Gage Weston and I made a video on preventing malaria! We talk about the malaria vaccine that is in trials, gene drives, GiveWell, AMF and Malaria Consortium's SMC program.
Feel free to give us any feedback in the comments here or on YouTube.
If you liked the video, I would encourage you to share it with your friends (especially those who aren't in the effective altruist movement). You're also welcome to use it for any EA events you're hosting! In case you do, let us know how it went!
I would love to hear if this video was interesting for fellow aspiring effective altruists as well: Did you learn any new things? Has it changed/updated your mind on anything?
The links in the description to donate to AMF and Malaria Consortium will help us give an idea of whether or not people actually made any donations because of our video.
More on A Happier World in this earlier EA forum post.
Sources are marked with an asterisk. Text might differ slightly in wording from the final video.
When we think of deadly animals, we usually think of creatures like sharks or lions. But these don’t even kill 1000 people per year.* And there are animals who kill plenty more.
Some people may say: “Humans kill the most humans!”. They’re close.
The deadliest animal is the mosquito. Specifically, the female mosquito. Mosquitoes kill over a million people. every. single. year. They’re deadlier than war*, plane crashes*, and terrorist attacks*, and all of these combined.
When one of these bugs sucks your blood, it acquires whatever transmissible diseases you had. Then, when it goes on to bite another person, it spits disease-carrying saliva in that person’s bloodstream.
This is how diseases like malaria, zika, yellow fever, and west nile virus spread. Malaria is the leading cause of death by mosquitoes, killing more than 400 thousand people every year, which is why we’ll be focusing on it in this video.
The good news is, if you’re watching this, you can have a big impact to help fight this awful disease.
Malaria isn’t only widespread and deadly, but it also causes a lot of suffering for those who get it.
“I’ve had malaria…
I had a fever, headache.
My body was shivering, chills, cold.
I was so scared I thought I was going to die.”
Nausea and vomiting also often occur.
Children younger than 5 years old comprise over half of the deaths from malaria, making it one of the world’s leading causes of child mortality.* It kills over 250 thousand children every year, which means a child dies from malaria every two minutes.*
In addition to its enormous death toll, over 200 million people fell ill with the disease last year, leading to massive economic losses. Each year malaria is estimated to cost Africa roughly $12 billion in lost GDP, which is more than the GDP of Madagascar.***
Malaria used to be prevalent across the world, even in the US and Europe. Thanks to insecticides, changes in land use and economic development, most countries eradicated malaria.*
Yet, some regions have far more malarial mosquitoes, more humid and rainy climates, and less access to insecticides and well-sealed housing.
These conditions are optimal for malaria to spread, which is why nowadays nearly 9 out of 10 cases take place in sub-saharan Africa.*
Thankfully, malaria deaths are declining, both according to the World Health Organisation and the Institute of Health Metrics and Evaluation. This is largely due to the increased usage of mosquito nets, anti-malaria medicine and insecticides.**
So why don’t we have a vaccine for malaria? After all, it took less than a year to get COVID vaccines.
According to the CDC, “The development of a malaria vaccine has faced several obstacles: the lack of a traditional market, few developers, and the technical complexity of developing any vaccine against a parasite,” as opposed to a virus like the coronavirus or a bacterium like the one that causes Cholera.*
Some malaria vaccines have undergone clinical trials in the past but were not very effective. But a new vaccine is in trials that has an efficacy of 77%, meaning that a vaccinated person is 77 percent less likely to get malaria than an unvaccinated person. This new vaccine could cut malaria deaths dramatically.*
Another potentially promising solution is gene drives. For a few years now, we have been able to genetically engineer mosquitoes to be immune to malaria. We can then spread these mosquitoes into affected areas.
Normally when you genetically engineer an animal and put it in the wild, only half of the offspring will get the altered gene. So it won’t really spread through all of the population.
