LLINs for Continuous and Campaign Distribution in Sub-Saharan Africa: A Collation of Global Funding Commitments for 2011–16

The goal is to achieve Universal Coverage of all populations at risk of malaria by the end of 2010. Countries have been planning LLIN distributions through campaigns and increasingly through continuous mechanisms, particularly from Round 10 onwards. Country-level quantifications of the number of nets needed to achieve Universal Coverage are frequently conducted as part of the GFATM proposal development process. Information is also available from the LLIN analyses being done by the Office of the UN Director-General's Special Envoy for Malaria (UN DGSE) and from the Roll Back Malaria (RBM) 2010 and 2011 Roadmaps, as well as from an Excel-based assessment model developed by the NetWorks project. Approximately 295 million LLINs have been distributed over the period 2008-2010, and around 360 million are already funded for the period 2011-2016. The proportion allocated for delivery through continuous channels has increased from 21.6% to 41.5% over these nine years, reflecting both the achievements of the intensive catch-up campaigns and the more recent shift in emphasis towards maintaining (keep-up) of these achievements. The available data on committed funding for LLINs and planned distributions indicate that a number of countries will not achieve the 80% Universal Coverage target by 2016. Based on predictions from the NetWorks LLIN model, there is a gap of approximately 185 million LLINs needed for continuous distribution over the period 2011-2016 to maintain Universal Coverage of 80% in all 47 countries in sub-Saharan Africa. The purpose of this review is to collate all available sources of information for sub-Saharan Africa, with particular emphasis on the Rounds 7-10 GFATM proposals, in order to: - Extract numbers of LLINs with allocated funding intended for delivery through campaign or through continuous mechanisms over the period 2011-2016. - Compare these figures with the expected number of LLINs needed to achieve and maintain Universal Coverage as determined by the NetWorks LLIN model. - Provide an estimate of the gap between allocations and needs for continuous net distributions, for use in advocacy at the global level and to assist individual countries with planning. The review of all 57 GFATM proposals funded in Rounds 7-10 and the Rolling Continuation Channel (RCC) was conducted to extract the number of LLINs needed, LLINs funded, and the remaining gap for the period 2011-2016, disaggregated by campaign or continuous delivery mechanism. These figures include LLINs funded by GFATM and other sources and are compared with those extracted from other net mapping projects, such as the Roll Back Malaria (RBM) Country Roadmaps for 2010 and 2011 and country-specific LLIN needs calculated using the NetWorks LLIN model. The review found that the proportion of LLINs allocated for delivery through continuous channels has increased from 21.6% to 41.5% over the nine-year period, reflecting both the achievements of the intensive catch-up campaigns and the more recent shift in emphasis towards maintaining (keep-up) of these achievements. Nevertheless, a considerable gap remains if Universal Coverage is to be achieved and maintained over the next few years throughout sub-Saharan Africa. According to the 35 countries with active GFATM grants, this gap is 47.7 million LLINs over the period 2011-2016. The RBM Roadmaps for 38 countries identify a gap of 58.3 million LLINs for 2011.