The current control paradigm for malaria is not sustainable in the long term from both a biologic and political perspective, said Dr Alan Magill, addressing the IVCC Stakeholder Day conference in Liverpool.

Dr Magill is a Director of the Bill and Melinda Gates Foundation charged with overseeing the development and implementation of strategies for the foundation’s ultimate goal of the eradication of malaria. He was addressing an audience of vector control and public health experts from across the world, who had gathered together to consider the latest developments in IVCC’s vector control programme. If malaria resurgence is to be avoided, Dr Magill said, eradication is the only strategy that makes sense moving forward.

He outlined five key principles in the malaria eradication strategy. Beginning with the first, precise definitions, he said, ‘the definition of malaria eradication is actually getting parasites out of people.’ The second and third principles involve complete clinical cure including removal of the ‘vast human reservoir of malaria parasites’ in asymptomatic people.

The fourth principle he outlined concerns the fundamental precepts of evolutionary medicine and correct ecologic thinking. ‘Malaria is a very big complex system.  It’s got the biology, the ecology, the political, and the social pieces,’ he said. It is important to understanding it as a system and then ensure that product development and policies are ‘evolutionarily correct’ going forward.

Dr Magill’s final principle was think globally and impact locally,  ‘there is no one size fits all, no one single solution that’s going to magically lead us to eradication,’ he said.

Talking about the role of vector control product development he said that it was important to accelerate the delivery of new vector control products through the current system and get them out to impact just as soon as possible.

‘Let’s finish the job,’ he said in conclusion. ‘We don’t like to get distracted by discussions about elimination and eradication.  This is all about saving lives.  It’s saving lives now in sick people and it’s saving lives for ever going forward because we’re going to avert all those deaths by elimination.  It’s a pure simple equation.  We know that this is biologically and technically feasible and we think the new tools that will be developed in the next few years will make a lot of the things we’re talking about much more operational and feasible.’

Turning to IVCC and the stakeholders in the room he said that the next decade would be an intense period of experimentation—’using current tools and new ways, and really thinking about that long term goal of eradication’.

‘IVCC is a hub in the eradication eco system, and through that hub we can reach out to all the talent in the room.  I would say that if there’s a problem out there in the vector space world, well this is the group of people to solve it.  You own it; if you don’t like it it’s up to you to change it.’

IVCC’s mission to bring new effective products to market will become even more critical in the next 12 to 15 years according to Stakeholder Day keynote speaker Admiral Tim Ziemer. “We’re not going to be able to achieve malaria control, sustainability and eradication without a mechanism like IVCC to facilitate development of the new vector control tools and products needed to continue the fight,’ he said.

Admiral Ziemer, U.S. Global Malaria Coordinator and leader of the President’s Malaria Initiative (PMI), was speaking at the beginning of the 2014 IVCC Stakeholder Day, with more than 130 vector control stakeholders gathered from across the world. He began his presentation by acknowledging the work of IVCC as a ‘key product development partner in the malaria fight.  ‘Product development partners like IVCC have resulted in accelerating new technology development and we’re seeing more promising products in the pipeline than we ever have before for.  For an investor that’s an exciting deliverable and expectation’, he said.

‘The potential to provide more value for money in a high risk, high gain and highly technical field by leveraging funding to gain support for continued development of critical commodities to combat a disease of poverty like malaria reflects an effective research investment.  We, the United States Government looks at this, IVCC, as an investment opportunity to leverage some of our research money for the future and we’re very pleased to be a partner.’

Watch Admiral Ziemer’s comments about the partnership between PMI and IVCC

The Innovative Vector Control Consortium (IVCC) has helped the CREC/LSHTM Collaborative Research Programme in Benin achieve Good Laboratory Practice (GLP) certification, the second vector control field trial site to attain certification in Sub-Saharan Africa.

