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Against Malaria Foundation

Against Malaria Foundation (AMF) works to prevent the spread of malaria by distributing long-lasting, insecticide-treated mosquito nets to susceptible populations in developing countries. AMF has been active in 36 countries in Africa, Asia and South America, with a particular focus on sub-Saharan Africa.

Since its founding in 2004, AMF has raised over US$211 million—enough to purchase and distribute 97.5 million nets to protect 175 million people. To date, AMF has distributed or is in the process of distributing over 67 million nets and is assessing distributions of 30 million more. AMF’s work is characterized by, and internationally recognized for, a focus on data and accountability.

The Problem

Malaria is one of the most severe public health problems worldwide, a widespread and deadly disease concentrated in equatorial regions, primarily in sub-Saharan Africa, where 93% of malaria-related deaths occur. Each year, over 200 million people become infected with malaria. Of those cases, the disease proves fatal for 435,000 people. 61% of these deaths are of children under five years old, making malaria one of the leading causes of child mortality in Africa. 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. Malaria is a drain on households and countries; it is estimated to cost Africa US$12 billion every year in direct costs of health care, absenteeism, days lost in education, decreased productivity, and loss of investment and tourism, with much higher costs in lost economic growth.

The Solution

Long-lasting insecticidal bed nets (LLINs), responsibly distributed and properly used. The World Health Organization (WHO) says that “insecticide-treated mosquito nets are currently the only viable option to prevent malaria transmission in large parts of Africa.” The disease is spread by mosquitoes at night, while people are sleeping. The Centers for Disease Control (CDC) says LLINs have been associated with sharp decreases in malaria in countries where malaria programs have achieved high LLIN coverage. The World Health Organization (WHO) recommends that LLINs be distributed to and used by all people (“universal coverage”) in malarious areas. Hung over beds and sleeping spaces, these nets are very effective at killing malaria-carrying mosquitoes that land on the net and pick up insecticide on their feet. A significant number of studies, including randomized controlled trials—the gold standard of scientific research—have demonstrated and quantified the effectiveness of LLINs in preventing malaria. With a series of effective distributions over the course of a decade in a malarious area, malaria can be brought under control and infection rates kept low long-term. Eradication is possible and is occurring. For example, Sri Lanka was declared malaria-free in 2017 after three years of no native cases of malaria.

How AMF is different from other charities

AMF doesn’t just fund or distribute bed nets—they ensure that nets are distributed to and are properly used by those who are most vulnerable to malaria infection. Without proper monitoring, bednets can be misappropriated or misused. Unlike traditional net distributors, AMF pays particular attention to distributing nets accountably, focusing on household-level data to ensure nets reach beneficiaries equitably and as intended. They also carefully conduct post-distribution monitoring to ensure proper net use. In 2014, AMF introduced smartphone technology in place of paper-based data collection to make monitoring even more cost-effective and accurate.

AMF reviews requests for nets from Ministries of Health in malaria-affected countries to determine where the malaria burden is high, where there is a funding gap, and where the nets will do the most good. It then purchases (typically) multiple millions of nets and partners with national health systems and other operational partners to ensure nets reach beneficiaries as intended. AMF’s work achieves ‘universal coverage,’ i.e. all sleeping spaces covered, as this is the most effective and cost-effective way of driving down malaria.

Another way AMF stands out from other bed net charities is that their overhead costs are covered by several private sponsors, allowing 100% of donations to go towards purchasing nets. Additionally, AMF has outstanding transparency and accountability. (See more below under Accountability and Sustainability). AMF is the only bed net charity recommended by rigorous charity evaluator GiveWell.

Why AMF is effective

Cost-effectiveness

An AMF net costs only US$2.00, and each net will protect two people (while in bed) for up to three years. 100% of donations from the public are used to buy nets. AMF’s central costs are very low (~1% of revenue) and already covered by several pro bono supporters. It is estimated that malaria prevention and treatment efforts between 2001-2004  saved US$900 million, with insecticide-treated nets contributing the largest savings.

Effective monitoring and evaluation

AMF gathers significant background and region-specific data ahead of a distribution to determine the number of nets needed per household, school, etc. This data is analyzed, verified and used to form the basis of the physical net distribution, thus ensuring equity, effective use of funds, and full coverage. During the distribution, local partner organizations ensure appropriate attention is given to providing communities with information on malaria prevention, proper net use recognizing the signs of malaria and when and how best to seek treatment.

They then track net presence, use and condition for three years post-distribution by making unannounced visits to a randomly selected 1.5% percent of recipient households. They also track malaria rates.

AMF publishes all data collected.

