The current push to eliminate malaria from many countries, and the longer term goal of eradicating malaria globally, will rely heavily on indoor residual sprays (IRS) and long lasting insecticide treated nets (LLINs), particularly in hyper-endemic areas where appropriate drugs and vaccines will only be effective at driving the disease towards elimination when transmission levels and parasite loads in the human populations have been depressed by coordinated large scale mosquito control campaigns.
Since the 1960s target product profiles for agrochemical insecticides have diverged from those of public health pesticides, leading to a 30 year drought of new public health products. Recently, insecticide resistance, particularly to pyrethroids, has threatened the efficacy of these older insecticides. The Innovative Vector Control Consortium (IVCC) was established in November 2005 with a US$50.7M investment from the Bill and Melinda Gates Foundation (BMGF). The Mission of the IVCC is to reduce transmission of insect borne pathogens through improved insect vector control with innovative products. Specifically we facilitate the development of improved public health pesticides and formulations, provide information tools to enable the more effective use of existing and new control measures, and work with the disease endemic country stakeholders and industry to establish target product profiles for new paradigms in vector control.
The IVCC has developed an insecticide based vector control product portfolio with the following specific goals;
- To develop alternatives to pyrethroids for LLINs for use in pyrethroid resistant areas.
- To re-purpose agricultural insecticides for the public health market.
- To stimulate the development of new Active Ingredients (AIs) de novo for the public health market.
- To improve IRS formulations to get 6-12 months stability.
All the major R&D-based industrial pesticide manufacturers that are active in the disease vector
control market have engaged with the IVCC and have active projects under way or in preparation.
The first five years of the IVCC are now forecast to deliver to market new long lasting IRS formulations and a healthy pipeline of projects that will deliver 2-3 new classes of AI, alternative AIs for LLINs and several re-purposed agrochemicals. In the next five years the re-purposing opportunities will be completed and the focus will shift to developing the lead candidates discovered in the screening and molecular design projects.
In addition to the insecticide projects IVCC has developed the following tools for more efficient management, monitoring, and evaluation of vector control programs:
- A malaria decision support system, best practice protocols and software.
- A dengue decision support system and associated dengue threshold modelling.
- A vector population monitoring kit, incorporating the ability to monitor insect species, infection and insecticide resistance status.
- Insecticide quantification kits.
These projects have delivered their development objectives and are now approaching a roll out phase beyond the IVCC. The roll out mode will vary from creation of spin out vehicles to deliver the decision support systems to commercialisation of kits and dissemination of protocols.
The last great barrier in vector control product development is the limitation of verified paradigms to IRS and LLINs. IVCC plans to identify and develop new interventions, with emphasis on those that can be delivered through the consumer product channel, that are epidemiologically effective. Our Industrial partners have already made a number of proposals to IVCC for products that may suit this paradigm.