This strikes me as a mind boggling development success. I’m scratching my head wondering why it’s not something more loudly broadcast.
A handy two para summary (as part of a more generally excellent blog post by Rachel Glennerster):
In the early 2000s a debate raged about whether to charge for ITNs. Advocates of free distribution said small costs could reduce access by the poor. Those arguing for charging cited anecdotes of bednets being used as wedding veils or fishing nets but neither side had much evidence. The RCTs on price and use were quickly taken up by advocates of free mass distribution and the opposition faded.
Coverage of ITNs in sub-Saharan Africa (the region with the highest burden of malaria) has improved dramatically with the vast majority of coverage accounted for by free mass distribution (43 out of 47 countries had mass free programs). As the great maps from Giving What We Can illustrate, malaria cases have fallen dramatically. A recent article in Nature estimates that 2/3 to 3/4 of the decline in malaria cases between 2000 and 2015 can be attributed to increased net coverage: 450 million cases of malaria and 4 million deaths averted from ITN distribution. That’s anything but small.