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

public funds. It needs to slowly build its business while continually watching the
bottom line. If a public sector program fails, another program is created to take its
place. If a commercial venture fails, people lose their jobs and the company may go
bankrupt. This difference gives rise to very different perspectives.
Nigeria also points out the need for a close relationship between implementer
and client. The best situation is when the client and implementer function as a
team, both focusing on the overall goals with ongoing and frank discussions about
the steps ahead. When the inevitable problems occur, the “team” is more likely to
surmount them.
In designing and implementing projects in developing countries, in particular,
there are only two things to worry about: the things you can control and the things
you cannot. Keeping an eye on both with regular monitoring and adapting to
changing circumstances is the only way to achieve success.
The NetMark Nigeria project resulted in 14 million ITNs getting into house-
holds and protecting at least 21 million people from malaria. Even more important
was that this was accomplished through educating consumers and building a com-
mercial infrastructure and investment pattern that will keep supplying the fight
against malaria for as long as the fight needs to be waged.

QU ESTIONS F OR DISCUS S ION

1. What are some of the inherent tensions in creating and maintaining public–
private partnerships for the marketing of a health product? How can you find
a win–win situation as the basis for a public–private partnership?
2. What are the pros and cons of balancing sustainability (e.g., systematically
building a viable market for ITNs) and achieving quick public health impact
(e.g., distributing millions of free ITNs)? What can be done to balance cost re-
covery and equity?
3. NetMark decided it had to go far beyond the 4Ps in order to succeed in Nigeria.
Under what conditions should a social marketing program go beyond the 4Ps?
What are the risks, rewards, and other factors to consider?

RE F E RE NCES

Central Intelligence Agency (CIA). (2008). The World Factbook. Nigeria. Retrieved January 3,
2009, from www.cia.gov/library/publications/the-world-factbook/
Central Intelligence Agency (CIA). (2009). The World Factbook. Retrieved July 28, 2009, from
www.cia.gov/library/publications/the-world-factbook/