Malaria Consortium's seasonal malaria chemoprevention program

This funding opportunity was recommended by GiveWell, our research partner focused on global health and development. For more information please see GiveWell’s write-up on Malaria Consortium.

Malaria Consortium seeks to prevent the spread of malaria, and to prevent illness and death, by distributing cheap and effective anti-malarial drugs to vulnerable populations across Africa.

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What problem are they trying to solve?

Malaria Consortium is trying to save lives and reduce ill health caused by malaria. Malaria is a life-threatening disease that is transmitted to people via the bites of infected mosquitoes. Even when not fatal, malaria is unpleasant, causing flu-like symptoms and in more severe cases, seizures, comas, multiple organ failure and, in pregnant women, stillbirths and low birth weight babies.¹

Malaria can be deadly, particularly for children. There were 229 million cases of malaria in 2019 and it was responsible for 409,000 deaths. Of these deaths, 67% were of children under 5 years old. Pregnant women and those with HIV/Aids are also at a higher risk both of contracting malaria but also of it making them seriously unwell.² This is a shocking loss of life.

While we tend to think primarily of the physical symptoms of malaria, its indirect effects can also be extremely damaging. Because malaria is common and even milder cases can incapacitate people, it has significant opportunity and economic costs on individuals, households and national economies. Malaria is a leading cause of school absenteeism in Africa.³ It’s estimated that in 2000, 4-10 million school days were lost due to malaria in Kenya alone.⁴ In one study in Mozambique, even when treatment was free, an uncomplicated case of malaria cost between 10 and 21% of a family’s monthly expenditure while severe cases could cost a family more than 300%.⁵ Because of this, malaria can contribute to poverty traps where family savings are wiped out and work and education opportunities are limited by unnecessary periods of illness. It also costs governments a great deal. As well as lost productivity from workers, malaria spending makes up on average 5% of all government health spending in low-income countries, although this ranges as high as 14% (Burkina Faso) and even 25% (Liberia).⁶

Most of the burden of this disease falls on low income countries in Africa, with around half of all malaria deaths occurring in just 6 countries: Nigeria, the Democratic Republic of the Congo, Tanzania, Burkina Faso, Mozambique and Niger.⁷ This means the burden of this disease falls on some of the world’s poorest and most vulnerable people.

Despite all of this, between 2010 and 2018, aid spending on malaria has been decreasing by on average 1.9% per year and global spending on this issue is $2.3 billion annually below the estimated sum needed for eradication.⁸

What do they do?

Malaria continues to be a menace to much of the world, despite the fact that there are cheap and effective ways to prevent it. One method is to take preventative anti-malarial drugs. This is highly effective and relatively easy to implement. Anti-malarial drugs are recommended for foreign visitors in malarial zones (e.g. the NHS’s advice to UK travellers)⁹ but are often not available to those who live year round in these regions.

Malaria Consortium provides anti-malarial drugs to children aged 3 months to 5 years in areas of high malaria prevalence during peak malaria season. This approach is known as seasonal chemo-prevention. They work with local partners who can implement the programme on the ground. Malaria Consortium’s role in these programmes includes funding and arranging drug procurement, shipping and distribution, as well as technical support to their implementing partners, financial management and monitoring and evaluation.

In 2020 they continued this work, throughout the COVID-19 pandemic. They ensured safety of participants by procuring the necessary PPE and updating their training and supervision guidelines. They reached an estimated 12 million children, protecting them from malaria despites the challenges of the pandemic.

Why do we recommend them?

GiveWell, our research partner in global health and development, has evaluated Malaria Consortium and found them to be one of the most cost-effective global health organisations in the world.

Why do we trust this organization?

This charity was recommended by GiveWell, our research partner for global health and development issues. GiveWell is a nonprofit dedicated to finding outstanding giving opportunities and publishing the full details of their analysis to help donors decide where to give.

Unlike charity evaluators that focus solely on assessing administrative or fundraising costs, GiveWell conducts in-depth research aiming to determine how much good a given program accomplishes, per dollar spent, in terms of lives saved or lives improved. Rather than try to rate as many charities as possible, they focus on the few charities that stand out according to a specific set of criteria, in order to find and confidently recommend high-impact giving opportunities. Malaria Consortium has been on GiveWell’s list of top charities for several years.

