The New Vision reports that, “ALL Ugandans will be given free insecticide-treated mosquito nets, the health ministry has said, adding that their distribution will start in September,” according to government officials. The is is keeping with the United Nations drive to achieve universal net coverage by 2010.Â Could this approach have any downsides?
Karen Grepin has observed that after free net distribution in Ethiopia, “the private distribution channels that existed before this distribution programs suffered major set backs. No one needed to buy a net anymore, so no one did. Importers stopped importing nets, distributors stopped distributing nets, and retailers stopped selling nets. Selling bed nets was no longer good business.”
Karen is not suggesting that nets should not be provided free, she does feel that, “donor funds (could have) been used to purchase some of the nets from local distributors, using local channels, than the networks might have been saved – even rewarded for their efforts.”Â Without these local sources, Karen asks how people will buy additional and replacement nets.
This problem gets at the heart of the challenge of undertaking both catch-up and keep-up net distribution strategies.Â Without alternative sources of net supplies, we may not be able to keep up with need in case donor program money does not flow continuously.
Up until recently net delivery strategies in Africa are categorised as public, private or mixed. Voucher schemes that include a public sector subsidy and private sector distribution are a good example of the mixed.Â Voucher schemes have never been touted as a solution to universal coverage, but now they are being made redundant by mass or universal distribution.
Campaigns are needed, especially if they can guarantee that people actually use the insecticide-treated nets they receive, but if they kill local business as well as mosquitoes, we have cause to worry.Â Malaria itself created economic burdens, and we don’t want malaria control to add to the burden.Â Local net production can benefit from campaigns if governments buy and distribute these local ITNs.Â Keeping local net production and sales alive can benefit the keep-up strategies, especially in these days of unxcertain economic and donor vitality.