(In part one of this series, A.C. Dhariwal, the NVBDCP’s director, accepts that the numbers are flawed but insists the program’s efforts are unharmed because the system accurately captures trends in the spread of the disease. “Malaria numbers are going down,” he says. “Our biggest challenge is continuing our efforts and consolidating the gains.”)

Those gains can’t come soon enough for Venkateswara Aiyyali or his neighbours in the village of Addumanda, in Andhra Pradesh. Residents of this malaria-prone area have been waiting years to receive mosquito nets treated with a durable insecticide — one of the most important components of anti-malaria strategies around the world.

But Aiyyali is among the 99 percent of Indians who don’t use the nets, known as long-lasting insecticidal nets (LLINs), which have helped other South Asian countries such as Sri Lanka and Nepal, make considerable gains. While India’s goal was to distribute nets to the 250 million people most at risk for malaria by this year, the government didn’t purchase a single LLIN from 2012 through the end of 2014, according to Indian officials and World Bank and government documents.

In 2010, the Indian government hired a state-run contracting agency, Rites, to purchase supplies for the malaria program. But procuring LLINs proved a disaster. The agency ended up cancelling an auction in which foreign and Indian-based companies were to bid for contracts for 10.2 million nets in 2012, as well as another auction in 2013 for 14.8 million nets — both of which would have been paid for with assistance from the World Bank and the Global Fund.

Mosquito net manufacturers that bid for these contracts blame unreasonable demands by the government for the failure of the auctions. A representative for Vestergaard Frandsen, one of the world’s top suppliers of these nets, said Rites officials insisted on rigid specifications for how the nets were stitched and sized and then balked at the higher prices.

“Rites ‘felt’ that prices offered by all bidders were much higher than the international prices being offered by the same manufacturers in the international market,” wrote the representative in an emailed response.

Officials at Rites, however, recall heated disputes among competing bidders, which lodged formal complaints against one another that the officials say kept them from making a decision.

“There was so much bad blood being created over LLINs, so many unnecessary references and letters that made it — how do I put this? — difficult to take a decision,” says Aditya Sharma, an executive at Rites who handled procurement for World Bank–funded contracts. “When there are bullets flying around, you have to be careful.”

The cancelled bids forced the Indian government to relinquish nearly $200 million in World Bank and Global Fund grants — money that could have bought enough nets for 80 million people. And because LLINs are critical to malaria intervention, the shortage devastated India’s fight against malaria and resulted in avoidable deaths, according to Allan Schapira, an epidemiologist and a former consultant with the World Bank.

“Delays in procurement in India are surrealistic,” says Schapira, who studied the effect of these delays. “Several thousand people, probably somewhere around 5,000, may have died as a result of the delayed procurement of nets.”

But such costly blunders are a recurring feature of corruption and mismanagement in global malaria programs. In 2013 the Global Fund suspended Vestergaard Frandsen and Sumitomo Chemicals, a major LLIN manufacturer that also sells to India, for paying $411,000 in bribes to Cambodian malaria officials to secure contracts. But the fund lifted the suspension a scant three months later, after both companies agreed to sign an anti-bribery pact.

A 2007 internal investigation of World Bank–funded health projects in India found that Vestergaard Frandsen falsely claimed that it manufactured nets in India to receive the 15 percent price preference awarded for being a domestic manufacturer, when in fact the bed nets it provided were from China and Taiwan. More seriously, the investigation discovered that multinational pharmaceutical companies such as Bayer and Aventis seemingly formed a cartel in the early 2000s to monopolize contracts on insecticide spray — another major malaria control technique — and that executives at Rites, which was handling procurement, colluded extensively with them.

The report also exposed collusion between companies and the government for contracts for the insecticide pyrethroid. The government and World Bank agreed that they would begin asking companies to comply with an extensive requirement and registration process with the Central Insecticide Board, a government regulation agency. But according to the World Bank, international companies such as U.K.-based Agropharm revealed later that their local agents were clandestinely told they could accelerate the government registration process for $20,000.

The report’s explosive findings nearly fatally jeopardized the relationship between the World Bank and India, but eight years later, little has changed. Many of the firms named in the report, including Rites (which denied most of these charges), continue to receive government contracts, while delays and shortfalls still plague procurement. And registration with the Central Insecticide Board remains an opaque and painfully slow process that keeps out potential competitors, according to M. Palaniappan, the CEO of Shobikaa Impex, a company that has been certified by the WHO to sell mosquito nets but has been waiting five years to register with the board.

The government has, at least, started buying LLINs again. India has ordered 12.4 million nets since 2014 and plans to buy 5 million more this year. It’s not nearly enough to meet the country’s needs, but advocates say it’s a move in the right direction.

Meanwhile, Aiyyali bought inexpensive nets from a local market on his meagre income. “The government isn’t doing enough to combat malaria in the villages,” he says. “The big leaders don’t care about people like us because we’re so small and so far away.”

But the cheap, untreated nets didn’t work. That monsoon, every member of his family contracted malaria.

This article was first published on Al Jazeera. Part Three will be published soon.