The Ministry of Health has not given its official position on whether Zambia received in 2017 approximately 2.7 million DawaPlus alleged low quality treated nets, known in technical terms Long-Lasting Insecticide Nets (LLINs).
DawaPlus brand of controversial nets has ceased to exist. The manufacturer behind was called Tana Netting, a foreign company which shut down before rebranding itself last year as Moon Netting. Since then, there haven’t been any announcements on suspension, sanctions or fines as a reaction to these allegations. The rebranded company continues therefore to receive international donors’ funds to manufacture treated nets.
The Ministry of Health in Zambia has neither denied nor issued any public reaction to the first story we published in late August this year. It is also not clear whether Zambian authorities, along with their global partners in the fight against malaria, have placed the needed mechanisms for inspection and testing, to avoid falling victim, again, to the 2017 substandard nets scenario, be it by Moon Netting or any other company and manufacturer in the business.
The follow-up enquiry we’ve put was directed to the office of the ministry’s Permanent Secretary, to whom we’ve addressed a letter seeking clarifications and an official statement. Nonetheless, at the time of writing, he has not provided a response to the letter delivered to his office on 11th September this year.
According to the 2017 – 2021 National Malaria Elimination Strategic Plan, Zambia aims to achieve 100 percent malaria free status by 2021. Experts and malaria campaign groups warn that the use of untreated nets could hinder the country’s elimination targets, pushing this deadline even further into the next decade.
Allegations on treated nets produced by Moon Netting are that the doses of insecticide mixed to the polyester are not of the right proportions, making their efficiency below global standards set out by the World Health Organisation (WHO).
The WHO country office has also not officially stated their position on the matter. When the query was emailed to their public relations officer, it was passed on to a senior unnamed official who asked for more time to consult with the National Malaria Elimination Centre (NMEC). No reply had been received at the time of writing.
In our first story published three weeks ago [28 August 2019], the health ministry spokesperson, Dr. Abel Kabalo, said the Ministry is not aware of the matter. He asked for more time to establish the facts behind Dawa nets. To this day, he has not come out to give his findings.
Meanwhile, many other African countries have reportedly received sub-standard DawaPlus despite the allegations and the concerns. In Ghana, the National Malaria Control Programme (NMCP) confirmed earlier this month to the local media outlet City News that over one million of the alleged low-quality LLINs were distributed in the west African nation last year 2018. Ghana is one of the 23 states feared to have received DawaPlus nets.
Ms Otubea Owusu Akrofi, a Medical Entomologist at Ghana’s Vector Control Unit of the NMCP is quoted as having said, “1,053,650 Dawa Plus Nets came in-country in 2018, for the mass campaign and were distributed in April 2018”.
While questions around DawaPlus remain unanswered, Zambia has hosted a meeting for national malaria control programme coordinators from the eastern and southern Africa from 16 – 19 of this month (September).
According to the RBM Partnership to End malaria website, the sub-regional meeting will provide an opportunity for the NMCP managers and partners to present an update of their programme implementation status, the challenges being faced as well as the progress made in malaria control and elimination.
A coordinator of an organization involved in the end malaria campaign who asked to remain anonymous has asked authorities to clear the air surrounding the alleged “sub-standard” DawaPlus, as well as on announcing safeguards around nets quality and compliance. He hopes that the issue would be discussed and swiftly addressed during this event.
Zambia is a highly malaria-endemic country. According to official statistics, malaria incidences vary from under 50 per 1,000 population in some districts to above 500 cases per 1,000 population in others. Malaria prevalence in the most vulnerable age group (children under five years) varies from below 3 percent in some districts such as urban Lusaka to 30 percent in the most rural provinces.
Continuous distribution of LLINs through antenatal care, expanded programme for immunization and selected primary schools is one of government’s malaria elimination plans. However, observers and civil society health advocates fear that such efforts will be rendered meaningless if the country allows distribution of non-compliant treated nets, not only rendering global standards meaningless, but also putting lives of Zambians and other Africans at higher infection and mortality risks.