Thanks for all the very good comments. Rob: Thanks for the link to your paper. I am not deeply familiar with the history and research on user fees for health, and I look forward to learning more. Robert: I haven't seen any research that examines the influence of ITNs for IMR using national data. This is something I would like to do using data for several countries. The Kenya paper does mention several relevant references. The most important is this review of evidence on the effect of ITNs on malaria infections: Lengeler, Christian. 2004. ―Insecticide-treated bed nets and curtains for preventing malaria.‖ In Cochrane Database of Systematic Reviews, ed. The Cochrane Collaboration and Christian Lengeler. Chichester, UK: John Wiley & Sons, Ltd, April Swati: I share your enthusiasm for recognizing that the widespread decline in infant mortality is a substantial achievement, for which the citizens and governments of the countries in questions deserve congratulations.