OVERVIEW OF LONG LASTING INSECTICIDAL NETS FOR MALARIA

OVERVIEW OF LONG LASTING INSECTICIDAL NETS FOR MALARIA Challenges & Way Forward Malaria Medicines & Supplies Services RBM Partnership Secretariat

Products Available n n LLINs: 2 WHOPES-certified products, 3 manufacturers, 1 in Africa • Olyset • Perma. Net® New Development: • Further technical development and analyses of potential end-point conversion of ordinary nets to LLINs through long-lasting treatment ongoing - Supply-side implication: 6 -50 m LLINs per annum. Net manufacturers are exploring the possibility of using the technology for factory treatment of nets. Newest Development: • Significant recent investor interest in LLIN technology

Mosquito Net Options ITNs (Insecticide-treated Nets) LLINs (Long Lasting Insecticidal Nets) - Pre-treated (not recommended) - Untreated net - Insecticide kit - Bundled – untreated net and insecticide kit. Pre-treated Efficacy ~ 6 months/ treatment Efficacy 3 -5 years Average Indicative Costs Untreated: ~ $ 2. 00 Insecticide kit: ~ $ 0. 70 Average Indicative Cost: ~ $5. 00/ net Healthy supply situation Emerging Commodity – very limited source and supply

Procurement Challenges: LLIN or ITN? Strategic Procurement = Efficient Programme, Planning & Execution n n Disbursements must be linked to procurement and planned distribution Product selection must be linked to established (procurement) lead times for LLINs Procurement of LLINs must be linked to clear pre-transmission season availability and distribution objectives Programmes, therefore, must adopt open mind to ITN procurement and distribution Use institutional buyers – benefit: more certain availability, stable price, country level value added, total cost of ownership reduction, economies of scale

PROCUREMENT CHALLENGES: LOGISTICS : Weights, Volumes & Costs The Shipment and Distribution of nets are a major logistical challenge. Depending, for example, on the type of LLIN, international shipping and handling costs (ITSH), inland transportation, testing and inspection costs could run between 45% and 65% of net cost. N. B. Different types have different weights and volumes Sample ITN LLIN - Type 1 LLIN - Type 2 Weight per bale (125 nets): 60 kg Weight per bale (100 nets): 42 kgs Weight per bale (40 nets): 29 kgs Volume per bale (125 nets): 0. 260 cbm Volume per bale (100 nets): 0. 1894 cbm Volume per bale (40 nets): 0. 127 cbm Nets per 40' container: 37, 000 pieces Nets per 40' container: 36, 900 pieces Nets per 40' container: 16, 800 pieces Data based on Rectangular net size 150 x 190 x 180 cm

FORECASTS / NEEDS 1. Recent RBM forecast establishes the vulnerable population in Africa (pregnant women & <5 s) as 122 m. With funding reportedly available for approximately 40 million, the net-need GAP for this vulnerable group is +/- 82 m. COVERAGE IMPACT: 20% 2. By contrast, the current at risk population in Africa is 645 m. COVERAGE IMPACT: NEGLIGIBLE 3. It is estimated that 50 million nets will need retreatment by 2007 (upgrading to LLINs more desirable) and another 50 million worn nets will have to be replaced. 4. Estimations should also take into account ITNs/LLINs needed according to population growth figures

By December 2005, production should have more than doubled Production 02/05 Current production (06/05) Expected production (12/05) 18. 5 m/year 30 m/year 3 m/year 4 m/year 13 m/year A to Z 0. 9 m/year 1 m/year 7 m/year Total 18. 9 m/year 23. 5 m/year 50 m/year 1. 6 m/month 2 m/month 4. 2 /month Vestergaard Frandsen Sumitomo 15 m/year The above figures are production objectives provided by manufacturers. Given the current problems manufacturers are having in scaling-up their production, such capacities could potentially not be achieved until well into 2006.

Way Forward n n Explore possibility of a NEPAD-led LLIN development and manufacturing consortia Bring more pesticide and fibre technology companies on board (technology improved and better adapted for local production, reduced prices) n Increase knowledge on long term efficacy and social acceptability of LLINs under programme conditions n Promote continued purchase and use of ITNs n Closer MMSS collaboration with RBM partners operating in highly at-risk countries in Africa. AED/Net. Mark currently working to improve QC at existing African textile manufacturers as a precursor to development of the LLIN technology in Africa. With USAID funding, Net. Mark planning a Quality Control Workshop for September 2005 in Johannesburg

WAY FORWARD ▪ MMSS has embarked upon an intensive, multi-pronged initiative to ensure: - Emergence of Public Private Partnerships - Technology Transfer (expand/replicate Sumitomo/A to Z initiative) - Bridging geographical gap between manufacturing and shipping points, a WTO/ITC initiative, (manufacturing/buying in Africa for Africa), thereby reducing significantly the delivery time for LLINs to highly vulnerable groups in at risk countries

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