But using gene drives it can, as nearly 100% of the offspring will carry the altered gene. This way after a couple of generations, entire mosquito populations will be immune, eradicating the disease in that area.
Vaccines and gene drives look really promising and will hopefully be widely used soon. But at the moment, more than a thousand people still die from malaria every day.
So what can we as individuals do to help now? Are there effective things we can do?
It turns out malaria is among the most cost-effective diseases to fight. The non-profit GiveWell publishes a small list of highly impactful charities every year. Out of this list, two giving opportunities focus on malaria prevention: The Against Malaria Foundation (or AMF) and Malaria Consortium’s Seasonal Malaria Chemoprevention program. These charities are also being recommended by other evaluators such as The Life You Can Save and Giving What We Can, though these use much of GiveWell’s research.
“GiveWell’s goal is to direct funding to save and improve the most lives and the way that we do that is by conducting intense research into giving opportunities: identifying the ones that best fit our criteria and publishing the full details of our analysis so that anyone who comes to our website can see what we recommend and why.”
So what do these two recommended charities do and what makes their programs stand out? Are there any good reasons not to donate to them?
An estimated 5 dollars donated to the Against Malaria Foundation buys and distributes an insecticide treated bed net for people in developing countries.* AMF has been a GiveWell recommended charity every year since 2009 except for 2013.*** Over 90% of contributions are used to directly buy and distribute nets. These nets surround the bed of 1 to 2 people for 2 to 3 years*, preventing mosquitoes from biting them while they sleep. Studies have shown that bed nets are very effective, reducing malaria cases by 45% on average.**
AMF works with local communities and governments to distribute the bed nets.*
“So nine months after the Against Malaria Foundation supports a net distribution in a particular location they go back and they check to see how many nets are hung. So they visit a proportion of the households and they look to see: are the nets still in use, are they in good condition?* And based on that information we feel reasonably confident that the majority of nets are in use after these distributions and that they’re doing their job of preventing malaria.”
Many people are worried the insecticides aren’t that effective anymore because mosquitoes are becoming slightly resistant against them. GiveWell takes these and many other factors into account, yet they believe AMF remains highly cost-effective.*
AMF also funded large-scale research with a new type of insecticide treated net, the PBO net, which inhibits the enzymes in mosquitoes that enable insecticide resistance. Preliminary data suggest that these nets may be even more effective at preventing malaria in areas where mosquitoes have developed insecticide resistance.***
Now let’s look at the Malaria Consortium, recommended since 2016.* Their Seasonal Malaria Chemoprevention, or SMC, program administers antimalarial medicines to children under 5 during the rainy season, when malaria transmission is at its peak.
The medicine reduces malaria cases by approximately 75% for a month* and is given 4 months in a row. It costs about $7 per child for the full treatment each year.
“During the administration stage of SMC medicine we go door-to-door.
Once we explain SMC, they know that it is a treatment for malaria and no family refuses it.
Before SMC, malaria affected a lot of our children.
Every season, almost all the children were afflicted with malaria.
With SMC, there are fewer children getting malaria.”
Communities notice this extreme decrease in malaria cases.
“I have had 8 children, two have died due to malaria and the other ones have had malaria before.
I am happy because the previous years they have not been given the SMC drugs but I like this one now, as you can see my son is not sick.”
Since these medicines are given to children under 5, it’s possible they will be less immune to malaria when they grow up. And only just over half of the targeted children receive the medication for the full 4 months.*
The chemoprevention may sometimes have rare side effects too, and like with bed nets, the malarial parasites may be developing a resistance to these drugs.* GiveWell accounts for all these effects in its assessment, and overall, Malaria Consortium remains a very cost-effective charity
GiveWell estimates that AMF and Malaria Consortium’s SMC program will each save one life for about 3000 to 5000 dollars.
“That number might sound high if you’re used to seeing charity marketing claims that say “Oh, one dollar can save a life or 5 dollars can save a life”. But when we’re calculating the cost to save a life we look at all of the different costs to a program and all of the different factors that go into achieving that program successfully.”
