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US$35m milestone passed!


We have now passed the US$35 million mark - thanks to a donation from New Jersey, USA!
 
We are also about to achieve 110,000 donations. As always, our sincere thanks to everyone for their support and generosity.
 
You can see all of our previous milestones on our milestone page.
 

Future distributions update


We have updated the information describing potential and future distributions.
 
We are currently discussing nine distributions in eight countries. The total net requirement across these distributions is 30 million nets for distribution in 2015 to 2017. Of these 6 million are in 2015, 4 million in 2016 and 20 million in 2017. We are not in a position to fund all distributions so expect to fund all or a part of a sub-set of these distributions. For the majority of these potential distributions we have agreed co-funding partnerships in principle and for all are in discussion with National Malaria Control Programmes (NMCPs) and/or potential distribution partners regarding elements of accountability.
 
We are allocating US$19.6m, sufficient to cover approximately 6 million nets.
 
In addition, AMF has been asked by the Malawi NMCP to continue to support malaria control activities in the four districts of Ntcheu, Balaka, Dedza and Dowa in 2018. This is a 1.5 million LLIN, US$6m commitment. We have allocated a further 150,000 LLINs to support an immediate flood-related emergency need in Malawi and we have agreed appropriate elements of net tracking and accountability for these nets.
 
You can see more details on our Future distributions page
 
Note: We consider potential distributions three years ahead as this matches the planning cycle of NMCPs and the advance period in which they seek commitments for support. There are also regions where distributions are needed on a shorter timescale, and we act to cover them. More information via Planning horizon and Allocating donations.
 

US$32m milestone passed!


We have now passed the US$32 million mark - thanks to a donation from Australia!
 
We have also just had our 106,000th donation. As always, our sincere thanks to everyone for their support and generosity.
 
You can see all of our previous milestones on our milestone page.

Initial net distribution verification data for West Kasai, DRC



Click on the image to view the GPS location of each of the 234,916 households that received nets
DRC is one of the most challenging countries in the world in which to distribute nets. Distances are vast, infrastructure is poor yet the malaria burden and the need for nets is great.  More than 500 people die from malaria every day in DRC, the majority children under 5.
 
Bringing accountability to a distribution therefore faces additional challenges.
 
The most important initial ingredient is a distribution partner who shares a strong desire to distribute nets accountably. In DRC we work with IMA World Health.
 
A new ingredient is the smartphone. The contrast between this cutting edge technology and the environment in which it is deployed could not be more stark but the smartphone has the potential to be a powerful tool in the fight against malaria.
 
Its use is in data collection. Rather than using paper and pen to note down household details and record nets distributed, and then face the logistical challenge of aggregating in one place from distant locations the information on many, many pieces of paper (approximately 7,000 for a 676,000 net distribution) data can be uploaded to a computer and aggregated with relative ease for correction, verification and analysis. And sharing. This last point is important as information in electronic form can be easily shared facilitating transparent review by interested parties, including health leaders and programme funders – thereby delivering accountability. 
 
Update on West Kasaï 
 
The distribution of 676,000 nets in West Kasai, DRC was completed in December 2014.
 
We are currently reviewing the distribution verification data and post-distribution report with our distribution partner, IMA World Health, and expect to publish a full report in the next few weeks.
 
This distribution is the first that both parties have undertaken using smartphones to collect household-level data. We expect teething problems, as with any new introduction of technology, especially in a country such as DRC. However, we are undeterred by this, as the benefits of improving processes in this region are so significant.
 
Typically, pen and paper are used to record such information during the registration and distribution process.  We have written previously about the potential for smartphone-based data collection.
 
Smartphones installed with a data collection program, created using open source software, were used to collect household-level data including how many nets were given to each individual household.
 
GPS coordinates were recorded for each household receiving nets and these data are being reviewed as one aspect of 'distribution verification' – ensuring nets were distributed to beneficiaries as intended.
 
We will publish a full report and distribution review in the coming weeks but in the meantime wished to share a summary image showing the GPS data received for this distribution. Each pin colour represents one of the eight Health Zones and each pin represents the specific location of one of the 234,916 households that received nets.
 
We believe these data are a promising sign that smartphones could be a powerful and practical tool to help net distributions deliver operational efficiencies and high levels of project accountability.
 

