Page 1

Soft. Strong. Sustainable. No compromise.

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INTRODUCTION

Introduction

The simple mosquito net has been used as a

LifeNetÂŽ is the first LLIN to combine the mechanical

protection against mosquitoes for hundreds of

strength of polypropylene with the efficacy of

years but has only relatively recently experienced

deltamethrin, using a patented incorporation

an evolution from being a basic physical barrier to

process that achieves biological efficacy beyond

a long-lasting insecticide-treated intervention in the

35 washes. A strong multifilament construction also

prevention of malaria.

means it is highly tear resistant but nevertheless still soft to the touch. No other net on the market

Up until now long-lasting insecticide-treated nets

has the same combination of qualities.

(LLIN’s) have been manufactured from either polyester (75 or 100 denier multifilament yarn) or polyethylene (100 to 200 denier monofilament yarn) and have been recognised (through the WHO Pesticide Evaluation Scheme - WHOPES) as lasting for about 3 years (with biological efficacy of the insecticide maintained for a minimum of 20 washes).

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CONTENTS

Contents

Background Why LifeNet, why now?

Soft 07

How net characteristics can affect usage rates 31

The next evolutionary step towards the ideal bednet

10

Sustainable

Strong

Greater Nights-of-Protection per net

36

The bed-net cost effectiveness calculator

38

A new standard in wash resistance and biological performance

15

Physically stronger and tougher

22

Support Information References 42 Customer support

44

In summary

46

Bayer: Science For A Better Life

47

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Background Why LifeNet, why now? The next evolutionary step towards the ideal bednet

The ideal and most valuable LLIN is one that combines highest possible durability without compromising acceptance and practicality

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WHY LIFENET, WHY NOW?

Why LifeNet, why now?

All LLIN’s have the potential to make a valuable contribution in the fight against malaria. This value can be defined by a nets effective lifespan and, to a lesser degree, its acceptability or use rate. • The effective lifespan (also known as durability) of an LLIN is correlated to the wash resistance of the insecticide treatment (ie. duration of biological efficacy) and the fabric’s physical strength (ie. resistance to tearing and hole formation). • The factors which contribute towards the acceptability (or use rate) of an LLIN are less easy to define (since they are more closely linked to the vagaries of human behaviour) but seem to be related to a combination of features of a net including; the feel of the fabric, ease of use, the mesh size, the ability to have an impact on nuisance biting insects and, in some situations, colour, shape and size. An overview of the features of different types of LLIN’s which have been available up until now is provided in the table below: MATERIAL TYPE

INSECTICIDE

INSECTICIDE TREATMENT PROCESS

FILAMENT TYPE

STATUS OF WHOPES RECOMMENDATION

Polyethylene

1,000 mg/m2 Permethrin

Incorporation

Monofilament

Full

Polyethylene

261 mg/m2 Alphacypermethrin

Incorporation

Monofilament

Interim

Polyethylene

63 mg/m2 Deltamethrin

Incorporation

Monofilament

Interim

Polyester

55 mg/m2 Deltamethrin

Coating

Multifilament

Full

Polyester

80 mg/m2 Deltamethrin

Coating

Multifilament

Interim

Polyester

200 mg/m2 Alphacypermethrin

Coating

Multifilament

Interim

(Refer: http://whqlibdoc.who.int/publications/2011/9789241502160_eng.pdf)

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WHY LIFENET, WHY NOW?

The variability in wash frequency, treatment during

Field studies and operational experience

use and level of adoption between and within

demonstrate that the attributes of polyester

different communities represents a significant

and polyethylene nets differ;

challenge in the estimation of how long LLIN’s will

• Polyester nets are usually smooth and soft to the

remain truly effective and the impact which they

touch, with good user acceptance, but generally

can sustain in terms of the reduction of morbidity

lack high mechanical strength, rarely maintaining

and mortality attributed to malaria.

their physical integrity beyond 2–3 years. • Polyethylene nets are generally stronger

The ideal (and most valuable) LLIN is therefore one which combines the highest possible durability

than polyester, however they often need

(high wash resistance and physical strength)

heat treatment or extra time for insecticide

without compromising acceptance and practicality.

regeneration and are usually rough to the touch,

This allows greater predictability in terms of long-

contributing to lower user acceptance (eg.

term disease impact, reducing the total program

Atkinson et al, 2009). The effective lifespan of

costs associated with repeated distribution cycles

these stronger nets is still limited by the retention

and subsequently resulting in a more effective long-

of insecticide after washing and independent

term use of available program funding.

assessment of this feature at periods beyond 3 years demonstrates that bio-efficacy drops below the required threshold without any extended wash resistance feature. (refer: http://whqlibdoc.who.int/ publications/2009/9789241598712_eng.pdf)

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BACKGROUND

The next evolutionary step towards the ideal bednet

Recognising the need to address this challenge

LifeNet is also the only LLIN available that combines

of bednet durability, the team of scientists at

insecticide inclusion technology with multifilament

Bayer have developed LifeNet; the first long-

construction, as a result LifeNet retains a smooth,

lasting mosquito net to combine the inherent

soft-to-the-touch quality as well as being free flowing.

features of polypropylene with the, already

(Other nets which currently use insecticide inclusion

proven, insecticide deltamethrin.

are made of monofilament polyethylene yarn which makes the netting stiff and rough to the touch).

