Africa specialists expect boost in production of malaria nets

By John Donnelly, Globe Staff

JOHANNESBURG, SOUTH AFRICA (SEPTEMBER 24, 2004) — Meeting in Nigeria four years ago, African leaders set a goal that 60 percent of children and pregnant women in malaria-affected areas around the continent would be sleeping under bed nets by the end of 2005.

Today, fewer than 5 percent in those areas use the nets, which are coated with insecticide to kill mosquitoes that carry the deadly disease. Most people cannot afford the nets, even at subsidized cost of a couple of quarters.

But at a conference yesterday attended by public health officials and business representatives, health specialists expressed optimism for rapidly expanding the availability of bed nets. They cited the development of longer-lasting nets as well as new incentives for companies to produce them.

Manufacturers now can produce a net that retains insecticides for five years, compared with six months for previous nets. The Global Fund to Fight AIDS, Tuberculosis, and Malaria recently approved $107.8 million over the next five years to buy bed nets. And dozens of manufacturers around the world could potentially make the product.

"The production of the long-lasting nets is still very low, maybe 2 to 3 million nets a year," said Kopano Mukelabai, senior health adviser at UNICEF, who estimated a global demand of 30 million to 50 million nets a year around the world. ''Clearly, demand is outstripping the supply, and that's why we organized this meeting with the private sector to try to interest them to start production."

Standing in front of 40 private-sector representatives in a hotel ballroom, public health officials first made a pitch on humanitarian grounds. Malaria, according to some estimates, kills an estimated 2 million people a year.

"Outside of southern Africa, the biggest health problem on the continent is malaria—not HIV/ AIDS," said Ebrahim M. Samba, regional director of the World Health Organization in Africa. "I've been involved in fighting it for 40 years. Many years ago, I decided to attack mosquitoes. The idea was the eradication of malaria, and we failed."

Samba, who is retiring in January, said, "One of the last things I could do is try to push ahead these long-lasting nets."

The health officials also told a success story, which they said indicated that collaborations can work. A Tanzanian company, A to Z Textile Mills, has begun making the nets on a large scale, with help from a host of partners. Sumitomo Chemical Co. of Japan, which had developed a long-lasting net, adapted the process to the A to Z plant and oversaw quality control; ExxonMobil donated $250,000 worth of plastics, which were used to make the yarn; Acumen Fund, a nonprofit institution, approved a $400,000 loan; and UNICEF bought many of the nets and plans to distribute them around Africa.

"This is one of the handful of public health technologies that is going to save lives in Africa," said Steven C. Phillips, medical director of global issues and projects at ExxonMobil. "What we are talking about is a $5 piece of plastic that needs to be distributed to everyone at village level."

Health specialists presented a success country as well—Malawi. In 2000, 10 percent of Malawi's population used a bed net. But a major effort in 2003 by the government and charities to distribute long-lasting nets at a subsidized cost of 50 cents each has increased coverage to 43 percent.

The specialists also produced an 85-page business plan. Written by analysts at Management Sciences for Health, a Boston-based nonprofit group, the plan included information on consumer demand; price breakdowns of conventional and long-lasting nets; distribution costs; the impact of taxes and tariffs; and projections of net distributions.

It was unclear whether the sales pitch was successful. Many officials from industry were noncommittal.

"They said the money is there," Nnamdi Iro Oji, director of Rosies Textile Mills in Aba, Nigeria, said during a coffee break. His company makes 60,000 nets a month that need to be redipped every six months in insectides to retain their effectiveness. "If they are able to convince us, we make it."

"I think it will be a big market," said Arun Seth, general manager of Sun Flag, a textile company in Nairobi that makes 100,000 nets a month. "They should encourage products made in Africa."

But Gerhard Hesse, head of management vector control at Bayer Environmental Science, based in France, said global market forces should dictate who produces the nets. "When I travel around the world, I find net manufacturers outside of Africa," he said. "It shouldn't matter where the net comes from."

After the conference, which ends today, organizers hope to continue discussions. If enough companies produce the nets, supply will skyrocket, competition will drive down the price, and more poor people will be protected against malaria.