Kenya has announced a breakthrough in malaria prevention, cutting childhood deaths by almost half with a mass distribution of free mosquito nets. The parasite kills a million people - mostly children - in Africa each year and cash-strapped governments have struggled to tackle a disease that is both treatable and preventable.
But the five-year Kenyan programme has for the first time shown that mass campaigns work and are cost-effective. Researchers found that seven lives were saved for every 1,000 nets given away.
The World Health Organisation (WHO) hailed the results as a milestone for Africa, and said it was changing its own guidance to advocate free nets for all.
Launching the report in the capital Nairobi, Charity Ngilu, Kenyan health minister, said she had just returned from a hospital in one of the study areas where she was astonished to find a paediatric ward with only one patient - a three-month-old baby with pneumonia.
She said: "A doctor came up to me and said, we are out of business, minister."
Malaria is currently the biggest killer of children under the age of five in Kenya, accounting for 34,000 deaths each year.
Some 25 million Kenyans are at risk from the mosquito-borne disease and it accounts for one fifth of all hospital admissions. Lack of progress in tackling malaria is considered one of the key obstacles to meeting some of the health targets among the UN's millennium development goals.
African governments have been hampered by lack of funds and disagreements over the best way to get the nets to vulnerable people.
Kenya's approach has been to flood the country with the $5 nets since 2002. At first 10 million were sold at subsidised rates, but last year the government - with funding from Britain's Department for International Development - started giving away some 3.4 million to families with young children.
Today, more than half of the country's youngsters go to sleep protected from mosquitoes. In some areas the figure rises to 65 per cent. The results show 44 per cent fewer children dying from malaria in high-risk areas compared with 2002 levels.
Mrs Ngilu said the government would continue to give away two million of the life-saving nets. "Malaria disrupts the daily patterns of the life of our people, the livelihood of families and often causes misery when people die from this preventable disease," continued Mrs Ngilu. "We must therefore do everything possible to stop malaria from denying Kenya and Africa its future."
Health experts have long been divided on whether the nets should be given away or sold at subsidised prices - in a process known as social marketing - which allows cash-strapped health services to plough money back into malaria prevention.
Arata Kochi, director of the WHO global malaria programme, said the Kenyan experience showed the argument was over. He said mass distribution was the only way to increase coverage and protect entire communities. "No longer should the safety and well-being of your family be based upon whether you are rich or poor," he added. "When insecticide-treated mosquito nets are easily available for every person, young or old, malaria is reduced."