OVERVIEW OF LONG LASTING OVERVIEW OF LONG LASTING INSECTICIDAL NETS FOR MALARIAINSECTICIDAL NETS FOR MALARIA

Challenges & Way Forward Challenges & Way Forward

Malaria Medicines & Supplies ServicesMalaria Medicines & Supplies ServicesRBM Partnership Secretariat RBM Partnership Secretariat

Products AvailableProducts Available LLINs: 2 WHOPES-certified products, 3 manufacturers, 1 in AfricaLLINs: 2 WHOPES-certified products, 3 manufacturers, 1 in Africa

• OlysetOlyset • PermaNetPermaNet®®

New DevelopmentNew Development: : • Further technical development and analyses of potential Further technical development and analyses of potential end-end-

point conversionpoint conversion of ordinary nets to LLINs through long- of ordinary nets to LLINs through long-lasting treatment ongoing - Supply-side implication: 6-50m lasting treatment ongoing - Supply-side implication: 6-50m LLINs per annum. LLINs per annum. Net manufacturers are exploring the Net manufacturers are exploring the possibility of using the technology for factory treatment of possibility of using the technology for factory treatment of nets.nets.

Newest DevelopmentNewest Development::• Significant recent investor interest in LLIN technologySignificant recent investor interest in LLIN technology

Mosquito Net OptionsMosquito Net Options

ITNs ITNs (Insecticide-treated Nets)(Insecticide-treated Nets)

LLINs LLINs (Long Lasting Insecticidal (Long Lasting Insecticidal

Nets)Nets)

- Pre-treated (not - Pre-treated (not recommended)recommended)- Untreated net- Untreated net- Insecticide kit - Insecticide kit - Bundled – untreated net and - Bundled – untreated net and insecticide kit.insecticide kit.

Pre-treatedPre-treated

Efficacy ~ 6 months/ Efficacy ~ 6 months/ treatmenttreatment

Efficacy 3-5 yearsEfficacy 3-5 years

Average Indicative CostsAverage Indicative CostsUntreated: ~ $ 2.00Untreated: ~ $ 2.00Insecticide kit: ~ $ 0.70Insecticide kit: ~ $ 0.70

Average Indicative Cost:Average Indicative Cost:~ $5.00/ net~ $5.00/ net

Healthy supply situationHealthy supply situation Emerging Commodity – very Emerging Commodity – very limited source and supply limited source and supply

Procurement Challenges: LLIN or ITN?Procurement Challenges: LLIN or ITN?Strategic Procurement = Efficient Programme, Planning & ExecutionStrategic Procurement = Efficient Programme, Planning & Execution

Disbursements Disbursements mustmust be linked to procurement be linked to procurement and planned distributionand planned distribution

Product selection Product selection mustmust be linked to established be linked to established (procurement) lead times for LLINs(procurement) lead times for LLINs

Procurement of LLINs Procurement of LLINs mustmust be linked to clear be linked to clear pre-transmission season availability and pre-transmission season availability and distribution objectivesdistribution objectives

Programmes, therefore, Programmes, therefore, mustmust adopt open mind adopt open mind to ITN procurement and distribution to ITN procurement and distribution

Use institutional buyers – benefit: more certain Use institutional buyers – benefit: more certain availability, stable price, country level value availability, stable price, country level value added, total cost of ownership reduction, added, total cost of ownership reduction, economies of scale economies of scale

PROCUREMENT CHALLENGES: PROCUREMENT CHALLENGES: LOGISTICS : Weights, Volumes & CostsLOGISTICS : Weights, Volumes & Costs

Sample ITNSample ITN LLIN - Type 1LLIN - Type 1 LLIN - Type 2LLIN - Type 2

Weight per bale Weight per bale (125 nets): 60 (125 nets): 60

kg kg

Weight per bale Weight per bale (100 nets): 42 (100 nets): 42

kgskgs

Weight per bale Weight per bale (40 nets): 29 kgs(40 nets): 29 kgs

Volume per bale Volume per bale (125 nets): (125 nets): 0.260 cbm0.260 cbm

Volume per bale Volume per bale (100 nets): (100 nets): 0.1894 cbm0.1894 cbm

Volume per baleVolume per bale (40 nets): 0.127 (40 nets): 0.127

cbmcbm

Nets per 40' Nets per 40' container: container:

37,000 pieces37,000 pieces

Nets per 40' Nets per 40' container: container:

