Intermittent preventive treatment in infants (IPTi) for malaria provides preventive antimalarial medicine to children under 12 months old. It is among the most promising programs we’ve identified in our active pipeline of new interventions. It’s also underutilized, and the population it targets is especially vulnerable to malaria. That implies potential to open up large amounts of room for more funding if IPTi begins to be used more widely—our crude estimate is between $50 million and$200 million globally once it’s scaled—which is something we’re increasingly thinking about as we aim to direct $1 billion in cost-effective funding by 2025. In September 2021, we recommended a small grant to Malaria Consortium and PATH to assess the feasibility and cost-effectiveness of implementing IPTi at national scale in two countries. We’re hopeful that this scoping exercise will answer some of our many open questions about IPTi, and that this intervention continues to look promising as we learn more. Read More # Initial thoughts on malaria vaccine approval The World Health Organization (WHO) recently recommended the widespread use of the malaria vaccine RTS,S/AS01 for children. It provides an additional, effective tool to fight malaria. This is great news! We’ve been following this vaccine’s development for years and, in the last few months, have been speaking with organizations involved in its development and potential wider rollout. Our work on RTS,S (and other malaria vaccines) is ongoing, and we might significantly update our views in the near future. But because we’ve been following its progress, we’re sharing some initial thoughts. Read More # GiveWell donors supported more than direct delivery: AMF and new net research Supporters of the Against Malaria Foundation in recent years may have had even more impact than they expected. The Against Malaria Foundation (AMF) is a GiveWell top charity because we believe its program to distribute insecticide-treated nets prevents people from dying of malaria. AMF-supported net distributions are incredibly cost-effective; we estimate that a$2,000-3,000 donation averts one death.[1] AMF’s work is important in and of itself to fund.

Not all AMF donations, however, just support typical net distributions. In recent years, AMF supported research on a new type of insecticide-treated net, the piperonyl butoxide (PBO) net. This research itself (i.e., researcher time, equipment, and administrative costs) was funded by a small number of AMF donors who explicitly agreed to support it. The research was conducted on nets that were contributed by a broad group of AMF donors.

Preliminary data suggest that PBO nets are more effective at preventing malaria than standard insecticide-treated nets in areas where mosquitoes have developed insecticide resistance. We think it is likely that AMF sped up the completion of a large-scale, high-quality study of these new nets.

We’re thrilled to recommend charities that contribute research in the fields in which they operate. AMF doesn’t just prevent deaths from malaria by distributing nets—it has improved our and others’ understanding of which nets can work best in the future. This post is to share this story with our donors, whose contributions make this work possible.

## Summary

In this post, we’ll discuss:

• Insecticide resistance and the potential of PBO nets. (More)
• AMF’s role in PBO net research. (More)

# Our recent visit to Burkina Faso

GiveWell staff recently visited Burkina Faso to meet with staff of one of our top charities, Malaria Consortium’s seasonal malaria chemoprevention (SMC) program, and observe its work. Through its SMC program, Malaria Consortium distributes preventative anti-malarial medication at a time of year when it is needed most.

As I write below, GiveWell donors have directed more than \$37 million to Malaria Consortium over the last 18 months at our recommendation. We expect that this will provide preventative treatments to 4.8 million children and avert over 16,000 deaths. We’re so appreciative of the support of our community in enabling this tremendous impact.

We originally sent a version of the following message to supporters of Malaria Consortium’s SMC program in late August. We received positive feedback on this message and decided to share it more broadly on our blog. We plan to publish more information about the 2019 Burkina Faso site visit in the future.

Hello from Burkina Faso!

I’m here on a site visit of Malaria Consortium, one of our recommended charities, to see its malaria prevention program in action.

This visit helped me relate more deeply to the program by getting to know some of the people who run it and some of the people who benefit from it. I wanted to share my experience with you.

# Why we don’t use subnational malaria mortality estimates in our cost-effectiveness models

### Summary

We recently completed a small project to determine whether using subnational baseline malaria mortality estimates would make a difference to our estimates of the cost-effectiveness of two of our top charities, the Against Malaria Foundation and Malaria Consortium. We ultimately decided not to include these adjustments because they added complexity to our models and would require frequent updating, while only making a small difference (a 3-4% improvement) to our bottom line.

Though this post is on a fairly narrow topic, we believe this example illustrates the principles we use to make decisions about what to include in our cost-effectiveness model.