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Strengthening its position as a global center in the fight against malaria, the Johns Hopkins Bloomberg School of Public Health is one of two Baltimore institutions tapped for a five-year, $100 million project to help combat the mosquito-borne disease.

The school will work with Catholic Relief Services to use a grant from the U.S. Agency for International Development to procure and promote long-lasting, insecticide-treated bed nets in countries with malaria, a disease that sickens more than 650 million people a year.

Catholic Relief Services, which has offices and experience in most of those countries, will help ensure the distribution and proper use of the nets.

Matthew Lynch, chief of the Global Program on Malaria at the Center for Communication Programs, said Thursday from Senegal that the program, called NetWorks, would begin in the West African nation where nearly 30 percent of childhood deaths are related to malaria. Lynch, USAID and the government of Senegal are discussing how to distribute the nets most effectively.

Individual country programs could be established elsewhere in Africa, Southeast Asia and Latin America. In each case, Lynch said, organizers will take a comprehensive approach - not simply handing out nets, but conducting public awareness campaigns to make certain that families understand their importance and use them correctly, and lobbying governments to ensure that the appropriate priorities and policies are established to achieve malaria control.

While he could not say how many nets the grant money would buy, he said: "We're likely to be protecting about a million people in Senegal over the next year."

Hopkins is an international center in the fight against malaria, which kills up to 3 million people a year, the great majority of them in Africa, and most of them children under 5 years old. The disease can cause brain damage or cognitive and learning deficiencies in children, according to the Global Program on Malaria, and can account for up to 40 percent of a country's health expenditures.

The Bloomberg School is home to both the Malaria Research Institute, headed by Dr. Peter Agre, a Nobel laureate in chemistry, and the Global Program on Malaria, which marshals the programs of the Center for Communication Programs to combat the disease.

Catholic Relief Services will offer what business development director Anna Schowengerdt described as "our extensive network of community-level, faith-based and other local partners in the countries targeted."

"We have quite a bit of bed net distribution experience," she said. Catholic Relief Services has received grants of its own from the Global Fund To Fight AIDS, Tuberculosis and Malaria, she said, and "we've developed a pretty strong capacity in purchasing and distributing bed nets in really remote, rural, very hard-to-reach parts of Africa."

NetWorks represents an effort under the President's Malaria Initiative, launched by President George W. Bush in 2005, to rapidly expand the availability and use of what USAID calls "an essential tool for achieving and sustaining malaria control."

The goal, U.S. Global Malaria coordinator Rear Adm. Tim Ziemer said this week, is "universal coverage." To get there, he said, the United States must "create a culture of net use, getting everyone to sleep under nets."

The Hopkins Global Program recently won an $8.7 million grant from the Bill and Melinda Gates Foundation to launch VOICES for a Malaria-Free Future, which is to highlight successful anti-malaria efforts with the aim of encouraging donors to increase malaria-specific funding and make sure it is used effectively.

Lynch said NetWorks will be one of the Global Program's larger projects.

"The CCP has worked on behavior-change communication in a number of countries with USAID funding in the past," he said. "There have been other programs where we've worked with procuring and distributing nets through social marketing, but they've been much smaller."

Particularly labor-intensive are plans to design individualized programs on a country-by-country basis, for greatest efficiency and impact. Lynch said the results are likely to vary among different populations and cultures.

"You can distribute [the nets] through a huge national campaign," Lynch said. "You can distribute them through routine services like [prenatal] care for pregnant women, who are at particularly high risk for malaria. You can distribute through vaccination services, so that you catch kids when they come in for their vaccinations and make sure that they've got a net. You can also do some innovative subsidy arrangements to promote sales through the private sector, through shops.

"There's a lot of creativity in trying to figure out what's the best mix of interventions in this particular country at this particular point in time."

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