Last month I applauded aid workers who stress long-term commitment to poor communities over dependence on silver bullets -- new inventions like sustainable toilets. As I wrote then, lasting change comes only from building respectful, compassionate relationships with people in need. Also, situations evolve over time, which can make solutions as difficult to find as the proverbial moving target.

 Occasionally a novel idea or a new approach really does improve thousands of lives. When that happens, there’s cause for celebration. But as a story from sub-Saharan Africa shows, the benefits may be short-lived.

 I learned about the Against Malaria Foundation on the site GiveWell, which ranks aid organizations and makes recommendations to potential donors about the few that staff members consider most worthy. Of the hundreds of charities it evaluated, GiveWell named only six as top charities in 2010, two in 2011, and three in 2012. (Beware of this approach. With rampant poverty and suffering in our world, there’s no need to fund only the “best” charities. And as we’ll see, “best” is a slippery concept.)

 The Against Malaria Foundation was named as GiveWell’s #1 charity for 2012 and 2013. It’s indeed a stellar organization. Its entire program consists of distributing bed nets that are treated with long-lasting insecticide to people who live in regions where malaria is rampant. According to the Foundation’s web site, malaria kills a million people each year. Seventy percent are children.

 All the donations the Foundation receives from the public are put toward buying and distributing the nets, which cost $3 each. In the past decade the Foundation has given away nearly seven million bed nets. Volunteers follow up to make sure the nets are being properly used. With only two employees and a huge corps of volunteers, the Foundation is incredibly efficient. And the bed nets have provided an inexpensive, effective control for malaria.

 Unfortunately, Mother Nature, always crafty, appears to be in the process of ripping holes in the bed net solution.

 The nets distributed by the Foundation are treated with a synthetic pyrethroid, an insect repellent considered safe for frequent contact with children. In 2013 reports began circulating that mosquitos in sub-Saharan Africa, where the Foundation does most of its work, were showing signs of resistance to the insecticide. The insects were also altering their behavior, biting not at night but early in the morning, when rural residents rise and leave the safety of their beds.

 The potential consequences are dire, especially since people have come to depend so heavily on this one tool to protect them from malaria.

Financial Times, August 25, 2013

Financial Times, August 25, 2013

Late last year I contacted the Against Malaria Foundation’s CEO, Rob Mather, to ask how the organization was responding to the problem. He directed me to a blog post on the organization’s web site. Yes, he wrote, the mosquitos’ resistance and their changes in behavior pose challenges. But so far the regions affected are relatively small, and scientists are working to find solutions. For now, he noted, bed nets are still the best defense in malaria-plagued regions of the world.

 Are bed nets a valid form of aid to the poor? Absolutely. Are they the definitive answer to the problem of malaria? Apparently not.

 GiveWell dropped the Foundation from its top charities list in 2013, citing the organization's failure to use a large proportion of the funds that had poured in after its ringing endorsement. Personally, I can understand how the unexpected receipt of thousands of dollars would make the Foundation's staff and board of directors step back and think for a time about what to do next. Givewell made no mention of the potential problems caused by adaptations in mosquitos.

 This story points to two lessons. First, as I’ve said before, there is no silver bullet when it comes to helping people better their lives.

 Second, there’s no need to waste time looking for this year's best, most effective charity. Sure, it’s wise to vet organizations before giving them money. In fact, it is imperative in this era of scam artists. But once you find a group that’s doing good work, support it with confidence. Don’t fret that your money might be better spent elsewhere. It’s only money. Solutions to deep problems can take time and commitment -- lots of it. And the world is full of Seva heroes who could use more cash with which to work their magic.

Subscribe to my twice-monthly blog at

AuthorJan DeBlieu