Bed nets: free or for sale?



Insecticide-treated bed nets have been hailed as one of the most effective and cheapest ways of combating malaria. Studies show that using these nets can reduce mortality in children under five by about 20 percent, and malarial diseases among children and pregnant women by up to 50 percent.

The long-running debate particularly among economists is how the nets should be distributed. Should they be given out for free or should organizations charge a price for them?

New York University economist William Easterly has argued for selling them at a minimal price, known as cost-sharing, as this will ensure that they will go to people who really need them. The sense of investment created by paying for the bed nets would be an incentive for people to use them properly.

Giving them away has resulted in the nets being diverted to the black market or used for fishing or even as wedding veils, Easterly said in his book White Man's Burden.

Dean Karlan of Yale University contends in a recent article that providing bed nets free of charge extends the benefits even to those who don't use them by breaking the chain of transmission.

He cites research done in western Kenya which found no difference in usage between people who bought them and those who didn't pay anything. The research also hasn't found evidence that cost-sharing filters the recipients of bed nets according to greater need. Those who purchased the nets weren't any sicker than those who received them for free.

What do you think? What would be a more effective way of ensuring that insecticide-treated bed nets will really serve their purpose?

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