much the spirit be­hind what we do at AMF is that we’re or­di­nary folks, so very grass­rootsy in that I don’t think this is about celebrity. It’s about all of us, be­cause it’s al­most the power of all the or­di­nary folk that can get things done. And that was very much the spirit, and it is to­day be­hind what we do at AMF. And so there were some won­der­fully nutty peo­ple swim­ming as part of World Swim Against Malaria in 2005 in Ser­pen­tine, not far from where we are now. A whole bunch of peo­ple at PWC de­cided to go into the chan­nel. And then some very sen­si­ble peo­ple in Aus­tralia and Amer­ica where it was warmer.

And it was par­tic­u­larly im­por­tant to me that there were lots of chil­dren in­volved, given the death toll is par­tic­u­larly af­fect­ing chil­dren. This was my first ex­pe­rience, if you like, of… ac­tu­ally it was the sec­ond ex­pe­rience af­ter a swim for a burns vic­tim. But I learned a lot from this ex­pe­rience of how peo­ple re­acted to cer­tain sorts of com­mu­ni­ca­tion. It was a sem­i­nal pe­riod, if you like.

I was in­tend­ing to go back and get a proper job be­cause I had taken two years off to launch World Swim. And when we went to see the Global Fund, an or­ga­ni­za­tion based in Geneva, a big fun­der, they said, “Do you re­al­ize with 130,000 peo­ple swim­ming (which is what we had at the time), you are the largest malaria ad­vo­cacy group in the world?” And I said, “Are you tel­ling me that 20 phone calls out of the back room of my home in Lon­don has cre­ated the world’s sin­gle largest ad­vo­cacy group for the world’s sin­gle largest kil­ler of chil­dren.” And they said, “Yes.” And I said, “Well, that’s shame on all of us if that’s the case.” I guess that meant that I didn’t want to go back into a proper job. I wanted to do an im­proper job.

What AMF Does

What we do at AMF is we provide nets. We dis­tribute them. We make sure they don’t get stolen. That’s po­ten­tially a very big is­sue, back to op­er­a­tions. We cer­tainly want to en­sure they’re used. And when we get in­volved in fund­ing nets we go to gov­ern­ments and we talk to them about data. In fact we put it a lot more po­litely than I’m go­ing to put it now, but we ba­si­cally say to gov­ern­ments, “Please don’t ask us to trust you, be­cause we won’t. But we won’t ask you to trust us ei­ther. Let’s just fo­cus on the data.” And that is re­ally im­por­tant to mak­ing sure that we do the best job we pos­si­bly can. We don’t always get it right. We’re not perfect, and things do hap­pen we have to dive in and try and solve. But in essence this is all about data for us op­er­a­tionally.

1100 Rob Mather (6)

When we started, again more po­litely than I’m about to put it, but I went to a whole bunch of peo­ple and or­ga­ni­za­tions and said, “Please will you help me, but I’m not go­ing to pay you be­cause you don’t need $5 more than a cou­ple of kid­dies in Africa need a bed net.” And I’m delighted to say that ev­ery­body I spoke to, I can’t think of any­body who didn’t hear the ques­tion, “Who do I talk to in your in­dus­try that would be able to help me do X, Y, and Z?” and re­ply, “Me.” And it’s in­cred­ibly hum­bling get­ting a lot of peo­ple in big com­pa­nies. I run this with six other peo­ple out of the back room of my house in Lon­don, and ev­ery­body works from their own homes, so we don’t have any offices. But there are a lot of blue chip com­pa­nies that said, “We get it. We’ll sup­port you.” Be­cause fun­da­men­tally the chief ex­ec­u­tive of big com­pany X and big com­pany Y, he or she have got kids, and they know kids, and they’re hu­man be­ings. So I guess I ap­peal to that sense: how do we do this to­gether, as a lot of peo­ple com­ing to­gether?

1100 Rob Mather (7)

We have five full time staff. We pay four of them. So one of the things that was a lit­tle bit differ­ent about what we do is I don’t have to re­ally go out and raise money to fund ad­min costs. I could, and I could cer­tainly use the money we have to do that, but as you can imag­ine, we want to spend the money on nets. So I have four costs globally, cen­trally, and no other costs than those four peo­ple we say a com­mer­cial salary to. We have no bank­ing, ac­count­ing, le­gal, web­site, trans­la­tion. You name it, we don’t have it.

When we wanted to trans­late the web­site into Ger­man, the think­ing was we could go to a pro­fes­sional com­pany and they’d charge us five grand to do it, or we could go to a lot of other hu­man be­ings and say, “You’re a pro­fes­sional trans­la­tor. Who do we talk to in your in­dus­try such that we could get four peo­ple who would trans­late two and a half thou­sand words each?” That’s 10,000 words. We can now put our web­site in a lan­guage and show peo­ple the cour­tesy in Ger­many of be­ing able to read the web­site in their own lan­guage. So I sent out 48 e-mails, not dear all be­cause that doesn’t work, but Dear Clau­dia and Dear Claus and Dear Matthew and so on. And in 24 hours I had 44 pos­i­tive re­sponses out of 48. So I could’ve trans­lated the web­site 11 times over for free. And the same thing hap­pened in ev­ery other lan­guage. So you sort of want to jump up and kiss peo­ple when that hap­pens be­cause it’s ter­rific that ev­ery­body said, “We’ll help.” And that in a sense is re­ally be­hind what we’ve all built at AMF.

We have very low over­heads as a re­sult, as you’ll be un­sur­prised to hear since we’re only pay­ing four salaries. Our over­head last year, or FY 2017 rather, was 0.6% of the money we re­ceive, so 99.4% of what comes in goes to the front line. And that’s be­cause I am in­cred­ibly cyn­i­cal about char­ity, which is why peo­ple say peo­ple like me set them up. And I want to keep those costs re­ally low down, and I want to show peo­ple ex­actly what hap­pens with their money be­cause I think that’s the right thing to do.