The properties of polypropylene (light weight, high tensile strength and ability to resist wear, fatigue and

LifeNet therefore represents a new generation of

erosion) make it ideally suited for fibre applications

bednet, providing:

and it is often used in ropes and carpets. Textile

• Biological efficacy beyond 35 washes

testing conducted on LifeNet (which is summarised

• Textile durability which matches

in later sections of this booklet) confirms the choice

extended wash resistance

to use this robust material.

• An effective lifespan which is expected to exceed 5 years across a range of conditions

Using a patented incorporation process, that allows controlled release, deltamethrin has

• More nights of protection provided per net

been embedded deep within the LifeNet fibres.

• Short regeneration time

This sustained release of active ingredient from

• Soft and smooth to the touch with improved free-fall.

the reservoir within the fibres results in a wash resistance that far exceeds current standards. The fibre surface regenerates with insecticide beyond 35 washes and biological efficacy is therefore maintained for many years of useful life of the net.

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THE NEXT EVOLUTIONARY STEP

Basic specifications of LifeNet

DESCRIPTION

SPECIFICATION

Net Shape

Rectangular or Conical

Colour

White

Dimensions: Height x Length x Width

Dimensions as indicated and/or required

Fabric composition

100% polypropylene

Fabrication

Warp knitted

Yarn

Multifilament

Denier

100 Den

Mesh size

min 21 holes/cm2

Weight

40 g/m2

Flammability

16-CFR1610 test results say: Class 1 normal flammability (did not ignite)

Dimensional stability

Not more than Âą 5% shrinkage/expansion in both directions

Burst Strength (netting and seam)

min. 450 kPa

Active ingredient

Technical deltamethrin complying with the requirements of WHO Specification 333/TC (April 2005)

Content

Deltamethrin 0.85% w/w (Incorporated into fibres)

Retention index

Not less than 80% after first wash and then within a range between 94 to 99% (2nd to 35th wash).

Efficacy according to WHO LLIN Testing Guidelines

Exceeds current WHOPES requirements for LLIN. Fulfils requirements for at least 35 WHO standard washes

Useful life

>5 years when used as directed

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Strong A new standard in wash resistance and biological performance Physically stronger and tougher

LifeNet substantially exceeds WHOPES minimum requirements for bioefficacy of LLIN’s in every aspect

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A NEW STANDARD IN WASH RESISTANCE AND BIOLOGICAL EFFICACY

A new standard in wash resistance and biological efficacy

Extensive laboratory efficacy tests1 and field studies carried out according to the WHOPES testing requirements in-house and with external collaborators demonstrate that LifeNet substantially exceeds WHOPES minimum requirements for bio-efficacy of LLIN’s in every aspect. LifeNet performance is by far beyond today’s requirements: • Full control of susceptible malaria mosquitoes beyond 35 washes (far superior to other LLIN’s) • Good efficacy against field populations of Anopheles spp. • No regeneration delay – LifeNet is fully recharged within a day • Demonstration of excellent insecticide retention beyond 35 washes and good personal protection against prominent malaria vectors due to strong inhibition of blood feeding, as shown by WHOPES Phase II experimental hut trials carried out in Tanzania, Benin and India. (refer: 14th WHO WG report: http://whqlibdoc.who.int/publications/2011/9789241502160_eng.pdf)

In addition LifeNet shows excellent efficacy against Culex mosquitoes.

1

All Testing was carried out according to WHOPES guidelines, WHO/CDS/NTD/WHOPES/GCDPP/2006.3

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STRONG

LifeNet速 offered efficacy lasting beyond 35 washes corresponding to more than 5 years of useful life assuming that a net is washed 7 times per year on average. (Rossignol M. et al, 2010) In a laboratory study by LIN Montpellier, France, according to WHOPES Phase I protocols, LifeNet samples 速 washed 35 times proved fully protective efficacy above WHOPES threshold criteria against susceptible Efficacyup of to Bayer samples (LifeNet batch 2009-007281) against susceptible malaria mosquitoes, Anopheles strain KISUMU. An. Gambiae (KISUMU strain) gambiae after different cycles of wash-dry-wash.

