The RBM Partnership to End Malaria is leading the global malaria community in celebrating the milestone of 2 billion insecticide-treated mosquito nets (ITNs) delivered worldwide since 2004. The development and scale up of these nets are responsible for 68% of the malaria cases prevented in Africa since 2000, contributing to global efforts that saved more than 7 million lives and prevented more than 1 billion malaria cases.
A new video highlights the global collaboration it took to boost funding, pioneer, produce, and deliver the insecticide-treated mosquito nets to millions of families around the world living at risk of malaria, a preventable disease that kills a child every 2 minutes. The film follows the journey of one of the nets passed among representatives from the global malaria community including advocates, a scientist, global leaders and malaria-endemic country health workers to reach a family in Nampula, Mozambique – one of 5 countries with the highest burden of malaria. It also features a classroom of young women in Nyanza Province, Kenya, including Clementina Akinyi. Ms Akinyi, now in her last year of high school, grew up sleeping under insecticide-treated nets, and was photographed as a young child under a mosquito net – an image which became iconic for the fight against malaria.
According to the latest World Malaria Report, between 2010 and 2018, the number of pregnant women and children under 5 in sub-Saharan Africa who slept under an insecticide-treated net more than doubled, up from 26% to 61%. Key initiatives driving this progress include The Global Fund to Fight AIDS, Tuberculosis and Malaria and the U.S. President’s Malaria Initiative (PMI), which purchased and worked with malaria-endemic countries and partners to distribute 1.13 billion and 400 million insecticide-treated mosquito nets, respectively. Many other governments, notably the UK, and organisations, including UNICEF, International Federation of the Red Cross and Red Crescent Societies (IFRC), the World Bank, the United Nations Foundation’s Nothing But Nets initiative and Against Malaria Foundation, also made significant contributions to the 2 billion net milestone.
While current evidence suggests that nets treated with pyrethroid insecticides continue to be effective against the mosquito, resistance to pyrethroids – the only insecticide class currently used in ITNs – is widespread and highest in the WHO African Region. To combat insecticide resistance, partners are developing, testing and scaling up nets with new insecticide combinations and harnessing data to better target where to distribute current and new nets. At IVCC, we are leading the implementation of the New Nets Project which began in 2019 in Burkina Faso and will expand in 2020 to Côte d’Ivoire, Mali, Mozambique, Nigeria and Rwanda. The pilot project is funded by Unitaid and the Global Fund. The Bill & Melinda Gates Foundation and U.S. Agency for International Development are providing supplementary funding. And, in October 2019, MedAccess and the foundation announced an agreement with a mosquito net manufacturer to accelerate the availability of 35 million new nets. Ultimately the project and its partners seek to not only establish the necessary evidence base needed to support an appropriate policy recommendation, but to also make the new nets a sustainable choice for countries looking for the best value for money in controlling malaria.
“The milestone of delivering 2 billion life-saving nets is a hallmark example of effective global partnership and sustained commitment over the past two decades. As we enter a new decade, we must now step up action to meet the ambitious global targets of further reducing malaria deaths and cases significantly by 2030. Political commitment and engagement from all levels of society will be crucial to ensure we reach those most vulnerable – pregnant women and children under 5 in sub-Saharan Africa – who still suffer from malaria with life-saving mosquito nets. Equally, we need to continue investing in developing, testing and scaling up nets with new insecticides and active ingredients to stay ahead of the evolving mosquito.”
Dr Abdourahmane Diallo
CEO, RBM Partnership to End Malaria
Notes to Editors
To arrange an interview with a representative for an organisation referenced in this press release, please contact the RBM Partnership press office at Grayling on [email protected] or call +44 (0)20 3861 3747.
This video marking the announcement is available for media outlets to use and share, with credit to the RBM Partnership to End Malaria. Pre-recorded interviews with the below spokespeople and case studies are also available on request.
*Also available for further comment
To support this major milestone for global health and to engage in the celebration online, social media users can use #EndMalaria and #zeromalariastartswithme.
