The economic thinking behind malaria control in Africa is flawed. Bed nets, for example, are not marketed to individual Africans but to large organisations, which buy according to price rather than quality.

In this letter to the British Medical Journal, J. Derek Charlwood of the Danish Bilharziasis Laboratory in Mozambique argues that quality — not price — determines the development of markets for bed nets and that manufacturers should be challenged to produce more effective products.

He also says that for control programmes based on indoor spraying of insecticides, the World Health Organisation should issues guidelines in response to people's increasing refusal to have their house sprayed — in the same way it advocates changing treatment regimes as drug resistance grows.

Link to letter in the British Medical Journal

Reference: British Medical Journal 328, 1378 (2004)