Free insecticide for nets is cost effective

摘要: Response from Guyatt and SnowThe two issues raised by Curtis Maxwell demand further clarification. First, how much does it really cost to deliver insecticide-treated bednets (ITNs) communities? Second, should they be provided free-of-charge at-risk groups?Presenting the incremental financial costs of delivering insecticide a few villages, where research program has been operating for many years, can misleading different in an entire district or at national level. The implementation is important variable evaluation process crucial that are comprehensive, accounting all resources consumed. When evaluating interventions, often separated costs, although these inherently support delivery process. For example, expatriate salaries, field-workers surveillance systems rarely considered.These hidden excluded analyses other donor-supported, operational projects. if only directly attributable ITN its considered non-governmental organization (NGO)-managed Kenya, estimated per US$8.42 [1xA comparative analysis treated nets indoor residual spraying highland Kenya. Guyatt, H.L. et al. Health Policy Plan. 2002; 17: 144–153Crossref | PubMedSee References[1]. However, when external included (basically, amount money received donors), closer US$30 This consistent with donor- research-funded project Kenya (US$45 AMREF employer-based net US$29 CDC net)†. We agree precise details required provide robust cost-effectiveness analyses, but disagree estimates their villages Tanzania because fall prey general tendency exclusive rather than inclusive true costs.Curtis also highlight issue we were pains raise as controversial area original paper: whether ITNs free public health service. better quality, cost-data become available project-approach services, there will growing recognition ensuring maximal coverage this intervention not cheap. believe delivered those most burden posed malaria Africa. Most Africa's population lives below absolute poverty line. African Heads State have pleaded global community consider option protect equity health-service provision respective countries. Some donors scientists resisted position. What clear real donor maximizing equitable one persuasive evidence-based criteria upon which judge who right debate on bednets.