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Malaria is a mosquito-borne infectious disease affecting humans and other animals. Children under 5 are particularly susceptible to infection, with about 70% of all malaria deaths occurring in this age group. Distributing long-lasting insecticidal nets (LLINs) is a very effective way to prevent malaria transmission, and a highly cost-effective intervention overall.

Preventing malaria is important, tractable, and neglected. The World Health Organisation estimates that in 2015 alone, 438,000 people died of malaria. It might also have developmental effects that reduce labor productivity. There are many randomized controlled trials which show that mass distribution of these bed-nets reduces malaria fevers and prevents deaths from malaria. In spite of this, there are still tens of millions of people who are unprotected from malaria. The funding gap for net distributions is in the hundreds of millions of dollars. For these reasons, mass distribution of insecticide treated nets is recommended by the World Health Organisation.

The Against Malaria Foundation, a top charity recommended by Givewell, funds and provides technical assistance for net distribution. GiveWell estimates that it costs about $3,200 to save a life through an AMF-funded net distribution (GiveWell 2016b).

While distribution of bed-nets is arguably the most effective 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 aim to distribute preventive anti-malarial drugs to children under the age of five.

Another promising method to combat malaria is a malaria 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).

Finally, malaria could be combatted by eradicating the mosquito species responsible for spreading the disease, which could plausibly be achieved through gene editing (gene drives) or sterile male release. The Open Philanthropy Project has recently made a grant to enable the formation of a working group to further investigate genetic modification as a solution (Open Philanthropy Project 2016). The Philanthropy Advisory Fellowship (affiliated with Harvard Effective Altruism) has recommended funding a different research lab to investigate gene drives. The Effective Altruism Policy Analytics Project has performed research and advocacy on the risks and benefits of using transgenic mosquitoes to reduce mosquito populations (Gentzel 2016).

Further reading

Gentzel, Matt. 2016. Transgenic mosquitoes, update Effective Altruism Policy Analytics.

Gessner, Bradford, David Wraith & Adam Finn. 2016. CNS infection safety sgnal of RTS,S/AS01 and possible association with rabies vaccine.. The lancet 387(10026): 1376.

GiveWell. 2015a. Mass distribution of long-lasting insecticide-treated nets (LLINs).
Description and evaluation of mass distribution of malarial bed-nets.

GiveWell, 2015b. Seasonal malaria chemoprevention (SMC), interim intervention report.
Description and evaluation of seasonal malaria chemoprevention.

GiveWell, 2016a. Malaria Consortium.
Description and evaluation of the Malaria Consortium.

GiveWell. 2016b. Against Malaria Foundation (AMF).
Description and evaluation of AMF.

Giving What We Can. 2015. Bednets have prevented 450 million cases of malaria.
Description of trends in malaria between 2000 and 2015.

Open Philanthropy Project, 2016. Foundation for the National Institutes of Health — Working Group on Malaria Gene Drive Testing Path.
Open Philanthropy Grant writeup on NIH gene drive consensus group.

Penny 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 387(10016): 367-375.