In Development Programs

Accelerator Stage 5

Fundraising to launch in Malawi

We’re looking at fighting cervical cancer by improving global access to the HPV vaccine. In 2020, there were an estimated 604,000 new cases of cervical cancer and 342,000 related deaths – with 90% being in low- and middle-income countries. The HPV vaccine is 99% effective at preventing the two most common strains of HPV when given to adolescent girls, significantly reducing their risk of cervical cancer.

Because vaccine delivery systems are set up to target infants and young children, reaching adolescent girls remains a challenge. School-based delivery can change that — by vaccinating girls at school, rather than requiring them to spend time and money to reach clinics. And engaging trusted teachers can increase uptake and reduce misinformation. Evidence from Gavi, the Vaccine Alliance, shows that school-based HPV vaccination achieved 35% higher coverage than health facilities.

We’ve scoped school-based HPV vaccination for school-age girls in multiple countries to determine if it’s viable for cost-effective implementation at scale. We’re eager to launch HPV vaccination in Malawi, alongside our school health programming of Deworm the World and Equal Vitamin Access. HPV vaccination could prevent up to 53% of cervical cancer cases in Malawi, which has one of the highest cervical cancer mortality rates in the world.

We estimate that by scaling HPV vaccination for school-age girls in Malawi we can avert 10,000 cervical cancer cases and 8,000 deaths over three years.

Accelerator Stage 4

Pilot in Nigeria

We’re testing an intervention that helps pregnant women overcome micronutrient deficiencies. Micronutrient deficiencies are highly prevalent among pregnant women in low- and middle- income countries and can cause poor pregnancy and birth outcomes. Multiple micronutrient supplementation (MMS), known simply as prenatal vitamins that are the standard for pregnant women in high-income countries, is an effective, low-cost solution if taken regularly during pregnancy — reducing low birthweight by 21%, stillbirths by 9% and small for gestational age (SGA) by 10%.

MMS has yet to be introduced in most countries at scale, and has enormous potential to be delivered cost-effectively through prenatal care systems. We launched a pilot in Nigeria in September 2024 to assess achievable coverage and adherence levels in real-world settings; if successful, we’ll aim to scale up across multiple Nigeria states over the coming years. We also believe that MMS is a promising, cost-effective opportunity in countries including Tanzania, Liberia, and Cameroon, and are seeking funding for scale up so that women in these countries can get access to the same standard of care as those in wealthy countries.

Accelerator Stage 4

Pilot in Liberia

We’re exploring an additional safe water intervention so we can continue to reach new populations with safe water access .

Vouchers for Safe Water is an intervention to distribute bottles of chlorine to pregnant women and caregivers with children under five at health facilities upon redemption of a voucher, enabling them to treat their household drinking water at no cost.

There is rigorous evidence supporting the effectiveness of this intervention – results from a randomized controlled trial in Kenya showed that vouchers screened out 88% of people who would have accepted the chlorine for free but did not intend to use the product. This also has the potential to be highly cost-effective.

After scoping in multiple countries, we launched a vouchers for safe water pilot in Liberia in 2024 to assess whether we can feasibly and cost-effectively implement the intervention at scale and increase chlorination rates among households with children under five.

Accelerator Stage 4

Pilot in 2025

Almost everyone will experience age-related near vision loss in their lifetime – the WHO estimates that 1.8 billion people are suffering from it. Those without access to reading glasses face significant challenges, impacting both their productivity and quality of life. Evidence shows that inexpensive, non-prescription reading glasses can lead to substantial improvements. A randomized controlled trial in Bangladesh found a 33% income boost for people in vision-intensive occupations, along with a 15% improvement in their quality of life indicators.

While this intervention isn’t specifically health-related, it’s in our Accelerator pipeline because it scored highly against our rigorous criteria:

• There’s robust evidence of impact on income and health/wellbeing.
• It’s one of the most cost-effective interventions we’ve looked at – reading glasses cost less than a dollar ($0.60) in bulk.
• There’s massive potential for scale and low existing coverage.

We plan to launch a pilot program for this intervention in 2025 (country to be determined) to evaluate operational feasibility, including appropriate delivery and information dissemination channels.

Accelerator Stage 4

Prevalence study and pilot in Nigeria

We’re evaluating an intervention to provide preventive malaria treatment to children at schools.

Most malaria prevention and treatment strategies focus on pregnant women and children under five. But 200 million school-age children are also at risk for malaria, leading to severe health impacts as well as long-term educational and economic setbacks from missed school days.

By regularly administering antimalarial drugs to school-age children (typically 3-6 times a year), regardless of their infection status, this intervention is highly effective in reducing the burden of malaria. That’s because it not only treats and prevents clinical malaria, but also because school-age children often act as a reservoir for transmission; early evidence suggests that treating this population may reduce community-level transmission of malaria. Schools provide an efficient platform to reach large numbers of school-age children, as demonstrated by our other school-based programs such as Deworm the World.

We’re supporting the Nigerian government to conduct a prevalence survey and plan to launch a 2025 pilot in two states. The pilot will assess operational feasibility, drug selection, and treatment frequency to inform future scale-up efforts.