Against Malaria Foundation

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Mosquito nets against malaria

The Against Malaria Foundation (AMF) saves lives by distributing mosquito nets in developing countries to protect people from malaria. As the mosquitoes that transmit malaria are nocturnal, the risk of contracting malaria is significantly reduced if you sleep under a mosquito net. In the fifteen years between 2000 and 2015, the use of mosquito nets prevented around 450 million cases of malaria and saved around 900,000 lives.

The problem

Over the past two decades, significant successes have been achieved in the fight against malaria. According to estimates by the World Health Organization WHO two billion illnesses and almost twelve million deaths could be prevented between 2000 and 2021.[1] However, progress has stagnated since 2015 and the number of cases even rose again during the Covid-19 pandemic in 2020 and 2021.

Almost 250 million people worldwide still contract malaria every year, especially on the African continent.[2] The disease is fatal for more than 600,000 of them.[3] Over 70 percent of the fatalities are children under the age of five - that's over 1,000 children a day.[4] Every fourteenth child who dies worldwide dies of malaria; in sub-Saharan Africa it is one in eight.[5] 

Even if the disease is not fatal, people suffer enormously. In addition to flu-like symptoms, malaria can lead to permanent visual impairment, hearing loss or epilepsy. The life situation of sufferers worsens not only because they have to pay for visits to the doctor and medication, but also because they cannot go to school or work during an acute attack.

The solution

The best way to avoid contracting malaria is not to be bitten in the first place. The mosquitoes that transmit malaria are particularly active at dusk and at night. Long-lasting insecticide-treated mosquito nets therefore provide very reliable protection against the disease. The mosquito nets are made of polyethylene fibers. An insecticide is incorporated into these fibers in such a way that it slowly leaks out over several years.

A mosquito net thus protects in two ways: firstly, mosquitoes are physically prevented from biting humans. Secondly, the mosquitoes die on contact with the insecticide. The odorless insecticide is harmless to human health. Since 2007, the World Health Organization has recommended that insecticide-impregnated mosquito nets be distributed to every household in malaria regions.[6] As mosquitoes in many areas are now developing resistance to the pesticides, the nets increasingly have to be treated with other active substances, meaning that the WHO recommendations are constantly being developed and adapted.[7]

Mosquito nets are the most widely used measure to combat malaria. According to the WHO around 2.5 billion impregnated mosquito nets for malaria prevention have been distributed worldwide since 2005.[8]

Moksito nets (Alternative text)
Two children from Pujehun in Sierra Leone are happy about mosquito nets
A little girl holds a mosquito net.
A little girl from Odisha (Orissa) in India holds a mosquito net she received as part of a distribution campaign supported by the Against Malaria Foundation.

The effect

The extraordinarily high effectiveness of mosquito nets has been proven in several studies. A meta-study from 2004 shows that, on average, 5.5 out of 1,000 children who sleep under mosquito nets can be prevented from dying of malaria every year - a very high figure when you consider how simple it is to distribute nets for 1,000 children.[9]

Other studies show that pregnant women who sleep under mosquito nets give birth to healthier babies and have fewer stillbirths.[10] In the fifteen years between 2000 and 2015, around 450 million malaria infections in Africa were prevented by mosquito nets and around 900,000 lives were saved.[11]

The economic benefits of a reduction in malaria infections are also immense: a study that measured the correlation between expenditure on malaria control and gross domestic product in twelve African countries between 2007 and 2011 came to the conclusion that every €1 spent on malaria control increased the countries' gross domestic product by €6.75 - an extraordinarily high figure.[12]

The organization

The Against Malaria Foundation was founded in 2005 by Rob Mather and has since financed almost 250 million mosquito nets. Since 2009 AMF by GiveWell as a "Top Charity". In addition to its outstanding impact, the organization also stands out positively from many other aid organizations thanks to its transparency: For example, the Against Malaria Foundation publishes their own budget in real time and also publicly states which donation was made for exactly which net .


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FAQs

How long do the mosquito nets protect?

A durable, insecticide-impregnated mosquito net can provide protection for up to five years. During this time, it can also be washed without losing its protective effect. Thanks to the insecticide it contains, the net remains effective even if it already has small holes.

