Desperate Times Call For….. Innovation

One of the poorest countries in Africa, Niger also suffers one of the deadliest malaria epidemics on the continent - one in four children in the country die as a result of the disease. However, according to an article in this week’s Lancet (free registration), Niger is taking dramatic and strategic steps to combat malaria among women and children by distributing insecticide-treated nets in hard-to-reach areas.

The biggest innovation was using an existing public-health program to spread the word about the free bednets. This was done by working with the Niger Ministry of Health to attach net distribution scheme to a polio vaccination program that had already been knocking on doors of village huts for more than a decade.“We used the captive audience to tell them where to pick up the service”, says Stefan Hoyer, WHO’s adviser on malaria for Africa, who was one of the principal architects of the effort. By “piggy-backing” on the well-established polio campaigns, the organizers were able to reach a vast population extremely quickly.

Only time and the coming rainy season will show the effectiveness of the intervention, including whether the bednet distribution and education is sufficient to inspire behavior change. However, despite the final outcome, the initiative should be applauded for its innovation in response to crisis. The eradication of polio will be a stunning achievement in public health. Finding effective ways to tap into and build off of the infrastructure that makes it possible (including in the dangerous, mountainous and desert corners of the earth) will be a stunning gift to all.