100

WHOPES threshold KD min 95 %

Percentage

80

WHOPES threshold mortality min 80 %

60

40

20

0

unwash

10 washes

Knockdown effect

20 washes

25 washes

30 washes

35 washes

Mortality

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A NEW STANDARD IN WASH RESISTANCE AND BIOLOGICAL EFFICACY

LifeNet maintained protective efficacy even after more than 50 washes, providing a margin of safety for many more washes past our claim of 35. (Jung. R et al 2010)

LifeNet wash resistance vs Anopheles gambiae KISUMU, % knockdown and % mortality 100

% mortality

% knockdown

80

60

40

20

0

0

10

20

Number of washes required by WHOPES KD>=95%, M>=80%

25

30

35

40

45

50

Additional number of washes achieved by LifeNet

% Knockdown effect LifeNet

% Mortality LifeNet

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STRONG

LifeNet offered control against malaria mosquitoes for more washes than other LLIN’s (Nentwig G., 2010) Tested up to 35 washes, LifeNet efficacy remained above the WHO threshold of 95% KD or 80% mortality whereas a polyester multifilament LLIN coated with deltamethrin, a polyethylene monofilament with 0,18% deltamethrin and a polyethylene monofilament LLIN with 0,58% alpha-cypermethrin achieved WHOPES threshold only up to 20 washes.

Number of washes: Efficacy above WHO threshold of LifeNet and other LN vs malaria mosquitoes LifeNetÂŽ Alpha-cypermethrin in polyethylene DLT coated polyester DLT in polyethylene 0

5

10

15

20

25

30

35

40

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A NEW STANDARD IN WASH RESISTANCE AND BIOLOGICAL EFFICACY

Field studies in Benin, India and Tanzania demonstrate good efficacy of LifeNet washed 20 and 30 times on malaria vectors (WHOPES, report of 14 WG meeting, 2011) LifeNet was tested in experimental huts at WHO recognized testing sites against susceptible wild, freeflying Anopheles fluviatilis in India, and against pyrethroid-resistant populations of Anopheles gambiae and Anopheles arabiensis in Tanzania and in Benin2. The field studies demonstrated good efficacy of LifeNet washed 20 and 30 times on mortality and blood-feeding inhibition of these prominent malaria vectors. Even against a mixed population of pyrethroid-resistant malaria mosquitoes (Anopheles gambiae s.l.) in Benin, LifeNet provided good personal protection.

Mortality, blood feeding and BFI induced by LifeNet vs SP resistant An g in Benin, Malanville (Whopes 2011) 100

Percentage %

80 60 40 20 0

Untreated Net

LifeNet unwashed

% Corrected mortality

2

LifeNet 20x washed % Blood feeding

LifeNet 30x washed

CTN washed before exhaustion

CTN washed 20 times

% Blood feeding inhibition

Kdr Resistance, enhanced oxidase activity, 40% mortality at the discriminating dose of 0,05% deltamethrin

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STRONG

Efficacy against Culex mosquitoes (Nentwig G, 2010) Culex mosquitoes are important in the context of end-users perception of efficacy. Culex mosquitoes are generally abundant and aggressive biters; they are bigger, noisier (the typical mosquito whine) and hence are more likely to be noticed by the people sleeping under the bednet. Culex mosquitoes are less sensitive to insecticides than Anopheles mosquitoes, and therefore need longer exposure times on a net. In laboratory tests LifeNet demonstrates better knock-down properties than deltamethrin-coated LLIN’s and shows more than 80% mortality against Culex even after as many as 20 washes (again better than a deltamethrin-coated net). Since end-users can rarely distinguish between mosquito species this efficacy against Culex contributes to potentially better acceptance (and fewer complaints that the net does not work).

100

100

80

80

60

60

% efficacy

% efficacy

LifeNet efficacy against Culex sp.

40

20

0

40

20

0x

5x

10x

15x

0

20x

Knock down after 60 minutes LifeNet

0x

5x

10x

15x

20x

Mortality after 24 hours Deltamethrin coated polyester LN

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WHOPES, REPORT OF 14 WG MEETING 2011

No extra regeneration time needed (WHOPES, report of 14 WG meeting 2011) LifeNet does not require extra regeneration time or extra heat treatment to regenerate. The full efficacy of LifeNet against Anopheles mosquitoes is restored within a day after washing. Nets can be washed in the morning and used again the same evening. With LifeNet there is no protection gap after washing the net.

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STRONG

Physically tougher and stronger

LifeNet is the first long-lasting net that combines

Extensive textile testing carried out with LifeNet at

the known physical strength of polypropylene with

two internationally acknowledged textile institutes

the softness of multifilament fibres. LifeNet thereby

in France (Institut Francais Textile et Habillement,

offers higher durability without compromising end

Lyon) and Germany (Institut für Textil – und

user acceptance and practicality.

