Mosquito nets can't cure malaria
IPN Opinion article
The Guardian: Comment is Free
When TV talent show American Idol urged viewers to donate money to save people from malaria, they probably weren't thinking of pop star Cheryl Cole – a judge on the UK rival X Factor. But the singer has just announced she caught it on holiday in Tanzania, joining the millions of victims of a disease that kills a child every 30 seconds, mainly in sub-Saharan Africa.
Once rumoured to be going over to American Idol, Cole could have joined the presenters campaigning for insecticide-treated mosquito nets, like so many celebrities, NGOs and politicians who embrace this inefficient cause and reject the proven techniques that save lives.
"One out of two people will not sleep under a net," Ray Chambers, the UN special envoy for malaria, has confirmed. In Uganda, for example, the government gave bed-nets to hundreds of children and monitored the results. A few weeks later, over half had malaria.
In some of the poorer parts of Africa nets are used for other means. Bed nets given away free can be traded for fishing, for use as sieves or even for wedding dress material. From a western perspective this may seem foolish and ungrateful, but therein lies the problem – judging the travails of impoverished regions from a safe distance often ignores local conditions and cultural preferences. Silver bullet solutions often miss their target.
The aid industry originally considered bed nets a major breakthrough in the fight against the disease. They are easy to use, very easy to distribute and require no professional oversight (unlike insecticides and medicines).
But a lot of people do not like sleeping under a stifling net in hot and humid countries where mosquitoes thrive. They might not mind if it were seen as a life-saving necessity but malaria is so common in Africa, and in most cases goes away by itself, that many consider it routine – a bit like the colds or flu in the west that used to kill many children and adults until a few decades ago.
The parallel would be distributing medical masks all over the US in winter to save the 36,000 Americans who die every year from flu: how many people would bother?
Furthermore, nets do not last for ever. It is not entirely clear how long the insecticide coating lasts, especially as some people will wash the nets and dry them in direct sunlight and the open air. Generally they last for three years, when they have to be retreated or replaced. Distributing bed nets may be relatively simple, but in this sense it is only a short-term solution.
Nets cannot conquer the disease. As demonstrated in many parts of the world, malaria is defeated by economic growth (which improves living conditions), insecticides (the falsely maligned DDT eradicated it in Europe, the southern USA and India only a few decades ago) and good healthcare. Without these sustainable methods, it can simply return. In Tanzania, malaria had been nearly eradicated on the island of Zanzibar before coming back.
The message here is that health, prosperity and development are not created by top-down one-size-fits-all schemes by international bureaucracies, but by empowering the poor to come up with their own solutions.
After the misguided Malaria No More bed net campaign backed by David Beckham, Andy Murray and Gordon Brown last year, we wish Cheryl Cole a speedy recovery and look forward to her celebrity campaign for economic freedoms and DDT.