We work with co-fund­ing part­ners be­cause we can’t fund ev­ery­thing our­selves. And in fact we of­ten fill gaps, so some­body will say to us, “We need $11 mil­lion here. Have you got any money?” And then we can co­op­er­ate with an­other or­ga­ni­za­tion. And we work with dis­tri­bu­tion part­ners be­cause I don’t want to set up some mas­sive lo­gis­ti­cal op­er­a­tion in a whole se­ries of coun­tries. That would be daft. So this is very much us con­tribut­ing as one of a num­ber of or­ga­ni­za­tions be­cause this is a big team effort. It has to be. So im­pact and ac­countabil­ity are im­por­tant. Trans­parency and effi­ciency are very im­por­tant to us. I guess trans­parency is differ­ent from, but it goes hand-in-hand with, ac­countabil­ity. Effi­ciency cov­ers not just the money we re­ceive but how we ac­tu­ally get nets out to peo­ple in the right quan­tities to pro­tect them.

1100 Rob Mather (8)

I think a char­ity should be able to define in a sen­tence, or in a few words, what it is they’re try­ing to achieve. It sur­prises me when some can’t. In our situ­a­tion, it’s very sim­ple. We want to stop peo­ple dy­ing and stop peo­ple fal­ling sick. So that in essence is the met­ric we must be judged by, al­though I’m go­ing to throw some­thing out there that we ac­tu­ally don’t pub­lish malaria case rate data, and there might be some ques­tions on that later on as to why, if AMF is fo­cus­ing on these met­rics, aren’t they pub­lish­ing the met­rics as to what they’re achiev­ing? It’s a source of frus­tra­tion, but it’s some­thing that I think is im­por­tant.

1100 Rob Mather (9)

So ac­countabil­ity for us means hold­ing peo­ple to ac­count in coun­try, so say­ing to our part­ners, “We want to see data,” so we struc­ture our re­la­tion­ships so that it fo­cuses on data. And we think fun­da­men­tally what that does is it means that fewer peo­ple die and fewer peo­ple fall sick. We want to hold our­selves ac­countable to our donors and show, as I men­tioned, where ev­ery dona­tion goes so peo­ple can be en­gaged rather than, I’ve given them some money, it’s gone into a black box, don’t know what’s hap­pened to it. That, for me, would be frus­trat­ing. And we be­lieve that leads to this vir­tual cir­cle of driv­ing dona­tions be­cause we can­not do any­thing with­out dona­tions. Aware­ness is ter­rific, but aware­ness funds noth­ing. Aware­ness has to have an end­point of mov­ing on to driv­ing dona­tions.

1100 Rob Mather (10)

Each donor has their own in­di­vi­d­ual page, as long as we have their e-mail ad­dress, and we list all their dona­tions. I say as long as we have their e-mail ad­dress not as a cute way of say­ing, “Goodie, then we can mar­ket to them” be­cause we as an or­ga­ni­za­tion do no mar­ket­ing. We may be mak­ing mis­takes in not do­ing mar­ket­ing. In a sense other peo­ple mar­ket for us. The effec­tive al­tru­ism com­mu­nity has been sen­sa­tional in mar­ket­ing us, and is a fun­da­men­tal board mem­ber of AMF in terms of what it has helped us to achieve. We never send so­lic­it­ing e-mails. We only send in­for­ma­tional e-mails. It’s re­ally, re­ally im­por­tant to us be­cause I think what we do should drive our sup­port, not our abil­ity to per­suade be­cause we write good copy.

When we go out into the field we take enough nets to cover ev­ery­body in a par­tic­u­lar area, and the ra­tio is broadly two peo­ple sleep un­der a net. In fact its scale is 1.8. And what we fo­cus on is mak­ing sure that our part­ners have vis­ited ev­ery house­hold, so we un­der­stand whether this house­hold needs three, two, four, one. What­ever the num­ber of nets they need, that’s the num­ber of nets we get to them. We make sure at the mo­ment of dis­tri­bu­tion… and I should say there are a num­ber of things we do to ver­ify and en­sure that that data is ac­cu­rate. It’s not perfect, but we can send five data col­lec­tors out af­ter the first hun­dred and get them to visit 5% of the house­holds these guys vis­ited, and tell them be­fore­hand, so we’re putting psy­chol­ogy to play, to make sure they’re re­ally fo­cus­ing on get­ting ac­cu­rate data. And there are other things we do to make sure that data is good be­cause ob­vi­ously, garbage in, garbage out. And peo­ple, I’m afraid, a very small num­ber, do want to sub­vert what we’re try­ing to do and mis­ap­pro­pri­ate nets.

1100 Rob Mather (11)

It’s im­por­tant to have in­de­pen­dent su­per­vi­sion at the mo­ment of dis­tri­bu­tion so that, again, you make sure the right things hap­pen. We fol­low nets and their pres­ence and use and con­di­tion af­ter roughly six months. And we track malaria case rate data, albeit there are is­sues with the pu­rity or re­li­a­bil­ity of that data. So when we go back in and gather data we’re do­ing it not just be­cause it makes us feel good, but be­cause we do want to un­der­stand what the de­cline curve is, be­cause if we’re up at 95% here on day one, and we come down like this over three years, that’s okay, but also that’s not okay. And if we don’t know, we can’t do any­thing about it, and we do not want to bury our heads in the sand.

1100 Rob Mather (12)

So I have no prob­lem in say­ing af­ter 18 months, the cov­er­age with our nets is down to 40%, be­cause I’d rather know and be able to say to ev­ery­body, so we need to do some­thing about it, be­cause for the next 18 months we’ve got a sig­nifi­cant num­ber of peo­ple that we’re tel­ling ev­ery­body we’re pro­tect­ing from malaria and they’re not ac­tu­ally pro­tected. So let’s find the data.