36,900 pieces36,900 pieces

Nets per 40' Nets per 40' container: container:

16,800 pieces16,800 pieces

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

Data based on Rectangular net size 150 x 190 x 180cm

FORECASTS / NEEDSFORECASTS / NEEDS

1.1. Recent RBM forecast establishes the Recent RBM forecast establishes the vulnerable populationvulnerable population in Africa (pregnant women & <5s) as in Africa (pregnant women & <5s) as 122m122m. With funding . With funding reportedly available for approximately 40 million, the net-reportedly available for approximately 40 million, the net-need need GAPGAP for this vulnerable group is +/- 82m. for this vulnerable group is +/- 82m.COVERAGE IMPACTCOVERAGE IMPACT: 20%: 20%

2.2. By contrast, the current By contrast, the current at riskat risk population in Africa is population in Africa is 645m.645m.COVERAGE IMPACTCOVERAGE IMPACT:: NEGLIGIBLENEGLIGIBLE

3.3. It is estimated that 50 million nets will need re-treatment It is estimated that 50 million nets will need re-treatment by 2007 (upgrading to LLINs more desirable) and another by 2007 (upgrading to LLINs more desirable) and another 50 million worn nets will have to be replaced. 50 million worn nets will have to be replaced.

4.4. Estimations should also take into account ITNs/LLINs Estimations should also take into account ITNs/LLINs needed according to population growth figuresneeded according to population growth figures

By December 2005, production By December 2005, production should should

have more than doubledhave more than doubledProduction 02/05Production 02/05 Current Current

production production (06/05)(06/05)

Expected Expected production production

(12/05)(12/05)

Vestergaard Vestergaard FrandsenFrandsen

15 m/year15 m/year 18.5 m/year18.5 m/year 30 m/year30 m/year

SumitomoSumitomo 3 m/year3 m/year 4 m/year4 m/year 13 m/year13 m/year

A to ZA to Z 0.9 m/year 0.9 m/year 1 m/year1 m/year 7 m/year7 m/year

TotalTotal 18.9 m/year18.9 m/year 23.5 m/year23.5 m/year 50 m/year50 m/year

1.6 m/month1.6 m/month 2 m/month2 m/month 4.2 /month4.2 /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.

Way ForwardWay Forward

Explore possibility of a NEPAD-led LLIN development and Explore possibility of a NEPAD-led LLIN development and manufacturing consortiamanufacturing consortia

Bring more pesticide and fibre technology companies on board Bring more pesticide and fibre technology companies on board (technology improved and better adapted for local production, (technology improved and better adapted for local production, reduced prices)reduced prices)

Increase knowledge on long term efficacy and social Increase knowledge on long term efficacy and social acceptability of LLINs under programme conditionsacceptability of LLINs under programme conditions

Promote continued purchase and use of ITNsPromote continued purchase and use of ITNs

Closer MMSS collaboration with RBM partners operating in Closer MMSS collaboration with RBM partners operating in highly at-risk countries in Africa. AED/NetMark currently highly at-risk countries in Africa. AED/NetMark currently working to improve QC at existing African textile working to improve QC at existing African textile manufacturers as a precursor to development of the LLIN manufacturers as a precursor to development of the LLIN technology in Africa. With USAID funding, NetMark planning a technology in Africa. With USAID funding, NetMark planning a Quality Control Workshop for September 2005 in JohannesburgQuality Control Workshop for September 2005 in Johannesburg

WAY FORWARD WAY FORWARD

▪ ▪ MMSS has embarked upon an intensive, multi-MMSS has embarked upon an intensive, multi-pronged initiative to ensure: pronged initiative to ensure:

- Emergence of Public Private Partnerships- Emergence of Public Private Partnerships

- Technology Transfer - Technology Transfer (expand/replicate Sumitomo/A to Z initiative) (expand/replicate Sumitomo/A to Z initiative)

- Bridging geographical gap between - Bridging geographical gap between manufacturing and shipping points, a WTO/ITC manufacturing and shipping points, a WTO/ITC initiative, (manufacturing/buying in Africa for initiative, (manufacturing/buying in Africa for Africa), thereby reducing significantly the delivery Africa), thereby reducing significantly the delivery time for LLINs to highly vulnerable groups in time for LLINs to highly vulnerable groups in at riskat risk countries countries

Thank youThank you