The Journey of 7 Million Bed Nets

A leading cause of illness and death, malaria is one of Zambia’s major public health challenges. To families like Joyce Tembo’s, malaria looms as an increasing threat as Zambia’s November rainy season approaches. 

With the world’s attention fixed on the COVID-19 pandemic, gains in malaria elimination were at risk. Dedicated teams, led by the Zambian government’s National Malaria Elimination Program (NMEP), ensured millions of Zambians, like Joyce, continued to  receive life-saving protection from malaria.

During the 2020-2021 anti-malaria campaign, over 7 million Zambian families received insecticide-treated bednets (ITNs) to protect from malaria.  In support of the campaign, the U.S. President’s Malaria Initiative (PMI), through the United States Agency for International Development (USAID) and the Centers for Disease Control and Prevention (CDC) implementing partners, procured and distributed over 2 million ITNs in four Zambain provinces – Eastern, Luapula, Muchinga and Northern.

Joyce Tembo, from Gainzani village in Eastern Province, is one of the millions of Zambians who received a bed net during the 2020 campaign. However, the journey of Joyce’s ITN began many months before in the country’s capital, Lusaka, about 675 kilometers west of her village. Preparations for the mass campaign began in late 2019. The process of carrying out a bed net campaign requires months of planning, dozens of staff training sessions at provincial, district and community levels, as well as complex logistical arrangements.

Prior to ITN distribution to the various districts, households throughout the country are registered to determine the total number of nets needed in each community.  With the quantity of nets needed calculated, the nets begin their two-day journey east to Chipako Health Facility in Mambwe district, a regional distribution hub. 

Distributing nets on a massive scale comes with challenges such as restricted access to rural communities due to poor road networks and limited access roads/bridges due to the rains. Committed transporters, contracted by the USAID Global Health Supply Chain project, navigate difficult terrain and challenging roads to ensure the ITNs make it to the regional distribution hubs on time.

Once at the Chipako Health Facility, community-based volunteers (CBVs) arrive on foot or bicycle to pick up the ITNs for distribution in their target communities. Respected members in their community and key to the successful distribution and promotion of ITNs, CBVs must be able to read and write and have access to a bicycle to help with the campaign. 

One such dedicated CBV is Ester Zulu, who lives in Minga Stop East village with her family in Eastern Province’s Petauke District, where she is responsible for delivering 600 ITNs to 6 villages in her area. Ester and her fellow CBVs also play a vital role in sensitizing their communities on how to use ITNs correctly and encouraging them to sleep under an ITN every night.

Monitoring throughout the campaign is critical to keep the campaign on track. Patrick Nsofu, Public Health Officer in Mambwe district, is in charge of ensuring the CBVs receive the correct number of nets for delivery to the villages and that the correct paperwork is completed after the nets are delivered to ensure the ITNs make it to their designated final destination.

The road to Joyce Tembo and her family was long and bumpy, but with help of trusted CBVs, committed transporters, and thorough planning teams, families like the Tembo’s are now at a reduced risk of contracting malaria because they are able to sleep under an ITN every night.

As a result of the PMI 20210-21 ITN mass campaign, with support from NMEP, PMI, USAID, CDC and other partners, seven million bed nets were delivered across Zambia, protecting over 14 million Zambians, like Joyce and her family, from malaria.