That bad trend is not one we see of­ten, but we need to know whether it is there or not. And we can say to the dis­trict health officer, “You’ve got 37 health cen­ter catch­ment ar­eas, and you’ve got limited re­sources, and we’ve got this data of whether sleep­ing spaces are cov­ered or not, so you can fo­cus on these 10 ar­eas rather than the 37 and ac­tu­ally be more im­pact­ful, more effec­tive with your work.” So we’re not just col­lect­ing data for data’s sake.

We’re very happy to be held to ac­count by oth­ers, so we re­lease all of our ma­te­rial. There’s al­most noth­ing we won’t re­lease, apart from peo­ple’s per­sonal salaries and things like that. And that’s ob­vi­ously been a ter­rific benefit to us, as we’ve been re­viewed well. That has been a ma­jor driver of the dona­tions we’ve re­ceived. I don’t know what the cur­rent per­centage is, but it’s some­thing like 70% of the dona­tions or 60% of the dona­tions we can tie to GiveWell and other or­ga­ni­za­tions’ re­views of us. So that’s mas­sive. So take 60% of $178 mil­lion, we’re look­ing at about $100 mil­lion that has been driven by the EA com­mu­nity. So AMF is an EA com­mu­nity thing, re­ally.

1100 Rob Mather (13)

Last year we re­ceived about 90,000 dona­tions from 190 coun­tries, so we’re get­ting to lots of peo­ple. And ev­ery dona­tion mat­ters be­cause ev­ery $2 buys a net. And it means that when we talk to coun­tries that say, “Hi Rob, if you’ve got $11 mil­lion,” we say, “We’ve got 8.” But then the next week we’ve got 8.2 and 8.4. So we can liter­ally, through the dis­cus­sions come back and up the num­ber nets we can fund. So we put money to work, in essence, as soon as it comes in, be­cause I can’t com­mit to nets un­less I’ve got the money. So the three key num­bers we of­ten, if peo­ple are sort of bench­mark­ing, what does it cost to do some­thing in the world of malaria: it’s $2 buys a net, $500 pro­tects a village, and roughly $3,000 pre­vents a death, or $4,000 or $5,000. I don’t know what the lat­est num­ber is from GiveWell, which is where that comes from.

On top of that we have a small num­ber of large donors that build on top of what, in essence, is the likes of most of us or all of us in the room, the many in­di­vi­d­ual donors that are our life blood. Th­ese are very lumpy dona­tions. We’ve had some very sig­nifi­cant ones. When you get a $23 mil­lion dona­tion, that’s amaz­ing be­cause it just means we can say to a coun­try, we can fund 12 mil­lion nets for you. And when we’re fund­ing larger quan­tities of nets we can hope to achieve great suc­cess in some of the things we’re as­piring to.

So some fan­tas­tic big dona­tions, but I guess if there’s one thing I want to leave some­body with hear­ing me and look­ing at this slide, it’s that if ever some­body were to ask, “Some­body’s given $2 mil­lion. What does my $2 mat­ter?”, well, the an­swer is your $2 buys a net, and that mat­ters. It just so hap­pens that $1 mil­lion buys 500,000, but we need both. And if we didn’t have all of us con­tribut­ing small amounts, we wouldn’t be here, be­cause no big dona­tions would come in on the back of a few peo­ple giv­ing a few dol­lars, so these are in­ex­tri­ca­bly linked.

1100 Rob Mather (14)

Over the last few years we’ve started to hit the tens of mil­lions of dol­lars, and that means we can fund mil­lions of nets. Every­body who’s in­volved, all the donors, all the sup­port­ers, ev­ery­body that is in­volved to­gether, we can say that we’re putting our­selves in the po­si­tion to stop some­thing like 60,000 peo­ple dy­ing, pre­vent­ing 660 mil­lion cases of malaria through the num­ber of nets funded. And while we have op­er­ated in 36 coun­tries we fo­cus typ­i­cally on about seven in any one year. So this means that we can fund mil­lions of nets at a time. Rather than turn­ing up at the table and say­ing, “Yes, we can fund 100,000 nets,” where the coun­try would say, “Ter­rific-ish” be­cause they need 10 mil­lion, we turn up and say we can fund 5 of your 10 mil­lion. That makes us get listened to, and I think rightly so.

1100 Rob Mather (15)

We don’t turn up and say, “This is how you’re gonna do it” be­cause that would be in­sen­si­tive, crass, and just not a good way of go­ing about things. So we come for­ward and say, “Here’s our draft agree­ment. Here’s the fo­cus on data. You let us know what’s difficult, and let’s work with you as to how we ad­just it, but some things we’re gonna be pretty difficult to move on be­cause it’s all about ac­countabil­ity, and we think there’s sense be­hind them.” So we’re in­volved in a part­ner­ship in per­suad­ing. And the more money we have, the more we can do that. So things have rad­i­cally changed in the last four years, re­ally, with what we can achieve.

1100 Rob Mather (16)

But we have challenges, and most of those challenges… I’m not ex­pect­ing you to read the bot­tom bul­let point. The point is that they are many, and I could go on for­ever, be­cause the devil is in the de­tail. But the big ones are en­sur­ing effec­tive plan­ning where you’ve got limited re­sources and your span of con­trol is limited, clas­sic stuff. So we’re im­prov­ing all the time. We don’t get ev­ery­thing right, but we think we get things more right as each day, each week, each month goes by. And we’re in the busi­ness of per­suad­ing peo­ple to do things, be­cause that’s what part­ner­ships are all about. We’re also in the busi­ness of some­times man­ag­ing or do­ing a two step tango around the poli­tics that sud­denly can ap­pear in cer­tain situ­a­tions in the coun­tries we op­er­ate in.