About the RBM Partnership to End Malaria
The RBM Partnership to End Malaria is the largest global platform for coordinated action against malaria. Originally established as Roll Back Malaria (RBM) Partnership in 1998, it mobilises for action and resources and forges consensus among partners. The Partnership is comprised of more than 500 partners, including malaria endemic countries, their bilateral and multilateral development partners, the private sector, nongovernmental and community-based organisations, foundations, and research and academic institutions. www.endmalaria.org
IVCC is the only Product Development Partnership (PDP) working in vector control. IVCC was established in 2005, through a $50million grant to the Liverpool School of Tropical Medicine (LSTM) from the Bill & Melinda Gates Foundation, and is a registered charity in the UK. We work with stakeholders to facilitate the development of novel and improved public health insecticides and formulations to combat the rapidly growing problem of insecticide resistance. We bring together partners from industry, the public sector and academia to create new solutions to prevent disease transmission. By focusing resources and targeting practical scientific solutions we accelerate the process from innovation to impact.Fighting Insecticide Resistance in Ghana 25th May 2018
Ghana shares their story using SumiShield® 50WG
Ministry officials highlighted the successes over the past few years and emphasized the challenges faced in the country, in particular, the growing threat insecticide resistance.
The timely availability and launch of SumiShield® 50WG in Ghana, now provides the country with an alternative insecticide for indoor residual spraying (IRS) in a region in Ghana where entomological monitoring flagged up resistance to all other available insecticides. It has a new mode of action, and was prequalified by the World Health Organization (WHO) for indoor residual spraying in October 2017. The National Malaria Control Programme(link is external)(NMCP) in Ghana is now able to implement sub-national rotation in the country with 2, third generation insecticides SumiShield® 50WG and Actellic® 300CS.
Indoor residual spraying is one of several tools supporting the NMCP’s goal of reducing malaria morbidity and mortality by 75 percent in Ghana between 2012 and 2020. The two IRS implementation partners in Ghana working closely in partnership with the NMCP are AGAMal malaria control programme(link is external), supported by the Global Fund, and the President’s Malaria Initiative (link is external)(PMI) VectorLink(link is external) project.
Ghana has been a NgenIRS country partner since 2017, procuring 3GIRS insecticides at reduced prices as a result of participation in consolidated forecasting, followed by manufacturer discounts and a co-pay mechanism to reduce prices further. The NgenIRS project has enabled the country to expand its coverage compared to the 2016 campaign, with the inclusion of Karaga District.
During 2017, thirteen districts were sprayed by the AGAMal and seven by PMI VectorLink respectively, protecting an estimated 1.9 million people.
The Malaria Programme Manager, Dr. Kezia Malm, stated that malaria is still the number one cause of death in children under 5 in the country and the programme and partners are working tirelessly to reduce these numbers. The areas most affected by insecticide resistance is the Ashanti Region. Districts targeted for IRS in this region during 2018 would have been excluded due to resistance levels, if a new insecticide was not available at the time of spraying.
After the press briefing and a visit to the Noguchi Memorial Institute for Medical Research Institute, the press delegation went to Ashanti region where they were introduced to the AGAMal malaria control programme and the operational implementation of IRS using the new insecticide SumiShield® 50WG.
Village leaders, community members and spray operators were given the opportunity to directly tell their story to journalists.
Journalists talking to village leaders and community members in a village in the Ashanti region, Ghana.
Press event in Accra, from left, Samuel Asiedu (Project Director, AGAMAL), David McGuire (NgenIRS Project Director, IVCC) Atsuko Hirooka (Executive Officer, Sumitomo Chemical Co., Ltd.), HE Tsutomu Himeno (Ambassador, Japan), Tina Mensah (Deputy Minister of Health), Dr Gloria J Quansah Asare (Deputy Director General, Ghana Health Services), Alexandra Cameron (Technical Manager, Unitaid) and at the podium Dr. Keziah Malm (National Malaria Programme Manager).
Links to Unitaid’s Video & Photo Story
Links to related press releases, stories and articles
Unitaid, IVCC and Sumitomo Chemical Company announced the inclusion of the new insecticide SumiShield® 50WG, as part of the NgenIRS project. This announcement followed the prequalification listing by WHO in October 2017.
