"The integration of malaria into mass measles campaigns has already been tested and shown to be not only feasible but also one of the most cost-effective public health interventions for reducing child mortality and morbidity," says Nick Farrell, head of the Federation's Africa Health Initiative.

Every cent we save on the cost of each net for the whole campaign results in a million we save for donors.

Roadmap of Donations

Money you give to various organizations will end up buying Insecticide Treated Nets to reduce malaria. If you normally give money to particular groups or want to support a particular organization, please do so. Please make certain that the organization gets your funds to the specific accounts dedicated to the ITN Initiative. Tracking down misdirected donations can take months. Time is critical to buy ITNs for the 2004 campaigns, so delays could cost lives, literally.

Public Foundations supporting the Measles and Malaria project include:

The Rotary International Foundation
Grant #53293 (Will open new grant when this one is fully funded)
PO Box 75133
Evanston, IL 60201

UN Foundation
1225 Connecticut Ave, NW, Suite 400
Washington, DC 20036

The American Red Cross
Attention: Mark Grabowsky MD, MPh.
2025 E Street, NW
Washington, DC 20006

The CDC Foundation

The Conduits for Donations
The Red Cross/Crescent Societies of America and several other countries have already established accounts to finance measles projects and separate accounts for the malaria portions of the campaigns. Additionally, different foundations (eg, The UN Foundation) have similar accounts. In many countries the committee has arranged full tax deductibility of donations from the public at large.

We have sought to highlight what we feel are the top messages to convey to donors. The area is rich that we have included only a fraction of the material available. More background is available on the RAM website, http://www.rotarymalaria.org and on the web, see links. Should you need a particular question answered, please feel free to contact us.

The bottom line: The Measles Campaign has just proved up their ability to distribute ITNs. If they have the money, they will start to distribute the ITNs Fall 2004. If they don't, they won't. With full support the campaign can save a million lives per year. Full coverage can be accomplished in 3 years.

Budgets
The budgets are precise. The Measles Campaign delivers ITNs to the targeted audiences of pregnant women and children under 5 with great efficiency and accuracy. Rules of thumb may help. The delivered costs of ITNs average less than $5 each. The number of children under age 5 as a percent of population is roughly 18%. Pregnant women add another 3%. In round numbers, the two total about 21% of the total population, so $5 x 21% x total population approximately $1 per person, on average.

Cost Cutting Solution: Create a Pipeline of Mosquito Nets and Malaria-Related Goods
Manufacturers of nets and insecticides claim they can give us much better prices with large lead time and larger, regular orders. We suggest funding a purchasing group to negotiate orders of significant size with as large a lead-time as possible. The group would pass on any discounts achieved. As orders of ITNs increase in size, discounts may improve. The more that ordering of ITNs waits until the last minute, the more likely the orders are to swamp the manufacturing system. Bottlenecks create shortages and keep prices higher than they might be if a better financed operations or advocacy group were available. The pipeline boosts supplies and adds flexibility to the system.

Capacity
The Capacity to deliver vaccines and ITNs has been proven in larger scale implementations. Measles Campaigns commonly achieve 95% coverage rates. The micro planning done for measles vaccines adapts readily to the delivery of ITNs, so full country implementations are viewed possible.

Cash Accountability and Transparency
High assurance of accountability of handling funds has been proven through multiple campaigns over multiple years. The finances of every campaign are highly transparent.
· Known reliability of organizations.
· Detailed and fair procurement practices.
· High impact for $ invested
· Matching funds multiply investments
· Quantity discounts on procurement
· Use of Volunteers keep costs low
· Measurement and Evaluation by independent, outside and independently funded organizations such as the Center for Disease Control and Prevention (CDC)
· Independent evaluators review every campaign for implementation and impact both short and long term.
· Extensive data from all sources feed back into the systems as part of a continuous improvement model.

Equity: covering the poorest children
Many subsidy programs seek to sell ITNs. The development of private market is a worthy and laudable goal and the subject of many programs with varying success. The cost of sales of ITNs is high compared to direct distribution to the target audience. The Measles and Malaria coverage rates and low costs suggest direct delivery, at this point; achieve the highest coverage of the poor at the lowest costs. Additionally, free nets serve to help perpetuate sales by proving effectiveness.

The Measles and Malaria Campaign give nets at least to every family and where possible to every child and pregnant woman. This simple, straightforward decision assures extremely high coverage of people with ITNs regardless of economic status. The Red Cross Campaigns reach extraordinarily high levels of participation, typically over 95%, further assuring that all poor children are reached. Independent studies affirm these results.