Manag­ing mil­lions of house­hold records, which is what we do, is the rel­a­tively easy bit. We put 150 lovely peo­ple in the room. We say, “Here’s a lap­top. Here’s some data.” And we provide them with our data en­try sys­tem, and we get the data so we can see it, so there’s no filter. Really, re­ally im­por­tant. But I won’t bang on about that.

1100 Rob Mather (17)

In­sec­ti­cide re­sis­tance is a sec­ond challenge. Charles Dar­win told us that that would hap­pen, and cer­tainly it has, as it hap­pens with all of these things. So what we have done is we’ve played our part in say­ing, “We need to put these new PBO nets”… you’ll re­mem­ber from your chem­istry class of course that PBO stands for piper­onyl bu­tox­ide. Yes, ev­ery­body knows that. It’s a syn­er­gist that goes on the top of a net or on a net, and it switches off the re­sis­tance mechanism in the mosquito, which means that the pyrethroid kills it. We’ve stepped for­ward and funded six mil­lion of those, dis­tributed in 2017, lots and lots of clusters for the statis­ti­ci­ans in the room, so that we can ac­tu­ally have a very pow­er­ful study, a ran­dom­ized con­trol trial, the gold stan­dard if you like, so that for the rest of the malaria com­mu­nity, the fund­ing com­mu­nity, we can say, “Here’s the data that tells us whether PBO nets are good, and if they are in what way and in what cir­cum­stances.” And we’ll have those re­sults in about six months’ time. We don’t know them.

We are the fun­der, we are the sole fun­der of the study, and in a sense we were a bit sur­prised that oth­ers weren’t go­ing to step for­ward, but no­body did so we said, “We’ll do it be­cause this is im­por­tant.” In­sec­ti­cide re­sis­tance is a challenge to be met.

1100 Rob Mather (18)

The next challenge is fund­ing. We’re al­lo­cat­ing about $50 mil­lion at the mo­ment, and we have $200 mil­lion worth of re­quests, so we have to make some nasty, nasty de­ci­sions in the next three months where we will have to say to coun­tries, “We don’t have the money.” But we will do our best to try and make sure that the money we do de­ploy goes to op­ti­mize the im­pact we can have. But that challenge is also an op­por­tu­nity be­cause there are lots of coun­tries that need help. We don’t turn up in the morn­ing and think all these challenges are weigh­ing us down. Th­ese are op­por­tu­ni­ties for us to help. And we tend now to look at any­thing be­tween 2 and 20 mil­lion nets of re­quests a time, so some of the num­bers are quite chunky. We have to re­ally make sure that the part­ner­ships and the agree­ments we put in place are gonna de­liver what we ex­pect it to de­liver. We tend to look three years out now be­cause that matches with other fun­ders. It means we can re­ally plan op­er­a­tionally much bet­ter.

1100 Rob Mather (20)

We also have an op­por­tu­nity with tech­nol­ogy. And this is one of my fa­vorite pic­tures. It shows in one of the poor­est coun­tries in the world, the Demo­cratic Repub­lic of Congo, the use of tech­nol­ogy, smart phones, to demon­strate to within six me­ters where 250 odd thou­sand house­holds are lo­cated that re­ceived nets. And when you do stuff like this you’ve got real time data, you’ve got a bet­ter ac­countabil­ity, you’ve got lower costs, etcetera. The list goes on. So, fan­tas­tic op­por­tu­nity to do bet­ter, but there are challenges with de­ploy­ing it be­cause you can’t just put thou­sands of phones into the DRC and ex­pect it all to go well, so we have to be very care­ful how we do this.

1100 Rob Mather (21)

I’m go­ing to leave you, last slide, on the note of op­ti­mism, which is if we re­flect on what we’ve been do­ing in the last 15 years within the malaria com­mu­nity, all of us to­gether, it’s pretty dra­matic in bring­ing down over 15 years the num­ber of deaths and cases of malaria by about 60%. And there are coun­tries that have moved into elimi­na­tion, malaria is gone now. Sri Lanka, a very challenged coun­try, the tur­moils, war, all sorts of challeng­ing things go­ing on, but they are now malaria free, three years of no na­tive cases of malaria. That’s ter­rific. And there are now eight other coun­tries, I think, on the cusp of that. So elimi­na­tion is pos­si­ble, erad­i­ca­tion is pos­si­ble. But a child still dies from malaria ev­ery minute, so while I’ve been talk­ing, de­pend­ing on how long I’ve been talk­ing, 22 kid­diwinks have not made it, and that’s pretty shock­ing.

As we know what we need to do, which is nets, we don’t have a silver bul­let with a vac­cine. We don’t have a silver bul­let with gene drive tech­nol­ogy yet. Nets is a big part of what we do. So cer­tainly from our part and with oth­ers’ help, we’re go­ing to con­tinue to do as much as we can.


Ques­tion: Can you ex­plain a bit more of the de­tail about how your op­er­a­tions work? Do you dis­tribute nets that are man­u­fac­tured in the coun­tries they’ll be used?

Rob: The nets are man­u­fac­tured broadly in Asia, so the three dom­i­nant coun­tries of man­u­fac­ture are China, Thailand, and Viet­nam. There’s also a fac­tory in Tan­za­nia, and there may be other fac­to­ries sort of com­ing on­line in sev­eral other coun­tries. And there might be one that’s come on­line in, I think, Ethiopia and Nige­ria were look­ing at it. Effec­tively nets are a tex­tile, so economies of scale are key, and there­fore there are rel­a­tively few plants that pro­duce 80,000 nets a day or more, be­cause it’s just not eco­nomic to put small man­u­fac­tur­ing fa­cil­ities, one in each coun­try, which would be great for trans­port and lo­gis­tics and lo­cal economies and em­ploy­ment if you could do that, but it just doesn’t work.

