Earlier quoted context omitted.
Good point. But if the only way you can avoid malaria is if someone gives you a bed net, then your ability to improve your own circumstances is still close to 0. You're still impoverished and powerless, you're just not dead. And now you're dependent on a source of bed nets that might dry up. If plain old reciprocal altruism hadn't somehow failed, there would be a way that you could exchange your labour or otherwise f…
Some people value their independence over a reduced risk of malaria. These people would turn down the anti-malaria net(utility doesn't change). Other people value a reduced risk of malaria over independence. These people would take the anti-malaria net(increased utility). So by offering a malaria net you are always benefiting people. So I don't think I know how a charity could reduce utility as long as the recipients…
In other words, you're assuming they can have either independence or a reduced risk of malaria, but not both. What if having both is possible--but only if the charity is not there, so the person is forced to consider the third option? In other words, what if the second-order effect of providing charity to people is to make them unaware of other options that would actually provide more overall utility (because they would provide both independence and reduced risk of malaria, or whatever it is they're worried about)?