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Long-lasting insecticide-treated net (LLIN) distributions - Against Malaria Foundation (AMF)DRCGuineaTogoUgandaNigeria (PMI states)Nigeria (Global Fund states)Chad
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Funding allocation
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Percentage of total costs covered by AMF46%52%49%57%51%51%52%
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Percentage of total costs covered by other philanthropic actors3%0%0%0%0%0%0%
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Number of people covered
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Donation to AMF (arbitrary size)$100,000$100,000$100,000$100,000$100,000$100,000$100,000
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Total spending by all contributors$217,135$191,137$202,512$174,430$197,638$197,638$191,137
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Cost per long-lasting insecticide-treated net (LLIN)$5.51$4.50$4.86$4.65$5.35$5.35$4.50
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Number of people covered with each net1.81.81.81.81.81.81.8
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Cost per person covered$3.06$2.50$2.70$2.58$2.97$2.97$2.50
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Total number of people covered70,93376,50175,03567,48166,46866,46876,501
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Age distribution of net coverage
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Percent of population under 5 years old (used for mortality effects and development effects)16%17%14%17%16%16%20%
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Percent of population ages 5-915%15%14%15%15%15%17%
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Percent of population ages 10-1413%13%12%14%13%13%14%
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Percent of population ages 5-14 (used for development effects only)27%28%26%29%28%28%30%
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Children under 5 covered11,02712,96910,56011,63510,37210,37215,547
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Children 5-14 covered19,47121,60019,25519,67418,63418,63423,220
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Equivalent coverage-years for an LLIN over a 36-month distribution1.742.112.112.112.112.112.11
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Person-years of coverage for under 5s19,22627,36522,28224,55121,88421,88432,804
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Person-years of coverage for ages 5-1433,94845,57640,62841,51239,31939,31948,994
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Person-years of coverage for under 15s53,17472,94162,91066,06261,20361,20381,798
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Mortality reduction in children under 5
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Relative risk reduction for mortality per protected 1-59 month-old child (summary effect from Pryce et al. 2018 meta-analysis)0.170.170.170.170.170.170.17
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Adjustment for counterfactual mortality if AMF distributions ceased
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Baseline 1-59 month-old all-cause mortality before mass distribution of nets (per 1,000 child-years, GBD 2004) 24.326.217.720.033.235.630.8
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1-59 month-old all-cause mortality (per 1,000 child-years, GBD 2019)7.714.68.37.316.717.718.4
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Mortality today relative to pre-nets baseline32%56%47%37%51%50%60%
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Portion of mortality difference attributed to nets25%25%25%25%25%25%25%
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Malaria-attributable deaths averted per 1,000 children per year targeted with seasonal malaria chemoprevention0.00.00.60.01.10.60.7
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Counterfactual mortality with no bednet distribution (per 1,000 child-years)11.917.510.110.519.821.620.7
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Pre-existing net adjustment
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Adjustment for net coverage years lost due to residual nets from previous distributions97%97%97%97%98%97%97%
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Other adjustments
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Net use adjustment90%90%90%90%90%90%90%
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Internal validity adjustment — Nets95%95%95%95%95%95%95%
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External validity adjustment — Nets95%95%95%95%95%95%95%
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Proportion of mortality attributed to malaria in areas AMF works vs. the contexts of trials in the Cochrane Pryce et al. 2018 meta-analysis180%124%86%153%74%72%26%
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Efficacy reduction due to insecticide resistance5%32%33%11%14%14%27%
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Deaths averted per 1,000 person-years of coverage for under 5s2.721.990.781.901.721.810.53
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Total number of under-5 deaths averted52551747384017
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Comparable valuation
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Value assigned to averting the death of an individual under 5 from malaria116116116116116116116
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Total units of value from under-5 deaths averted (before accounting for leverage and funging)
6,0706,3462,0185,4134,3804,6062,024
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Mortality reduction in individuals 5+ years old
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Ratio of 5+ malaria deaths to under-5 malaria deaths
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Number of malaria deaths per year (GBD 2019)57,16011,3375,43622,58755,75377,6487,194
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Number of under-5 malaria deaths per year (GBD 2019)44,0788,1811,88017,38630,01544,9194,526
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Number of age 5+ malaria deaths per year13,0823,1553,5565,20125,73832,7282,668
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Ratio of 5+ malaria deaths to under-5 malaria deaths30%39%189%30%86%73%59%
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Relative efficacy of LLINs for reducing mortality of individuals age 5+80%80%80%80%80%80%80%
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Total number of age 5+ deaths averted1217261126238
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Comparable valuation
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Value assigned to averting the death of an individual 5 or older from malaria73737373737373
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Total units of value from age 5+ deaths averted (before accounting for leverage and funging)
9071,2331,9228161,8921,690601
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Overall mortality reduction
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Total deaths averted65714458646326
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Reduction in malaria prevalence (used for estimating income increases)
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Relative reduction in malaria prevalence
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Reduction in malaria incidence for children under 5 (from Pryce et al. 2018 meta-analysis)45%45%45%45%45%45%45%
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Expected reduction in malaria prevalence in current day distributions34%24%24%31%31%31%26%
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Baseline malaria prevalence
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Malaria prevalence in AMF context (Age <5) (GBD 2019)28%34%30%39%28%20%12%
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Malaria prevalence in AMF context (Age 5-9) (GBD 2019)31%37%34%43%12%
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Malaria prevalence in AMF context (Age 10-14) (GBD 2019)29%35%31%40%12%
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Malaria prevalence in AMF context (Age 5-14) (GBD 2019)30%36%33%41%30%21%12%
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Expected increase in malaria prevalence in the absence of an LLIN distribution20%20%20%20%20%20%20%
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Counterfactual malaria prevalence in AMF context in absence of distribution (Age <5)34%41%37%46%34%23%14%
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Counterfactual malaria prevalence in AMF context in absence of distribution (Ages 5-14)36%43%39%50%35%25%14%
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Absolute reduction in malaria prevalence
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Percentage point reduction in the point-in-time probability of a covered child being infected with malaria (Age <5)
11%10%9%15%10%7%4%
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Percentage point reduction in the point-in-time probability of a covered child being infected with malaria (Age 5-14)
12%11%9%16%11%8%4%