Verfahrenstechnik, Denkendorf) following required methods of FAO/WHO JMPS specifications3 and

The effectiveness of an LLIN can be compromised

other testing standards and in comparison to two

by simple wear and tear during use (eg. the creation

polyester (75 denier multifilament) and polyethylene

of holes which allow mosquito entry. It is accepted

(150 denier monofilament) LLIN’s, clearly identifies

that the presence of holes in LLIN’s reduces the

that LifeNet exceeds the existing categories of

efficacy of protection against mosquitoes [Malima

netting material in terms of mechanical strength.

et al, 2008]. Physically stronger nets clearly will have a greater chance of being able to stand up

• LifeNet showed excellent bursting strength

to wear and tear, reducing the probability of the

• LifeNet showed excellent dimensional stability after repeated washings

net’s integrity being compromised over time and

• LifeNet was highly resistant to tearing and ripping.

maintaining protection against malaria for longer.

3

Manual on development and use of FAO and WHO specifications for pesticides, 2010. 2nd revision of the first edition.

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PHYSICALLY TOUGHER AND STRONGER

Bursting strength Test (EN ISO 19338-1:1999) Bursting strength represents the ability of a net

Resistance to bursting (bursting strength)

to resist blunt force. The test involves pushing

600 540

an inflating rubber diaphragm through a sample

555

Force needed to bursting (kPa)

514,2

of fabric until the fabric bursts (refer diagram below). The bursting strength corresponds to the maximum pressure (in kPa) supported by the specimen before explosion. A minimum bursting strength of 250 kPa on a 7.3 cm2 sample of net is part of the WHO/JMPS requirements. This test is one of the recognized methods for assessing the mechanical strength of knitted fabrics (since it

500 400 300 200 100 0

tests the fabric in all directions).

291,2

Coated Polyester Net Panel

(It is considered that the additional range of tests

Polyethylene Net

LifeNet

Seam

referred to in this document gives a broader representation of the attributes of fabrics than the bursting strength alone). Under the conditions of this test, LifeNet was superior to the polyethylene net and much stronger than the polyester net. LifeNet also had a more consistent quality; which was reflected in a lower variability of results.

Â

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STRONG

Dimensional stability after washing It is important that a bed net maintains its size and

dimensions or shrinkage in measured dimensions

shape even after many washes: if a net shrinks it may

from the washing process. (WHO recommends no

no longer provide full protection as it may no longer be

more than 5% change in each direction, column or

able to be tucked under a mattress, bed roll or over

row and the specification for certain polyethylene nets

the edges of a bed. If the netting material expands it

indicates no more than 10% change in dimensions).

may lose physical strength.

LifeNet showed the least degree of dimensional

In this test, 50cm x 50cm pieces of each of the nets

change after washing compared to other LLIN and

are machine-washed five times at 40 degrees C and

had consistency between the degree of change in

dimensions are measured both before and after the

column and row. Other LLIN’s showed significant

washing process. This test assesses the change in

dimensional change after this washing process.

+% elongation

Variation in net size % (after five washes at 40ËšC) 5% 0%

-% shrinkage

-5% -10% -15% -20%

Length Polyester coated net

Width Polyethylene net

LifeNet

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PHYSICALLY TOUGHER AND STRONGER

Resistance to tearing - Dynamic Nail Test (NF G 07-147) This test mimics a sharp object catching in the net and the net being pulled against it with some speed (eg. such as a strong pull on a net snagged against a nail or splinter of wood). The results of this trial indicated that greater force was needed to cause tearing of LifeNet compared to a polyester coated net and a polyethylene net. Under the conditions of this test LifeNet was therefore considered to be about 2 times stronger than the polyethylene net and the polyester coated net. LifeNet was also more balanced with “equivalent” values in both directions of tear (column vs row). The polyethylene net used in this trial performed poorly in the row direction due to the weakness of the knit pattern (single loop construction).

Tearing resistance (Dynamic nail test) Force needed to rip the net (Newton)

60 52

51

50 40

37

30 24

21

19

20 10 0

Polyester Coated Net

Polyethylene Net

Tearing of the row threads

LifeNet

Tearing of the column threads

25

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STRONG

Resistance to slow ripping - Slow Nail Test (NF G 07-145) The slow nail test evaluates the ability of a fabric to withstand a slow rip, such as a heavy weight pulling the net against a nail in the bed-frame. One end of a sample of fabric is fixed in a clamp and the other end fixed over a nail. The nail is pulled slowly and steadily against the fabric. The force required to cause tearing is measured. Since there is variable resistance in a net (corresponding to the holes of the mesh), the average of the three maximum peaks of resistance are measured. Under the conditions of this test LifeNet was very balanced in both directions and almost twice as strong as the polyester coated net. LifeNet and the polyethylene net were very similar in the column direction but LifeNet was twice as strong in the row.

