Why SoGive is not updating charity ratings after malaria vaccine news

by Sanjay2 min read23rd Apr 20212 comments

36

MalariaDonation writeupSoGiveGlobal health and development
Frontpage

[Cross-posted from SoGive's blog.]

Today, the Jenner Institute at the University of Oxford announced that their malaria vaccine had achieved the WHO goal of 75% efficacy.

This could potentially save huge numbers of lives and is an exciting development.

Currently, SoGive’s top charities include charities which tackle malaria, for example the Against Malaria Foundation.

It is reasonable to wonder whether this sort of announcement might render activities such as distributing malaria nets redundant. All the more so since funds sent to one of these charities would not typically be deployed immediately, and may need several months or even more than a year before they turn into actual malaria nets on the ground.

We have not decided to downgrade or adjust our rankings on these charities in light of this news, although we will continue to monitor the situation.

Our reason for this is that we believe it would be too early to update our ratings:

  • The current trial was only small (c450 children); before we had confidence in the effectiveness of the vaccine, we would need to see the results of a larger trial, as would the WHO. This would likely not even be completed before some time in 2022, and more time would be needed after that before vaccines were actually being used at scale.
  • Hence even under pessimistic assumptions about the delay between a donation made now and the date when a malaria intervention reaches a beneficiary, it would likely be before effective vaccines are available.

Furthermore, we believe it is as yet unclear whether the vaccine will even be the most cost-effective solution:

  • We understand that the vaccine needs 4 doses, and that with only 3 doses it’s substantially less effective (in the interests of publishing this quickly, we have not carefully reviewed this information). Assuming this is the case, it would cast doubt on the cost-effectiveness of the vaccines, especially having incorporated either the costs of ensuring compliance, or including the wastage costs that come from imperfect compliance. 
  • There are uncertainties around the generalisability to different countries/contexts, especially if compliance with a demanding vaccination schedule were essential to success.
  • Multiple other uncertainties remain, including the cost of the vaccine, the logistics (e.g. is there a demanding cold chain required?), the duration of the protection, and the extent to which new vaccine-resistant strains might develop, and the extent of vaccine hesitancy among the population.

We do not believe that donations being made today to SoGive’s recommended malaria charities should be considered any less effective in light of the vaccine news. 

36

2 comments, sorted by Highlighting new comments since Today at 2:10 AM
New Comment

Good post Sanjay, though I think a better title would be "Why SoGive is not yet  updating charity ratings after malaria vaccine news" though. 

 I don't disagree with any of the points you've made - and there are certainly large uncertainties around this, but  there is at least a significant possibility that when some uncertainties are resolved this could  displace nets in terms of cost-effectiveness.  So its certainly a very promising development and even if we don't change our immediate funding priorities, we need to think about how they might change in the future.

Excellent! I am wondering a bit more about the timelines though, the article mentions the lag from donation to bed nets distributed. Let us call this period T_a. Then there is the expected duration of the bed nets. I think this is about 2 years, so does this mean that AMF is still as effective as long as the time to meaningful roll-out of a vaccine < 2 + T_a? And is my duration of 2 years the right duration? I am getting it from row 30 in GiveWell's cost effectiveness sheet.