Preventing Malaria: Because a Shot can Tear the Net

Using nets as the primary source of malaria prevention has gained tremendous momentum and currency in various parts of Sub-Saharan Africa. You might have seen such a poster:

And/or you may have chanced upon an advert like this one:

Then there are NGOs including this:

http://www.nothingbutnets.net/

The overriding logic is simple: if people use nets when indoors (or at least while sleeping), then they are safe from those marauding mosquitos.

While I am not a medical expert I wonder how this form of reasoning plays out when people are not in their nets. Mosquitos generally start operations in the late evening and most of the time people tend to be outside by then. In such cases nets can’t protect them. Mosquitos breed in stagnant water; this is something we learn as early as during Primary school. And our gutters have so much going on in them that these insects (and more) find them more accommodating than five star hotels.  By the time people access the safety of their treated nets then, chances are they have already been bitten a few times.

We should therefore focus (at the very least) a significant portion of the funds apportioned to netting on cleaning gutters and allowing them to facilitate waste disposal. Doing this will eventually prevent other killer diseases such as cholera and typhoid. There are also types of food that build the immune system to fight against malaria parasites. Like I said I don’t know much about medicine so I won’t explore that option. But do eat well :).

So the netting scheme is all well and good, but I think there are a few flaws in this reasoning, especially because (at least from my perspective) there is an undue bias toward this form of prevention.

In conclusion, I am not saying that it is wrong to promote nets. I also don’t mean to imply that there is a single simple solution to malaria prevention. However, nets appear to solve only a small portion of the problem. These stakeholders would probably make a much more lasting impact if they considered a multi-faceted approach to dealing with the epidemic.

After all, even in football a very strong shot can tear the net.