Resistance to slow ripping Maximum force needed to tear the net (N)

(Slow nail test) 50

40 34

35

34

30

20

18

18

18

10

0

Polyester Coated Net

Polyethylene Net

Tearing of the row threads

LifeNet

Â

Tearing of the column threads

Â

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PHYSICALLY TOUGHER AND STRONGER

The results for the textile tests carried out on new nets are summarized in the table below: TEST METHOD

LIFENET

POLYETHYLENE POLYESTER

OBSERVATION

Bursting strength – unwashed nets (kPa).

540

514

291

LifeNet and the polyethylene net were significantly stronger than polyester

Dynamic Nail Test (measures strength of force, in Newton’s, required to create tear in net against a fixed nail. The test is carried out in both directions of column and row).

51 (column) 52 (row)

21 (column) 37 (Row)

24 (column) 19 (row)

LifeNet resisted tearing significantly better than the other two nets and had better balance of strength between column and row.

Slow Nail Test (a similar test to the dynamic nail test but simulating a slower tearing force).

34 (column) 35 (row)

34 (column) 18 (row)

18 (column) 18 (row)

LifeNet shows good balance in strength between the two directions. Polyethylene net is strong. Both polyethylene and LifeNet are superior to polyester

Dimensional stability (assesses the % deformation or shrinkage of the net after washing)

2.2% (column) 1.8% (row)

17.6% (column) 5.4% (row)

3.6% (column) 2.3% (row)

LifeNet showed minimal shrinkage after washing and met the WHO recommendation for no more than 5% deformation in both directions.

Other tests carried out (not described in detail here) Tensile strip test (a piece of fabric is held between two clamps and the amount of force, in Newton’s, required to stretch it to breaking point is measured)

152 (column) 96.2 (row)

156 (column) 21.8 (row)

83 (column) 58.2 (row)

LifeNet shows superior balance in strength between column and row and significantly exceeds the row strength of both other nets.

Bagging test (mm of deformation after repetitive impact in one area)

1.5

8

4

LifeNet shows the least amount of deformation after a repetitive force is applied in the same area.

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Soft How net characteristics can affect usage rates

...acceptance and usage can be influenced by a combination of net features...

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SOFT

How net characteristics can affect usage rates

The effective lifespan of an LLIN is directly linked

• Shirayama et al (2007) noted from a study

to its ability to protect against malaria. Clearly a

in Laos that colour and size were important

more durable net has the potential to maintain

features for the end users and similar

a protective effect against malaria-transmitting

observations were recorded in relation to mesh

mosquitoes for longer. However behavioural

size (where the community associated the large

attitudes towards net usage obviously affect the

mesh size with fishing nets rather than bednets).

ability of any net to protect the user (ie. if someone

• Das et al (2007) observed in a study in

doesn’t like using a net and doesn’t fully understand

India and Nepal that the relative softness of

the protective benefits then the net may go unused

polyester was preferred over the roughness

– for example, during periods when mosquito

of polyethylene and comments were also

numbers are low).

noted in relation to the large mesh size of the polyethylene net used in this study.

A number of studies suggest that acceptance and usage can be influenced by a combination of

• Atkinson et al (2009) observed in a Solomons

features of a net including; the feel of the fabric,

Island study that polyester nets generally had

ease of use, the mesh size, the ability to have an

greater user acceptance than polyethylene and

impact on nuisance biting insects and, in some

that factors relating to the perception of ability

situations, colour, shape and size.

to prevent mosquito bites, softness of the fabric

• Banek et al (2010) recorded comments in relation

and ability to allow a pleasant nights sleep

to one polyethylene net from a study in Liberia

contributed to these differences in acceptability.

such as ‘I do not prefer this net because it is very

An important observation in this study was

hard and rough..’ and ‘…it has big holes that

also that the wrinkling/shrinkage of one of the

mosquitoes pass through…’

polyethylene brands due to washing resulted in decreased acceptability over time.

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SOFT

There are other studies which also suggest that if

The features of LifeNet are consistent with

nets are perceived as too damaged to be effective

addressing many of the issues identified in field

then they will be discarded by some users. This is

studies, across different geographical regions,

an important link back to the physical strength and

which relate to end-user acceptability.

durability of the net.

• LifeNet is soft or smooth to the touch

These studies should of course, be taken in

• LifeNet is efficacious against Culex mosquitoes

context; any bednet which is provided free of

• LifeNet demonstrates excellent dimensional stability

charge as part of a mass distribution program,

• LifeNet has excellent physical

which protects against mosquito biting and is

strength and durability.

understood by the user to protect against malaria will be generally accepted and used. However, where choice is available the optimization of end-user acceptance is more likely to improve the impact on disease.

