IVCC has the pleasure of announcing that, following a meeting of the South African National Accreditation System (SANAS) Approval Committee in June 2021, the Ifakara Health Institute’s (IHI) trials facility, headquartered in Bagamoyo, Tanzania, has been granted Good Laboratory Practice (GLP) certification. This facility is internationally recognised for its expertise in testing new vector control products for industry, product development partnerships, and generates data for regulatory submissions, including WHO Prequalification evaluations.
Since 2016, IVCC has been supporting the IHI trials facility towards GLP certification with funding from the Bill & Melinda Gates Foundation. Support was provided for the GLP certification process and to make the essential infrastructure improvements required for full GLP compliance. In addition, training was provided to key staff through participation in GLP workshops and specialist courses in quality assurance and data management systems. Ongoing mentoring was provided by the GLP project team on quality management system development, including the development of Standard Operating Procedures (SOPs) and on-site facility audits were conducted to provide information on progress of the facility towards becoming fully GLP compliant.
IVCC congratulates Sarah Moore, who leads the IHI test facility, Jason Moore (test facility manager), Emmanuel Mbuba (GLP coordinator) and all of the facility staff on this wonderful achievement.Forest Packs Could Have Public Health Impact 2nd July 2021
Recent semi-field results from Project BITE under IVCC’s Indo-Pacific Initiative (IPI) have shown that forest packs containing bite prevention tools could have an impact on public health beyond just personal protection. The results come from trials that UCSF-Malaria Elimination Initiative, IVCC’s lead partner on BITE, conducted at AFRIMS (Armed Forces Research Institute of Medical Sciences) and Kasetsart University in Thailand.
Project BITE aims to evaluate the effectiveness of forest packs containing a spatial emanator, topical repellent and insecticide-treated clothing when deployed to forest dwellers, goers and rangers in the Greater Mekong Subregion. The project comprises semi-field trials in Thailand and field trials in Cambodia. The trials conducted at the two sites in Thailand measured the protective efficacy of the products using the following endpoints: landing inhibition, knockdown, delayed mortality at 24 hours and blood feeding inhibition.
The semi-field findings demonstrated that these products not only prevent mosquitoes from landing but can also kill or delay them from seeking another host, thus preventing diversion of mosquitoes to nearby non-users of the tools. Delaying host-seeking and feeding inhibition also could have an additional impact on vectorial capacity by reducing human biting rate (HBR) and the vectors’ lifetime reproductive output.
Following the semi-field trials, a formative assessment is now underway in Mondulkiri province in Cambodia, looking at user acceptability of the products. A field entomology trial will take place in Q3-Q4 2021, and a field epidemiological trial will commence in Q1 2022, both at the same sites in Mondulkiri, which will test the hypotheses coming out of the semi-field results.
IVCC and its partners are hopeful that the evidence generated by BITE will help make the case to national programmes and donors on the effectiveness of forest packs in the fight against outdoor malaria transmission amongst at-risk groups – both in Asia-Pacific and beyond.Lethal House Lures for Malaria Control 14th June 2021
The global push to expand coverage of current vector control tools, namely long-lasting insecticidal nets (LLIN’s) and indoor residual spraying (IRS), has led to a halving of the malaria burden across sub-Saharan Africa between 2000 and 2015. This major headway has resulted in a renewed interest in the elimination of the disease. However, the recent stagnation in progress observed between 2015 and 2018 suggests that additional strategies, unaffected by contemporary control challenges including inseciticide resistance, are urgently needed to supplement existing interventions and bridge the gap between control and elimination.
The potential contribution of house-based interventions to malaria control and elimination has been emphasised in the RBM Partnership to End Malaria (RBM) ‘Global Framework for Action and Investment to Defeat Malaria 2016-2030 (AIM)’. This form of vector control, which involves the blocking of mosquito entry routes contributed to malaria elimination in other countries in the early decades of the 1900s but remains largely underexploited in Africa. However, the rapid economic growth in Africa and the need for additional houses to meet its expanding population offer an unrivalled opportunity to deploy improved housing as a complementary measure to existing malaria control tools. Data from observational studies, systematic review and meta-analysis of data collected in a range of African countries during Demographic and Health Surveys and Malaria Indicator Surveys suggest that residents of houses with features that restrict mosquito entry, for example closed eave and screened window, had lower rates of malaria infection.
