See also related articles by Acosta and by Kheang.
Two articles appearing in this issue of GHSP illustrate the diverse challenges—and limitations—of malaria vector control that has become heavily reliant on mass distributions of free insecticide-treated nets (ITNs). On the surface, the 2 contexts could not seem more different. Acosta et al. describe a school-based distribution scheme in Cross River State, Nigeria,1 and Kheang et al.2 service delivery strategies for mobile and migrant populations in Myanmar: two vastly different scenarios with unique tactical problems, but with options limited by the common strategic solution being implemented.
Mass distribution of free ITNs has shown proven success across many contexts. Between 2000 and 2015, reported malaria cases dropped from 271 million to 212 million, and deaths from 864,000 to 429,0003; 68% of the decline was attributed to ITNs, 19% to availability of artemisinin-based combination therapy, and 13% to indoor residual spraying (IRS).4 However, according to the latest data from the World Health Organization (WHO), there were an estimated 216 million cases of malaria in 2016, marking a return to 2012 levels, and deaths stood at about 445,000, similar to the previous year.5 Speaking at a Malaria Summit during the recent 2018 Commonwealth Heads of Government Meeting in London, Dr. Tedros Ghebreyesus, WHO Director-General, said6:
The latest data show that we are now at …