Fighting Malaria: The Bed Net Controversy

Jamal Protects his Children and Grandchildren with Mosquito NetsYesterday was world Malaria Day.  The social media community has embraced malaria of late, with the “king of twitter” Ashton Kutcher donating $100,000 to the cause after beating CNN to 1M twitter followers and some of twitter’s loudest voices such as Evan Williams (CEO of twitter) and Kevin Rose (Founder of Digg) tweeting to garner support for the cause.  Supporting the distribution of malaria nets has become the hot development cause du jour.

This has created quite a stir in some corners of the development community, with some lamenting the phenomena of perpetuating the problem with aid today.  From what I can see there are four primary issues being raised: 1) that the organizations distributing the nets don’t produce them in Africa 2) that these solutions do not enable Africa to develop the capacity to fight malaria on its own 3) that bed nets are only part of the fight against malaria and 4) celebrities are using important issues for self promotion and haven’t done their homework to really understand them.

I’ll give my thoughts on each in turn.

Organizations distributing the nets don’t produce them in Africa

I can understand the argument for the ideal solution being the same distribution of nets but all produced locally — then all of the economic activity from these organizations purchasing nets benefits Africans as well.  I could understand this being the best solution for Africa IF nets could be produced at the same level of quality and price as if produced elsewhere.  But if not, I’m not convinced it would be better to invest in local producers of the nets. If the nets can be produced cheaper in China, and hence distributed to more people, isn’t it possible the net benefit to Africans is greater (i.e. more lives are saved from malaria than producers are hurt by the competition?).  Not to be a die hard free trader here, but we have to look at the full picture and not just the net producers.

These solutions do not enable Africa to develop the capacity to fight malaria on its own

One of the loudest anti-aid voices of late is Dambisa Moyo, who has been all over media lately promoting her book “Dead Aid: Why Aid is Not Working and How There is a Beter Way for Africa.”  Here is what she has to say about supporting the approach to bed nets that organizations such as Malaria No More and Nothing But Nets are taking:

There’s a mosquito net maker in Africa. He manufactures around 500 nets a week. He employs ten people, who (as with many African countries) each have to support upwards of fifteen relatives. However hard they work, they can’t make enough nets to combat the malaria-carrying mosquito.

Enter vociferous Hollywood movie star who rallies the masses, and goards Western governments to collect and send 100,000 mosquito nets to the afflicted region, at a cost of a million dollars. The nets arrive, the nets are distributed, and a ‘good’ deed is done.

With the market flooded with foreign nets, however, our mosquito net maker is promptly put out of business. His ten workers can no longer support their 150 dependents (who are now forced to depend on hand outs), and one mustn’t forget that in a maximum of five years the majority of the imported nets will be torn, damaged and of no further use.

Moyo wants the malaria fight to happen locally.  But how much progress can impoverished local communities and developing country governments make against malaria in the near term?  How long are we willing to wait around for that capacity to develop? How many people are we willing to have die of malaria in the meantime?  How much more can be accomplished now by organizations with the capacity and resources of the West?

If our second best, and immediate answer, are malaria nets being distributed by well intentioned and well managed organizations – isn’t it better to do something? And wouldn’t that free up resources in developing countries to focus on the long list of other issues to tackle?

Another important point that Western backed aid is a mechanism to support R&D that might not happen otherwise.  An interesting thing about Nothing but Nets is that they are working with companies who have developed nets that release insecticide over a five-year period. This is an example of R&D that likely wouldn’t happen if the nets were produced in Africa – at least in the near term – either because they lack the expertise to develop the technology, or the market is unwilling to pay the premium for these types of nets that Nothing But Nets is.

I think that aid needs to work harder to build local capacity in tandem with current efforts, but I don’t support the idea that the current efforts do more harm than good.

Bed nets are only part of the fight against malaria

I don’t think there’s much to say here.  Yes, these organizations are focusing on one part of the problem.  Then this enables other organizations to focus on other mechanisms to combat the disease.

Celebrities are doing this for the publicity

Finally, I’m not sure why there is so much frustration about celebrities touting development issues. Even if it’s driven by their megalomania, I’m happy to see these problems get visibility.  And even if their messaging is wrong (of course bed nets alone can’t eradicate malaria, Ashton), — there is awareness, and it’s up to the rest of us to seize the opportunity to educate on how to think more holistically about these issues.

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