Long-Lasting Insecticide-Treated Nets

Many friends I’ve talked to about effective charities don’t know about long-lasting insecticide-treated nets (LLIN) and how using LLINs is most of the most cost-effective ways to save lives. I didn’t know much about it either, and part of that ignorance had given me enough confusion to procrastinate on donating to effective charities.

This short post brings together a series of facts that tipped me over the decision boundary from not donating any of my income to pledging 2% of my gross income this year to effective charities, 50% of that money which is towards the Against Malaria Foundation, which uses its money to purchase and distribute LLINs in endemic areas devastated by malaria.

Bulletpoints

  • Malaria is a horrible disease that can cause fever, chills, headaches, vomiting, sweats, and aches. These symptoms lasts for about 2 weeks with treatment, but treatment symptoms can sporadically relapse through many years. 1
  • It caused approximately 429,000 deaths worldwide in 2015. The number of casualties would be as if four 9/11 attacks happened every day, 365 days a year. 2
  • Malaria can be demonstratively solvable through the distribution of long-lasting insecticide treated nets (LLINs) to malaria-infested areas.
  • Each LLIN costs about $4.85 to manufacture AND distribute. 3
  • Every 100 to 1000 mosquito nets purchased saves about 1 person’s life (not accounting for the effects of infected and treated malaria patients)
  • You can use your donations to deduct your income taxes and large companies (like Microsoft and Google) offer charity matching, so you can double your impact. 4

Donate here: https://www.againstmalaria.com/Fundraiser.aspx?FundraiserID=7744

Summary

The World Health Organization estimates that in 2015 malaria caused 212 million clinical episodes, and 429,000 deaths.5

Malaria is transmitted by the genus of mosquitoes under Anopheles. What is particularly relevant for LLINs is that Anopheles tend to bite at night, which means the highest exposure of malaria transmission is at night 6. Mosquito nets work at preventing malaria largely because these mosquitos’ feeding patterns.

Not all mosquito nets are made the same, and the different type of mosquito nets you donate has strong implications on how successful a charity is at preventing malaria.

Normal Mosquito nets: These are mosquito nets that physically separate a person and mosquitos. These are the cheapest solution and an upgrade from no mosquito net but are not nearly as effective as the mosquito nets we’ll talk about below. When people say malaria nets, this is the type of net I use to imagine how effective it would be at preventing malaria, which it is not.

Insecticide Treated Nets (ITN): ITNs are mosquito nets with insecticide woven into the fabric. When a mosquito lands on an ITN, the chemicals from the ITN rubs off on the mosquito and kills it.

Unlike normal mosquito nets, even a damaged ITN or a net that has holes can be effective since most mosquitos cannot maneuver through the holes without touching the net and therefore would have to land on the insecticide, thereby causing knockout.

Most ITNs have their insecticide wear off in about 6 – 12 months. A worn-out ITN has to be retreated before it can be used again.

The nice thing about ITNs is that each ITN has a positive externality of killing malaria-carrying mosquitoes and preventing those mosquitos from biting other people in a city or village, even those without mosquito nets.

Long-Lasting Insecticide-Treated Nets (LLIN): To be approved by WHO as an LLIN, a insecticide-treated mosquito net must last 4-5 years. Comparing to 6 – 12 months, LLIN’s are worth 4 – 10 times more than ITN’s. This makes LLINs much more preferable than ITNs, since distribution of mosquito nets are logistically difficult in rural areas, and distribution on average accounts for about half the cost of distributing LLIN’s. 7 Each LLIN costs about $2.5 – 3 8

Common Objections

Taking Against Malaria’s Risk Register’s quotes and data.

Misusing Mosquito Nets

“What if the people handed these mosquito nets don’t use them for their intended purposes?” (example)

“Data shows correct net use is very high, but  this will continue to be monitored.”9

Theft or Corruption

“Will most of the nets make it to village if there is rampant theft or corruption?”

“Against Malaria Foundation considers this the greatest risk of achieving effective distribution. So far there has been no material loss of nets  through theft. This is based on extensive  data‐based reporting immediately post‐ distribution as well as regular post‐ distribution net use and condition check‐ups  (PDCUs) which can reveal immediate and  subsequent material theft of nets. However,  AMF is aware all countries in which nets are  needed are prone to theft and corruption.  AMF will counter this by continuing to set  high standards of data‐provision and  monitoring and working with distribution  partners with a commitment to this work.”

CTA

Convinced? Donate here10:

https://www.againstmalaria.com/Fundraiser.aspx?FundraiserID=7744

Not convinced? Feel free to comment or message to and I’d be happy to chat.

More Resources

Long overview of insecticide-treated nets

http://www.givewell.org/international/technical/programs/insecticide-treated-nets#Basics

Initially, I was quite surprised by how few lives I can save with $100 considering all the charities advertisements I’ve been bombarded saying how “$10 could save a child’s life.” To understand a bit more in-depth how cost-effectiveness works, I suggest reading Givewell’s criteria for measuring cost-effectiveness.

http://www.givewell.org/how-we-work/our-criteria/cost-effectiveness

High level cost-effectiveness analysis of average cost per life saved

https://docs.google.com/spreadsheets/d/1TZ-9eP0et9eYPRj2il4l1UCGS3xmqWarucW5UKQCBIU/edit#gid=1537947274

Want to learn more about applying rationality to philanthropy? You can start here by reading this career guide:

https://80000hours.org/career-guide/introduction/

  1. https://www.drugs.com/health-guide/malaria.html
  2. http://www.who.int/gho/malaria/epidemic/deaths/en/
  3. http://www.givewell.org/charities/against-malaria-foundation
  4. https://www.irs.gov/uac/eight-tips-for-deducting-charitable-contributions
  5. https://www.cdc.gov/malaria/about/facts.html
  6. https://www.cdc.gov/malaria/about/biology/mosquitoes/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3348006/pdf/1478-7547-10-5.pdf
  8.  https://www.againstmalaria.com/DollarsPerNet.aspx
  9. https://www.againstmalaria.com/downloads/AMF_RiskRegister.pdf
  10. I use a fundraiser ID to track how my writing contributes to generating more donations to charities I care about. I don’t get commission from your donations.

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