Standard house improvements do not generally rely on the use of insecticides to reduce malaria transmission. Nonetheless, a wide array of house modification strategies including In2Care® EaveTubes, insecticide-treated eave baffles and insecticide-treated eave and window screening, have an insecticidal component which, according to modelling simulation, could contribute to a community-wide effect under high coverage scenarios. This form of house improvement has recently been classified by the WHO Vector Control Advisory Group (VCAG) as “Lethal House Lure” vector control strategy. The first prototype of this new class of control method to generate epidemiological evidence is the In2Care® EaveTubes intervention. This innovative control method consists of installing plastic piping fitted with insecticide-treated inserts into house walls at eave height. Human odours emanating from houses are then channelled through the tubes attracting Anopheles mosquitoes, which prefer entering houses through the eaves. The static netting insert placed inside the tube is treated with an insecticide powder formulation which delivers a lethal dose to mosquitoes that make contact with it.
The effectiveness of In2Care® EaveTubes, combined with general house improvement (screening of windows and patching of holes in walls) has recently been investigated in a cluster randomized controlled trial in a high malaria transmission area with pyrethroid resistant mosquito populations in central Cote d’Ivoire. Findings from this village-level trial showed that children living in improved houses fitted with EaveTubes and house screening were ~40% less likely to contract malaria compared to those living in villages where the intervention was not installed. The impact of the technology was greater where village-level coverage was higher. The technology reduced indoor vector populations by approximately 60% in comparison to control villages and was shown to be similarly cost-effective to other available malaria control tools. The high impact of the EaveTubes and house screening reported in this trial confirm the potential contribution of house-based control method towards malaria elimination.
Another randomised controlled trial demonstrating efficacy of the EaveTubes intervention in a different geographical setting is required before WHO policy can be issued. However, the path to market for house-based interventions for malaria control is challenging and will require cross sectoral collaboration, particularly with the housing sector, to promote incorporation of protective designs into housing in areas at risk of malaria.IVCC’s June 2021 Update 7th June 2021 Accelerating Global Health R&D Report 24th May 2021
Global Development recently published an overview of activities and impacts of product development partnerships (PDPs), commissioned by the UK’s Foreign, Commonwealth & Development Office (FCDO, formerly DFID). The study entitled ‘Accelerating global health R&D: the role of product development partnerships’ assesses development of new medicines and technologies for 35 poverty-related and neglected diseases, including HIV/AIDS, malaria and tuberculosis. The findings and recommendations will help shape future investments and activities in this field for the UK government and other major government donors and philanthropies.
PDPs, including IVCC, work as virtual orchestras by acting as R&D systems facilitators, aggregating funding and technical expertise from public, private, academic and philanthropic sectors to develop vaccines, drugs and other technologies for diseases of poverty. They were formed 20 years ago to address the so-called 10/90 gap which strikingly still persists today. This gap shows that only 10% of worldwide resources devoted to health research are put towards health in developing countries, where over 90% of all preventable deaths exist, according to the findings by the Forum on Health Research for Development in 1990.
“The Global Development report ‘Accelerating global health R&D: the role of product development partnerships’ was just published and is one of several independent PDP impact reports in the past year by different organisations, including Australia Aid and PDP Funders Group. These reports are timely as we engage in a debate about the future of PDP funding post the Covid-19 pandemic. All reports confirm that the PDP model has been one of the most successful approaches to address the need for products to tackle diseases in resource poor countries. PDPs are highly cost effective and their pipelines are robust, but that they need sustained and flexible funding to increase their impact on global health and development. The latest report confirms that the ten PDPs assessed within the context of this study have collectively brought 85 new products to market, including 3 vaccines, 27 therapeutics, 50 diagnostics or health technologies, and 5 vector control tools. PDPs are seen as ‘virtual R&D conductors’ that ‘successfully cultivate and enhance networks of partners in industry, academia, research institutes, governments and philanthropies’. PDP’s such as IVCC will continue to play a critical role in driving public/private partnerships to ensure global health security.”
Nick Hamon, CEO, IVCC
Read the full report here >