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.

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 > 

According to the World Health Organization, every year there are more than 200 million new cases of malaria, with children under 5 the most vulnerable group affected by the disease. Avient is working together with IVCC, a not-for-profit Product Development Partnership (PDP) based in the UK, to step up the global fight to eradicate malaria and tackle insecticide resistance. Avient and IVCC are creating a new masterbatch production laboratory in Guangzhou, China to support research and development of novel, active insecticide ingredients for long-lasting nets.

The pioneering new facility is expected to be fully operational this summer, and open to current and future innovation projects. It will provide a medium-scale platform for testing and developing masterbatch formulations with insecticides to speed up the process of bringing LLINs to the market. Developing these formulations is imperative to eliminating malaria, as insecticide resistance is making the most widely used formulations, such as pyrethroids, increasingly ineffective. The new facility will also support scale up for those formulations that prove promising.

With extensive global expertise in groundbreaking material solutions to support malaria control, Avient has the capabilities to optimize masterbatch formulations for LLINs to deliver ideal insecticide performance. This includes optimum bio-efficiency and controlled migration of the insecticide to the fiber surface — just enough to kill any mosquito on contact.

Established in 2005 through a Bill & Melinda Gates Foundation grant, IVCC works with industry, funding partners and researchers to develop new public health insecticides for use in LLINs, indoor residual spraying (IRS), and other vector control tools. Its mission is to facilitate innovative approaches to preventing vector-borne diseases globally and to tackle insecticide resistance.

Nick Hamon, CEO of IVCC, comments: “Partnering with Avient is an important step in our product portfolio development work. Improving our capabilities to develop and deliver new tools to help address the growing threat of insecticide resistance is critical if we are to achieve our mission of delivering a toolbox of effective interventions to eradicate malaria. We are extremely grateful to all our funding partners who have helped us achieve this important milestone.” 

Avient, a leading sustainable solutions provider for synthetic fiber applications, enables enhanced fiber performance and coloration for a more agile and environmentally friendly textile industry.

“Avient’s collaboration with IVCC will enable LLINs manufacturers to transform their visions into groundbreaking products that improve quality of life in a meaningful way,” said Michael Adam, global technology director at Avient. “Working towards a solution that saves lives and improves public health aligns with Avient’s sustainability goals and commitment to our communities, both local and global.”

About IVCC
IVCC is a not-for-profit Product Development Partnership (PDP) working in vector control. It was established in 2005, through a $50 million grant to the Liverpool School of Tropical Medicine (LSTM) from the Bill & Melinda Gates Foundation, and is a registered charity in the UK. IVCC works with stakeholders to facilitate the development of novel and improved public health insecticides and formulations to combat the rapidly growing problem of insecticide resistance. IVCC brings together partners from industry, the public sector and academia to create new solutions to prevent disease transmission. IVCC is funded by the Bill & Melinda Gates Foundation, UKaid, USAID, Unitaid, The Swiss Agency for Development and Cooperation (SDC), The Global Fund and Australia Aid.

About Avient
Avient Corporation (NYSE: AVNT), with 2020 pro forma revenues of $3.8 billion, provides specialized and sustainable material solutions that transform customer challenges into opportunities, bringing new products to life for a better world. Examples include:

•    Barrier technologies that preserve the shelf-life and quality of food, beverages, medicine and other perishable goods through high-performance materials that require less plastic
•    Light-weighting solutions that replace heavier traditional materials like metal, glass and wood, which can improve fuel efficiency in all modes of transportation
•    Breakthrough technologies that minimize wastewater and improve the recyclability of materials and packaging across a spectrum of end uses

Avient employs approximately 8,400 associates and is certified ACC Responsible Care®, a founding member of the Alliance to End Plastic Waste and certified Great Place to Work®.  For more information, visit www.avient.com.

The introduction of new vector control technologies is critical to supporting insecticide resistance management (IRM) and progressing towards the elimination of malaria.  However, these new tools including 3^rd generation insecticides for indoor residual spraying (IRS) and dual-active ingredient mosquito nets are more expensive than existing tools and will be difficult to introduce without reducing coverage as malaria budgets have plateaued and are under further pressure due to the economic impact of the COVID-19 pandemic.

With this in mind IVCC is working on a range of market shaping interventions to increase affordability and expand coverage, including a “New Routes to Market” initiative.  IVCC is working with a handful of High Burden High Impact (HBHI) countries including DRC, Ghana, Nigeria and Uganda to explore the potential of expanding coverage beyond the constraints of current donor funding through public private partnerships based on successful work done with mining companies, mission hospitals and NGOs under the Next Generation IRS project (NgenIRS). Although these new distribution networks will be initially set up to expand IRS coverage, they will ultimately be available for the distribution of other vector control tools based on the specific needs of partner countries.

Although in the early stages, countries have expressed great interest and have begun the process, with IVCC’s support, to identify and engage private sector funding and implementation partners.  To this end a private sector roundtable was organised by the Ghanaian National Malaria Program as part of the Zero Malaria Starts with Me campaign. The roundtable brought together over 80 private companies to discuss the pressing need for their involvement in the fight against malaria. In Nigeria a similar roundtable hosted by GBCHealth’s Corporate Alliance on Malaria in Africa and the National Malaria Elimination Programme (NMEP) brought together over 155 participants including speakers from government, industry, academia and civil society to deliberate on ways to maximise impact on malaria vector control interventions in Nigeria. Other private sector roundtables will be planned in other partner countries in the coming months with the hope of identifying partners that can expand IRS coverage within the next year.

The IVCC Annual Report 2019-2020 has been published. The report showcases IVCC’s work to facilitate innovative approaches to preventing vector-borne diseases and tackle the growing threat of insecticide resistance. With activities across the globe and spanning research and development and market access, we are accelerating the process from innovation to impact. The report is a reminder of the importance of collaborative working and the progress laid out in it is testament, too, to the commitment of our partners from industry, academia, the public sector and advocacy. We are grateful for the support of all of our funders, who make life-saving vector control possible.

“ IVCC is showing its resilience, nimbleness and adaptability to keep a constant focus on its goals and how its people will work together to overcome and rise to this unprecedented challenge of our time.”

The Right Honourable Sir Stephen O’Brien KBE
Chair, Board of Trustees, IVCC

For more information or to request a physical copy please provide your full name and postal address to Chris Larkin on christopher.larkin@ivcc.com.