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Cost-effectiveness
Every dollar donated from the public is used to buy nets. An LLIN from AMF costs only $2 and protects two people for up to three years.
Against Malaria Foundation
Against Malaria Foundation works to prevent the spread of malaria by distributing long-lasting, insecticide-treated mosquito nets to susceptible populations in poor countries.
Their annual demonstrated impact includes:
- Distributing 36.5 million mosquito nets over 12 months, protecting 66 million people. The impact of these nets is estimated to be 24,300 deaths averted, 12 to 24 million malaria cases prevented, and $880 million in improved economic performance.
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- Key Strengths
- Scale
- Multidimensional Poverty Index Indicators
- Child Mortality
- Other Key Outcomes
- Malaria Rates
- Recent Expense Budget
- $120.74 Million
- Year Founded
- 2004
The problem: malaria
Malaria is one of the most severe public health problems worldwide. [1] It’s a widespread and deadly disease concentrated in equatorial regions, primarily in sub-Saharan Africa, where 93% of malaria-related deaths occur. [2]
Each year, over 200 million people become infected with malaria — and 435,000 die. [3] Over 60% of these deaths are children under five years old, making malaria one of the leading causes of child mortality in Africa. [4]. Even when non-fatal, malaria can damage children’s cognitive development. Pregnant women are also highly vulnerable, with the health of both mother and unborn child at risk. [5]
Every year, over 200 million people become infected with malaria — and 435,000 die. Over 60% of these deaths are children under five years old.
Malaria is a significant financial drain on both households and countries. It’s estimated to cost Africa $12 billion every year in direct costs of health care, absenteeism, days lost in education, decreased productivity, and loss of investment and tourism. [6] A 50% reduction in global malaria incidence is estimated to produce $36 in economic benefits for every $1 invested globally, with an even greater estimated return on investment of 60:1 in sub-Saharan Africa. [7]
The solution: long-lasting insecticidal bed nets — also known as LLINs
Malaria is spread by mosquitoes at night while people are sleeping. When LLINs are hung over beds and sleeping spaces, mosquitoes land, pick up insecticide on their feet, and die. This is a hugely effective intervention. The Centers for Disease Control (CDC) confirms LLINs have been associated with sharp decreases in malaria in countries where malaria programs have achieved high LLIN coverage [8], and the World Health Organization says that “insecticide-treated mosquito nets are currently the only viable option to prevent malaria transmission in large parts of Africa.” [9]
“Insecticide-treated mosquito nets are currently the only viable option to prevent malaria transmission in large parts of Africa.”
World Health Organization
A significant number of studies, including randomized controlled trials, have demonstrated and quantified the effectiveness of LLINs. We know that malaria can be brought under control and infection rates kept low long-term when LLINs are effectively distributed over the course of a decade in malarious areas. Eradication is possible — and is occurring! In fact, Sri Lanka was declared malaria-free in 2017 after three years of no native cases of malaria [10].
How Against Malaria Foundation works
Unlike traditional net distributors, AMF pays particular attention to distributing nets accountably, using household-level data to ensure nets reach beneficiaries equitably. AMF reviews requests for nets from Ministries of Health in malaria-affected countries to determine where the malaria burden is high, if there is a funding gap, and where the nets will do the most good.
Then they purchase (typically) multiple millions of nets and team up with national health systems and other operational partners to ensure nets reach their beneficiaries as intended. An LLIN from AMF costs only $2 and protects two people for up to three years. AMF’s work achieves “universal coverage,” which means all sleeping areas in a community or region are covered. This is the most effective way of driving down malaria.
Video of a bednet distribution in Kadokolene, Uganda. A bednet costs only $2 and protects two people for up to three years.
Post-distribution, AMF tracks net presence, use, and condition for three years by making unannounced visits to a randomly selected 1.5% of recipient households. They also track malaria rates. In 2014, AMF introduced smartphone technology in place of paper-based data collection to make monitoring even more cost-effective and accurate. [11]
- 190M+
- nets distributed
- Two
- people protected for every net
- The cost of buying and delivering a bednet is
- $5
- 12 to 24 million
- malaria cases prevented each year
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Photo: The Global Fund/Karin Schermbrucker
What makes Against Malaria Foundation so effective
Monitoring and evaluation
AMF gathers significant background and region-specific data ahead of a distribution to ensure equity, effective use of funds, and full coverage. They then track bednet use alongside malaria rates for three years post-distribution.
Impactful results
Bednets are estimated to have averted 450 million cases of malaria between 2000–2015, and, according to the CDC, “in community-wide trials in several African settings, [bed nets] were shown to reduce the death of children under 5 years from all causes by about 20%.” [12][13]
Compounding impact
Lower malaria rates help more children stay in school and more adults continue working, which helps individuals and families, and stimulates developing economies.
Exceptionally low overhead
From its inception, AMF has attracted and maintained significant pro bono support to fund its operations — so much so, the organization has almost no central costs. As a result, 100% of donations received from the public buys nets.
Long-term sustainability
During the distribution of nets, local partner organizations ensure local communities are educated about proper net use, malaria prevention, symptoms, and treatment.
Against Malaria Foundation’s accountability and sustainability
AMF publishes extensive pre-distribution, post-distribution, and financial data on its website, including malaria case rates and survey results. [14] They also publish their year-to-date financials “in real time,” and their financial records are easily accessible. [15] Even more unique: AMF allocates each individual donation to a specific net distribution so donors can see exactly where the nets they fund go.
AMF has been operating since 2004 and has developed strong relationships with multiple operating partners in eight of the world’s most malaria-affected countries. Other indicators of the strong sustainability of AMF’s work include:
- There is still a significant malaria problem with a funding gap of hundreds of millions of dollars
- There are many governments that have requested AMF to fund nets
- There are organizations eager to co-fund AMF’s non-net costs
Recognition for Against Malaria Foundation
AMF’s work is internationally recognized for its focus on data and accountability. AMF has been top rated by GiveWell since 2009 and also recommended by Giving What We Can and Focusing Philanthropy. [16]
Sources
All photos and videos courtesy of Against Malaria Foundation.
[1] Centers for Disease Control, Malaria’s Impact Worldwide
[2–5] World Heath Organization, Malaria fact sheet
[6] Centers for Disease Control, Malaria’s Impact Worldwide
[7] The President’s Malaria Initiative, 2017 executive summary
[8] Centers for Disease Control, Insecticide-Treated Bed Nets
[9] World Health Organization, 2001 bulletin
[10] Journal of Health Specialities, Malaria elimination in Sri Lanka
[11] Against Malaria Foundation website
[12] Nature, The effect of malaria control Plasmodium falciparum in Africa between 2000 and 2015
[13] Centers for Disease Control, Insecticide-Treated Bed Nets
[14] Against Malaria Foundation website
[15] Against Malaria Foundation website
[16] GiveWell’s review of Against Malaria Foundation
[17] Against Malaria Foundation website
[18] World Heath Organization, Malaria fact sheet
[19] Nature, First proven malaria vaccine rolled out in Africa — but doubts linger
[20] The American Journal of Tropical Medicine and Hygiene, Pathway to deployment of Gene Drive Mosquitoes as Potential Biocontrol Tool for Elimination of Malaria in Sub-Saharan Africa
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