The fi­du­ciary duty I have, if you like, is if I’m look­ing to spend a mil­lion dol­lars do I spend a mil­lion dol­lars on fund­ing nets from a fa­cil­ity in Africa — there is one — that is gonna charge me be­cause of rea­sons of econ­omy of scale 20% more, or do I buy 20% more nets and pro­tect 20% more peo­ple? And the lat­ter has to be my re­spon­si­bil­ity. I’m not here to em­ploy peo­ple. I’m here to pro­tect peo­ple from malaria. How­ever, when there’s a very nar­row gap, then we can make judg­ment calls. But broadly those are the lo­ca­tions of the nets. They’re brought in, and it costs roughly $2 a net and about 20 cents a net to ship a net, so it’s about 10% of the cost. It used to be $5 a net, so that ship­ping cost has be­come a larger pro­por­tion, but that’s still the way the pro­duc­tion works.

Ques­tion: Do you try and mea­sure or think about the im­pact be­yond just im­me­di­ately sav­ing peo­ple’s lives? So for ex­am­ple like the knock-on effects that has to their econ­omy and to the other lives that they then af­fect in the next 10, 20 years. Is that some­thing that you think about at all?

Rob: No and yes. No in terms of the de­ci­sion we make each day is where can we pro­tect the most peo­ple over the next three years with these nets. We’re cog­nizant of the fact that if you’ve got peo­ple that are not sick, as I men­tioned they can func­tion and they can lead healthier lives, and you can trans­form fun­da­men­tally the health of a com­mu­nity, be­cause if you pro­tect peo­ple with nets you’re re­duc­ing the peo­ple in the blood pool who are in­fected, so when a non-malaria car­ry­ing mosquito bites the per­son who is now not in­fected, it’s an­noy­ing and they’ll bite some­body else, but they’re not trans­mit­ting. They’re not act­ing as a vec­tor. So we’re aware of the im­pact it has at the micro level within a com­mu­nity, the macro level within a coun­try. But re­ally our day-to-day fo­cus is more prag­matic and pro­saic.

Ques­tion: If or­ga­ni­za­tions like GiveWell started to look at those longer term im­pacts, do you think they might be able to start mea­sur­ing some of those longer term things even if they’re not your im­me­di­ate fo­cus?

Rob: Whether they can start mea­sur­ing them I don’t know. That’s prob­a­bly more for ex­perts within their or­ga­ni­za­tion, but it would prob­a­bly be of benefit in terms of our own statis­tics, be­cause there is a dra­matic eco­nomic im­pact, not just the health im­pact.

Ques­tion: If peo­ple are in­ter­ested in donat­ing do you have a prefer­ence around peo­ple donat­ing lit­tle and of­ten out of their pay pack­ets, or groups of peo­ple get­ting to­gether and pool­ing dona­tions, or sav­ing now and donat­ing more later? Do you have a par­tic­u­lar prefer­ence around any of that kind of thing?

Rob: So in re­verse or­der donate now rather than later be­cause we’ve got mas­sive gaps. I sup­pose we would pre­fer peo­ple to… we have no method prefer­ence per se be­cause we don’t want to frighten any­body off by say­ing, “They want me to give on­line, and I don’t re­ally want to do that. I’d rather give by bank trans­fer.” So we’re ag­nos­tic when it comes to that per­spec­tive. We do like re­cur­ring dona­tions. It’s some­thing that I look at re­ally closely be­cause I think it acts as a bel­lwether. It acts as… there’s an el­e­ment of, are we see­ing re­cur­ring dona­tions fal­ling away? Is that say­ing some­thing about peo­ple think­ing, “I think I’ve done my bit. I’m go­ing to do some­thing el­se­where.” So if some­body was think­ing of giv­ing 12 pounds, would I pre­fer 12 pounds now or a pound a month I’d prob­a­bly pre­fer a pound a month be­cause this also is the long game.

This is not some­thing where we’re af­ter money now, de­spite my prior com­ment. If some­body’s think­ing about whether they’re re­cur­ring or not, re­cur­ring sort of shows, I think it also shows a more con­sid­ered view that I’m not just go­ing to give 50 bucks. I’m ac­tu­ally go­ing to give 20 bucks a month be­cause I’m prob­a­bly not go­ing to can­cel it in three months’ time. And there was one other part of that ques­tion I missed, I think.

Ques­tion: One of the things that peo­ple do in the com­mu­nity is pool money to­gether into EA funds and things like that. Is that preferred to peo­ple donat­ing in­di­vi­d­u­ally?

Rob: In­di­vi­d­u­ally much bet­ter, sim­ply be­cause, go­ing back to the point I made about try­ing to con­nect in­di­vi­d­ual dona­tions to a dis­tri­bu­tion, so if some­body’s given us $50 we can say, “Your $50 have bought 25 nets that have gone to this area of Uganda.” I think this is, we hope, more en­er­giz­ing and en­gag­ing than if col­lec­tively we raise $1,000 from 50 peo­ple and we fund some­thing there. We can only at­tach one e-mail to a dona­tion, so there­fore I’m only en­gag­ing one per­son whereas I’d like to en­gage all 50. But again we’d pre­fer the dona­tion of funds rather than not.

So yeah, what­ever comes to us. It’s op­por­tu­ni­ties like this and peo­ple ask us ques­tions and we put them on our blog and so on in terms of how do you pre­fer. I think in some ways it’s prob­a­bly a re­fined level of thought be­cause at the top level we need to per­suade peo­ple why should I give to this char­ity. And if you’ve got en­er­getic peo­ple that are go­ing to group peo­ple to­gether and say, “Hey, why don’t we do a fundraiser or do some­thing” then that’s ter­rific. That’s also an­other peb­ble in the pond in the sense be­cause peo­ple get­ting in­volved will… it’ll spread to their friend groups and net­works and so on.

