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9

C H APT E R

Creating a

Commercial Market

for Insecticide-

Treated Mosquito

Nets in Nigeria

Willard D. Shaw

The best-laid schemes of mice and men often go awry.
—Robert Burns

Malaria is one of the greatest health scourges on the planet, infecting 300 to 500
million people every year and causing at least 1 million deaths—mostly among
pregnant women and children under 5 years of age in Africa. Malaria costs Africa
$12 billion in lost gross domestic product (GDP), reducing economic development
by 1.3% annually. Many poor families spend a significant portion of their income
on the prevention and treatment of multiple cases of malaria each year. It is Africa’s
leading cause of under-5 mortality (20%) and constitutes 10% of the continent’s
overall disease burden. It accounts for 40% of public health expenditure, 30% to 50%
of inpatient admissions, and up to 50% of outpatient visits in areas with high
malaria transmission (Roll Back Malaria [RBM], 2008).
The international health community has launched a variety of initiatives to re-
duce the impact of malaria, including the Roll Back Malaria (RBM) Partnership in
1998; the Global Fund for AIDS, Tuberculosis, and Malaria (2001); and the $2 billion