Rolling Back Malaria in Madagascar

According to the Ministry of Health, malaria is the leading cause of morbidity and mortality in Madagascar, with more than 1.4 million cases and nearly 30,000 deaths reported in 2000.

As in many countries, malaria has a disproportionate effect on children under the age of five, who account for 90 percent of malaria deaths. As a result of political instability in recent years, the Ministry of Health has been unable to make significant gains in the fight against malaria, and has relied increasingly upon the private sector and non-governmental organizations to support efforts to control the disease.

Political instability has also prevented Madagascar from forming a Country Coordinating Mechanism, and the Global Fund has accepted and approved a US$1.5 million malaria proposal from Population Services International, a nongovernmental organization that has pioneered the use of social marketing techniques throughout the world.

In an effort to reduce malaria-related mortality by 20 percent and morbidity by 30 percent among pregnant women and children, Population Services International will scale-up its social marketing of insecticide- treated nets to control the mosquito that carries the parasite.

Global Fund financing has proven to be the catalyst for a national consensus under the Roll Back Malaria partnership. The government of Madagascar, the United States Agency for International Development, UNICEF and the World Bank have agreed to develop and to utilize a single brand of long-lasting insecticide-treated nets that will be distributed primarily through Population Services International.

In addition, Population Services International will launch an information campaign to raise awareness of the benefits of insecticide- treated nets and to increase demand for these products.

Insecticide-treated nets will sell for approximately US$2.30, reduced from a previous price of nearly US$10 per net.

The profits will be rolled into a subsidy to enable some nets to be distributed free of charge to those who cannot afford to purchase them. With a target of purchasing and distributing 250,000 insecticidetreated nets over a two-year period, Population Services International, working with other non-governmental distributors, has begun implementing the program with an initial disbursement of almost US$600,000 from the Global Fund.