Net use and the importance of data-driven distributions and monitoring


The New York Times recently ran an article reporting that some anti-malarial mosquito nets have been used for fishing and other purposes in a coastal village in Zambia, an area where there are no AMF-funded nets.
 
Potential mis-use of nets is an important issue for anyone concerned with trying to prevent malaria. It is clear some nets were being used for fishing and, anecdotally, this is familiar to all who work in malaria control so it is not a new finding.  
 
The most important issue is scale.

In AMF’s experience over ten years in several hundred distributions across Africa, the number of nets used in ways other than as intended is extremely small.

It would be wrong to ignore these situations and we work to discourage and stop any occurrence of nets being used in this way.

However, it would also be wrong to move from anecdotal evidence of nets being misused, to suggest it is a widespread practice having a material effect on the impact of the nets in preventing malaria. Nets are the most significant mechanism for protecting people from malaria, saving hundreds of thousands of lives every year, far more from illness. We do not believe that we should deprive people of their main defence against a deadly disease because of the risk that they might misuse their net.
 
However, AMF takes a number of steps to stop misuse. We believe that each of them has contributed to the success of our distributions.
  1. Malaria education is key. We work closely with local health officials, the front line health teams and the village and community leaders, to ensure the community is fully aware of the connection between sleeping under intact nets and preventing malaria.

  2. AMF uses extremely rigorous pre-distribution surveys to determine precise net needs, followed by independent checks when the nets are given out to ensure no nets are diverted away from households that need them.

  3. AMF conducts post-distribution check-ups to ensure nets are being used as intended every 6-months during the 3 years following a distribution. People are informed that these checks will be made by random selection, and via unnannounced visits. This gives us a data-driven view of where the nets are and whether they are being used properly. We publish all the data we collect: example here. This type of follow up work is currently unique to AMF, although we hope the practice will become more widespread where it is feasible.
At AMF, the extensive data we have collected verifies that the number of nets we have distributed that are used for fishing is immaterial.

Old nets that have outlasted their effectiveness in the fight against malaria may be made into footballs or other harmless objects and we do not try to interfere with this.
 

Malawi, Balaka District: net use assessment 12-months post-distribution


The 12-months post-distribution net use check-up (PDCU) was recently carried out in Balaka District, Malawi.  Five percent of households, randomly selected, across 14 health centre catchment areas in the district were visited, unannounced, to assess net use and condition.

The data are being entered in Malawi now and may be viewed in real-time. As soon as all data have been entered we will publish a summary of the results.

The specific nature of the data - at the health centre level - means the District Health Officer (DHO), health centre leaders, community leaders and other health workers are able to decide what targeted malaria control intervention might be appropriate in specific areas. In circumstances where health systems and resources are stretched, information that assists with targeted interventions can help with effective use of resources and that is the aim of this information.

Background: Almost 154,230 LLINs were distributed in Balaka District in October and November 2013.

We have reached the 100,000th donation!


What a great way to end the year! We have reached the 100,000th donation thanks to a donor in Sydney, Australia.
 
We have received donations both large and small and every $3 matters as every net matters. 100% of the funds we have received will buy nets and all donors will be able to see exactly where the nets they fund are distributed.
 
Our very best wishes for 2015. 

US$29m milestone passed!


We have now passed the 25, 26, 27, 28 and US$29 million milestones, thanks to a significant US$5m grant from Good Ventures, the San Francisco based philanthropic foundation!
  
You can see all our milestones on the website.

US$5m grant to AMF from Good Ventures


We are absolutely thrilled to have recently been awarded a US$5m grant from Good Ventures, the San Francisco based philanthropic foundation.
 
This is the largest grant AMF has ever received (previously US$1.25m, also from Good Ventures) and it will make a huge impact on fighting malaria, saving many lives, reducing illness and boosting economic growth.
 
It comes at an exciting time for AMF as we work to expand the number and scale of the projects we support. We have no doubt it will be pivotal.
 
Every single donation is important, no matter how large, in the fight against malaria. There is a huge gap between the funding available and the net need. We never forget that every $3 buys a net and every person covered by a net is potentially a life saved. There are now over 99,000 donations to AMF. Together we have built a community that will keep the fight against malaria high on the international agenda. We are aiming to secure a further US$20+m for the projects we are currently considering. Aside the occasional marvellous large donation, the majority of AMF’s funds come from donors giving less than $100 and we are incredibly grateful for every one of them.

