Nets for All

A malaria control curiosity appeared in the news this past week – vaporized lighting. The concept seems simple enough – using the heat of a light bulb to vaporize and disperse insecticides. While we encourage multiple vector control efforts, the feasibility of finding functioning light bulbs among the must vulnerable populations gives pause to the quest for ever more clever mosquito control innovations.

bed-net-nsukka-sm.jpgIn contrast Jeffrey Sachs and colleagues draw us back to the basics by asking whether we can get insecticide treated nets to everyone and make a real impact on malaria. He stresses the importance of long lasting insecticide-treated nets (LLINs) as both an individual and a community protection intervention. What is unique in Sach’s call for action is asking donors to get serious about providing nets for ALL people in endemic communities, not just children, not just pregnant women, not just those who can afford subsidized socially marketed nets. This gets at the heart of the supply and demand problem. As long as there are inadequate nets to cover the whole population (and working adults also need nets to prevent malaria and increase their economic productivity) then there will always be loss and leakage from the supplies intended to serve the most vulnerable.

The practicalities of getting nets out to all is addressed by Grabowsky et al. (2007) who examine a dual approach of using both campaigns and routine health services as complimentary methods for net distribution. In this way malaria control programs can both ‘catch-up’ and ‘keep-up’ with need.

Finally Charles Griffin of the Brookings Institute calls on donors, large and small, as well as national malaria control programs to take the long term view to preventing malaria. He calls on donors and governments not only to make a long term commitment to sustain efforts but at the same time to strengthen the ability for local industry to produce and sustain supplies for malaria commodities and to enhance the role of the private sector in protecting its workforce.

the foregoing ideas require an unprecedented level of donor-government-private sector collaboration – but without such cooperation we will not achieve nets for all.

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