Ques­tion: What re­la­tions do you have with the Bill Gates Foun­da­tion, who are also in­volved in fight­ing malaria?

Rob: Effec­tively none in the sense that we don’t have ac­tive con­nec­tions. I chose not to go ei­ther to friends and fam­ily or big or­ga­ni­za­tions when I started AMF, be­cause I didn’t want peo­ple say­ing, “Oh, what’s he do­ing now? We’ll give him 50 quid.” And I didn’t want to tap into money that already ex­isted. I re­ally wanted to get a whole set of peo­ple like me who re­ally didn’t know any­thing as much as I felt could be known about malaria. So we’ve not gone to the Gates Foun­da­tion and said, “Hi, would you give us tens of mil­lions?” I think they know of us. I’m aware of that. I was in a room with Mr. Gates re­cently, but one of 500 peo­ple, so there’s noth­ing spe­cial there.

How­ever, there have been con­nec­tions along the way. The chair of my malaria ad­vi­sory group was a guy called Pro­fes­sor Sir Brian Green­wood, and Brian was also the di­rec­tor of the Gates Malaria Part­ner­ship in Lon­don, and three of our malaria ad­vi­sor group mem­bers also were chair­per­sons of Gates Malaria Cen­ters in Africa. And one of our trustees ad­vised Bill Gates Sr. when they were set­ting up the Gates Foun­da­tion. So we have con­nec­tions, but we’ve not ex­ploited them be­cause what we’re about is new money.

Ques­tion: So I sup­pose that’s the money side of it. Is there also the ex­per­tise and the knowl­edge side of things that could be benefi­cial to work to­gether?

Rob: They tend to work in re­search rather than product, which is what we are. And there have been con­nec­tions and I have spo­ken with se­nior peo­ple at the Gates Foun­da­tion over the years, and it’s been swap­ping ideas and notes on things, so that does hap­pen.

Ques­tion: You say that you’ve worked with the Depart­ment for In­ter­na­tional Devel­op­ment in the UK Govern­ment as a col­lab­o­ra­tor. Again around sort of the fund­ing point, is there ever a pos­si­bil­ity or are you in­ter­ested in the gov­ern­ment ac­tu­ally fund­ing your work?

Rob: Yes, in the sense that prag­mat­i­cally I could use $150 mil­lion now that I don’t have. So if some­body came for­ward and said, “We’d like to talk to you se­ri­ously about that,” we’d be straight there. And even though that’s not new money, that’s just a sort of prag­matic re­sponse to… it is also an ob­jec­tive. I think we feel that we are a good fun­der of nets. I think there are some less good fun­ders of nets. I could get my­self into dodgy ter­ri­tory here, so I’ll be care­ful what I say, but I think that we bring an at­ten­tion to data, an ac­countabil­ity that some­times other or­ga­ni­za­tions don’t have as their spe­cific fo­cus.

So I think that we back our­selves. If some­body said, “We’d give you this much money. Can you spend it on nets?” We’d say, “Yes, but I’ll tell you what. Hold onto the money. We’ll put that pro­gram in place, know­ing that you’re com­mit­ted, right?” And they’ll go, “Yes.” And we’ll say, “Right, okay. Don’t give us the money. We’ll go and put it in place and get it all ready to go, and then we’ll come back and say now there’s no risk to you. Here you go. Eval­u­ate that. Now give us the money.” And at the mo­ment I think my fo­cus is in­creas­ingly on how do we in­crease the vol­ume and the con­stancy of dona­tions, and also some of the re­ally big dona­tions be­cause I think if I’m go­ing to try and do my best, we’re all go­ing to try and do our best to fill that $150 mil­lion gap. If I can phrase it that way then I have to have some re­ally, re­ally big dona­tions come in, so that’s some­thing I’m think­ing a lot about at the mo­ment.

Ques­tion: Do you think there is an ac­tual re­spon­si­bil­ity for gov­ern­ments to be ac­tu­ally do­ing some of this work, or are you happy for it to be kind of a third sec­tor kind of thing?

Rob: Ag­nos­tic. At the end of the day, as fast as we can, we need to make sure that $5 billion a year is made available to malaria, and it’s only $5 billion a year. Fi­nan­cial crisis and billions talked about here, there, and ev­ery­where. It’s a tiny amount of money for the num­ber of peo­ple that die and the lack of pro­duc­tivity. So I don’t care where it comes from. Our plan B, we in AMF have a plan B, and it’s to close. And I want to do that as fast as I can, not just to see more of my four kids but be­cause then I’d be an un­be­liev­able hyp­ocrite if I wanted AMF to keep go­ing. Be­cause I want to see malaria gone. There are plenty of other things to work on.

So, yes, we want to see money com­ing from wher­ever it comes. The re­al­ity is, it’s not com­ing from gov­ern­ment. Or rather, all of the money at the mo­ment is com­ing from gov­ern­ments, and in 2017 the four biggest fun­ders of nets were the Global Fund, about $500 mil­lion, the Bri­tish gov­ern­ment and the Amer­i­can gov­ern­ment in one or­der or an­other, and then AMF, which is ridicu­lous. We need to try and tap into that wall of money that I pas­sion­ately be­lieve ex­ists within our com­mu­ni­ties. And I think the great­est bar­rier to it, frankly, is ac­countabil­ity. I think there’s mas­sive cyn­i­cism of, “If I give money to a char­ity op­er­at­ing in Africa where’s it go­ing to go?” And I think that’s a valid con­cern, hence my cyn­i­cism. And boy if I was cyn­i­cal when I started AMF 14 years ago, boy am I cyn­i­cal now given what I’ve seen, which is why we do what we do the way we do it.

Ques­tion: So, tell me what’s the cyn­i­cism that you’ve de­vel­oped over the last 14 years?

Rob: I’ve seen many, many cases of be­nign in­com­pe­tence all the way through to ma­lign cor­rup­tion at stag­ger­ing lev­els.