With two long-lasting IRS (3GIRS) products now available, SumiShield® 50WG and Actellic® 300CS, the pre-emptive annual rotation goal outlined in the Global Plan for Insecticide Resistance
Management in malaria vectors (GPIRM) is achievable. Bayer’s 3GIRS product, Fludora® Fusion is currently undergoing final stage trials required for WHO prequalification and we hope this 3rd long lasting product can join the NgenIRS programme in 2019. BASF´s Sylando® 240SC is under WHO-evaluation.
Funders and procurers now have the opportunity to simultaneously prevent resistance build up and affect the cost-effectiveness of IRS by adopting pre-emptive, subnational rotation strategies where appropriate. Rotating all effective and available insecticides is key as a wholesale shift from one effective long-lasting IRS product to another within the market would undermine the goals of increasing competition, reducing product cost, and the market volatility of IRS products. Experts have proposed a new strategic approach based on pre-emptive rotation of multiple 3GIRS products within a country to:
Half of the NgenIRS partner countries adopted a sub-national rotation strategy for 2018, as part of their national insecticide resistance management plan. Tanzania has completed their IRS sub-national rotation campaign for 2018, Ghana and Burkina Faso are in the process of adopting this strategy and the remaining four countries will follow.
In the last two years, NgenIRS has been working in close collaboration with a number of stakeholders in Mali to study the impact of IRS. The team’s first trip was conducted in September 2016 to introduce the NgenIRS evidence team, discuss current vector control/malaria landscape, review data sources and availability, prioritize research questions, and discuss study designs. The key partners in Mali include the National Malaria Control Program (NMCP), the US President’s Malaria Initiative (funds IRS implementation in Mali), Africa Indoor Residual Spray Project (implements IRS in Mali), and the MEASURE Evaluation project (supporting NMCP on health information systems management and monitoring and evaluation activities). From the outset, all stakeholders were enthusiastic about the collaboration and expressed interest in conducting the IRS impact evaluations. Ideas, approaches, and data sets—including implementation and routine malaria surveillance data— were shared and the analysis process began. Two additional trips took place in 2018 to present preliminary analysis, review data gaps, and discuss future plans. During these visits, the NgenIRS team received feedback from NMCP, PMI, and MEASURE Evaluation and the analysis was refined and additional research questions posed.
Engaging country-level partners and providing frequent status updates on the analytic process has proven successful in building sustained and productive partnerships in Mali. As a result of this successful collaboration, the evidence base demonstrating that IRS is a cost-effective malaria control intervention has grown: a manuscript recently co-authored by study partners was published in early 2018 and its results have been discussed at length by multiple stakeholders during several presentations at ASTMH 2017, ASTMH West Africa 2018, and at MIM 2018.
As further NgenIRS analyses of more recent spray campaigns get underway, it’s clear that enthusiasm of in-country partners remains strong. MEASURE Evaluation, NMCP, and PMI have promptly validated and shared the latest malaria surveillance data and provided feedback on the data challenges and caveats to consider in the analysis as well as providing inputs for integrating the latest entomological surveillance data.Analysis on New IRS Product SumiShield® 50WG in Ghana 30th November 2018
In September 2018, members of the PATH NgenIRS team visited the Upper West Region in Ghana to conduct a site visit in areas where the AGAMal malaria control programme is piloting the use of SumiShield® 50WG, a third-generation indoor residual spraying (3GIRS) product, in 3 districts. Sumishield, prequalified by the WHO in October of 2017, is effective against pyrethroid-resistant mosquitoes and now, along with Actellic®300 CS, provides vector control programmes the ability to annually and pre-emptively rotate between different 3GIRS products to prevent the emergence of resistance. With the introduction of SumiShield into Ghana, the NgenIRS evidence team now has an opportunity to analyze through routine data the public health impact of introducing a second 3GIRS product into an existing spray program. For the purpose of this impact evaluation, PATH is partnering with AGAMal to enhance routine epidemiological surveillance in the study sites through an assessment and selection of sentinel sites for accurate, timely, and complete monthly reporting of routine data in the DHIMS2 database.
Available to view/download – Evidence Snapshot: 3rd generation IRS (3GIRS) in northern savannah, Ghana