Love you Nick. Keep be the person you are. Modernization, in the sense of making the world less darker, was always related to nurses and doctors working in rural and remote areas. It is not only the direct giving but also the spirit of it.
I hope people will donate oneDay Health above the explicit cost effectiveness of it.
Thank you for sharing your comment with us. We have considered it in our analysis, but we cannot confirm the accuracy of the morbidity and mortality ratios we have used. We may be able to provide the exact calculation next week, if time permits. It is worth noting that we have assumed that semi-urban areas may be a significant contributor to mortality. These areas differ from Gulu in two important ways - they are more rural and have more water bodies, and they are less developed, which means they may have fewer clinics.
Hi Ian, I totally agree, super important to engage leading scientists (and the company is working together with leading scientists on some collaborations and publications).
In this specific operation (which was not designed as a study but rather as an operational pilot) the authors are from Sao Tome's Ministry of Health and from the company, so we do have here a level of external control, but again, we should aim for more.
Thanks again. This, too, is a good point.
First of all, a small clarification - we are seeking $6M for various purposes; the cost of the RCT should be about $1.5M. To the main point: historical data from the Ministry of Health on Anopheles mosquitoes supports the same conclusions but was not included in the publication (history of malaria data per district has not been shared with us by the government). As highlighted in the paper, the intervention was a pilot and NOT a clustered randomized control trial (cRCT), though it was the Ministry of Health (and not us) who selected the intervention and control areas.
In other words, we do need a cRCT to fully validate our method, but the existing evidence is definitely strong enough to justify spending $1.5M on rolling out such an cRCT.
Hope this answers your questions. Let me know if something is still unclear.
That's a valid point. Morbidity and mortality rates are indeed lower in cities, and I attempted to reflect this in my calculation. However, if someone has more accurate data, I would be happy to update my calculations. Designing an experiment around death is extremely challenging because it requires 200 times more area to achieve the same statistical power.
Hi thanks for your comment1) Bed nets are a good example, but other interventions like house spraying, seasonal drugs for toddlers, and investing in diagnostics are also relevant. A separate post may be needed to discuss the best combination of interventions for different conditions.In brief, compared to bed nets, our interventions require strong implementation capabilities and government commitment, making the process more complex. Zzapp aims to simplify implementation, but it remains a challenging task. Kind of "deep" implementation.
2)That's a great question! As malaria rates are higher in rural areas of Africa than in urban areas, we are still deciding whether to focus or expand. Our decision will be based on our internal resources, demand from countries, and potential impact.
Thank you for sharing. I recommend to try "Aquatain AMF" instead of BVA Mineral oil. If you do try, please tell me which one was better in which context