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202 CHAPTER 9 ■ Creating a Commercial Market for Insecticide-Treated Mosquito Nets

Nigeria is a nation of great promise with an energetic and creative citizenry
and natural resources, but sociopolitical instability continues to hinder its
progress. It is a federal republic composed of 36 states and the Federal Capital
Territory of Abuja. The state governors generally have significant autonomy. The
Federal Ministry of Health (MOH) and National Malaria Control Program set
policies and guidelines, but each state has its own health minister and malaria di-
rector and often acts independently.

CASE STUDY
Insecticide-Treated Mosquito Nets

C A MPA I GN B A C KGR O UND A ND EN V IR O NMEN T

Malaria in Nigeria
Malaria is endemic throughout much of Nigeria, with more than 90% of the
population at risk. Malaria accounts for 25% of infant mortality and 30% of
childhood mortality with up to 200,000 child deaths occurring every year.
Malaria is the most common cause of hospital outpatient attendance in all age
groups. It is estimated that 50% of the population has at least one episode of
malaria each year. In the southern half of Nigeria, malaria is perennial (7 to 12
months a year), while in the northern regions it is seasonal (4 to 6 months a
year; NetMark, 2000).
The National Malaria Control Program made ITN use a key strategy for
malaria prevention. In 2000, NetMark’s survey of households with a child under
5 years of age found that only 10% of households had at least one mosquito net,
and none was a treated net. Only 6% had ever heard of an ITN. For a long time,
the importation of ready-made nets was prohibited. The few Nigerian net man-
ufacturers made nets only part of the year and manufactured other products like
mattress covers the rest of the time. Local production was not adequate to meet
the needs of the Nigerian market. The four main insecticide treatments are im-
ported from multinational companies with some brands packaged in the country.

ITN Activities before NetMark
Before NetMark started in Nigeria, no major efforts had been undertaken to ex-
pand the availability and use of ITNs. Untreated nets were sold in most parts of