We have reached our 99,000th donation!


We have just had the 99,000th donation thanks to a family in Normal, USA and we are looking forward to celebrating the 100,000th soon.

We have received donations both large and small and every $3 matters as every net matters.

100% of the funds we have received will buy nets and all donors will be able to see exactly where the nets they fund are distributed.



Update on AMF activities in Malawi (December 2014)


Ntcheu District (Population: 580,000) - Post-distribution Check-Up (PDCU) at 33-months just completed
The fourth PDCU of net use and condition has been completed, 33 months after the mass distribution of 268,420 nets in January 2012. The PDCU data, that could be followed ‘live’ as it was being entered in Malawi, is now in the final stages of being checked. The results are good.  We will publish shortly a commentary on the results.
 
Dedza District (690,000) - Distribution nearly complete 
245,000 nets have now been distributed protecting 440,000 people and achieving universal coverage in all distribution areas, bar one. Nets have been distributed according to household-level net need information gathered during a comprehensive pre-distribution registration survey (PDRS). The number of nets required for the final ‘mop up’ area is being determined now and they will be distributed early in 2015.
 
Dowa District (700,000) - Pre-distribution Registration Survey (PDRS) underway
Every household in Dowa district, some 165,000, will be visited over the next two weeks by 440 Health Surveillance Assistants (government health service staff) to assess the number of sleeping spaces, perfectly usable nets and therefore net need for each individual household. Supervisors will make unannounced visits to randomly selected households to monitor the accuracy of the data collected. The data collected will be put in electronic database form, cleaned, checked and passed to village and community leaders for a public reading to ensure no omissions or inaccuracies. The final list will form the basis of an accurate net distribution to ensure full sleeping space coverage is achieved with no material theft of nets. This process is managed and supervised by our distribution partner Concern Universal working in close partnership with the Dowa District Health Officer, Malaria Coordinator and District Executive Committee and their teams. 396,900 LLINs have arrived in Dowa and are now in secure storage awaiting distribution in January and February 2015.
 
Balaka District (400,000) - Post-distribution Check-Up (PDCU) at 12-months about to start
The second PDCU of net use and condition is in the final stages of planning and will commence shortly. 5% of the households that received the 154,230 nets in November 2013 will be randomly selected and visited unannounced to assess net use and condition. Supervisors will check 5% of households visited by each data collector to ensure data accuracy. For any PDCU we ask it be carried out within ± 1 month of the appropriate anniversary.

Future distributions update


We are currently in detailed discussions regarding four potential distributions in four different countries (total 2.76 to 4.76 million nets), and four potential distributions are at the information stage. We will provide updates on each as meaningful progress is made or decisions are taken.

You can see more details on our Future distributions page



GiveWell rates AMF a top charity in 2012, 2013 and now 2015!


GiveWell has updated its top charity list and we are delighted to be included.  

"The Against Malaria Foundation (AMF) is one of our top-rated charities, and an organization that we feel offers donors an outstanding opportunity to accomplish good with their donations."

GiveWell conducts extensive research with a particularly high level of rigour and analysis and to date has spent hundreds of hours investigating AMF and our work including a distribution site visit to Africa.

GiveWell comments, "Ranking our top charities against each other is difficult and laden with judgment calls... ...for any donors looking to give as we would, we recommend an allocation of $5 to AMF, $1 to SCI, $1 to GiveDirectly and $.50 to DtWI for every $7.50 given." 

More: GiveWell.org


US$24 million milestone passed!


We have now passed the US$24 million mark - thanks to a donation from Dunstone, United Kingdom!
 
We are also close to reaching our 100,000th donation and 500,000 fundraising participants. Our sincere thanks to everyone for their support and generosity.
 
You can see all our milestones on the website.

Malawi, Ntcheu District: net use assessment 33-months post-distribution


The 33-months post-distribution net use check-up (PDCU) is currently being conducted in Ntcheu District, Malawi.  Five percent of households, randomly selected, across 37 health centre catchment areas in the district were visited, unannounced, to assess net use and condition.
 