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HOW NET CHARACTERISTICS CAN AFFECT USAGE RATES

Flammability

Safety Assessment of LifeNet

The common use of kerosene-lamps and/or

A human exposure risk assessment carried out

candles in housing where LLIN’s are frequently used

according to the guidelines of the generic risk

represents another threat to the integrity of nets.

assessment model proposed by WHOPES (2004)

Contact of netting material with naked flames can

show that when using LifeNet according to the

result in anything from the formation of significantly

label instructions there is no unacceptable risk

sized holes to ignition of the net leading to dripping

to persons using or washing the net. The interim

of burning plastic onto the skin or mattress,

WHOPES recommendation supports the positive

potentially leading to skin burns or house fires.

safety assessment of LifeNet.

LifeNet and other WHOPES recommended LLIN’s pass flammability test 16CFR Part 1610. However, simple visual demonstrations show that polypropylene, polyethylene and polyester have different flammability properties. When exposed for short periods (a few seconds) to a naked flame (eg. match or candle) LifeNet shrivels but does not maintain a flame, this is in contrast to polyester or polyethylene nets which show maintained flame and melting and dripping of burning plastic after such exposures. The different behaviour of netting material exposed to naked flame is best illustrated by viewing a video which can be seen on the Bayer vector control website (www.vectorcontrol.bayer.com).

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Sustainable Greater Nights-of-Protection per net The bed-net cost effectiveness calculator An environmentally responsible option

...the objective of any LLIN is to provide protection against malaria transmitting mosquitoes for as long as possible...

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SUSTAINABLE

Greater Nights-of-Protection per net

The lifespan of an LLIN has traditionally been considered in terms of the number of years it will last (with the 20 wash standard expected to translate to a period of about 3 years), since a year is equivalent to 365 nights, a net which lasts for three years could be expected to provide 1095 Nights of Protection. Since the objective of any LLIN is to provide protection against malaria transmitting mosquitoes for as long as possible and the frequency of washing and treatment during use will vary between different users, within communities and within cultures, the adoption of a net with high physical strength and greater wash resistance increases the potential nights of protection which a net can provide – ultimately having a longer term impact on disease and improving the cost effectiveness of the program. Even taking into account an initial higher price for the net, a genuinely longer lasting net can still prove to be more cost effective than a cheaper less durable alternative.

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GREATER NIGHTS-OF-PROTECTION PER NET

The cost-effectiveness of longer lasting nets is well illustrated in the simple calculation below: Compare three LLIN’s of the same size, (each with different expected lifespan) at the same price (in this example a figure of US$4.50 per net has been assumed).

Expected lifespan (years)

Number of nights of protection provided

Number of nights of protection which can be purchased with $1

Bednet 1

2

730

162.2

Bednet 2

3

1095

243.33

Bednet 3

5

1825

405.56

This basic calculation shows that, at equivalent pricing, a net which can be expected to last five years is 1.7 times more cost effective than a net which only lasts for 3 years. When the additional administration and logistical costs associated with each net distribution are taken into account it can be seen that during the high risk period of a child’s first five years of life, far greater cost effectiveness for health impact can be achieved with longer lasting nets than those which are less durable. Of course, the actual number of Nights of Protection an LLIN will provide is also influenced by the user acceptance of a net in any given situation. A higher preference rate suggests a higher frequency of use, a greater number of nights of protection and thus a greater impact on disease. Whilst user acceptance is not something that can be predicted for any given situation, certain attributes of a net can influence the probability of good acceptance. The features of LifeNet (superior durability combined with attributes consistent with high end-user acceptance) support a greater number of Nights of Protection per net than any other product currently available.

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SUSTAINABLE

The bednet cost effectiveness calculator

A more detailed calculation tool to compare

Taking into account a 5 year time horizon

the cost effectiveness of different nets can be

(corresponding not only to the usual period of

found at the Bayer Vector Control website

strategic program plans but also considered on

(www.vectorcontrol.bayer.com). This tool, which

the basis of representing the first five years of a

has been developed in conjunction with University

child’s life; the period during which a child is most

College London, allows a detailed comparison of

at risk from infection with malaria) the model allows

the cost-effectiveness of health impact from nets

input of a range of different variables to assess the

which last between 1 and 3 years and LifeNet,

benefits of a longer lasting net over less durable

which is expected to last significantly longer.

alternatives. Outputs include a comparison of overall program costs, total procurement costs as well as annual costs per net.

