OVERVIEW OF LONG LASTING INSECTICIDAL NETS FOR MALARIA Challenges

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OVERVIEW OF LONG LASTING INSECTICIDAL NETS FOR
MALARIAChallenges Way Forward

• Malaria Medicines Supplies Services
• RBM Partnership Secretariat

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Products Available

• LLINs 2 WHOPES-certified products, 3
  manufacturers, 1 in Africa
• Olyset
• PermaNet
• 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 6-50m 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

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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
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Procurement Challenges LLIN or ITN?Strategic
Procurement Efficient Programme, Planning
Execution

• 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

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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
180cm
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FORECASTS / NEEDS

• 1. Recent RBM forecast establishes the vulnerable
  population in Africa (pregnant women lt5s) as
  122m. With funding reportedly available for
  approximately 40 million, the net-need GAP for
  this vulnerable group is /- 82m.
• COVERAGE IMPACT 20
• 2. By contrast, the current at risk population in
  Africa is 645m.
• COVERAGE IMPACT NEGLIGIBLE
• It is estimated that 50 million nets will need
  re-treatment by 2007 (upgrading to LLINs more
  desirable) and another 50 million worn nets will
  have to be replaced.
• Estimations should also take into account
  ITNs/LLINs needed according to population growth
  figures

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By December 2005, production should have
more than doubled
Production 02/05 Current production (06/05) Expected production (12/05)
Vestergaard Frandsen 15 m/year 18.5 m/year 30 m/year
Sumitomo 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
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.
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Way Forward

• 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)
• Increase knowledge on long term efficacy and
  social acceptability of LLINs under programme
  conditions
• Promote continued purchase and use of ITNs
• Closer MMSS collaboration with RBM partners
  operating in highly at-risk countries in Africa.
  AED/NetMark currently working to improve QC at
  existing African textile manufacturers as a
  precursor to development of the LLIN technology
  in Africa. With USAID funding, NetMark planning a
  Quality Control Workshop for September 2005 in
  Johannesburg

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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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• Thank you