The CREC/LSHTM Collaborative Research Programme is a research partnership set up in 2003 between the London School of Hygiene & Tropical Medicine and the Centre de Recherche Entomologique de Cotonou (CREC) at the Ministry of Health in Benin.

The partnership has extensive experience in the evaluation of vector control products (mainly long-lasting insecticidal nets and Indoor residual spraying) to WHO standards.  It is part of PAMVERC (The Pan-African Malaria Vector Research Consortium) and its research activities are largely funded by USAID and by the Bill & Melinda Gates Foundation (BMGF) through IVCC and collaborating agrochemical companies.

Nick Hamon, CEO of IVCC said: “Field trials facilities in Africa play an essential role in evaluating novel vector control products being developed by our agrochemical partners. The generation of reliable data through GLP compliant field trials is important, as this is the key to establishing the true performance of the products being tested.”

Since 2000, IVCC, in partnership with the London School of Hygiene & Tropical Medicine, has been working to strengthen the quality and reliability of data generated by African vector control field trial sites.  This work has included the development of quality management systems including Standard Operating Procedures (SOPs), the auditing of facilities for GLP compliance, and GLP training workshops.

An important element of IVCC’s GLP rollout programme has also been its funding of infrastructure improvements including buildings and equipment at its collaborating trial sites. This research capacity building is establishing a network of facilities in Africa that can generate testing data on vector control products of the highest standard.

Dr. Corine Ngufor, Assistant Professor, Disease Control Department, London School of Hygiene and Tropical Medicine and Facility Manager of CREC/LSHTM Facility said: “GLP accreditation is never an easy process for any facility. CREC/LSHTM is now the first facility in the West African region and the second in Africa to achieve GLP accreditation for vector control product evaluation. We look forward to working with agrochemical companies to deliver high quality data on the efficacy of novel vector control products in line with the WHO pre-qualification requirements.  As a team, we have worked hard over the past 2 years and are very proud of this achievement.  We are also grateful for the support provided by IVCC through this process.”

Graham Small, IVCC’s Trials Quality and Project Support Manager added: “The growing network of GLP certified trials sites across Africa will allow manufacturers of vector control products to generate their own efficacy data for inclusion in their product dossiers submitted to the WHO Prequalification Team product evaluation process. This represents a major step forward for vector control product testing, which will be of major importance in delivering the IVCC mission and in achieving malaria elimination in the future.”

In 2016, the first field trial site to achieve GLP certification was the Kilimanjaro Christian Medical University College (KCMUCo) was in Moshi, Tanzania.   Five further IVCC collaborating trials sites are now planning their GLP studies and will be submitting their applications for OECD GLP certification through SANAS in the coming year.

IVCC has welcomed the WHO Pre-Qualification of Bayer’s Fludora™ Fusion, combining different modes of action, as another major step forward in malaria control and insecticide resistance management.

IVCC supported the development of this new indoor residual spray (IRS) product in field trials where the product was tested against various resistant mosquito strains and on different relevant surface types. The data generated demonstrated that Fludora™ Fusion provides robust and consistent results, matching the needs of malaria control programs across Africa.

Nick Hamon, CEO of IVCC said: “We were pleased to have been able to support part of the Fludora™ Fusion trial program and to see this milestone achieved. New vector control tools are desperately needed to combat resistance and this is another positive addition to the toolbox.”

IVCC’s David McGuire who, with other consortium partners PMI, Abt Associates and PATH, leads the $65.1m Unitaid funded NgenIRS initiative, added: “Fludora™ Fusion will be a powerful and timely addition to the range of new indoor residual spray products implementing partners can use across sub-Saharan Africa.Following the successful deployment of Syngenta’s Actellic® 300 CS and Sumitomo’s SumiShield® we now have greater choice of new generation IRS products that can support sub-national rotation of insecticides, a major weapon against the threat of insecticide resistance. The introduction of more products from different manufacturers has also created a competitive environment for third generation IRS that is driving down prices to affordable levels for malaria control programs and their donor partners.

