1. OVERVIEW OF LONG LASTING INSECTICIDAL NETS FOR MALARIA Challenges & Way Forward Malaria Medicines & Supplies Services RBM Partnership Secretariat

2. Products Available LLINs: 2 WHOPES-certified products, 3 manufacturers, 1 in Africa LLINs: 2 WHOPES-certified products, 3 manufacturers, 1 in Africa OlysetOlyset PermaNet®PermaNet® New Development: New Development: Further technical development and analyses of potential end-point conversion of ordinary nets to LLINs through long-lasting treatment ongoing - Supply-side implication: 6-50m LLINs per annum. Net manufacturers are exploring the possibility of using the technology for factory treatment of nets.Further technical development and analyses of potential end-point conversion of ordinary nets to LLINs through long-lasting treatment ongoing - Supply-side implication: 6-50m LLINs per annum. Net manufacturers are exploring the possibility of using the technology for factory treatment of nets. Newest Development: Significant recent investor interest in LLIN technologySignificant recent investor interest in LLIN technology

3. Mosquito Net Options ITNs (Insecticide-treated Nets) LLINs (Long Lasting Insecticidal Nets) - Pre-treated (not recommended) - Untreated net - Insecticide kit - Bundled – untreated net and insecticide kit. Pre-treated Efficacy ~ 6 months/ treatment Efficacy 3-5 years Average Indicative Costs Untreated: ~ $ 2.00 Insecticide kit: ~ $ 0.70 Average Indicative Cost: ~ $5.00/ net Healthy supply situation Emerging Commodity – very limited source and supply

4. Procurement Challenges: LLIN or ITN? Strategic Procurement = Efficient Programme, Planning & Execution Disbursements must be linked to procurement and planned distribution Disbursements must be linked to procurement and planned distribution Product selection must be linked to established (procurement) lead times for LLINs Product selection must be linked to established (procurement) lead times for LLINs Procurement of LLINs must be linked to clear pre-transmission season availability and distribution objectives Procurement of LLINs must be linked to clear pre-transmission season availability and distribution objectives Programmes, therefore, must adopt open mind to ITN procurement and distribution Programmes, therefore, must adopt open mind to ITN procurement and distribution Use institutional buyers – benefit: more certain availability, stable price, country level value added, total cost of ownership reduction, economies of scale Use institutional buyers – benefit: more certain availability, stable price, country level value added, total cost of ownership reduction, economies of scale

5. PROCUREMENT CHALLENGES: LOGISTICS : Weights, Volumes & Costs Sample ITN LLIN - Type 1 LLIN - Type 2 Weight per bale (125 nets): 60 kg Weight per bale (100 nets): 42 kgs Weight per bale (40 nets): 29 kgs Volume per bale (125 nets): 0.260 cbm Volume per bale (100 nets): 0.1894 cbm Volume per bale (40 nets): 0.127 cbm (40 nets): 0.127 cbm Nets per 40' container: 37,000 pieces Nets per 40' container: 36,900 pieces Nets per 40' container: 16,800 pieces The Shipment and Distribution of nets are a major logistical challenge. Depending, for example, on the type of LLIN, international shipping and handling costs (ITSH), inland transportation, testing and inspection costs could run between 45% and 65% of net cost. N.B. Different types have different weights and volumes Data based on Rectangular net size 150 x 190 x 180cm

6. FORECASTS / NEEDS 1.Recent RBM forecast establishes the vulnerable population in Africa (pregnant women & <5s) as 122m. With funding reportedly available for approximately 40 million, the net-need GAP for this vulnerable group is +/- 82m. COVERAGE IMPACT: 20% 2.By contrast, the current at risk population in Africa is 645m. COVERAGE IMPACT: NEGLIGIBLE 3.It is estimated that 50 million nets will need re- treatment by 2007 (upgrading to LLINs more desirable) and another 50 million worn nets will have to be replaced. 4.Estimations should also take into account ITNs/LLINs needed according to population growth figures

7. By December 2005, production should have more than doubled By December 2005, production should have more than doubled Production 02/05 Current production (06/05) Expected production (12/05) Vestergaard Frandsen 15 m/year 18.5 m/year 30 m/year Sumitomo 3 m/year 3 m/year 4 m/year 13 m/year A to Z 0.9 m/year 1 m/year 7 m/year Total 18.9 m/year 23.5 m/year 50 m/year 1.6 m/month 2 m/month 4.2 /month The above figures are production objectives provided by manufacturers. Given the current problems manufacturers are having in scaling-up their production, such capacities could potentially not be achieved until well into 2006.

8. Way Forward Explore possibility of a NEPAD-led LLIN development and manufacturing consortia Explore possibility of a NEPAD-led LLIN development and manufacturing consortia Bring more pesticide and fibre technology companies on board (technology improved and better adapted for local production, reduced prices) Bring more pesticide and fibre technology companies on board (technology improved and better adapted for local production, reduced prices) Increase knowledge on long term efficacy and social acceptability of LLINs under programme conditions Increase knowledge on long term efficacy and social acceptability of LLINs under programme conditions Promote continued purchase and use of ITNs Promote continued purchase and use of ITNs Closer MMSS collaboration with RBM partners operating in highly at-risk countries in Africa. AED/NetMark currently working to improve QC at existing African textile manufacturers as a precursor to development of the LLIN technology in Africa. With USAID funding, NetMark planning a Quality Control Workshop for September 2005 in Johannesburg Closer MMSS collaboration with RBM partners operating in highly at-risk countries in Africa. AED/NetMark currently working to improve QC at existing African textile manufacturers as a precursor to development of the LLIN technology in Africa. With USAID funding, NetMark planning a Quality Control Workshop for September 2005 in Johannesburg

9. WAY FORWARD MMSS has embarked upon an intensive, multi-pronged initiative to ensure: MMSS has embarked upon an intensive, multi-pronged initiative to ensure: - Emergence of Public Private Partnerships - Technology Transfer (expand/replicate Sumitomo/A to Z initiative) - Bridging geographical gap between manufacturing and shipping points, a WTO/ITC initiative, (manufacturing/buying in Africa for Africa), thereby reducing significantly the delivery time for LLINs to highly vulnerable groups in at risk countries

10. Thank you