Ques­tion: Apart from dona­tions, how else can peo­ple con­tribute to AMF’s mis­sion?

Rob: That’s a good ques­tion. Ju­lian has been with us for a year as op­er­a­tions man­ager, and he runs the vol­un­teer pro­gram. We need to work out how we can do even bet­ter at tak­ing the fan­tas­tic offers we get from peo­ple say­ing, “How can we help with our time?” So that’s one an­swer to your ques­tion, and ex­per­tise. I sup­pose there are spe­cific ways in which we ap­proach vol­un­teer­ing and say… be­cause that’s in a sense where I’m headed, is that if you’ve got ex­per­tise or con­nec­tions with peo­ple I’m shame­less.

My fa­vorite din­ner party would be three of the 170, I think it’s 170, peo­ple in the world that have as­sets of $10 billion or more, and I’d like to sit down with three of them at din­ner and say, “Just give me the in­ter­est on the money. That’s all I want.” That’s lev­er­age. Three of you could save God knows how many peo­ple and et cetera, et cetera.

But apart from that we need to re­design our web­site. Although there’s a huge amount of tal­ent that’s gone into it, it’s way out of date. It’s not re­spon­sive. We sort of cringe at it. So what I would like is a re­ally big web­site de­sign­ing com­pany to come for­ward and say, “Great, here’s your team, Rob, all for free,” be­cause we do things for free, right. And then we re­design it. And we get an­other group of peo­ple who say, “You’ve got ex­per­tise, we don’t. How do we keep this, this, this, this, and this, but gen­er­ate a fan­tas­tic web­site that’s re­spon­sive so that… how do we...” Another thing I’d throw out there is where we need help, but it’s very prag­matic to AMF’s needs if you like, be­cause we have to be fo­cused on what we’re try­ing to de­liver and then fold in vol­un­teers so they can do things that ex­cite them and they’re good at, so we have to marry those two things up.

I would like to try and get a mil­lion peo­ple to give me one net each, and only one net each. They’re not al­lowed to give us more. Well, if you want to you can go over here, but this bit of the pro­ject is a mil­lion peo­ple giv­ing me a net, in a way that so when Ju­lian gives a net he can come back 10 days later and see, “Wow, five other peo­ple gave a net.” It’s pyra­mid sel­l­ing, but it’s so­phis­ti­cated. And then there’s more down here. And he can see that, “Wow, there are 42,000 nets that are be­ing given as the re­sult of the net I gave and the five e-mails I sent or the three or the two or the one.” Now, I don’t know who to talk to about that, so if there’s any­body who knows the se­nior peo­ple at Google and Face­book and wher­ever we get those two guys and say, “How do you guys make that hap­pen? You must be able to do that in about three weeks.” And that would be a mil­lion nets and two mil­lion peo­ple pro­tected.

So the help we get is we’re always re­ally in­ter­ested in get­ting peo­ple writ­ing to us and say­ing, “How can I help?” And we’ve now got a se­ries of ques­tions where we say, “What are you good at? What do you want to do? How much time do you got, et cetera?” We have a database run­ning, so we can then work out how do we not gets lots of time sucked into vol­un­teer man­age­ment, be­cause that can be a real dan­ger, but we can fo­cus peo­ple on helping.

Ques­tion: So it sounds like it says partly in­di­vi­d­u­als who have those skills can get in touch and ask to help, but is it also that peo­ple who work at big cor­po­ra­tions can try and get in touch with you and lev­er­age the ex­per­tise in their or­ga­ni­za­tion?

Rob: Yeah. And we might say to some­body, is there a con­sult­ing team that over the next three months… not that it’s the time thing be­cause peo­ple have got jobs, they’re earn­ing money, they’re pay­ing the rent, so most peo­ple can’t just say, “I can do some­thing for three weeks.” But in the next three months could you guys take on, and we would li­ase with them, a study to work out what are the top new types of net on the mar­ket that we might have missed and so on, and do a re­search pro­ject and come back with us. And what we try and do is iden­tify peo­ple who are to­tally self driven. So our man­age­ment time doesn’t get sucked into it, be­cause there are only seven of us. They then go away, say, “Got it. We’ll be back to you in …” and ev­ery four weeks we have a con­ver­sa­tion, and they de­liver some­thing that we go, “That’s ter­rific. We can now use that.” And there are lots of ex­am­ples of that, where we try and in­volve peo­ple as best as we can in helping with the mis­sion.

Ques­tion: I saw an ar­ti­cle a cou­ple of months ago about new nets with a com­bined ap­proach of com­bined chem­i­cal and some­thing to do with growth reg­u­la­tion that effects the growth of mosquitoes, and I was won­der­ing if there had been de­vel­op­ments with that since, and whether the nets have changed, or that’s some­thing that you fo­cus on?

Rob: I don’t know is the an­swer. The PBO net is a com­bined net in terms of two chem­i­cals try­ing to have a par­tic­u­lar im­pact. There are a num­ber of differ­ent types of nets that are now be­ing tested. They’re not on the mar­ket be­cause they have to go through some­thing called WHOPES, the WHO Pes­ti­cide Eval­u­a­tion Scheme, a bit like the FDA in Amer­ica where it’s got to be tested. You can’t put a baby un­der­neath a net with in­sec­ti­cide on it un­less it’s been fully tested. And by the way, a baby could lick two square me­ters of net and get a mild tummy ache, so ob­vi­ously these things are tested. There are differ­ent things that are be­ing brought to bear, to try and solve the prob­lem of re­sis­tance rather than greater effi­cacy. They’re fan­tas­ti­cally effec­tive as long as re­sis­tance isn’t an is­sue, so I don’t have… back to my vol­un­teer­ing thing. We need some­body to go and help the team by work­ing at briefing us.