What would they do with more funding?

According to GiveWell, Malaria Consortium has identified $141.2 million in spending opportunities for the next three years. Taking into account expected funding, GiveWell estimates that Malaria Consortium could use up to an additional $44.7 million to support the work of its existing programs in Burkina Faso, Chad, Nigeria, and Togo until 2022-23.¹⁰

What are the major open questions?

While there is evidence that anti-malarial drugs reduce the prevalence of malaria in the short term,¹¹ there are some concerns that the use of these drugs may result in increased drug resistance among malaria parasites, or reduction in natural immunity among target populations.¹² Research on these concerns is not yet conclusive, but some studies have shown increased resistance to drugs among malaria parasites in regions where their usage is more common.¹³

More resources

GiveWell report on Malaria Consortium GiveWell report on Seasonal Malaria Chemoprevention Founders Pledge summary report on Malaria Prevention Malaria Consortium’s website

Notes

1. WHO | Regional Office for Africa, “Malaria,” WHO | Regional Office for Africa, accessed January 6, 2021, https://www.afro.who.int/health-topics/malaria. ↩

2. World Health Organization, “Fact Sheet about Malaria,” accessed January 5, 2021, https://www.who.int/news-room/fact-sheets/detail/malaria. ↩

3. Joaniter Nankabirwa et al., “Malaria in School-Age Children in Africa: An Increasingly Important Challenge,” Tropical Medicine & International Health 19, no. 11 (November 2014): 1294–1309, https://doi.org/10.1111/tmi.12374. ↩

4. S. Brooker et al., “Situation Analysis of Malaria in School-Aged Children in Kenya - What Can Be Done?,” Parasitology Today (Personal Ed.) 16, no. 5 (May 2000): 183–86, https://doi.org/10.1016/s0169-4758(00)01663-x. ↩

5. Sergi Alonso et al., “The Economic Burden of Malaria on Households and the Health System in a High Transmission District of Mozambique,” Malaria Journal 18, no. 1 (November 11, 2019): 360, https://doi.org/10.1186/s12936-019-2995-4. ↩

6. Annie Haakenstad et al., “Tracking Spending on Malaria by Source in 106 Countries, 2000–16: An Economic Modelling Study,” The Lancet Infectious Diseases 19, no. 7 (July 1, 2019): 703–16, https://doi.org/10.1016/S1473-3099(19)30165-3. ↩

7. World Health Organization, “Fact Sheet about Malaria.” ↩

8. Haakenstad et al., “Tracking Spending on Malaria by Source in 106 Countries, 2000–16.” ↩

9. “Malaria - Prevention,” nhs.uk, October 23, 2017, https://www.nhs.uk/conditions/malaria/prevention/. ↩

10. GiveWell. (2020). Malaria Consortium - Seasonal Malaria Chemoprevention: Is there room for more funding?. Retrieved 1 March 2021. From https://www.givewell.org/charities/malaria-consortium#Roomformorefunding ↩

11. GiveWell. (2020). Malaria Consortium - Seasonal Malaria Chemoprevention: Have malaria rates decreased in target populations?. Retrieved 1 March 2021. From https://www.givewell.org/charities/malaria-consortium#Have_malaria_rates_decreased_in_targeted_populations ↩

12. GiveWell. (2020). Malaria Consortium - Seasonal Malaria Chemoprevention. Retrieved 1 March 2021. From https://www.givewell.org/charities/malaria-consortium#Are_there_any_negative_or_offsetting_impacts ↩

13. “Resistance to sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) is associated with specific gene mutations in the malaria parasite. Monitoring the prevalence of these markers, in malaria cases health facilities and in P. falciparum carriers in the general population, permits early warning of emerging problems with drug resistance.” ACCESS-SMC. (2017). SMC evaluative studies: Monitoring the prevalence of drug resistance molecular markers. Retrieved 1 March 2021. From https://files.givewell.org/files/DWDA%202009/Malaria%20Consortium/ACCESS-SMC_Progress_update_Resistance_monitoring.pdf ↩

14. Malaria Consortium. (2021). What We Do. Retrieved 1 March 2021. From https://www.malariaconsortium.org/pages/what-we-do.htm ↩