Dr. Jacqueline M. Applegate, Head of the Environmental Science business unit at Bayer added: “We are very proud to have achieved WHO Pre-Qualification for Fludora™ Fusion; it reflects our long-term commitment towards supporting the elimination of vector-borne diseases. It is a clear example of our focus on applying science to advance life – malaria control programs will now have access to an additional safe, efficient and cost-effective solution to protect the millions at risk from the disease.”

For further information, please contact:

Chris Larkin
Head of Communications and External Relations
IVCC
Phone: +44 151 702 9371
Mobile: +44 7712 402498
Email: christopher.larkin@IVCC.com(link sends e-mail)

About IVCC

IVCC is the only product development partnership (PDP) working in vector control. Established in 2005, IVCC works with stakeholders to facilitate the development of novel and improved public health insecticides and formulations and provides information tools to enable their effective use. IVCC’s vision is simply to save lives, protect health and increase prosperity by preventing insect-borne diseases. IVCC is funded by The Bill & Melinda Gates Foundation, UKaid, USAID, Unitaid, the Global Fund, the Australian Government and The Swiss Agency for Development and Cooperation.

About Bayer

Bayer is a global enterprise with core competencies in the Life Science fields of health care and agriculture. Its products and services are designed to benefit people and improve their quality of life. At the same time, the Group aims to create value through innovation, growth and high earning power. Bayer is committed to the principles of sustainable development and to its social and ethical responsibilities as a corporate citizen.

The 67th Annual Meeting of the American Society of Tropical Medicine and Hygiene

Members of the NgenIRS project, along with a few thousand colleagues from around the world, met in New Orleans, LA for five days to share recent findings from world-class research on tropical medicine and hygiene, including malaria. Molly Robertson, Evidence lead for the NgenIRS project at PATH, along with Larry Slutsker, Director of Malaria and Neglected Tropical Diseases at PATH, co-chaired a symposium on indoor residual spraying (IRS) and drug-based malaria control. Symposium presenters reviewed observational evidence and modeling showing the benefits of combining IRS for malaria vector control with drug-based interventions, including mass drug administration (MDA) and seasonal malaria chemoprevention (SMC), for malaria parasite control. Diadier Diallo of MEASURE Evaluation presented research on IRS and SMC in the Segou Region of Mali showing that there was a 39 percent reduction in all-ages malaria incidence in areas that received both IRS and SMC compared to a 16 percent reduction in SMC areas and a 28% reduction in IRS areas. Other symposium presenters included Thom Eisele from Tulane University, Dorothy Echodu from Pilgrim Africa, and Ellie Sherrard-Smith from Imperial College.

NgenIRS partners from PATH also presented updated analyses on the cluster randomised control trial in Mopeia, Mozambique; the impact of introducing IRS in Mopti Region, Mali; and the reintroduction of IRS in Northern and Upper East Regions, Ghana. In Mozambique, preliminary results from active cohort surveillance based on spray status have shown a 17-month cumulative rate ratio of .81 (.77-.94). Interim analysis of case data from routine health systems reflect the same trends seen in infection data from the active cohort—a significant reduction in malaria incidence of approximately 19.4% to 25% in IRS vs. non-IRS clusters. In Ghana, preliminary analyses show clear correlations in time and space with indoor residual spraying of a 3GIRS product and reduced incidence of confirmed malaria cases from routine surveillance systems in the north of Ghana, where pyrethroid resistance is widely reported. Finally, in Mali, after introducing IRS into 4 districts of Mopti in 2017, rapid diagnostic testing (RDT)-confirmed malaria rates fell 37% compared to similar unsprayed districts. And after suspending IRS in Segou District in 2017, RDT+ confirmed malaria rates rose 125% compared to similar unsprayed districts. Final in-depth analyses on all of the aforementioned work will be forthcoming in 2019.

Symposium co-chairs and speakers show up in costume during the October 31st ASTMH session on combining IRS and drug-based interventions.