In research published this week in PLoS Medicine Stephen Lim and colleagues (University of Washington) systematically estimate the changes in distribution of insecticide-treated bed nets (ITNs) across Africa between 2000 and 2008, and find that several countries have managed to scale up their ITN coverage from near zero to more than 60%.

Development assistance for health (DAH) targeted at malaria has increased massively over the past decade, with substantial funds directed towards increasing ITN coverage. In this study the authors combined data from three sources — manufacturers' records of ITN supply, National Malaria Control Program reports on ITN distribution, and household surveys of ITN use — to estimate ITN ownership coverage and ITN use in children under 5 for 44 African countries. They also analyzed the effects of DAH for each country on ITN coverage.

The authors found that although several countries have managed to scale up their ITN coverage, some countries, e.g. Nigeria, continue to have low ITN coverage. Africa as a whole will therefore fall far short of the target of 80% ITN coverage by the end of 2010. The authors finding that increased DAH was related to improved ITN coverage suggests that inadequate funding might have contributed to a lack of progress in some countries. Continued financial assistance will be required to maintain and improve ITN coverage in Africa.

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Funding: This study was funded by the Bill & Melinda Gates Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: MM is employed by the US Centers for Disease Control and Prevention and is funded by the US President's Malaria Initiative.

Citation: Flaxman AD, Fullman N, Otten MW Jr., Menon M, Cibulskis RE, et al. (2010) Rapid Scaling Up of Insecticide-Treated Bed Net Coverage in Africa and Its Relationship with Development Assistance for Health: A Systematic Synthesis of Supply, Distribution, and Household Survey Data. PLoS Med 7(8): e1000328.doi:10.1371/journal.pmed.1000328

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