siem reap town – Mosquito nets are one of the best ways to prevent malaria—no one would argue that. But ask whether a government should distribute nets for free, or charge for them to improve overall health care, that’s when arguments fly.
On their first morning of Mekong Malaria Symposium discussions Tuesday, the 320 participants from 24 countries immediately launched into an emotional debate over whether bednets—a key weapon in any successful fight against malaria, particularly in developing countries—should be donated or sold.
At either end of the debate were researchers who pioneered the use of bednets as protection against malaria, a deadly blood parasite. The mosquitoes that carry the disease bite at night, making bednet prevention highly effective.
Pierre Carnevale, research director of the Institute for Research and Development in Montpellier, France, first envisioned bednets as a prevention against malaria with two colleagues in 1983. Jo Lines of the London School of Hygiene and Tropical Medicine was among the researchers who took on the idea in 1984 and further developed it.
Carnevale said he strongly believes that bednets must be distributed for free in developing countries. Too much is at stake in terms of human development to even hesitate to do this, he said.
Protecting an entire family may take more than one bednet, with parents using the one, and the younger children another, or even a third, he said.
If a bednet is sold for $5, a family can afford only one bednet, if any at all. This leaves children unprotected, Carnevale said. Parents then must take time away from work to have children treated. Because of this, families fall into debt if more than one child gets sick, he said.
For Lines, the question of whether bednets should be sold must be weighed against the fact that governments in developing countries often don’t have the resources to pay for adequate health care.
People usually agree to buy bednets if they know the money will go towards getting a well-equipped health center nearby, he said. Research in Burma and Laos has demonstrated people’s willingness to pay for nets, Lines argued.
One can’t draw conclusions from one country to the next, said Roberto Garcia, European co-director of the European Commission Malaria Control Project in Cambodia.
“If you sell it, poor people won’t be able to afford such a prevention product,” he said. They will save the little money they have for medicine in case of sickness, and it takes education campaigns to make them spend on prevention, Garcia said.
Christopher Curtis of the London School of Hygiene said the cost of net replacement and insecticide in malaria-prone areas of Africa is $478 million a year, which is 55 percent of the $860 million spent annually on cat flea products in US, he said.