Universal Coverage – much to accomplish in 2010

Bauchi is the next Nigerian state to experience the drive to universal coverage with over 60 million long-lasting insecticide-treated nets expected to be in place nationally by the end of 2010. Nearly 2 million nets are targeted for Bauchi alone.

dscn0216a.JPGAccording to a representative of the National Malaria Control Program, “preliminary report showed that over 15 million LLIN were distributed to beneficiaries between May and December, 2009 in nine states,” out of the 36 total (plus Abuja). This figure is down from the projected 12 states and 22 million nets slated for 2009. Thus, there is even greater logistical and management pressure to reach the remaining 75% of states/people by the end of 2010.

Nigeria is not the only country trying to catch up with net distribution to meet 2010 targets.  Burkina Faso is hoping to cover all households in a campaign in July. In addition, in December the UN Special Envoy’s office explained that Kenya “is facing a “critical” shortage of funding for 11 million nets that must be addressed.”

Sometimes efforts are delayed, as they have been in Burkina Faso and Akwa Ibom State Nigeria, when expected donor support and net supplies are not available when and as expected. The slower than anticipated progress in Nigeria occurs despite the fact that “World Bank, DfID, USAID, and UNICEF … the Global Fund and many other funding agencies, NGOs, and the private sector” have joined together in the effort.

A team of researchers from Burkina Faso and Germany has warned that, “Lack of coordination between donors and international health agencies is leading to the needless deaths of too many African children from malaria.” Even with donor support and coordination, one cannot afford to repeat a massive campaign twice, and so malaria program staff wait until they get the nets they need to reach everyone.

While adequate numbers of nets will likely be in place by 31 December 2010, the battle will not be over. The UN Special Envoy “emphasized that global efforts should focus not only on solving the malaria problem in the short term, but also on sustaining prevention and treatment so that it won’t once again spiral out of control.” He explained that even when we succeed in distributing the needed nets, we must remain on top of the efforts – the achievement will only occur when people actually sleep under the nets regularly.

Researchers from Burkina Faso give us pause to reflect when they reported on “Decreased motivation in the use of insecticide-treated nets in a malaria endemic area in Burkina Faso.”  Continued outreach efforts to encourage people to sleep under their nets every night for years to come may prove more challenging that distributing millions of nets by the end of 2010.

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