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News for 2019, November - Show latest items

PBO Net Trial Results Released (to 18 months)


AMF funded the largest trial ever undertaken to assess the effectiveness of a new type of net in dealing with those malaria-carrying mosquitoes that are developing some level of resistance to the insecticide used on nets. The results of the first 18 months of the trial have just been released.

The net type being assessed was the ‘PBO net’, so called as piperonyl butoxide is added to the net to counteract the resistance mechanism in the mosquito, thereby allowing the insecticide on the net to work as usual and kill the mosquito.

The results show that both conventional nets and PBO nets reduced malaria prevalence. PBO nets were more effective, both at killing mosquitoes and at reducing malaria in the population. Specifically, after 6 months (of usage) PBO nets were 26% more effective at reducing malaria, after 12 months 27% better, and after 18 months 16% better.

PBO nets are currently more expensive than conventional LLINs. However, manufacturing capacity is growing and, as it does, PBO nets are likely to become more attractive compared to conventional nets in countries (like Uganda) of high resistance.


The trial used an innovative design, being conducted as part of Uganda’s nationwide net campaign which began in 2017. It assessed new nets in the context of a mass campaign rather than in a separate field trial. AMF provided 6 million PBO nets and 6 million conventional nets to the campaign and the study took place across 104 districts, approximately half the population and land area of the country.

Data was analysed from blood tests of over 23,000 children 2 to 10 years old. After 18 months, malaria prevalence had declined with the use of both conventional nets and PBO nets. PBO nets were more effective in reducing malaria prevalence at each of the time points – 6, 12 and 18 months. This was reinforced by a very significant effect on the mosquito population. After 12 months, households supplied with the PBO-treated nets had 80% fewer malaria-carrying mosquitoes compared to households using conventional LLINs.

The results therefore suggest that although both PBO and conventional nets were effective, PBO nets provided better protection against malaria in the setting of high-level insecticide resistance.

AMF’s approach is to evaluate any malaria resistance data in an area to receive nets, then apply the most cost-effective net intervention on a region-by-region or country-by-country basis. We do this by applying the research to country data, and work in close collaboration with national malaria programme teams and other partners. We strongly encourage more data collection on resistance patterns and the nature of that resistance, and will continue to encourage research into this critical area.

AMF is very pleased that the research concluded on time, on budget and gained additional support from DFID (for the 18 month results) and The Gates Foundation (for the 24 month results to come).

We would like to thank the teams at the Liverpool School of Tropical Medicine, London School of Hygiene and Tropical Medicine and the Makerere University Kampala for their hard work throughout the study.

The study is openly accessible at The Lancet: Effect of long-lasting insecticidal nets with and without piperonyl butoxide on malaria indicators in Uganda.

AMF funds 16.2 million nets for distribution in the Democratic Republic of Congo (DRC) in 2020/21

Nets will be distributed in three waves: Kinshasa, Kongo Centrale (Q2/Q3 2020); Tshopo, Haut Uele, Ituri (Q3/Q4 2020); Maniema, Bas Uele (Q1 2021)

AMF has signed an agreement with the DRC Ministry of Health to fund 16.2 million nets for distribution from June 2020 to March 2021. This represents 67% of DRC’s long-lasting insecticide treated net (LLIN) need for the 2020/21 portion of their three-year rolling universal coverage campaign.

DRC is one of the two most malarious countries in the world with malaria responsible for the deaths of at least 100 children under 5 each day in DRC alone. Malaria is one of the primary health issues in DRC, with high incidence levels seen across the majority of the country.

The nets will be distributed in seven of DRC's 26 provinces, specifically:

  1. Kinshasa: 4.1m nets to protect 7.4m people, distribution during Q2/Q3 2020
  2. Kongo Central: 2.6m nets to protect 4.7m people, distribution during Q2/Q3 2020
  3. Tshopo: 2.2m nets to protect 4m people, distribution during Q3/Q4 2020
  4. Haut Uele: 1.2m nets to protect 2.2m people, distribution during Q3/Q4 2020
  5. Ituri: 3.6m nets to protect 6.5m people, distribution during Q3/Q4 2020
  6. Maniema: 1.7m nets to protect 3m people, distribution in Q1 2021
  7. Bas Uele: 0.8m nets to protect 1.4m people, distribution in Q1 2021

In total, 29 million people will be protected from the bites of malaria-carrying mosquitoes.

These nets have the potential to play a major part in reducing deaths and illness. This quantity of nets could be expected to prevent 10,500 deaths, 5 million cases of malaria and make a material impact on the economy of DRC. It is estimated that the improvement in GDP (Gross Domestic Product), a measure of economic performance, would be about USD 385 million.

AMF allocates individual donations to specific distributions and so far we have allocated 50,310 individual donations from 12,990 donors from 105 countries. These figures will increase as further donations are allocated. Many donations, large and small, help fund these nets.

We will report openly on progress and performance throughout and after the distribution.

Key elements of our agreement include:

  1. AMF is funding 16,200,000 LLINs for distribution in 2020/21
  2. This is a co-funding partnership with non-net costs (shipping, pre-distribution, distribution) funded by the Global Fund
  3. To support accurate data gathering, re-checks of net need numbers will take place by re-visiting a material number of households chosen at random.
  4. Household-level data will be collected on paper or using electronic-devices and then entered into AMF’s Data Entry System (DES) for analysis and verification. This, and the above elements combined, are the basis for a highly accountable distribution.
  5. Post-distribution monitoring of net use and condition (PDMs) will take place every nine months for two and a half years in all districts. AMF will fund this.

Further information via the dedicated distribution page

Other DRC distributions
2019 Equateur and Sud Ubangi
2019 Tanganyika, Haut Katanga and Haut Lomami


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