Insecticide-Treated Netting (ITN)
The President’s Malaria Initiative (PMI) – a collaborative U.S. Government effort led by USAID in conjunction with the Department of Health and Human Services (Centers for Disease Control and Prevention), the Department of State, the White House, and others – uses a comprehensive and sustainable approach to saving lives. This includes the purchase and distribution of medicines for treatment; distribution of medicines for prevention of malaria in pregnancy; and both the spraying of residual insecticides on the indoor surfaces of dwellings in selected areas and the improved access to insecticide-treated nets, either through direct distribution, or targeted subsidies.
Insecticide-treated mosquito nets, or ITNs, are one of the most effective methods to prevent malaria in sub-Saharan Africa, where over a million people die every year as a result of the disease – the majority of its victims being pregnant women and children under five years of age. Pregnant women and children benefit the most from the use of ITNs. By promoting the widespread use of ITNs and recommending that pregnant women and small children sleep under the nets to help prevent malaria, PMI is helping to protect millions of children and mothers in Africa from one of the most serious threats to their survival.
A simple mosquito net treated with an insecticide is a proven and cost-effective way to repel or kill mosquitoes carrying the parasite that causes malaria. Dipping nets in a solution of a pyrethroid insecticide transforms the net from a simple physical barrier into a physical and chemical barrier that can repel or kill the female Anopheles mosquito, which is responsible for transmitting the malaria parasite. Pyrethroid insecticides are effective for up to 12 months, after which the nets must be retreated. More recently, companies have been producing long-lasting insecticidal nets (LLINs), which can retain residual insecticidal activity for three years or more.
Consistently sleeping under an ITN has been shown to decrease all-cause child mortality by 17 to 29 percent. There is also evidence that if more than 80 percent of households in an area sleep under an ITN, malaria transmission is significantly reduced, which can benefit people who do not use an ITN themselves.
PMI is expanding access to free and highly subsidized mosquito nets while also supporting the creation of a sustainable commercial market for ITNs in African countries. PMI supports the provision of free mosquito nets to those at highest risk from malaria – pregnant women and children under five – and to those who cannot afford to purchase a mosquito net. PMI also is increasing access to subsidized and highly-subsidized nets, which increases demand, availability, and affordability of these nets among vulnerable populations.
In just a year of implementation (December 2005 – December 2006), PMI has delivered more than one million insecticide-treated nets. This includes the distribution of free LLINs to children and pregnant women in camps for internally displaced persons in Uganda and through voucher programs, as in Tanzania where, in partnership with the Global Fund to Fight AIDS, Tuberculosis and Malaria, pregnant women and mothers of infants get a voucher that they can use at participating retailer outlets to receive a mosquito net.
PMI has partnered with UNICEF and others to deliver nets as part of an integrated national child health campaign in Angola that included measles vaccinations, vitamin A supplements, and de-worming medication. This strategy of combining ITN distribution with measles vaccinations and other health interventions was piloted two years ago. About 800,000 LLINs (420,000 of which were provided by PMI) were distributed across seven provinces where malaria transmission rates are highest in Angola.
In Uganda, an insecticide re-treatment program for 505,000 nets is helping to protect residents from malaria in 28 districts. Mosquito nets are being treated with insecticides in a plastic bag by a trained dipper in a village, allowing a large number of nets to be treated. Re-treating nets is an essential interim strategy to continue to provide protection against malaria for owners of traditional nets until existing nets are replaced with LLINs.
February 2007
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