[1] According to the World Health Organization, the estimated number of malaria in 2024 was 610,000 (561,000–738,000). World Health Organization, World Malaria Report 2025, p. 8, Table 2.1.
"The WHO African Region continues to carry a disproportionately high share of the global malaria burden. In 2024 the Region was home to about 95% of all malaria cases and deaths. Children under 5 years of age accounted for about 76% of all malaria deaths in the Region." World Health Organization, Malaria Fact Sheet, December 2025. More than 70% of total malaria deaths were children under five years old in Africa (95% of total malaria deaths in Africa multiplied by 76% of malaria deaths occurring in children under five results in 72.2%).
"In 2024, four countries—Nigeria (30.3%), the Democratic Republic of the Congo (11.1%), the Niger (5.8%) and the United Republic of Tanzania (4.3%)—accounted for just over half of all malaria deaths globally." World Health Organization, World Malaria Report 2025, p. 11.
[2] This is by far GiveWell’s largest grant, more than double the size of what had been our largest grant: $96.3 million to AMF to support nets campaigns in Chad, DRC, Nigeria, and Zambia.
[3] The grant is being funded by approximately $57.9 million from donations to the Top Charities Fund, $212.2 million from Coefficient Giving, and $5.8 million in rollover funds. Figures are rounded.
[4] This covers around 30% of the total expected distribution costs; we expect most of the distribution costs to be covered by funding from the Global Fund. We expect the grant to lead to net campaigns happening in roughly 16 provinces that would not otherwise receive mass campaigns during this cycle. Without GiveWell funding, we expect that DRC’s national malaria program (Programme National de Lutte contre le Paludisme, or PNLP) would likely exclude many provinces from the campaign due to insufficient funding, and/or use strategies other than universal coverage campaigns (e.g., continuous distribution, campaigns with lower caps on nets per household, or campaigns using community health workers). While we’re not certain which provinces would be covered without our support, as campaign planning is ongoing, we have a rough sense based on the latest prioritization done by PATH, which provides technical support to the DRC malaria program.
[5] AMF typically surveys households 9, 18, and 27 months after nets are distributed. These surveys reach hundreds of thousands of households in DRC. AMF reviews and compiles digitally collected data from household registration and net distribution, and it also contracts a local firm to conduct an audit of survey data by visiting a sample of households to confirm that distribution occurred as reported. AMF also contracts an independent monitor to attend stakeholder meetings, flag challenges to AMF, and shadow training, planning, and distributions of nets at 40 villages per province and to shadow backchecks at 10 villages per province. More details here.
[6] With the exception of an $9.6 million grant approved in August 2025 that supported distribution costs in Ituri province.
[7] Our specification follows Dolan et al. 2019, which is a cohort difference-in-differences analysis comparing cumulative under-five mortality across birth cohorts within each province. It compares children born after the province’s campaign against those born just before, using the staggered campaign timing across provinces to identify the effect and province-specific trends absorbing background mortality decline. The sample is restricted to rural areas with above-median malaria ecology. In our analysis of the 2023-2024 DHS data, we found that children under five born the year after a campaign show 1.3 percentage points (16%) lower mortality (95% CI −2.8 to +0.3 pp, p = 0.107; post-campaign cohorts jointly p = 0.021); in comparison, GiveWell’s cost-effectiveness analysis predicts a 28% first-year reduction in malaria mortality. In this rural, high-transmission sample, up to half of all-cause mortality may be malaria-attributable, implying a first-year all-cause mortality reduction of at most ~14%.
[8] For example, the 2017-2018 MICS reported that 39% of children tested using rapid diagnostic tests were infected with malaria and 31% were positive when using microscopy to check blood samples. PMI, DRC Malaria Profile, Aug 2023, p. 1. See also the 2023 DHS, p. 299, which showed 32.8% malaria prevalence among children under five per rapid diagnostic test.
[9] 97% of the population lives in areas with stable malaria transmission for eight to 12 months per year. PMI, DRC Malaria Profile, PMI, 2023, p. 1.
[10] “Between December 3, 2016, and December 31, 2022, 2673 deaths underwent MITS and had a CoD attributed from four CHAMPS sites with at least 1 malaria-attributed death. . . . Malaria was in the causal chain for 42.9% (126/294) of deaths from Sierra Leone." Ogbuanu et al. 2024, abstract.
[11] We’ll also collect additional data to assess whether increasing the frequency is effective at further reducing malaria rates.
[12] See our analysis of ITN durability here, based on the U.S. President's Malaria Initiative, "Durability Monitoring of LLINs in Democratic Republic of Congo," 2019.