insecticide-treated nets


Taking a closer look at whether anti-malaria programs really work | 

Malaria and the mosquitoes that carry it met a formidable foe in the form of nets laced with deadly pesticides a decade ago. Hanging a net above the bed so that it drapes around the people inside provided protection from mosquito bites while not making it hotter in tropical locations nor harming the people that use them.

Programs flourished that distributed and/or sold the bed nets. People used them and progress towards ending malaria seemed on track.

Ten years later malaria is still around and the mosquitoes are showing signs of resistance to the insecticide used in the bed nets. Journalist Amy Costello, host of the podcast Tiny Spark, recently traveled to Malawi to see what was actually happening in the fight against malaria. She sees mosquitoes that are surviving the only pesticide used in bed nets to kill them and families using bed nets with giant holes.

The story was carried by Public Radio International’s The World earlier this week. It’s the first in a series of stories called Tracking Charity. Like she does with the malaria piece, Amy will travel around the world to see if aid projects are delivering on their promises.

“To my mind, the most important barometer of aid effectiveness is how it impacts the people it is trying to help. That is why I will put the recipients of aid at the forefront of every story I report,” explains Costello in introducing the series.

“I am interested in knowing if programs work for them. I want to find out what happens to people who live at the end of dirt roads when charitable projects don’t pan out as promised.”

In this week’s podcast, I spoke with with Amy about the project (our producer re-recorded my questions to improve audio quality). We discuss her previous investigations into TOMS shoes and medical volunteers following the Haitian earthquake. Costello explains why she is driven to take a tougher look at the business of doing good and the resistance she receives from people in and out of the charity sector.

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Nets protect against malaria, scientists say (but you already knew that) | 

Global health number crunchers, led by Seattle’s Institute for Health Metrics and Evaluation, have determined after an exhaustive survey of medical and demographic records in 22 sub-Saharan African countries that treated bed nets do protect against malaria.

Duh, you say.

Flickr, 4Cheungs

You might well think it’s a no-brainer to ask if handing out hundreds of millions of insecticide-treated bed nets in sub-Saharan Africa helps to reduce malaria.

But it’s not.

To begin with, there are lots of things that can — and do — reduce the incidence of malaria deaths and illnesses. There is the practice of indoor household spraying of insecticide, which has been increased along with the massive campaign to distribute insecticide-treated nets (ITNs).

There also seems to be a routine ebb-and-flow of malaria severity in the tropics. The disease, like many things in nature, tends to alternate between severe and mild cycles. It’s not clear why.

Flickr, Aya Rosen

And there was this confusing report recently, about the unexplained decline in mosquito populations in parts of Africa. This happened even in places where nobody was spraying or using bed nets.

There’s changes in rainfall patterns and land use that affect mosquito breeding. There are changes in access to malaria drugs (which has also been increased in recent years). And there’s a chronic problem of misdiagnosis of malaria in poor communities lacking labs. Continue reading