AFRO-NETS> My $1.00 X-mas gift to the RBM (2)

["A. A. van Geldermalsen" <aadvg@healthnet.zw>]

My $1.00 X-mas gift to the RBM (2)
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Dear Jacques,

I have followed the bednet discussion from the sideline and did a bit 
on it myself in our province Mashonaland Central in Zimbabwe. Your 
Christmas present prompted me to give my contribution, quickly off-
the-cuff and don't look back.

You have posed the rhetorical question:

>  "Does the world need a $1.00 bednet?" 

We have a very old problem here (applicable to many, if not all, pub-
lic health interventions).

The question is: Who defines need? In my definition it is the Health 
Sector. The so-called specialists or technical people. They tell you 
(the individual but also the 'communities' they 'serve') to vaccinate 
children, to not smoke, to not eat saturated fatty acids, to have 
regular exercise, to wear seatbelts / helmets / sun-creams / condoms, 
etc., etc. etc.

These knowledgeable 'specialists' define Health and in short: Know 
What Is Good For Us. Well, they have answered your question:

> Of those who responded 17.5% said NO, 40% said YES, 42.5% YES with 
specific requirements.

The question now is who *demands* a bednet? That means, who in the 
'community' asks for it and is willing to pay a price for it (in this 
case 1 US$)? By the way, the community also asks for: work, low 
prices for food, decent prices for their agricultural products, water 
at a convenient distance from their home, education for their chil-
dren, and yes, health services (often voiced as: A clinic next door), 
etc. etc.

Well, question of demand is just not for us (health workers) to an-
swer. At most we can try to let people make their own choices knowing 
the costs and benefits of alternatives. This has to be done by expos-
ing and explaining the alternatives (and first, let's  answer the 
questions that come from the people / patients / community members 
themselves!).

So how to go about the need / demand issue were it concerns $1.00 
bednets?

One way is to 'create demand', a tested technique to make people buy 
product X rather than Y: Coca Cola, Surf washing powder, Castle La-
ger, etc., or buy a product at all: cigarettes, the latest fashion,  
the newest hit record, tamagotchis, etc. It can also be used to let 
people *do* certain things: Use latrines rather than go to 'the 
bush', use mosquito nets / condoms, etc. Some people use this demand 
creation when it is deemed 'Good For The People' and call it "Social 
Marketing". (Marketing-) psychologists know you can go a long way in 
making people buy / do what you want them to. How far one can and 
should go in this 'demand creation' and the ethical consequences may 
give enough discussion to open anther conference site!

In short: The question whether the world needs a $1.00 net is irrele-
vant. Yes, people should know they would be better off if they pro-
tect themselves against mosquito bites. How they want to do that is 
the next question. A mosquito net may help, an insecticide treated 
net even more. A cheap net may be more affordable and within reach 
than a knitted one, etc.

So what you can do now is to start a factory, a distribution network, 
shops, etc. and try to sell $1.00 nets. Create the demand for as far 
as it is ethical. You may use all the advantages you mention in the 
advertisements and promotions that would be needed to sell the prod-
uct. There is no need to convince me to have a conical shape rather 
then a square one, that giving a colour better than leaving it white.

If it is unmistakably the world's best low-cost / disposable bednet 
as you say, proof it! (and make some money on the side you'd deserve 
it). The bottom line will be: sales figures of nets bought by people 
(willingly!) putting up their (own!) money to buy them. If the nets 
are bought and used, hurray! Hurray for the individual who has helped 
him/herself, hurray for the malaria control programme officer whose 
goal has come slightly closer.

Best regards and Christmas greetings,

Aad

--
A. A. van Geldermalsen
Medical Officer of Health
Dept. Epidemiology and Disease Control
Mashonaland Central
P.O. Box 98
Bindura, Zimbabwe 
Tel: +263-71-6/369 /479/381/204 (direct)
Fax: +263-71-6659
Tel: Private +263-71-7075 
mailto:aadvg@healthnet.zw

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