The world's scientific and social network for malaria professionals
Subscribe to free Newsletter | 10858 malaria professionals are enjoying the free benefits of MalariaWorld today

Mosquito Net Distribution Drive Blotched

November 9, 2011 - 21:31 -- Bart G.J. Knols

The article below was contributed by journalist Ntaryike Divine Jr. (Douala, Cameroon) as part of the SjCOOP project in collaboration with MalariaWorld.


On August 20 2011 amid bloated pomp, Cameroon’s Prime Minister Philemon Yang flagged off a countrywide government campaign to distribute over 8.6 million long lasting insecticidal mosquito bednets gratis.  But the operation that was initially slated to span a dozen days from 8 to 20 September is yet to take off in six of the country’s ten administrative regions.

And even where distribution has been declared complete, many enrolled beneficiaries are still without the treated nets.  “Here is my voucher which entitles me to a net.  But the distribution agents tell me they have run out of supplies,” Jacques Ndoum, a Yaoundé resident complained in late October.  Across the country, other omitted recipients are grumbling and threatening protests.


Cynics originally raised eyebrows over the timetabling of the venture.  They insinuated it was a tacit vote-canvassing gambit for 29-year-serving President Paul Biya, who sought and won reelection last 9 October.  “There can be no election gift better than that which takes care of the health of the population. The head of state has instructed that every family head in the country receives at least one bednet,” Health Minister Andre Mama Fouda declared at the campaign launch.


Sustained criticism over heavy politicization of the initiative purportedly motivated the Global Fund to demand its suspension until after the election.  The fund is financing the project, alongside the Cameroon government to the tune of over 34 billion FCFA [about US$68 million]. Yet despite the lag, abundant flaws rued at various levels of the drive stayed unfixed. 


Data garnered from a nationwide headcount of beneficiaries preceding distribution showed gross mismatches with field realities.  In the West Region for example, headcount statistics indicated over 1.8 million inhabitants with about 890.000 shortlisted beneficiaries.  But the region was eventually allocated only 640.000 nets.


“On paper, the technicians presumed it would be easy, but the realities in the field have shown it’s a complex operation.  The first complexity is transportation.  We had planned to distribute before the start of the rainy season, but the rains caught up with us and in several areas it was impossible to distribute,” Minister Fouda acknowledged on state radio.  


He also named reliance on now-evolved 2008 census statistics, and the omission of several households as other pitfalls. Elsewhere, various civil society associations coopted to assist dropped out upon discovering they would not be remunerated, while some headcount and distribution agents were simply chased away by suspicious family heads.  


Meantime, residents of the country’s largest city Douala are still waiting for distribution to commence. “We are waiting for the minister to give the go-ahead for distribution to begin.  Over 1.2 million bednets are due distribution in the Littoral Region,” regional public health delegate, Andre Bita Fouda announced late October. 


Across the malaria-endemic city, some anxious voucher-holders are heaping accusations on local health officials.  “They have derailed the nets and soon you will find them on shelves at pharmacies and markets where they will sell like hot cake because we hear they have been designed to last longer,” Melanie Talom, a housewife and mother of two charged.


Mama Fouda has issued a release reiterating the nets are not for sale.  He has urged the population to denounce anyone vending or hoarding the nets.  He says the Global Fund will undertake an audit of the process when it is completed nationwide, and culprits will be harshly punished.


Nonetheless, the 2011 treated bednet distribution campaign is the country’s hugest.  Between 2003 and 2009, only 2.4 million nets were shared out to pregnant women and for kids under five years old.  The long lasting insecticidal nets are impregnated with a substance that kills mosquitoes when they come in contact with it.


‘Such mass distributions have enabled considerable reduction of malaria-related deaths in other African countries and the impact should also be positive for Cameroon. Treated nets can curb deaths by between 20 to 25 percent and have proven to be the most effective method of preventing transmission of the malaria parasite by the female anopheles mosquito which bites mostly at night,” Dr Leopold Gustave Lehman, parasitology researcher at the University of Douala explained.


Latest figures from the Ministry of Public Health show a malaria-related mortality rate of 43 percent, implying the disease snuffs out more lives than AIDS and TB put together.  40 percent of consultations in health structures are still blamed on malaria, which causes an annual GDP loss of 1.3 percent.  


The ongoing campaign is intended to scale up the usage of nets in Cameroon from 13 to 80 percent among high risk populations and help the country attain Millennium Development Goals 3, 4 and 5 by 2015.  


However, there are looming fears the nets may again end up as window blinds, material for wedding gowns or serve as fishing nets.  Elsewhere across the country, some complain that sleeping under the nets gives the spooky impression they’re lying in coffins, while others say their tight meshing hinders the smooth flow of air.