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THE ENVIRONMENTALLY RESPONSIBLE OPTION

The environmentally responsible option

Climate change is a reality which has the potential to impact us all. Bayer has made a commitment across all business groups to reduce the contribution to climate change (more details can be viewed www.climate.bayer.com/en/homepage.aspx). The development of the malaria intervention tool, LifeNet, has been completed with this commitment to Sustainable Development in mind. In order to measure and compare the potential impact of LifeNet against older technologies Bayer has commissioned a full ISO-Standard Life-Cycle Assessment (LCA) for LifeNet to compare the environmental impact of this new category of polypropylene net against two traditional products (a polyester and a polyethylene net). This assessment takes into account the ‘cradle to grave’ concept and has measured the impact on human health, ecosystem quality, resource consumption, climate change and water quality from all stages of the life cycle of these products, assessing the raw material inputs, the emissions associated with freight and the lifespan of the nets. The full report is available upon request. The outcomes of the report suggest that LifeNet not only plays a role in saving lives but, in doing so, also contributes less to climate change and environmental damage.

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Support Information References Customer support In summary Bayer: Science For A Better Life

Science For A Better Life: This is the promise we all give to our stakeholders.

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REFERENCES

References

1. Atkinson J.A. et al. A cluster randomised controlled cross-over bednet acceptability and preference trial in Solomon Islands: community participation in shaping policy for malaria elimination. Malaria Journal 2009, 8:298 http://www.malariajournal.com/content/8/1/298 2. Banek et al. Evaluation of Interceptor long-lasting insecticidal nets in eight communities in Liberia. Malaria Journal 2010, 9:84. http://www.malariajournal.com/content/9/1/84 3. Das M.L., Singh S.P., Vanlerberghe V., Rijal S., Rai M., et al. (2007) Population Preference of Net Texture prior to Bed Net Trial in Kala-Azar–Endemic Areas. PLoS Negl Trop Dis 1(3): e100. doi:10.1371/journal. pntd.0000100 4. Shirayama Y. et al. Maintenance behaviour and long lasting insecticide treated nets (LLITNs) previously introduced into Bourapar district, Khammouane provide Lao PDR. Public Health (2007) 121, 122 – 129. 5. Malima R.C., Magesa S.M., Tungu P.K., Mwingira V., Magogo F.S., Sudi W., Mosha F.W., Curtis C.F., Maxwell C., Rowland M.: An experimental hut evaluation of Olyset nets against anopheline mosquitoes after seven years use in Tanzanian villages. Malar J 2008, 7:38. 6. W  HO recommended long-lasting insecticidal mosquito nets http://www.who.int/whopes/Long_lasting_insecticidal_nets_Jul_2011.pdf 7. Report of the 14th WHOPES Working Group Meeting, Geneva, 11th-15th April 2011, http://www.who.int/whopes/en/ 8. http://www.who.int/whopes/recommendations/en/

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9. R  ossignol M. et al., Regeneration, wash resistance and efficacy of Long-Lasting Insecticidal Mosquito Net LifeNet batch 2009-007281 from Bayer CropScience against susceptible and resistant Anopheles gambiae. 2010. Report of the 14th WHOPES Working Group Meeting, Geneva, April 2011, http://www.who.int/whopes/en/ 10. S  mith S.J. et al, Evaluation of Bednets after 38 Months of Household Use in Northwest Ghana. Am. J. Trop. Med. Hyg., 77(Suppl 6), 2007, pp. 243–248 11. Manual on development and use of FAO and WHO specifications for pesticides, 2010 2nd revision of the first edition. 12. Nentwig G. Wash resistance of LifeNet: Wash resistance study of LifeNet against Anopheles gambiae, susceptible strain KISUMU, according to WHO protocols. Bioassay and chemical analysis of Deltamethrin content. Results after 0-60 washes. 2010 13. J ung R. et al, Efficacy of Bayer CropScience Polypropylene LN (batch code: 2009-007281) : Biological Test Report BioGenius, Germany. Regeneration time study. Wash resistance study 0-60 washes. 2010 14. Garbers H., Efficacy of LifeNet against Anophleles arabiensis and Culex quinquefasciatus. Wash resistance study after 0-35 washes. SABS South Africa. 2011

43

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CUSTOMER SUPPORT

Customer support General email enquiries: vector.control@bayer.com

EUROPE

AFRICA

Global Headquarters

Sub-Saharan Africa Headquarters

Bayer S.A.S

Bayer (Pty.) Ltd.

