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Quick Wins Versus Sustainability: Options for the Upscaling of Insecticide-Treated Nets

A review of the main elements determining strategic choices for the large-scale distribution of insecticide-treated nets (ITNs) clearly shows the need for multiple strategies. Mass distributions of free nets provide a unique opportunity to achieve quickly high coverage rates. However, there is also a need for additional approaches to 1) provide continuous provision of ITNs for newly pregnant women and their babies and 2) provide protection for the rest of the population. Targeted subsidies will continue to be an important tool to achieve the first objective, either through direct distribution of ITNs or through vouchers. To achieve objective 2, a strong and competitive commercial sector for ITNs seems to be a good option. It is clear that "one size doesn’t fit all," and more experience needs to be gathered and shared. With planning and good promotion campaigns, these strategies can co-exist and re-enforce each other.

Received February 9, 2007. Accepted for publication May 1, 2007.

Acknowledgments: The authors thank the members of the RBM Working Group on Scalable Vector Control (WIN) for many stimulating discussions.

^* Address correspondence to Christian Lengeler, Swiss Tropical Institute, P.O. Box, 4002 Basel, Switzerland. E-mail: Christian.Lengeler{at}unibas.ch

Authors’ addresses: Christian Lengeler, Swiss Tropical Institute, PO Box, 4002 Basel, Switzerland, Telephone: 41–61–2848221, Fax: 41–61–284–8105, E-mail: Christian.Lengeler{at}unibas.ch. Mark Grabowsky, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Chemin de Blandonnet 8, 1214 Vernier, Geneva, Switzerland, Telephone: 41–22–7915943, Fax: 41–22–7911701, E-mail: Mark.Grabowsky{at}theglobalfund.org. David McGuire, Academy for Educational Development, 1875 Connecticut Avenue, NW, Washington, DC 20009, Telephone: 202–884–8506, Fax: 202–884–8844, E-mail: dmcguire{at}aed.org. Don deSavigny, Swiss Tropical Institute, PO Box, 4002 Basel, Switzerland, Telephone: 41–61–2848160, Fax: 41–61–284 8105, E-mail: D.Desavigny{at}unibas.ch.

Reprint requests: Christian Lengeler, Swiss Tropical Institute, PO Box, 4002 Basel, Switzerland, Telephone: 41-61-2848221, Fax: 41-61-284 8105, E-mail Christian.Lengeler{at}unibas.ch.

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