News

AMF activity update: September 2019

A short update on activities going on in-country this month.

• In DRC, preparations are being made for the distribution of 1.5 million nets in Équateur province, which is due to begin mid-October. Nets have arrived in province and are being sent to the health zones in the correct quantities according to registration data. Nets are also arriving in Sud Ubangi province, where the registration of 600,000 households will begin in the coming weeks using electronic devices. Half the nets purchased were PBO nets, and half standard nets, and the effectiveness of these nets will be monitored. In Haut Katanga, registration of 1.4 million households will take place in October using paper forms. The printing of these forms is complete and we are engaging with our data entry partner, AGAPE, to put in place a data entry centre in Kinshasa. 8.4 million nets have been produced for the provinces of Tanganyika, Haut Katanga and Haut Lomami and are being shipped to the port of Dar Es Salam in Tanzania, and from there to Eastern DRC.
   
• In Zambia, our partner CHAZ has just finished post-distribution monitoring in Western province, completing the first round of PDMs in all four provinces receiving AMF-funded nets. Across these provinces, the sleeping space coverage is 65%, with a hang up rate of 81%. This is low and we are investigating with our partners in country. One explanation is that AMF nets are generally being used, but too few were given out during distribution to cover all sleeping spaces. 3.0 million nets were distributed in 2018.
   
• In Ghana, our partner World Vision has completed data collection for the 9-month PDM in Upper East region using electronic devices. Photos below. The results of the PDM in Brong Ahafo region have been imported into AMF's database and show a sleeping space coverage of 84% at 9 months post distribution.
   
• In Malawi, our partner the Malawi Red Cross Society has collected PDM data in 6 districts in Southern region, which show an average sleeping space coverage of 73% at 9 months post distribution. Data is currently being collected in Central region.
   
• In Guinea, we are currently investigating a possible theft of AMF nets and are working closely with all partners to 1) establish if the nets recovered in Mali are AMF-funded nets, and 2) conduct, as necessary, a thorough audit of the movement of all nets in country.
   
• In Uganda, lists of specific households in specific villages, randomly selected by AMF, that will visited during PDM activity have been shared with our partner organisation Malaria Consortium for the 30-month PDM taking place in the Eastern region. Results from the 24-month PDM in selected districts in the Western region show a sleeping space coverage of 83%.
   
• In PNG, our partner RAM continues to distribute nets on a rolling basis. So far in 2019, more than 395,000 nets have been successfully distributed in the provinces of Southern Highlands, Hela, Oro and Central. Distribution is ongoing in the New Ireland and North Solomons (ARoB) provinces. In total, about 1.0 million nets will be distributed during 2019. PDM activity has just been completed in Milne Bay, two years after the distribution, and data is being entered for review.
   
• In Togo, preparations are taking place for the 24-month PDM which will take place in all four regions (Savanes, Kara, Centrale and Plateaux) that received 2.4 million nets in 2017. Data will be collected using electronic devices.

AMF investigating possible theft of nets in Guinea

Summary: It is possible that a number of tens of thousands of AMF nets have been stolen from the recent Guinea universal coverage net campaign. A quantity of nets have been discovered and recovered in Mali, across the border.

AMF recently provided 4.8 million nets for distribution in Guinea as part of a larger nationwide campaign. The vast majority of the nets were distributed as planned and are accounted for in our database. However, we are currently investigating a possible theft of some nets. Our investigations relate to a quantity in the region of 2 to 3 per cent of the nets provided. However, we take any instance like this extremely seriously and are working with local organisations to carry out an investigation thoroughly. We also want to report on any such matter openly to our donors. We are also working intensively to recover all nets possible and learn what process improvements can be made to reduce the probability of recurrence.

Detail: On Wednesday 11th September it was brought to AMF's attention that a small quantity of nets with AMF labels and clear 'For Guinea' markings had been found in Bamako, the capital of Mali. Mali shares a border with Guinea.

The report indicated that further nets, potentially tens of thousands could be involved and that these were likely to include some of the nets provided by AMF. All the organisations affected informed the Minister of Health in Mali, who, late in the evening of Friday 13th September, with support from ministry department staff and the local police, visited a privately owned warehouse in Bamako. They reported that 800 nets were found, empty USAID-Guinea packaging, as well as cut-off net labels and 1,900 unused counterfeit packaging. After further investigation, on Wednesday 18th September, a second warehouse was visited and 98,500 nets were found in counterfeit packaging with the net brand labels removed. Both quantities of nets were placed under guard by the authorities. Initial indications are that there are four different types of nets involved, including PermaNet 2.0 nets, the brand funded for Guinea by AMF.

The authorities in Mali have so far responded quickly and decisively. In Guinea, the authorities have begun an investigation to establish where in the supply chain a potential theft of nets may have occurred.

We do not yet know the exact quantities of AMF-funded nets involved.

Our immediate next steps, working closely with other net funding partners and the authorities in Mali and Guinea are to

• identify the brands, quantities and provenance of the nets found;
• establish if other quantities of nets may be found in other warehouses;
• perform a full audit of net movements in Guinea

Identifying the brands and batch numbers of nets will help establish what quantity of nets has come from Guinea and, for any such nets, help establish from which region they came.

Given AMF collects detailed household-level distribution data, we were able to establish an initial estimate of the quantity of AMF-funded nets that may be involved of 80,000. AMF shipped 4.8m nets to Guinea and detailed household-level distribution records are currently being verified and error-checked as part of the normal process following a campaign, so the following numbers may change. They show 4,551,694 nets were distributed. The difference is 248,306 nets. From this figure we subtract the current estimate of nets in the possession of the authorities in Guinea, reported to us by the National Malaria Control Programme, which is 170,000. This leaves an initial estimate of 80,000 nets to be accounted for.

As verification is completed this number will change. However, we felt it important to report on the situation and the steps we are taking in advance of knowing all the details.

Our longer term goals are of course to a) return any AMF-funded and other Guinea nets to their original destination so they can protect the intended beneficiaries and b) understand what caused this and, as necessary, update our processes accordingly.

In the coming days we will provide updates and report fully on what is found.