Yeah, the logic is basically "sure there are lots of structural or root issues, but I'm not confident I can make a substantial positive impact on those with the resources I have whereas I am confident that spending money to prevent people (mostly kids who would otherwise have survived to adulthood) from dying of malaria is a substantial positive impact at ~$5000 / life saved". I find that argument compelling, though I know many don't. Those many are free to focus on structural or root issues, or to try to make the case that addressing those issues is not just good, but better than reducing the impact of malaria.