“So in order for the cost to save a life of giving to the Against Malaria Foundation to be five dollars it would need to be true that 100% of people who don’t receive these nets would have otherwise died of malaria. And we know that’s not true.”
“We look at how long we expect a net to last and how many people we expect to sleep under a net.”
“And so we look at all of these different factors and many many many more. Our cost-effectiveness model has hundreds of inputs into it and ultimately comes out with that bottom line figure of around 3000 to 5000 dollars”
Even if the true cost per life saved is anywhere near $3000, the average American would still save a life every year if they donated just a few week’s wages to one of these charities.*
Most people think saving lives is restricted to doctors or firefighters. But in fact, many of us can save lives by donating to effective charities like these. Even much smaller donations will still have a tremendous impact.
Many families are very grateful for these organizations’ efforts. They remove the almost constant fear from parents that their child might die. Communities celebrate the fact that they are more free from the disease and the poverty and pain it brings.
“When we heard talks about this project that has the goal of preventing malaria with children under 5, we were very happy. We hurried to pray for God so he could quickly bring the medicines to better protect our children that suffer every year of malaria. Today I’m not the only one that appreciates and thanks this project. All mothers are really happy to be able to benefit from this project. We thank God for this project.”
We’ve mentioned GiveWell a lot in this video, but that’s just because we believe it’s a good source of information. None of the organizations mentioned funded this video or asked us to make it.
Right now, donating to the Malaria Consortium’s SMC program and the Against Malaria Foundation are one of the best things you can do to help the global poor.
There’s a link to donate to both of these charities in the description. But perhaps you think other problems in the world are more pressing, so subscribe to learn about more ways we can move towards a happier world!
Hi! Jeroen here, the editor of this video and creator of this channel. If you liked the video and you think it’s important, share it with your friends! We’ve tried our best to explain this topic as accurately as possible. But since we’re human, there’s a good chance we’ve made mistakes. We welcome discussion on the issue raised and feedback on our presentation of it in the comments below. Thanks for watching!
- Deadliest animals to humans (wikipedia)
- Deadliest animals to humans (video)
- What’s The Deadliest Animal In The World? (video about mosquitoes)
- Mosquitos, malaria and education – Bill Gates
- The deadliest animal in the world | Bill Gates
- Deadliest Creature In the World | Mosquito
- Our charts on Causes of Death – OurWorldInData
- GBD Results Tool | GHDx (Mosquito borne illnesses)
- Against Malaria Foundation – GiveWell
- Mass Distribution of Long-Lasting Insecticide-Treated Nets (LLINs) – GiveWell
- Meant to Keep Malaria Out, Mosquito Nets Are Used to Haul Fish In (New York Times 2015)
- Putting the problem of bed nets used for fishing in perspective
- AMF: Net use and the importance of data-driven distributions and monitoring
- Insecticide Resistance and Malaria Control – GiveWell
- GiveWell donors supported more than direct delivery: AMF and PBO net research
- Against Malaria Foundation – TLYCS
- Malaria Consortium – GiveWell
- Malaria Consortium – TLYCS
- Video library – Malaria Consortium
- Photo library – Malaria Consortium
- Yellow fever – Wikipedia
- Chikungunya fact sheet
- Dengue fever – Wikipedia
- Prevent Mosquito Bites | Dengue
- Prevention | Japanese Encephalitis
- Complications of Zika virus disease
- Guide to GiveWell CEAs
- [public] 2020 update on GiveWell’s moral weights
- Are You Sure You Want To Donate To The Against Malaria Foundation? – EA Forum
- GiveWell’s Cost-Effectiveness Analyses
- All our charts on Malaria – OurWorldInData
- Genetic Engineering and Diseases – Gene Drive & Malaria (Kurzgesagt)
- The bold plan to end malaria with a gene drive (Vox)