World Malaria Day: Innovation and the role of Nets

Insecticide Treated Nets (ITN) are currently a key intervention against malarial mosquitos and have been shown to reduce all cause mortality in children under five by 20%. (Lengeler C, Cochrane Review, 2002.) Pregnant women are also vulnerable to severe complications of malaria and recommended interventions are ITNs and intermittent preventative treatment with SP (sulfadoxine-pyrimethamine).

Despite the proven successes of ITNs in preventing malaria, the distribution of bed-nets is not universal. Baseline levels of ITN measured between 1997 and 2001 were as low as 2-3% in most African countries. It was decided that improving ITN distribution could be a quick win for the Roll Back Malaria initiative. Key barriers to distribution included: a lack of funding for ITNs, inadequate distribution channels, and the cost of nets. In addition, ITNs need to be retreated with insecticide to maintain effectiveness, so insecticide must also be supplied. Several countries consider ITNs textiles, and not essential medical supplies, so they are subject to import taxes, which further increases their price.

One promising innovation in ITNs is led by a group from the University of Leeds, who are developing a non-insecticide bednet that will kill mosquitos based on the material structure. They have received significant funding from the Gates Foundation. If successful, this will help with the loss of effectiveness of existing nets, where insecticides wash out after about 20 washes, as well as the increasing resistance to insecticides that mosquitos are developing.

Here are some news reports on the progress of ITN Distribution, but I wasn’t able to find a comprehensive report on distribution.

Simple Bed Nets Key to Preventing Malaria: CTV

Africa Marks Day for Deadly Malaria: Mail and Guardian, South Africa

Another reason for the inadequate coverage of ITNs has been a lack in funding. This is primarily an international health investment issue, but civil society has been getting into the act and a new grassroots initiative Malaria No More caught my eye.  Malaria No More personalizes your role in the effort against malaria – Donate $10 and buy a bed-net! This is a small and do-able effort for most people, who want to see a tangible benefit from their donation.  Malaria No More is sponsoring a wide range of fundraisers including Music to End Malaria which was created to get college students involved in the fight against the disease. More than 50 colleges and universities around the country have signed on to raise money and in the lead up to the first US Malaria Awareness Day, campuses will organize bed net demonstrations, T-shirt sales, BBsQuito cookouts, film screenings, festivals, informational sessions with public health experts, and more. Joining with major recording artists, Music to End Malaria will culminate with awareness-raising concerts on campuses in Atlanta (April 25), Geneva, NY (April 28), and New York City (April 30).

Ashley Judd has weighed in with commentary on Malaria No More and PSI’s initiative Five & Alive on CNN.