Lovita Birabwa, 4 1/2 years, left, and
Precious Nabawesi, 4 years.
Uganda

"None of our friends have nets... Grandmother puts it up every day before we sleep. Grandmother does not allow us to play in the net. We play before we come into the bedroom."

If kids don't have nets they will get sick. In 2008, model-based estimates suggest 31% of African households owned at least one insecticide treated net, and 24% of children under 5 used an insecticide treated net. There has been significant improvement over the last decade, but coverage is still far short of the UN target of 80% of all children under 5. Countries with a high level of success implementing bed nets and treatment programs have reported a 50% reduction in cases and deaths due to malaria.

It is not enough to only distribute nets. They must be both used and effective. A recent survey conducted in Togo found that 30 - 40% of treated nets examined did not pass the WHO bioassay for killing mosquitoes, or had at least one hole that was 10cm or larger, three years after their distribution. In Sierra Leone, household insecticide treated net ownership declined 37% three years after mass distribution. A successful net distribution campaign is not the end, but the beginning, of the fight against the desease.