Ques­tion: You said you spend zero pounds on mar­ket­ing, is that right? A lot of ad­ver­tis­ing agen­cies can demon­strate the effec­tive­ness of their cam­paigns. Quite similarly you said that 1 mil­lion US dol­lars spent can save about 12 mil­lion for a coun­try’s lo­cal econ­omy. That’s about the same ra­tio as the John Lewis Christ­mas Ad­ver­tis­ing Cam­paign. So is there not a bit of an eth­i­cal dilemma in not spend­ing money on mar­ket­ing and ad­ver­tis­ing, given that you could get more money if you did it?

Rob: I think it’s not an eth­i­cal dilemma. It’s a sort of com­mer­cial one. If I put my com­mer­cial hat on as to how do I spend the mil­lion dol­lars that some­body gives me: do I buy a mil­lion dol­lars worth of net? I think the way we’ve come out at AMF is that I think we’re get­ting into some tricky ter­ri­tory. If we were to an­nounce to you that we were spend­ing $5 mil­lion over Christ­mas on a mar­ket­ing cam­paign I think there would be some peo­ple that would go, “Really?” And the prob­lem with ad­ver­tis­ing is that 50% is effec­tive. The prob­lem is which 50%.

The way we pre­fer to look at mar­ket­ing and the most gen­eral thing is that let’s put in front of peo­ple what we do and how we do it and the re­sults we have, and hope­fully that will en­courage peo­ple to sup­port what we do. If some­body from an ad­ver­tis­ing firm said, “We’re pre­pared to put to­gether a mar­ket­ing cam­paign for you all for free. Here’s a case team. And we’ve got a mil­lion dol­lar bud­get. Are you in­ter­ested?” I’d say maybe rather than yes be­cause it de­pends on the na­ture of the mar­ket­ing. Be­cause I think one of the things that we value at AMF is, if some­body gave me a billion dol­lars to­mor­row I couldn’t spend it all. It’s a ca­pac­ity is­sue. So our growth has been man­aged in a way. Boy, it took eight years to here, but now we’re at the stage where we could scale, and we could take $150 mil­lion eas­ily.

I would be in­ter­ested in an ad­ver­tis­ing cam­paign, but we’re not about celebri­ties. This is back to this grass­roots thing. I think celebri­ties, they’re in­ter­ested for a while and then they go. And I think that can of­ten be dis­em­pow­er­ing. It can ob­vi­ously be em­pow­er­ing be­cause it gets the mes­sage out. If Oprah Win­frey said, “Look, I’m in­ter­ested in sup­port­ing you all. What can I do?” I think we’d be re­ally in­ter­ested in hav­ing a con­ver­sa­tion. But there’s an el­e­ment of, maybe I’m mis­taken and I’m not a mar­keter, but I feel there’s a sort of… I don’t like the word brand, as­so­ci­ated with AMF.

At AMF we’re sort of quite fam­ily, we’re quite grass­rootsy. We want to try and en­gage as many peo­ple as we have, but we just want to get on with the job and do it as well as we can. And I think that’s hope­fully the best way that will al­low us to ex­pand and maybe DFID will come to us and say, “Look, you’ve got a track record now op­er­a­tionally. We’d like to talk to you about big dol­lars. Make the case to us. Maybe we should give you some money.” I think that’s more the way we put our limited hours than think­ing about get­ting… I’m be­ing pe­jo­ra­tive… get­ting sucked into the mar­ket­ing side of it. But we’re not com­pletely closed to it, and we’re ac­tu­ally deal­ing with some­thing at the mo­ment with, do we AB test some­thing, and we’ve got free stuff given to us. And we’re even sort of sit­ting here go­ing, “Ooh, do we want to do this?” So we prob­a­bly need some­body to ad­vise us be­cause we’re not very good in this area. Sorry, that’s a rather in­ad­e­quate re­sponse.

Ques­tion: I’m quite in­ter­ested in AMF’s mon­i­tor­ing and eval­u­a­tion. It’s so ex­cep­tional. Why do you think that most NGOs ac­tu­ally don’t do mon­i­tor­ing and eval­u­a­tion, and do you think that you can ad­vise other NGOs with differ­ent types of pro­grams in low in­come coun­tries to do mon­i­tor­ing and eval­u­a­tion bet­ter?

Rob: I think there are three things. Firstly, it can be ex­pen­sive. Se­condly, it can be difficult and time con­sum­ing. And I think there’s at­ti­tude as well. I think that many start with the at­ti­tude that they don’t want to do no mon­i­tor­ing and eval­u­a­tion, but they don’t want to do much be­cause it re­quires effort and time. So surely the best thing is just get 10 mil­lion nets out to the coun­try. And even if some of them get stolen and so on, “Hey, look, like seeds be­ing cast they’ll cover most peo­ple, right.” And my an­swer to that, is that I’ve heard of, on very good au­thor­ity, tens of thou­sands and in one case 1.4 mil­lion nets be­ing stolen and sold to an­other coun­try, which means that the two mil­lion peo­ple that were go­ing to be pro­tected with those 1.4 mil­lion nets, they didn’t get any nets. And no­body was com­ing in af­ter­wards. None of these were AMF nets, to be clear. So I think mon­i­tor­ing is re­ally im­por­tant to stop these sorts of things hap­pen­ing.

But a lot of or­ga­ni­za­tions think there are so many challenges we have already. If we’re go­ing to do mon­i­tor­ing in this way then we’re gonna have to have a team of peo­ple do­ing it. There’s money in­volved. So I think gen­er­ally things fo­cus on the statis­ti­cal. So let’s do a sur­vey and see how many house­holds are cov­ered or not cov­ered rather than what I would al­most call proac­tive mon­i­tor­ing where you’re try­ing to in­fluence be­hav­ior up­stream by let­ting peo­ple know you’re ac­tu­ally gonna mon­i­tor af­ter the fact what goes on.