Africa's best hope to fight malaria is the wide distribution of mosquito-repelling bed nets. But who best serves that need: the public sector or private interests?
Jenifa John recently spent $1 on a billowy swath of gauze that could help keep her family alive. The 22-year-old mother of two in the village of Engutoto, Tanzania, bought a mosquito-repelling bed net that will keep parasite-bearing insects away from her young children while they sleep. It's a matter of utmost concern: Before she bought the net, one of John's children was hospitalized with malaria—and fortunately survived.
All across Africa, there's new hope in the long-running battle against malaria. In the last decade, funding to control the preventable, treatable disease has increased tenfold. And now, millions of insecticide-laced nets that keep mosquitoes away from sleeping men, women, and children are making their way into a growing number of homes, helping to defeat the spread of a disease that still kills up to 3 million people a year and 3,000 children a day. Experts say Africa could need upwards of 90 million bed nets to fight back against a disease that costs the continent an estimated $12 billion per year in lost economic potential.
Who Can Best Deliver?
But while the distribution of treated bed nets is a welcome development, many health-care advocates are troubled by how slowly it's happening. Indeed, the pace of progress raises profound ideological questions over the best way to disseminate the life-saving nets—and, indeed, all sorts of assistance. On one side are believers in the traditional aid model, who say that bed nets should be given away for free by governments and nonprofits to reach the maximum number of people as quickly as possible. On the other side are backers of so-called social marketing, who argue that bringing businesses into the mix improves efficiency and adds incentives and economic benefits to doing good. Harnessing the private sector, they say, creates self-reliance—not dependence.
Both sides make valid points. Advocates of free distribution worry that selling bed nets—even at heavily subsidized prices as low as $1—puts them out of reach of poor people and slows uptake. Indeed, a recent study in Kenya found that free distribution of bed nets raises their use to 66% of the population, compared with just 7% when they are sold commercially.
Such figures have prompted some advocates to call for the abandonment of social marketing in favor of free public distribution. Leading the charge is economics professor Jeffrey Sachs, who directs the
Earth Institute at Columbia University and gained renown in the 1990s advising Eastern European governments on "shock therapy" transitions to free-market economies.
"Shock Therapist" Backs Giveaways
Sachs is outraged that after seven years of effort, the goals for distributing bed nets in Africa haven't been met via social marketing programs. Take Tanzania, which is known as the "epicenter" of malaria because of the high incidence of disease there. For years, its government has subsidized sales of nets to the most vulnerable populations for prices typically between $1.50 and $3.50 each. But even now, just one-third of adults and one-quarter of children are protected by nets while they sleep.
"Tanzania is not a success story, it's a debacle," says Sachs, who flew to the East African nation last July to persuade President Jakaya Mrisho Kikwete to adopt a new plan for free distribution of nets in 103 rural districts.
Despite his long history as a free-marketeer, Sachs thinks business isn't working fast enough in this case to address an urgent human crisis. So he's pushing for more direct action. "We'll distribute free nets all over Africa, and we'll do it again and again," he says. "There's no reason why markets should be able to handle this problem."
Others think Sachs and his supporters are giving up too soon on the private sector. They admit that paying even $1 for a bed net can be a hardship for people living on less than a dollar a day. But people who buy nets tend to take better care of them and use them more regularly.
Youth Vibes: I for one I am very aware of these sort of things as my own sister died of Malaria so be aware. it can kill!!
