EA - Why GiveWell funded the rollout of the malaria vaccine by GiveWell

Link to original articleWelcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Why GiveWell funded the rollout of the malaria vaccine, published by GiveWell on May 12, 2023 on The Effective Altruism Forum.Author: Audrey Cooper, GiveWell Philanthropy AdvisorSince our founding in 2007, GiveWell has directed over $600 million to programs that aim to prevent malaria, a mosquito-borne disease that causes severe illness and death. Malaria is preventable and curable, yet it killed over 600,000 people in 2021—mostly young children in Africa.[1]Following the World Health Organization’s approval of the RTS,S/AS01 malaria vaccine (RTS,S) in late 2021,[2] GiveWell directed $5 million to PATH to accelerate the rollout of the vaccine in certain areas of Ghana, Kenya, and Malawi. This grant aimed to enable these communities to gain access to the vaccine about a year earlier than they otherwise would, protecting hundreds of thousands of children from malaria.[3]Although we’re very excited about the potential of the RTS,S malaria vaccine to save lives, it isn’t a panacea. We still plan to support a range of malaria control interventions, including vaccines, nets, and antimalarial medicine.In this post, we will:Explain how we found the opportunity to fund the malaria vaccineDiscuss why we funded this grantShare our plan for malaria funding moving forwardIdentifying a gap in vaccine accessIn October 2021, we shared our initial thoughts on the approval of the RTS,S malaria vaccine by the World Health Organization (WHO). At that point, we weren’t sure whether the vaccine would be cost-effective and were not aware of any opportunities for private donors to support the expansion of vaccine access.In the following months, our conversations with PATH, a large global health nonprofit that we’ve previously funded, revealed that there might be an opportunity to help deploy the vaccine more quickly in certain regions. PATH had been supporting the delivery of the vaccine in Ghana, Kenya, and Malawi as part of the WHO-led pilot—the Malaria Vaccine Implementation Program (MVIP)—since the pilot began in 2019.[4] In order to generate evidence about the effectiveness of the vaccine, randomly selected areas in each country received the vaccine during the early years of the pilot, while “comparison areas” would receive the vaccine at a later date, if the vaccine was recommended by the WHO.[5]Once the vaccine had received approval from the WHO, the WHO and PATH believed there was an opportunity to build on the momentum and groundwork of the pilot to roll out the vaccine to the comparison areas as soon as possible. However, the expectation at the time was that expanding use to the comparison areas would need to wait for the standard process through which low-income countries apply for support to access vaccines from Gavi, the Vaccine Alliance.[6] This process would have made it possible to introduce the vaccine at the end of 2023 at the earliest.[7]However, there was another path through which these vaccines could be provided more quickly. GlaxoSmithKline (GSK), the vaccine manufacturer, had committed to donate up to 10 million vaccine doses as part of its support for the MVIP.[8] This quantity of vaccine was set aside to allow completion of the pilot program, including vaccination in the comparison areas.[9] However, additional support was needed to be able to utilize these vaccines in advance of Gavi financing, including (for example) funding to cover the costs of safe injection supplies and vaccine shipping and handling, as well as the technical assistance required to support vaccine implementation.With funding from GiveWell, PATH believed it could provide the necessary technical assistance to the ministries of health in Ghana, Kenya, and Malawi to support them in using the donated vaccines from GSK and expand vaccine access to the comparison areas at the end of 202...