Will GiveWell fund Intermittent preventive treatment in infants (IPTi) for malaria by 1st January 2027?

DRAFT

GiveWell has recommended grants to over 10 charities over the years. They are currently investigating 12 charity areas with other areas of research in the pipeline including Intermittent preventive treatment in infants (IPTi) for malaria.

The following sections are quoted from GiveWell’s explanation of the topic 

“Malaria is the fourth largest cause of death for children under 5 in sub-Saharan Africa, accounting for 12% of deaths. It is transmitted from person to person by infected mosquitoes and involves flu-like symptoms, including fever. When a case of malaria is severe, it leads to life-threatening complications, particularly in children. It is also believed that malaria can cause permanent disability (hearing impairment, visual impairment, epilepsy, etc.).

Malaria is preventable with insecticide-treated nets and drugs (among other interventions), and it is treatable with drugs…

IPTi is a full therapeutic course of antimalarial medicine delivered to infants through routine immunization services, regardless of whether the child is infected with malaria. ... Treatment is given 3 times during the first year of life at approximately 10 weeks, 14 weeks, and 9 months of age, corresponding to the routine vaccination schedule of the Expanded Programme on Immunization (EPI)...

IPTi is a full therapeutic course of antimalarial medicine delivered to infants through routine immunization services, regardless of whether the child is infected with malaria. ... Treatment is given 3 times during the first year of life at approximately 10 weeks, 14 weeks, and 9 months of age, corresponding to the routine vaccination schedule of the Expanded Programme on Immunization (EPI)...

Overall, we believe there is strong evidence that IPTi reduces clinical malaria, which gives us a moderate level of confidence that it reduces deaths due to malaria…

We have created a modified analysis of 9 trials (with 10,308 participants in total), based on analysis 1.1 in Esu, Oringanje, and Meremikwu 2019.13 Evidence from the 9 trials suggests that IPTi reduced the number of cases of clinical malaria by 24% (95% confidence interval: 17-31%)...

We have a moderate level of uncertainty about the extent to which findings from trials will generalize to future implementation, though we haven’t explored this issue in depth yet…

The authors of Esu, Oringanje, and Meremikwu 2019 believe that, due to increasing SP resistance across Africa, SP may soon no longer be a useful drug in IPTi…

We found that IPTi may be highly cost-effective, and may be within the range of programs we would consider recommending funding…

We are aware of some potential negative impacts of IPTi. Based on a cursory investigation, they did not seem likely to significantly offset the programs’ positive impacts, so we have not prioritized looking into them further at this stage, though we may conduct additional research on these issues…”