According to the Presidentâ€™s Malaria Initiative (PMI), one in seven children under five years of age dies in Mozambique, and at least 20% of these deaths are caused by malaria. Brentlinger et al. report on a project that attempted to save these lives using ITNs in the central part of the country.Â These nets were sold through local shops and community leaders, although the latter channel proved to be ineffective. By the end of the 2-year project ITN ownership was still low at 40% and even lower (20%) for a net treated within the past 6 months.Â Ownership was positively associated with higher socio-economic class and urban residence.
PMI selected Mozambique for attention in mid-2006 and since then has contributed to a mass ITN re-treatment campaign, with a goal of re-treating approximately 500,000 nets, protecting up to 1 million people. Upcoming plans will use Long Lasting Insecticide-treated Nets (LLINs) distributed through Antenatal Clinics.Â Hopefully lessons learned about the low coverage achieved from selling nets will inform future national and PMI efforts to ensure that nets reach the rural poor at little or no cost.