The following post is by Amanda Makulec, Monitoring and Evaluation Associate, John Snow, Inc.
Malaria continues to be one of the leading causes of child deaths around the world, despite the availability of low cost interventions to prevent those deaths. According to USAID, the disease causes an estimated 700,000 deaths annually, with nearly 90% of the illness and death caused by malaria occurring among children under five years of age in sub-Saharan Africa.
A young girl in Timor-Leste carries home an insecticide treated net from a distribution site for the USAID Timor-Leste Health Improvement Project. Copyright JSI.
From the Nothing but Nets campaign to the WHO’s Roll Back Malaria Initiative, we’ve all heard about the impact a $5* bednet can make in the life of a child or a pregnant woman. The Institute for Health Metrics and Evaluation reported in September 2011 that homes owning at least one bednet were associated with a 23% reduction in child mortality. Other simple commodities, such as rapid diagnostic tests (RDTs) and the drugs used to treat malaria—a million ACTs—headline advocacy campaigns less frequently, but are essential for providing low-cost diagnosis and treatment of malaria.
As important as the $5 that buys the net is the part of the story often simplified to a sentence or two: how is that bednet transported from a storage facility and distributed to populations that need it most? Without a robust logistics system, bednets could easily remain unopened and packaged for transport, rather than hanging over the beds of small children and pregnant women in rural Uganda or elsewhere; ACTs may not be delivered to rural health facilities and remain in a warehouse; and RDTs may never be provided to community health workers to enable them to rapidly diagnose malaria in a child’s blood using only a small sample.
Responsibilities for procuring malaria commodities for the US President’s Malaria Initiative delivering them through effective supply chains, and, in turn, strengthening in-country supply chains to best manage malaria commodities are at the core of one task of the USAID | DELIVER PROJECT, implemented by John Snow, Inc. and various partners. The project purchases bednets, ACTs and RDTs and supports the supply chain systems to distribute the commodities to sites around the world. USAID | DELIVER PROJECT also works to overcome the challenges in procuring and transporting malaria prevention and treatment commodities to the populations that need them most, including global shortages of ACTs and questions of quality assurance around the safety and efficacy of various commodities. From 2007-2011, the team procured 22.4 million bednets, 17.5 million RDTs, and 47.6 ACTs for the prevention and treatment of malaria, which were delivered through both facility and community based programs.
On this World Malaria Day, let’s celebrate the achievements that have been made not only in the number of bednets procured and distributed, but also the immense achievements of the people and programs who make it possible to get the bednets and other commodities to the places they’re most needed. Achieving reductions in malaria morbidity and mortality worldwide—and meeting the ambitious goal to end preventable child deaths in a generation—will continue to require not only quality commodities, but also insightful problem solvers, creative thinkers, and skilled logisticians, all of whom make it possible for that $5 bednet to be delivered to a girl in Timor-Leste, like the one pictured above.
Interested in learning more about supply chains and logistics systems that take a bednet or a drug from a storage facility to a community? You can learn more about the USAID | DELIVER PROJECT, and review the findings of the recent External Evaluation of the President’s Malaria Initiative.
*USAID estimates the actual cost of a bednet is between $4 and $5.