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Malaria

TagLast edit: 11 Jun 2021 4:51 UTC by Michael Huang

Malaria is a life-threatening infectious disease affecting humans and other animals. It is caused by parasites spread through the bites of infected female mosquitoes. In 2019, there were 229 million cases of malaria and 409,000 deaths caused by this disease worldwide (World Health Organization 2020: xiv-xv).

Multiple randomized controlled trials show that mass distribution of long-lasting insecticide-treated nets reduces malaria fevers and prevents deaths from the disease (GiveWell 2018a). Despite the existence of effective prevention methods, tens of millions of people are still unprotected from malaria, and the funding gap for net distributions is in the hundreds of millions of dollars.

The Against Malaria Foundation provides funding for distribution of bed nets to high-risk populations. GiveWell estimates that it costs $4.59 to purchase and distribute an AMF-funded net (GiveWell 2020), and that a marginal donation of $4,106 to AMF is expected to avert the death of a child under five (GiveWell 2020b; for caveats, see GiveWell 2017).

While distribution of nets is the most common method to combat malaria at present, there are other promising approaches. The Malaria Consortium works on preventing, controlling, and treating malaria and other communicable diseases in Africa and Asia. One intervention they carry out is seasonal malaria chemoprevention (SMC) programs, which seek to distribute preventive anti-malarial drugs to children under the age of five (GiveWell 2018b; 2020c).

In principle, malaria could be controlled, and ultimately eradicated, by means of an effective vaccine. However, currently the only existing vaccine is just 35% effective and its use is slightly less cost-effective than that of insecticide treated bed-nets (Gessner, Wraith & Finn 2016). There are also some concerns about its safety (Penny et al 2016).

Yet another approach to combat malaria is to eliminate the mosquito species responsible for spreading the disease, or to modify it genetically to render it incapable of carrying malaria. Gene drives—genetic modifications designed to spread through a population at higher-than-normal rates of inheritance—could achieve both of these goals. In 2016, Open Philanthropy made a grant to enable the formation of a working group to further investigate genetic modification as a form of malaria control (Open Philanthropy 2016), and the following year it made a $17.5 million grant to Target Malaria, a nonprofit research consortium working to develop gene drive technologies to eradicate malaria in sub-Saharan Africa (Open Philanthropy 2017).

Bibliography

Gentzel, Matthew (2016) Transgenic mosquitoes , update Effective Altruism Policy Analytics, Effective Altruism Forum, August 10.

Gessner, Bradford D., David C. Wraith & Adam Finn (2016) CNS infection safety signal of RTS,S/​AS01 and possible association with rabies vaccine, The Lancet, vol. 387, p. 1376.

GiveWell (2017) Cost-effectiveness, GiveWell, November.

GiveWell (2018a) Mass distribution of long-lasting insecticide-treated nets (LLINs), GiveWell, March.

GiveWell (2018b) Seasonal malaria chemoprevention, GiveWell, October.

GiveWell (2020a) Against malaria foundation, GiveWell, November.

GiveWell (2020b) 2020 GiveWell cost-effectiveness analysis — version 2, GiveWell, November 19.

GiveWell (2020c) Malaria Consortium – Seasonal malaria chemoprevention, GiveWell, November.

Hillebrandt, Hauke (2015) Bednets have prevented 450 million cases of malaria, Giving What We Can, December 18.

Open Philanthropy (2016) Foundation for the National Institutes of Health — working group on malaria gene drive testing path, Open Philanthropy, July.

Open Philanthropy (2017) Target Malaria — gene drives for malaria control, Open Philanthropy, May.

Penny, Melissa A. et al. (2016) Public health impact and cost-effectiveness of the RTS,S/​AS01 malaria vaccine: a systematic comparison of predictions from four mathematical models, The Lancet, vol. 387, pp. 367–375.

Sánchez, Sebastián (2019a) Timeline of mosquito net distribution, Timelines Wiki.

Sánchez, Sebastián (2019b) Timeline of malaria vaccine, Timelines Wiki.

Sánchez, Sebastián (2020) Timeline of malaria, Timelines Wiki.

Snowden, James (2016) The economic benefits of malaria eradication, Giving What We Can, January 18.

World Health Organization (2020) World Malaria Report 2020: 20 Years of Global Progress and Challenges, Geneva: World Health Organization.

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