MIN/Sp/AU/CAMH3/6 Malaria Page 14 2.4.1 Insecticide Treated Nets (ITNs) To increase the access to malaria control interventions, 74% of countries have waived taxes on antimalarials, 64% have removed taxes or introduced waivers on ITNs while about half have waived taxes and tariffs on nets, netting materials and insecticides. Since 2002, several countries have prioritized the rapid scale up of ITN use by targeting mainly young children and pregnant women with free or highly subsidized ITNs. In 2006-2007, over 33 million ITNs were distributed in 22 countries, mainly through integration with immunization campaigns and maternal and child health services. This has resulted in a dramatic increase in ITN coverage to about 50% in those countries. However, the ITN use at household level is consistently lower than ITN possession due to inadequate communication about consistent use of ITNs. Also, distribution of free ITNs through routine EPI and ANC services is still very low. Across the region, 25% of households own at least one mosquito net of any type. However, some countries such as Guinea Bissau 79%, Congo 76%, and Niger 69 % have much higher coverage with any net. With regard to insecticide-treated nets (ITNs), about 12 % of households have at least one ITN. By end of 2006, some countries had achieved high coverage rates with ITNs such as Rwanda 50%, the Gambia 50%, Guinea Bissau 44%, Niger 43% and Togo 40% 5 . On average, 8% of children under-five sleep under an ITN. All countries in the African Region with trend data available showed that ITN use among children aged less than 5 years has increased at least thrice in 19 countries since 2000 as shown in figure 2. ITN use by children under-five years in 2006-2007 had exceeded 40% in Rwanda, the Gambia, Guinea Bissau, Sao Tome and Principe and Guinea Bissau as shown in Fig 1. In spite of these gains, ITN use still falls far short of the regional and global targets. Use of ITNs by pregnant women is a key intervention for prevention of malaria. Across the region, it is estimated that only 5% of pregnant women sleep under an ITN. Some countries with recent data (2003-2007) have achieved higher coverage levels such as Benin 20%, Rwanda 60%, Eritrea 50%, Kenya 37% and Malawi 15%. 5 UNICEF & RBM (2007) Malaria & children progress in Intervention coverage Status Report on Malaria in Africa 2008