World Malaria Report 2016 highlights importance of new Vector Control tools
The 2016 WHO World Malaria Report provides encouraging reading given the continuing reduction in malaria morbidity and mortality. But mixed progress outside of Africa and the focus on insecticide resistance demonstrates the importance of I2I now more than ever.
Vector control has played a crucial role in the battle against malaria with the proportion of the risk population in sub-Saharan Africa who are protected by either Insecticide Treated Nets (ITNs) or Indoor Residual Spraying (IRS) increasing from 30% in 2010 to 53% in 2015. However, with an estimated 114 million people in sub-Saharan Africa still infected, contributing to approximately 429,000 deaths worldwide each year, it is clear the fight is far from over.
The impressive gains reported by WHO since 2010 are threatened by resistance of the Anopheles mosquitoes to pyrethroids, the only insecticide currently in use on ITNs and as such the cornerstone of malaria vector control. The report, released this week, states that resistance to at least one insecticide was reported in 60 of the 73 countries who provided data to WHO between 2010 and 2015. In addition to this, recent publications make it clear that insecticide resistance in Anopheles is present and intensifying in many countries, particularly in sub-Saharan Africa.
The WHO Global Malaria Program recently published a 5 country study to assess the effects of insecticide resistance on the efficacy of vector control tools. While it found resistance to be highly variable, there was evidence that LLINs provide personal protection against malaria in areas of pyrethroid resistance. The study also noted that the introduction of a second, non-pyrethroid insecticide in the form of an IRS almost halved malaria incidence and appeared to slow the progression of pyrethroid resistance in the vector population.
Taken together, the World Malaria Report and WHO study provide a strong case for the I2I initiative. Bringing new, safe and efficacious tools to the market to counter the effects of pyrethroid resistance is crucial to maintain the downward trend we have seen in malaria control over the past decade. The significant reduction in malaria incidence with a second insecticide highlights the importance of maintaining an effective portfolio of public health insecticides rather than relying on a single class. Moreover, new technologies are needed that can help to protect the 50% of people who are not reached by ITNs in sub-Saharan Africa, or those who live in areas where biting occurs outside.
I2I is committed to supporting these efforts by working with all the stakeholders involved in development, regulation and implementation of vector control tool to ensure long term, effective coverage for those most at risk from malaria.