How much does a mosquito net cost?

AMF only distributes durable, insecticide-impregnated mosquito nets that meet the requirements of the Pesticide Evaluation Scheme of the WHO. AMF estimates the cost of buying a mosquito net at around $2. If the costs of distributing and checking the distributed mosquito nets are also taken into account, the costs amount to $4.89, or $5.19 if donations in kind from governments are also taken into account. [13]

Are the mosquito nets used for other purposes, for example as fishing nets?

There are repeated reports of mosquito nets distributed free of charge being misused, e.g. as fishing nets. However, the number of such cases is very low. The Against Malaria Foundation makes home visits to ensure that the nets are hung up correctly and used for as long as possible. In addition, the organization has been one of the first aid organizations to use smartphones in the field since 2014, which makes monitoring even more effective and detailed.[14]

External evaluation

Sources

[1] ↑ World malaria report 2022, World Health Organization (WHO). https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2022. December 2022.

[2] ↑ World malaria report 2022, World Health Organization (WHO). https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2022. December 2022.

[3] ↑ The World Health Organization states 619,000 deaths in the "World malaria report 2022". Based on a slightly different methodology, the "Global Burden of Disease (GBD) Project, estimates that more than 643,000 people worldwide died from malaria in 2019. See also: Max Roser and Hannah Ritchie. Malaria. Our World in Data. https://ourworldindata.org/malaria. Last updated February 2022.

[4] ↑ Max Roser. Malaria: One of the leading causes of child deaths, but progress is possible and you can contribute to it. Our World in Data. https://ourworldindata.org/malaria-introduction. March 2022. See in particular footnotes 2 & 3 of the source: The WHO estimates that around three quarters of all deaths will be among children under the age of 5, i.e. more than 450,000 in 2021. "Global Burden of Disease"-study estimates that the majority of malaria deaths affect children under the age of 5. According to their research, the proportion of children under 5 years of age among malaria victims has decreased slightly over the last generation, from 66 % in 1990 to 55 % in 2019. This corresponds to 356,000 deaths among children under 5 years of age in 2019. It is not entirely clear why the IHME estimates differ in their age composition from the WHO estimates.

[5] ↑ Institute of Health Metrics and Evaluation (IHME). Malaria. Global Burden of Disease Study 2019. https://www.healthdata.org/results/gbd_summaries/2019/malaria-level-3-cause. October 2020. 

[6] ↑ WHO Guidelines for Malaria. World Health Organization. https://www.who.int/teams/global-malaria-programme/guidelines-for-malaria. March 2023. 

[7] ↑ WHO publishes recommendations on two new types of insecticide-treated nets. World Health Organization. https://www.who.int/news/item/14-03-2023-who-publishes-recommendations-on-two-new-types-of-insecticide-treated-nets. March 2023. 

[8] ↑ World malaria report 2022, World Health Organization (WHO). https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2022. December 2022. 

[9] ↑ Christian Lengeler. Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database of Systematic Reviews. https://www.ncbi.nlm.nih.gov/pubmed/15106149. 2014. 

[10] ↑ Carrol Gamble et al. Insecticide-treated nets for preventing malaria in pregnancy. Cochrane Database of Systematic Reviews. https://www.ncbi.nlm.nih.gov/pubmed/16625591. 2006. 

[11] ↑ Samit Bhatt et al. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015 Nature 526: 207-211. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4820050/. October 2015.

[12] ↑ William Jobin. Suppression of malaria transmission and increases in economic productivity in African countries from 2007 to 2011. MalariaWorld Journal. Vol 5. No. 4. https://www.malariaworld.org/malariaworld-journal/research-suppression-malaria-transmission-and-increases-economic-productivity-african. March 2014.

[13] ↑ Against Malaria Foundation - Cost per LLIN distributed. GiveWell. https://www.givewell.org/charities/amf#CostperLLINdistributed. December 2022.

[14] ↑ Rob Mather. Introduction of smartphone technology to collect distribution data. Against Malaria Foundation. https://www.againstmalaria.com/NewsItem.aspx?newsitem=Introduction-of-smartphone-technology-to-collect-distribution-data. October 2014.