Policy Wise

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A story in the Economist questions the conventional wisdom that giving away free goods is not the best way to advance public policy,

Dr Kochi and his team reviewed antimalaria operations in Ethiopia, Ghana, Rwanda and Zambia, looking mainly at under-fives, who are most threatened by the disease. WHO says that over 1m people die each year of malaria, mostly in Africa. In Ethiopia, the amount of childhood malaria reported at clinics fell by 60% and the death rate halved within two years of the beginning of the mass-distribution programme. In Rwanda, things were even more spectacular: both cases and deaths dropped by two-thirds within a single year. In Zambia the fall in both was around a third. Only in Ghana were the data equivocal. Cases fell by an eighth and deaths by a third, but that was against a background of generally improving health in which the amelioration rates for malaria were worse than those for non-malarial illness and death. In other countries, the rate of malaria tracked the general disease rate until the programmes began, and then fell suddenly.[link]

With Malaria still a huge public health challenge in India and other developing countries, the success story in Africa can be instructive. However, it would be wise not to conclude that Malaria was controlled only because the nets were given away free; among other things, the team also rolled out a nation wide campaign to educate people. To replicate the success elsewhere, other elements including constant monitoring and evaluation may also be necessary.

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