Malaria Consortium — LLIN Funding Gap Scoping

Published: January 2021

Note: This page summarizes the rationale behind a GiveWell Incubation Grant to Malaria Consortium. Malaria Consortium staff reviewed this page prior to publication.

The intervention

Long-lasting insecticide-treated net (LLIN) distributions are intended to reduce the burden of malaria by distributing free LLINs to households in areas with high malaria transmission. LLINs are designed to be hung over beds to prevent malaria-carrying mosquitoes from infecting people while they sleep. Mass LLIN distributions have been shown to reduce child mortality from malaria and are one of the most cost-effective interventions we've identified for saving lives. See our intervention report on mass distribution of LLINs for more detail.

The organization

Malaria Consortium's seasonal malaria chemoprevention (SMC) program is a GiveWell top charity. Based on its work on SMC, we believe the organization has a strong track record of implementing large-scale malaria prevention programs.2

Planned activities

The grant was intended to pay for staff time spent collecting information on the funding situation for LLIN campaigns in several countries and suggesting priorities for additional funding for LLIN campaigns.3

Malaria Consortium expected to focus on Nigeria, Uganda, and possibly Mozambique. These countries were chosen based on their high malaria burdens, the likelihood of their peak malaria transmission seasons overlapping with COVID-19 transmission, their LLIN campaign timelines, and the significant staff presence Malaria Consortium has in these countries.4 We expected this work to take place from May 2020 through June 2020.5 (Malaria Consortium sent us reports about completed grant activities for Uganda in July 2020 and for Nigeria in September 2020.)

Case for the grant

We decided to recommend this grant for the following reasons:

• Scoping efforts paid for by the grant had the potential to identify highly cost-effective funding opportunities. Mass LLIN distributions are one of the most cost-effective interventions we've identified for saving lives. Nigeria, Uganda, and Mozambique have high rates of malaria transmission.6 Malaria Consortium had already established local offices and relationships with the Ministries of Health in these countries, which could position it to implement LLIN campaigns in underserved regions if funding gaps were found.7 Additionally, we believed it was possible that the COVID-19 pandemic would divert resources away from malaria prevention efforts at a time when they may have been more needed (if COVID-19 caused disruptions in malaria treatment). Based on these considerations, we believed it was possible that the funding opportunities identified as a result of this grant would be within the range of cost-effectiveness of our top charities.
• The funding opportunities found could be more time-sensitive than our other funding opportunities. We believe it is plausible that funding directed toward these gaps will be used sooner than if we directed it to Malaria Consortium's SMC program or to the Against Malaria Foundation instead, which we believe are the most likely alternative uses of this funding.8
• Malaria Consortium has a track record of delivering a high-quality, large-scale malaria prevention program, and we have thoroughly vetted that track record. Based on our knowledge of Malaria Consortium's past work on SMC and the conversations we've had with Malaria Consortium about potentially funding its LLIN distribution work in the future, we have somewhat high confidence in Malaria Consortium's ability to conduct mass LLIN distributions effectively.
• We believed the grant could make Malaria Consortium more likely to prioritize this work. While Malaria Consortium may have been able and willing to conduct this scoping work without a grant, we believed providing this relatively small amount of funding and agreeing upon the scope and timeline for the project in advance would increase the likelihood that Malaria Consortium would prioritize it more highly than it would have otherwise.

Our process

We had several conversations with Malaria Consortium about potentially funding its mass LLIN distributions. Malaria Consortium then sent us a concept note describing its proposed activities for this grant.

Sources

Document	Source
Malaria Consortium, Concept note, April 2020, Redacted	Source

• 1

  See this page for all of our published content on the Against Malaria Foundation.

• 2

  See all of our published content on Malaria Consortium's seasonal malaria chemoprevention program here.

• 3

  "Phase 1: Carry out rapid scoping and delineate priority areas for emergency LLIN distribution in 2020 in the context of COVID-19 pandemic

  • Gather available data to identify gaps in LLINs and operational funds in Nigeria, Uganda and Mozambique in relation to distribution campaigns scheduled in 2020. Campaign planning documents, campaign progress reports, logistics (e.g. procurement and delivery reports), donor funding allocations, and any gap analysis data in relation to net distribution campaigns in 2020 will be obtained from national malaria programmes and other sources to estimate additional resource needs. The unprecedented nature of the pandemic meant that initially planned operational budgets in these countries are insufficient as additional delivery costs, PPE items and changes in distribution strategies will be required. These unexpected extra costs will be estimated, and timing impacts overlaid.
  • Analyze climatic, epidemiological, entomological (vector species, abundance and insecticide resistance), vector control coverage, and demographic situations for rapid selection of priority areas to be targeted. Although WHO estimated the risk in each of increased number of malaria cases in each of these countries under various scenarios, impacts of delayed campaigns in different parts of the countries in relation to the above factors still needs to be worked out in order to identify areas that should be prioritized.
  • Delineate priority target areas for emergency LLIN distribution and determine type of nets based on gathered information (target areas are defined as local government areas or LGAs in Nigeria, sub-counties in Uganda, and districts in Mozambique)."

  Malaria Consortium, Concept note, April 2020, Redacted, p. 2

• 4

  "Nigeria and Uganda have been identified as priority countries for this project. Mozambique is also under consideration. The countries were selected due to high number of malaria cases, potential overlap of the peak malaria transmission season with the COVID-19 transmission, their LLIN campaign timelines, and presence of Malaria Consortium (MC) country offices with close working relations with their respective ministries of health." Malaria Consortium, Concept note, April 2020, Redacted, p. 1

• 5

  See Malaria Consortium, Concept note, April 2020, Redacted, p. 4, "Timelines" table.

• 6
  • "The countries were selected due to high number of malaria cases, potential overlap of the peak malaria transmission season with the COVID-19 transmission, their LLIN campaign timelines, and presence of Malaria Consortium (MC) country offices with close working relations with their respective ministries of health." Malaria Consortium, Concept note, April 2020, Redacted, p. 1
  • From our review of the Against Malaria Foundation: "'Over 50% of all cases globally were accounted for by Nigeria (25%), followed by the Democratic Republic of the Congo (12%), Uganda (5%), and Côte d'Ivoire, Mozambique and Niger (4% each).' Pg. 6 of this report."

• 7

  "The countries were selected due to high number of malaria cases, potential overlap of the peak malaria transmission season with the COVID-19 transmission, their LLIN campaign timelines, and presence of Malaria Consortium (MC) country offices with close working relations with their respective ministries of health." Malaria Consortium, Concept note, April 2020, Redacted, p. 1

• 8

  Additional funding directed to Malaria Consortium's SMC program now would likely be spent in 2022 or 2023. Additional funding directed to the Against Malaria Foundation now would likely be spent in late 2021 or 2022 (more in this blog post).