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CGD'S effort to weigh malaria interventions stirred new controversy. Malaria control didn't make it into the first two editions of Millions Saved, in 2004 and 2007, which documented triumphs from global ones like smallpox eradication to little-known efforts to combat diarrheal disease in Egypt or trachoma in Morocco. Although malaria has plummeted in many countries, the CGD researchers said none of the existing evaluations met their criteria: a study of a large-scale intervention of at least 2 years duration that demonstrated a clear, causal link to a drop in disease or death. They also wanted to see evidence that the intervention had an acceptable cost based on the number of cases averted or lives saved.
“We know from a bunch of small-scale studies that bed nets can protect you from mosquitoes biting you,” says Amanda Glassman, who heads global health policy at CGD. “That's not what we're interested in evaluating.” In the real world, nets aren't always used, for instance because they're uncomfortable on hot nights or people think there are few mosquitoes around.