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.[1]

Multiple randomized controlled trials show that mass distribution of long-lasting insecticide-treated nets reduces malaria fevers and prevents deaths from the disease.[2] 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,[3] and that a marginal donation of $4,106 to AMF is expected to avert the death of a child under five.[4][5]

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.[6][7]

In principle, malaria could be controlled, and ultimately eradicated, by means of an effective vaccine. RTS,S/AS01 (trade name Mosquirix) is a recombinant protein-based malaria vaccine approved for use by European regulators in July 2015. Among children aged 5–17 months who received 4 doses of RTS,S/AS01, efficacy was 36% over 4 years of follow-up.[8] In October 2021, the World Health Organization endorsed RTS,S/AS01 for "widespread use" among children, making it the first vaccine candidate to receive that recommendation.[9] The WHO decision was partly based on results from an ongoing pilot program started in 2019 intended to vaccinate 360,000 children per year in Malawi, Ghana and Kenya over a five-year period.[10] A month before the WHO announcement, a randomized trial had found that a treatment combining antimalarial medication with a four-dose schedule of the RTS,S vaccine, culminating with a booster shot just before the most vulnerable season, was much more effective than either of those methods alone.[11] In 2020, a study using a standard model of malaria transmission estimated that 4.3 million cases and 22,000 deaths in children under five could be averted annually assuming 30 million people are vaccinated, provided areas with the highest malaria burden are prioritized.[12]

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 drivesgenetic 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,[13] 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.[14]

Further reading

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

Roser, Max (2022) Malaria: One of the leading causes of child deaths, but progress is possible and you can contribute to it, Our World in Data, March 22.

Sánchez, Sebastián (2019) 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.

Wiblin, Robert & Keiran Harris (2022) James Tibenderana on the state of the art in malaria control and elimination, 80,000 Hours, May 9.

global health and development | mass distribution of long-lasting insecticide-treated nets

  1. ^

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

  2. ^
  3. ^

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

  4. ^

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

  5. ^

    For caveats, see GiveWell (2017) Cost-effectiveness, GiveWell, November.

  6. ^

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

  7. ^

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

  8. ^

    Laurens, Matthew B. (2019) RTS,S/AS01 vaccine (Mosquirix™): an overview, Human Vaccines & Immunotherapeutics, vol. 16, pp. 480–489.

  9. ^
  10. ^

    World Health Organization (2021) WHO recommends groundbreaking malaria vaccine for children at risk, October 6.

  11. ^

    Chandramohan, Daniel et al. (2021) Seasonal malaria vaccination with or without seasonal malaria chemoprevention, New England Journal of Medicine, vol. 385, pp. 1005–1017.

  12. ^

    Hogan, Alexandra B., Peter Winskill & Azra C. Ghani (2020) Estimated impact of RTS,S/AS01 malaria vaccine allocation strategies in sub-Saharan Africa: A modelling study, PLOS Medicine, vol. 17, e1003377.

  13. ^
  14. ^

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