Economically beneficial

Lower malaria rates help more children stay in school and more adults continue working, which helps individuals and families, and stimulates developing economies. A 50 percent reduction in global malaria incidence could 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.

Proven results

The World Health Organization (WHO) promotes the use of long-lasting insecticidal nets as providing “a substantial level of protection in most settings.” Net are estimated to have averted 450 million cases of malaria between 2000–2015. According to the Center for Disease Control (CDC), “In community-wide trials in several African settings, ITNs were shown to reduce the death of children under 5 years from all causes by about 20%. 

Exceptionally low overhead

From its inception, AMF has attracted and maintained significant pro bono support from individuals and corporations and as a result, the organization has almost no central costs. To our knowledge, AMF is unique in this way. The only overhead  AMF has are the salaries of five (of seven) staff, which are covered by several donors. As a result, 100 percent of donations received from the public buys nets.

Designed for long-term impact

AMF ensures local communities are educated about proper net use, malaria prevention and treatment. It distributes nets through “universal coverage” campaigns.

High Impact

AMF’s accountability and sustainability

AMF publishes extensive pre-distribution, post-distribution and financial data on its website, including malaria case rates and survey results. They publish their year-to-date financials ‘in real time’ and their financial records are easily accessible. Donors can see exactly where the nets they fund are distributed, as AMF allocates each individual donation to a specific net distribution and shares that information with the donor. AMF is the only organization we know of that allocates donations specifically in this way so the donor can track what they have funded.

The organization has been operating for 15 years and has strong relationships with multiple operating partners in eight of the world’s most malaria-affected countries, so is well placed to carry out net distribution programs. Other indicators of the strong sustainability of AMF's work include that there is still a significant malaria problem; much can be done if the funding is available; the funding gap runs into hundreds of millions of dollars the funding AMF raises and deploys helps close the gap; there are many governments that wish to have AMF as a funder of nets; there are organizations eager to co-fund AMF's non-net costs.

 

Recognition

AMF has been named a best charity by The Life You Can Save, Giving What We Can, and Focusing Philanthropy, and is the only organization to have been rated a top charity by GiveWell for the last eight years.

Frequently Asked Questions

How will AMF use my donation?

100% of public donations are used to buy nets. AMF's minimal administrative costs are already covered by a small group of private donors while distribution costs are covered by partners on the ground. So a $100 donation buys $100 of nets—they end up over heads and beds and AMF demonstrates that this has happened, showing donors exactly where the nets they funded are distributed.

How do I know AMF recipients will use the nets properly?

Net distributions are accompanied by malaria education programs delivered by local health leaders, including information on effective net use. Follow-up surveys consistently show this education to be effective: for example, six months after a distribution in Ntcheu District, Malawi, over 90 percent of nets were still being used properly, with 99 percent still in very good condition. See more above under Accountability.

Don’t mosquitoes just strike during the day instead?

The overwhelming majority of malaria-carrying mosquitoes bite people at night between dusk and dawn.

Can’t we just treat infected people instead?

Treatment can be very effective, but it is difficult to provide consistently to rural regions of developing countries. Nearly half a million people still die from malaria each year. Prevention is much better in terms of health outcomes than treatment, and substantially more cost-effective.

Won’t there be a malaria vaccine soon?

There is currently no effective wide-use vaccine and sadly there are no strongly positive candidates. Some experimental malaria vaccine trials have shown early promise but malaria nets are still the most effective means of preventing malaria transmission.

What about a gene drive solution?

Gene drive technology focuses on editing gene composition. Related to malaria control, it is possible that a mosquito gene could be altered such that the only impact is to prevent a malaria parasite surviving inside a mosquito, meaning the mosquito no longer transmits malaria. There is no breakthrough or solution currently, but scientists and researchers, monitored by genetic engineering regulators, are working in this area. In the years to come there could be developments that play a major role in malaria control.

Why does The Life You Can Save recommend Against Malaria Foundation?

We recommend AMF because they have been a Top Charity recommendation of rigorous charity evaluator GiveWell for many years. Anchor

Is my donation tax-deductible?

U.S. donors can make tax-deductible gifts via TLYCS US, and Australian donors can claim applicable tax advantages through The Life You Can Save Australia.

AMF is based in the UK, where donors can claim Gift Aid on their donations. Donations are also tax-deductible in Australia, Belgium, Bulgaria, Canada, Croatia, Denmark, Estonia, France, Germany, Hungary, Ireland, Italy, Luxembourg, the Netherlands, New Zealand, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, South Africa, Spain, and the USA. See further information about AMF's charity-status in these countries.

More Information

Video of a bednet distribution in Kadokolene, Uganda.
Image credits: All photos courtesy of Against Malaria Foundation

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