Mission Possible: End Malaria
In troubled times like today, ridden by international conflict, inter-group hatred and multilateral disorder, some of the first lessons from recent history to go out the window are 1) The need to address long-term societal challenges, 2) the rationale for doing so collectively.
As has been shown most rigorously and viscerally with the case of world peace, the benefits of a peace dividend are easy to communicate (yet seemingly harder to convey to world leaders).
By maintaining largely peaceful relations with your neighbors and at the global stage at large, each country’s government needs to allocate less of the national budget (and GNP) towards military and defensive capabilities. Holding a standing army, at the ready to enforce national borders in the unlikely (yet highly consequential) situation a foreign adversary were to attack, is expensive. A smaller border defense force is cheaper. For each country and in the aggregate.
With each war, each threat from increasingly bold authoritarian ruler and each bombing of militias across the world, this peace dividend falters.
Yet, increased attention to military and defense purposes represents not only a fiscal strain, but also a cognitive one. The threat of war or invasion is imminent, near-term and quite salient to most people. It will force itself into the front and center of national politics, and inevitably crowd out other pressing, yet longer-term threats and concerns.
One class of such concern, increasingly on scientists’ radar, yet quickly diminishing from public spotlight, is the emergence of novel virus strains, antibacterial resistance among urban wildlife or livestock and proliferation of other neglected tropical diseases. For the most part, communicable diseases, bacteria and parasites such as malaria and dengue fever are carried by mosquitoes. And the mosquitoes are turning more comfortable and cuddlier to urban centers of human settlement…
For many years (at least the last two decades), things have been looking brighter. In 2000, malaria was identified as one of the biggest impediments to global development and selected as a critical global target of the Millennium Development Goals (MDGs). By the time status was made by the WHO in 2015, malaria incidence had fallen by 37% globally and death rates by 60%. WHO has later estimated that malaria deaths fell from 897,000 in 2000 to about 619,000 in 2021. The same year, scientists even suggested mosquitos could be genetically modified to eradicate the disease carte blanche.
Now, however, this cause of death is on the rise. The main reason: increasingly adaptive and resistant species of malaria-carrying mosquitoes.
A dramatic change in conditions, mosquito evolution and — horrifyingly — antibiotic resistance — could lead to failure of meeting the UN sustainable development goal #3, target 3.3: “By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases”.
Malaria and other mosquito-borne viruses are actually one of the main causes of premature deaths globally, causing about 620 000 deaths each year. As laid out in this report from The New York Times, one big reason for this is climate change and the loss of wild habitats, insect-eating predators and new patterns in human settlement. More recently, as adeptly reported by New York Times-journalist Stephanie Nolen , one particular malaria-carrying species of mosquito, Anopheles stephensi, that first emerged on health official’s radar about a decade ago, is becoming resistant to most (if not all) of the cheapest and most accessible preventive measures, such as insecticides.
What is more, the mosquitos are becoming better adapted to survive the dry season — and even thrive in areas formerly believed to be safe from malaria, such as coastal cities and the continental interior. This means a large new population (researchers have estimated additional 126 million people) is becoming susceptible to mosquito-borne malaria, especially vulnerable children under the age of 5 in the poorer regions of sub-Saharan Africa. This effectively threatens to undermine most if not all progress on promoting malaria prevention measures over the last decade.
This is why I believe the work of The Against Malaria Foundation is more important than ever. This small-scale foundation has brought the issue to global concern, raised funds and ensured the mass distribution of insecticide-treated nets. Through collaborating with each country’s national malaria program and other partner organizations to distribute these nets in mass distribution campaigns, they have provided more than 200 million nets to millions of households in more than 8 malaria-endemic countries, largely in Africa. These nets have likely prevented more than 150 000 deaths by malaria and other communicable diseases.
The provisioning of life-saving nets, moreover, is proven highly cost-effective. In fact, GiveWell, an organization that vets charities and verifies their aid claims, considers it one of the most effective donations you can make. Based on a price of $5 per net, GiveWell estimates the cost per life saved at $5000, one of the most cost-effective interventions around.
Even after several years of effective campaigning and fund-raising by AMF, GiveWell and Effective Altruists around the world, there remains a considerable funding gap (as explained here https://www.givewell.org/charities/amf#Identifying_funding_gaps).
Filling this gap can make a big impact — providing another 1,8 million nets to households could save about 1600 lives, according to GiveWell.
Therefore, I have decided to give most of my annual donations to the Against Malaria Foundation and I challenge you to join me in supporting their important mission: To end death by malaria!
What is more: I suggest you do it annually, through the portfolio management programs of either
1) Giving What We Can: https://www.givingwhatwecan.org/donate/organizations
or to a Norwegian audience;
2) Gi Effektivt: https://gieffektivt.no/gi-en-donasjon
Further reading:
You can read more about the work of AMF here: https://www.againstmalaria.com/HowWeDoIt.aspx
More on how GiveWell calculates the program effectiveness: https://www.givewell.org/charities/amf#Summary
More on how the EA community prioritizes ‘global problems’: https://80000hours.org/problem-profiles/
A WHO progress report on Malaria from 2015: https://iris.who.int/bitstream/handle/10665/184521/9789241509442_eng.pdf?sequence=1