To reduce the burden of malaria in Africa, NetMark uses a comprehensive approach that builds sustainable commercial markets for ITNs while providing targeted subsidies to the very poor and biologically vulnerable. NetMark’s targeted subsidy programs create an immediate public health impact and work toward the equitable ownership of ITNs.

NetMark works with ministries of health, NGOs, donors, and the commercial sector to offer discount vouchers for ITNs or impregnation kits to pregnant women and children under five years old. These voucher programs most often use existing health interventions (e.g., antenatal clinics, immunization programs) to get discount vouchers to the target groups. NetMark’s commercial partners handle the logistics of ordering, stocking, and supplying the ITNs through retail outlets or special depots.

How NetMark’s Approach Works

NetMark’s targeted subsidy programs provide vouchers that usually offer a discount equal to half of an ITN’s commercial price. In some cases, as with vouchers distributed through the measles campaign, the voucher covers the full price of the ITN. Those who receive vouchers redeem them at retail outlets to obtain a discounted or free ITN. All retailers also offer ITNs to the general population at the full commercial price.

NetMark Targeted Subsidies in Action

Jointly with partners, NetMark piloted this approach in Zambia in 2002 before expanding it to five countries in 2004. Overall, NetMark plans to reach more than 500,000 vulnerable persons from 2003 to end 2005. The average redemption rate for the interventions already completed in Ghana and Zambia is 84%.

In countries such as Mali where the net coverage is already over 70%, NetMark is piloting voucher distribution for treatment kits with the National malaria Control Program, CARE and PSI. By the end of 2005, NetMark will have distributed 500,000 insecticide treatment kits to vulnerable populations who already own nets.

The Future of Targeted Subsidies

Because there will always be a portion of the at-risk population who cannot afford ITNs, there will always be a need for targeted subsidy programs. NetMark’s approach ensures that vulnerable populations can obtain ITNs (including free products), maximizes public health resources, and supports the development of sustainable commercial markets. To target vulnerable populations who reside in areas not reached by the commercial sector, NetMark is developing strategies that are not reliant on retail outlets. With the development of long lasting treatment kits, targeting mechanisms will be developed to treat nets already in use, specifically in countries where the net coverage is already high or in areas where ITNs have been distributed but need to be retreated.

The key to obtaining widespread ITN coverage lies in coordinating the free/subsidized efforts with those of the commercial sector so that immediate public health impact and long-term sustainability of ITNs are achieved.