Will Mosquito Nets Save the World?

Guess what? The next big fad for AID to Africa is Moquito nets…

“Millions of children have died from malaria because they were not protected by an insecticide-treated bed net, or did not receive effective treatment. If we expand malaria control programs, and invest what’s needed in R&D, we can stop this tragedy.” — Bill Gates

1. DeSagana Diop
2. Elizabeth Gore
3. the NBA
4. MLS
5. the United Methodist Church
6. Union of Reformed Judaism
7. the United Nations Foundation
8. VH1
9. Sports Illustrated and Rick Reilly
10. Luol Deng
11. Diego Gutierrez (whew I think I get ‘em all)

AgainstMalaria.com does nothing but raise money for nets

So the WHO just announced some really positive findings: The New York Times article about the report is simply retelling of the basic findings of the WHO report. Not alot of investigative reporting happening in that article. At least I don’t think so. I can find lots of articles ABOUT the report. However I can not find the report itself. According to the New York times however there is significant reduction in the rate of Malaria infection in four African countries

…It looked at programs in four countries that tried to distribute mosquito nets to the families of every child under 5, and medicines containing artemisinin to every public clinic.

In Ethiopia, deaths of children from malaria dropped more than 50 percent. In Rwanda, they dropped more than 60 percent in only two months.

Zambia, Dr. Kochi said, had only about a 33 percent drop in overall deaths because nets ran short and many districts ran out of medicine. But those areas without such problems had 50 to 60 percent reductions, he said.

Ghana was a bit of a mystery, according to the report. It got little money from the Global Fund, Dr. Kochi said, and so bought few nets and had to charge patients for drugs. Malaria deaths nonetheless fell 34 percent, but deaths among children for other reasons dropped 42 percent.

Scientific American published a better article on the technology behind the nets and why they are not well suited to the average African at-risk for Malaria.

Prior to this report I had been hearing some negative information concerning mosquito net programs. I have been pondering these programs for a few months and the thing is… there seems to be a basic problem with the programs as implemented to date. Let’s evaluate for a moment how these programs work.

Nets are provided to women and children for use at night
Nets have insecticide which needs to be reapplied (ok, this is changing)
Nets require bed or dedicated sleeping area

This raises some questions fore me: Are men magically immune to Malaria? Who is paying for the insecticide? What if you don’t have a bed? What if your bedroom doubles as the living room when you are not asleep? Who is making these nets? (Does not do much good to survive malaria only to starve to death) AND most importantly… what if you are not in bed at dusk… when the mosquitos start to bite?

One thing jumps out at me about the report… they are not relying on nets alone to fight the disease. What seems to be most effective is a layered approach. Medicine, insecticide, nets AND community buy-in. One of the early criticisms of the net programs was that the nets were not being used appropriately… anecdotes about mosquito nets as wedding veils of fishing nets were pretty common. So it does not do much good to have an amazing net that is never used… It also does not do any good to depend on nets alone. Mosquitos do not wait until you are safely tucked in to your bed to begin biting. Any solution offered MUST include protection at night and during the day.

Let us not forget that Malaria is not the only issue facing Africa today… and yet most of these nets are not made in Africa. India and China are the most common suppliers. Huh. I guess killing two birds with one stone would be too much to ask. Why not help Africa fight Malaria and supply jobs? Right… any money you raise can only do the one thing. That’s effective.

Just curious, but do all repellents need to be manufactured in a lab in China?
What about Pyrithrium plants? Eucalyptus, citronella, camphor trees, wax myrtles, cedar, verbena, pennyroyal, geranium, The Mosquito Plant is a genetically engineered geranium hybrid, lavender, pine, cinnamon, rosemary, basil, thyme, allspice, garlic, Grey Santiolina and peppermint? All those oils will help fight mosquitos… and any farmer can grow them given the right climate and soil conditions. Maybe I am being too simple-minded. But wouldn’t a simple inexpensive, naturally regenerating product be more effective? Nope that won’t work alone either. They wear off, sweat off, absorb into the skin, and are often irritating to the skin. Sigh.

Here is the thing… There are NO simple solutions. There is NO ONE thing that is going to win the fight. It is important that the people designing and manufacturing the nets understand how they are to be used (might be helpful to actually ask the people who have to use them… or better yet get them to make them). It is important that the people receiving the nets know what they are for and how to use them. It is important to provide 24 hour protection and not just depend on nets for 100% of the solution. It is important to provide inexpensive, easy to take medications, it is important to educate people about Malaria so this it is reported and treated quickly.

Just like everything else. Effective solutions require time and attention. So although the nets are nice, maybe some folks should look a little deeper and acknowledge the complex issue that it really is.

Tagged as: Africa, against malaria, Ethiopia, Ghana, Malaria, Mosquito nets, Nothing but nets, pyrithrium, Rwanda, World Health Organization, Zambia