What are the indicators to monitor toward MDGs

There is hope among world leaders that the Millennium Development Goal of reducing malaria deaths to near zero is now likely to happen. Ray Chambers, the UN Special Envoy for Malaria is quoted as saying …

“Today, enough nets are in place to protect 75 percent of those at risk, and we will reach universal coverage by December 31, 2010, an astounding testimony to the power and efficacy of the unified global campaign. These nets have reached nearly 500 million people in the last two years alone, and their impact on saving lives is profound – current levels of intervention are saving 200,000 lives per year. We are on track to meet the Secretary-General’s goal of ending malaria deaths by 2015, and our work won’t be finished until we do.”

Having nets ‘in place’ and having nets used are two different indicators of success. ‘Nets in place’ will not achieve the MDG for malaria unless nets are used. Numerous surveys have been mentioned in our previous postings showing that even when nets are ‘in place’ in homes, they are not always used by the most vulnerable members of the household.

Another concern is that even if nets are ‘in place’ by the end of 2010, we may not achieve the MDG of near zero malaria deaths. LLINs are known to wear out after 2-3 years of normal use. Unless there are plans for net massive replacement efforts around 2013, we may see slippage in attaining and sustaining the goal.

A major weakness of past public health programming has been providing people with technologically sound and useful interventions without taking into full account the social, cultural and behavioral factors that influence acceptance and use of the interventions.  In order to continue to save lives with nets and other malaria interventions, we must strengthen the social and behavioral components of programming now and not wait until 2015 to see if we actually saved lives or not.

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