Bayer CropScience

Environmental Science

Environmental Science

P.O. Box 143, Isando, 1600

16 rue Jean-Marie Leclair,

27 Wrench Road, Isando

69266 Lyon

South Africa

France Bayer East Africa Limited

NORTH AMERICA

BCS - Environmental Science Head Office, Ruaraka,

Bayer Cropscience LP

P O Box 30321-00100,

2 T.W. Alexander Drive

Nairobi

P. O. Box 12014

KENYA

Research Triangle Park RTP, North Carolina 27709 USA

EASTERN MEDITERRANEAN AND NORTH AFRICA HEADQUARTERS

Washington Liaison Office Bayer CropScience

Bayer Turk Kimya San. Ltd. Sti

701 Pennsylvania Avenue

Fatih Sultan Mehmet Mah. Balkan Cad. No:53

NW Suite 720

34770 Umraniye,

Washington, DC 20004

ISTANBUL - TURKEY

44

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EAST ASIA PACIFIC

SOUTH ASIA

Singapore

India

Bayer (South East Asia) Pte Ltd

Bayer CropScience Limited

63 Chulia Street

Bayer House

OCBC Centre East, 14th Floor

Central Avenue

Singapore 049514

Hiranandani Gardens Powai Mumbai - 400076

CENTRAL AND SOUTH AMERICA Brazil Bayer Cropscience Brazil Ltda Rua Verbo Divino, 1207 Bioco B-2 andar Chacara Santo Antonio Sao Paolo SP

Mexico Bayer de México S.A. de C.V. Miguel de Cervantes Saavedra N° 259 Col. Ampliación Granada C.P. 11520, Mexico D.F. Mexico

45

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IN SUMMARY

In summary

LN PRODUCT

MATERIAL TYPE

INSECTICIDE

INCLUSION PROCESS

FILAMENT TYPE

STATUS OF WHOPES RECOMMENDATION

LifeNet

Polypropylene

340 mg/m2 Deltamethrin

Incorporation

Multifilament

Interim

• A paradigm shift in insecticide wash-resistance expectations • Superior physical strength and robustness matching superior wash resistance • Short regeneration time, a net which is washed in the morning can be reused the same evening with full efficacy to be expected • A smooth, soft, free flowing net which retains comfort for the end-user: LifeNet offers an opportunity to improve the cost-effectiveness, impact and sustainability of malaria control programmes, through a breakthrough, first-in-class, net technology which achieves as yet unmet durability standards with a soft, ‘comfortable’ net; eliminating the need to compromise net lifespan with end-user acceptance. • LifeNet enhances the long term impact of malaria control programmes • LifeNet supports improved cost effectiveness of malaria control programs • LifeNet is an environmentally responsible option • LifeNet is brought to you by Bayer – backed by German technology.

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SCIENCE FOR A BETTER LIFE

Our mission “Bayer: Science For A Better Life”

Bayer is an inventor company with a long tradition of research. By applying science to the major global challenges, we deliver innovations that address unmet customer and market needs. Our focus on innovation is the key to maintaining or gaining a leading position in every market in which we operate. It is also the foundation for improving the lives of many millions of people: • We help patients around the world by preventing, alleviating and curing diseases as well as improving diagnosis • We ensure a sufficient supply of high-quality food, feed and fiber • We make significant contributions in the fields of energy and resource efficiency, mobility and home living - to name just a few. By working sustainably and accepting our role as a socially and ethically responsible corporate citizen - and by committing to our Bayer values - we create benefits for the communities in which we live. Science For A Better Life: This is the promise we all give to our stakeholders.

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Publisher Bayer SAS - Bayer CropScience Environmental Science Division 16 rue Jean-Marie Leclair F - 69266 Lyon (Cedex 09) France Design & Production Sugar Rush Advertising Concept & Design

Mike Sumpter & Andy Kemp

Photo Credits

Michelle Cornu on behalf of Bayer

Throughout this brochure the use of the company name Bayer refers to Bayer CropScience and it’s division Environmental Science. This brochure is issued by Environmental Science division of Bayer CropScience. Forward-Looking Statements This brochure may contain forward-looking statements based on current assumptions and forecasts made by Bayer Group or subgroup management. Various known and unknown risks, uncertainties and other factors could lead to material differences between the actual future results, financial situation, development or performance of the company and the estimates given here. These factors include those discussed in Bayer’s public reports which are available on the Bayer website at www.bayer.com. The company assumes no liability whatsoever to update these forward-looking statements or to conform them to future events or developments.

Cert no. SA-COC-001654 CC

Environmental Science is an Associate Member of the FSC

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Our mission: “Bayer: Science For A Better Life” Bayer is an inventor company with a long tradition of research. By applying science to the major global challenges, we deliver innovations that address unmet customer and market needs.

Contact information:

www.vectorcontrol.bayer.com

Bayer SAS - Bayer CropScience Environmental Science Division 16 rue Jean-Marie Leclair F - 69266 Lyon (Cedex 09) France

Copyright Bayer 2012 LifeNet® is a Registered Trademark of Bayer

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