The data are being entered in Malawi now and may be viewed as they are entered. As soon as all data have been entered we will publish a summary of the results.
 
The specific nature of the data - at the health centre level - means the District Health Officer (DHO), health centre leaders, community leaders and other health workers are able to decide what targeted malaria control intervention might be appropriate in specific areas. In circumstances where health systems and resources are stretched, information that assists with targeted interventions can help with effective use of resources and that is the aim of this information.
 
We will provide our assessment of the data once all have been entered.
 
Background: 268,400 LLINs were distributed in Ntcheu District from December 2011 to February 2012.

Professor Hilary Ranson joins AMF’s Malaria Advisory Group


Professor Hilary RansonAMF is delighted to announce Professor Hilary Ranson of the Liverpool School of Tropical Medicine (LSTM) has joined AMF’s Malaria Advisory Group (MAG).
 
The MAG advises AMF on many aspects of its activities including assessing target distribution locations and ensuring best practice in carrying out pre-distribution activities (including assessing household level net need and delivering malaria education), distribution management and verification, and post-distribution follow up.
 
Professor Ranson is one of the world’s leading authorities on insecticide resistance (IR). Hilary joined LSTM in 2001 and has been the Head of the Department of Vector Biology since 2010. She leads a portfolio of IR related research and advises widely on IR policy, including that relating to net distributions. She will be a very valuable addition to the group advising AMF.
 

Operational planning (12 months) and planning horizon (18 to 24 months)


The operational plan for a distribution typically covers 12 months. The planning horizon for a specific distribution is, however, typically 18 to 24 months as discussions to assess and approve a distribution start six months earlier and the funds required (we need to have funds in hand in order to have serious discussions) are aggregated in the preceeding months.
 
For the distribution in Balaka (Sep/Oct 2015), recently announced, the sequence of operational steps (simplified) are:

Nov 14: Distribution (new timing) confirmed
Dec 14: Budgets agreed
Jan 15: Planning starts
Feb 15: Pre-distribution registration survey (PDRS, all households) planning document received
Apr 15: PDRS carried out, including verification activities and report received
Apr 15: Nets ordered
Jun 15: Nets produced
Jun 15: Nets shipped (two month transit time)
Aug 15: Nets arrive in country, pre-positioned
Sep 15: Distribution of nets (Sep and Oct 2015)
 

Next Balaka, Malawi distribution brought forward to Sep/Oct 2015


The Malawi National Malaria Control Programme (NMCP) will be coordinating a country-wide mass distribution of nets during 2015 in 24 (of the 28) districts in Malawi. This follows the nationwide mass distribution on nets in 2012 and is therefore a re-coverage campaign. This timing is consistent with the three year repeat cycle common to many national programmes matching the degradation profile and useful life of the nets.
 
As a result of discussions between the NMCP and the wider Task Force group, within which AMF and our distribution partner Concern Universal are represented, and which coordinates and manages malaria control activities in-country, it has been decided a re-coverage distribution in Balaka during 2015 is both the optimal action for protecting the people of Balaka and means the Balaka three year distribution cycle will be aligned with the rest of Malawi.
 
This means the distribution is now planned for September and October 2015 rather than September and October 2016.
 
As a result, all specific donations to AMF that are funding this distribution which had been previously designated as ‘underwriting donations’ (given it was considered likely an early distribution, elsewhere, and prior to Sep/Oct 2016 would mean the specific donations would be moved to fund an earlier distribution) have now been designated as ‘confirmed allocated’ and will fund the Balaka distribution.
 
Further information:
 
A partial coverage distribution took place in Balaka in June 2012 conducted by the NMCP. The 70,000 LLINs found in place via an AMF/CU-conducted district-wide audit of all households were supplemented by the distribution of 154,230 LLINs in October 2013 which achieved district wide sleeping spaces coverage. By September 2015 at least 70,000 LLINs will need replacing (to protect some 130,000 people) as well as an estimated 30-40% of the nets distributed in October 2013 (an additional 45,000 to 60,000 LLINs to protect some 80,000 to 110,000 people). In addition, nets that have less than 12 months life remaining will be replaced which is anticipated will increase the number of nets required by a further 50,000, and population growth will add an additional 10,000 LLINs for a total requirement of up to 190,000 LLINs.

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