I was reminded when putting together a presentation this afternoon of just how badass bed nets are. Not only do they reduce the number of acute infections a person gets by about half, but they also protect people within a radius of 300 meters. For pregnant women, sleeping under an insecticide-treated net reduces miscarriages by 33% and reduces the proportion of infants born with low-birth weight by 23%; babies are better off for the rest of their lives if they’re not born with low-birth weight. When is the leading cause of morbidity and mortality, as it is in Ghana and many countries throughout Africa, this is a big deal. If a whole community has insecticide-treated bed nets, all cause child mortality goes down 18%! Pretty cool. It’s great that the Ghanaian government, in partnership with USAID and other organizations, is aiming for 100% bed net coverage by 2012.
There is, however, an interesting and unfortunate situation; none of the bed net manufacturers in Africa have World Health Organization Pesticide Evaluation Scheme (WHOPES) certification. Manufacturers achieve certification by approaching WHOPES with their product description, whereupon WHOPES develops an evaluation plan to be funded by the manufacturer; evaluations are very worthwhile, but can also be prohibitively expensive for a small company. It takes a long time to test long-lasting insecticide-treated nets, which can last up to seven years and are now the standard in malaria prevention (though interim recommendations may be made).
Most of the major funders like USAID will only buy WHO certified nets. There are actually shortages of bed nets because the companies that are WHO certified can’t produce them quickly enough. While of course it is important that the bed nets people receive are up to par, it seems that a better balance might be struck regarding the process for certification, particularly for companies based in countries where both malaria and the economy pose problems. From my perspective, aid organizations purchasing good quality nets from local companies would help protect more people from malaria, would reduce the monetary and environmental cost of shipping bed nets, would help the WHO fulfill its mission, and would help the African economy.