The targets for this goal are to halt and begin to reverse the spread of HIV and AIDS and the incidence of malaria and other major diseases by 2015.
Malaria is a disease transmitted by the bite of infected mosquitoes. There are 300–500 million cases of malaria each year, resulting in around one million deaths. Around 90% of these deaths are in Africa, mostly in young children. As well as fever, it causes many other health problems in children, including low birth-weight, epilepsy and anaemia. Malaria causes a fifth of all childhood deaths in Africa.
Nearly half of all requests for treatment in clinics and hospitals in Africa are for malaria. Malaria has a considerable impact on the economy of many countries by reducing the number of people able to work effectively.
Protecting our families from malaria
by Isabel Carter
Using insecticide-treated nets is one of the most effective ways of reducing the spread of malaria. The mosquitoes responsible for spreading malaria are most active at sunset, after dark and at sunrise. Sleeping under nets, particularly nets treated with insecticide, is the most effective way of protecting our families from malaria. If the family only has one net, young children and pregnant and nursing mothers should have priority for sleeping under the net.
Using nets correctly – treating them regularly with insecticide, mending holes and tucking them in to prevent mosquitoes entering – will greatly reduce cases of malaria. If nets are available locally at reasonable or subsidised prices, they are a valuable investment. ‘Perma’ nets are recommended as they only require treatment with insecticides every four years. If none are available, then it is possible to make your own nets.
Making mosquito nets
Netting can be bought in bulk and used to make many nets. Heavier quality netting is better, as the nets will be much stronger and less likely to tear. Square nets are easier to sew, give more protection and are more useful when several people are sharing one net. If netting is too expensive, is there any other thin, light material that could be used? For example, old sari material in Asia, fine muslin or shamma cotton in Ethiopia.
Bed nets Cut out netting for the side. First measure the width and length of the bed. Add these figures together, double the result and add 20cm for the seam. Allow plenty of length for the net so it can be tucked in. If people sleep on mats on the floor, nets will need to be longer. Sew up the side seam. Cut out a piece for the top, using the width and length of the bed. Sew this in, adding tapes and strengthening triangles in the four corners. Hem if necessary.
Doors and windows If possible, make frames for each window and door and fit mosquito wire. If this is too expensive, consider fitting netting to the windows and doors. Cut the netting to fit windows and doors, adding 40cm for edging. Make a wide hem at the top and bottom and push a stick of wood through both. Hang the top of the net curtain using hooks or bent nails. The weight of the wood in the bottom hem will help the net to hang straight. Tie the door curtain back during the day to avoid damaging it.
Insecticide treating Treat all nets and curtains with pyrethroid insecticides such as permethrin, etofenprox or deltamethrin, using the recommended dosages. Long-lasting insecticides are now available. Wash and dry used nets well with soap first. Soak the nets in a bowl containing insecticide at the correct dilution. Use plastic gloves or bags to cover your hands. Wring out the net and let it drip into the bowl until the drips stop. Nets can be hung over the bed to dry. This has the advantage of killing bedbugs! As the nets dry, turn them a couple of times to make sure the insecticide is evenly distributed.
Nets and curtains should be washed and treated with insecticide every six months. The insecticide will kill fish, so dispose of the waste carefully, away from rivers and ponds.
Case study: Smartnet
In Tanzania, a partnership between the Ministry of Health, NGOs, researchers, net manufacturers, insecticide suppliers, donor agencies, distributors, wholesalers and retailers was established. Known as Smartnet, the partnership aims at building up a market for insecticide treated nets while ensuring that poor people also have access. Tanzania now produces 90% of Africa’s insecticide-treated mosquito nets.
Other ideas to meet Goal 6
- Sprinkle neem leaves on the floor.
- Close windows and doors before sunset.
- Fill in any pools of stagnant water near the house.
- Clear waste vegetation near the house to prevent mosquitoes breeding.
- Provide education and discussion groups for young people about HIV and AIDS so they are well informed and fully aware of how the virus spreads
Progress for Goal 6
Some countries such as Senegal, Brazil, Thailand and Uganda have managed to halt the rate of increase of HIV and AIDS. However, many others have not and accurate figures are hard to obtain. Without a medical breakthrough, it is unlikely that the rate of increase of HIV and AIDS will be halted. Considerable progress has been made controlling and treating tuberculosis, but not malaria.