A new $65 million initiative to boost malaria control was announced today in Geneva. IVCC signed a partnership agreement with Unitaid in a project that will combat resistance to insecticides by improving access to new, low-cost anti-mosquito sprays across Africa.
The Next Generation Indoor Residual Spray project, known as NgenIRS, will support countries in obtaining new and effective insecticides at lower prices to spray walls in homes and fight growing insecticide resistance. Over four years, the project aims to protect as many as 50 million people from malaria in 16 African countries. Despite its effectiveness in combating malaria, indoor spraying of walls has fallen by 40 per cent in the past four years. The drop is due to increased resistance of mosquitoes to older products and higher cost of new alternatives.
IVCC will team up with the US President’s Malaria Initiative, Abt Associates, PATH and the Global Fund to work with industry and country malaria-control programmes to make alternative insecticides with high efficacy more readily available in countries with a high burden of malaria. The initiative will use a co-payment from Unitaid to bring down the price of these new and more effective products in the short term.
A further aim is to reduce the cost of procuring products in the long term through improved forecasting and increased competition among manufacturers.
Welcoming the project, Dr Nick Hamon, IVCC CEO said, “recent evidence has shown that insecticides are the first line of defence against malaria, responsible for nearly 80 per cent of malaria cases averted since 2000. We are working with our industry partners to bring to market as soon as possible novel insecticides that are in the pipeline.’
Lelio Marmora, Executive Director of Unitaid said that the initiative would bolster the central role of insecticides in controlling malaria. “If the insecticide resistance continues to spread unabated, there could be 120,000 more deaths from malaria a year”, he said. “Unless newer insecticides are used, we run the risk of considerable reversals in the fight against malaria. This is the first of many other initiatives by Unitaid to control the spread of malaria-transmitting mosquitoes.”
Speaking at the launch of the project, Dr Pedro Alonso, Director of the WHO Global Malaria Programme, said that it would help maintain the effectiveness of vector control in the short term and encourage competition as prices decrease and demand grows. “Effective vector control is a cornerstone of our global strategy for malaria,’ he said. “It is responsible for many of the gains seen over the last decade in malaria control and elimination. We welcome this joint initiative to accelerate the development and deployment of new insecticides and vector control tools.”
Find out more at www.ivcc.com/market-access/ngenirs/
Novel Mosquito Net Marks Breakthrough in New LLINs 17th November 2016A novel mosquito net that combines the pyrrole chlorfenapyr and the pyrethroid alpha-cypermethrin represents a breakthrough in the development of Long Lasting Insecticidal Nets (LLINs) to control pyrethroid resistant mosquitoes.
A novel mosquito net that kills insecticide resistant mosquitoes which would normally survive exposure to standard pyrethroid treated nets marks a breakthrough in the development of new long-lasting nets that can meet the challenge of malaria control in countries in areas of high insecticide resistance, reports a new study published in Plos One. The project was a partnership between IVCC, the London School of Hygiene & Tropical Medicine, the West African vector control trial site (CREC) in Benin, which together with the chemical company BASF SE, have developed and evaluated a new type of long lasting net, Interceptor® G2.
LLINs that kill the Anopheline mosquitoes which transmit malaria are the simplest and most widely used method to prevent the disease. The World Health Organization (WHO) estimates that over half the population of sub-Saharan Africa now sleeps under LLIN and this has helped to reduce malaria cases by a third and mortality rates by two thirds over the last 15 years.
Until recently, the LLIN technology has been wholly dependent on pyrethroids as the only class of insecticide safe to use on LLIN. The rapid spread of resistance to these insecticides in malarial mosquitoes threatens further progress unless new types of insecticide which are both effective and safe can be developed. Professor Mark Rowland and Dr Raphael N’Guessan of the London School of Hygiene & Tropical Medicine anticipated this problem over 13 years ago. It was discussed with BASF to repurpose an insecticide which previously had been used to control termites and pests from indoor areas including commercial kitchens.
Mark Rowland said: “Back then we knew that selection of resistance to pyrethroids in malarial mosquitoes was only a question of time. The challenge was to identify a suitable insecticide that had right combination of residual efficacy against insects, low water solubility, no cross resistance to other classes of insecticide and was safe to use on nets. Chlorfenapyr, a pyrrole insecticide, seemed to have that rare collection of attributes and we started working with BASF. A few years later BASF and LSHTM had demonstrated chlorfenapyr’s potential in bioassay, subjected it to WHO toxicological risk assessment, and completed the first experimental hut trials, small-scale studies under house-like conditions in West and East Africa”.
In 2011, BASF entered into full partnership with IVCC and set its sights on developing a long lasting insecticidal net which would combine chlorfenapyr and the pyrethroid alpha-cypermethrin.
Dr Susanne Stutz, the BASF Project Manager, said: “Even then it was not plain sailing. Chlorfenapyr would simply not behave predictably in laboratory bioassay. However, when applied to nets and testing in experimental hut trials, chlorfenapyr would always kill mosquitoes that made contact with the netting. The explanation lies in the chlorfenapyr’s unique mode of action. Unlike standard public health insecticide which are neurotoxic, chlorfenapyr disrupts cellular respiratory pathways and is most toxic to mosquitoes which are active at night when they make contact with the net”.
The target product profile set by BASF and IVCC was a chlorfenpyr / alpha-cypermethrin mixture long-lasting insecticidal net that would remain effective against pyrethroid resistant mosquitoes after 20 standardised washes, a threshold established by WHO for all LLIN. Four years later, Interceptor® G2, has fulfilled its initial promise and in experimental hut trials killed over 70% of pyrethoid-resistant Anopheles gambiae when the standard pyrethroid LLIN killed only 20%. The long lasting formulation retained insecticidal activity on the net after 20 standardized washes in soap solution.
Raphael N’Guessan, the scientist who managed the trials in West Africa said: “The unique mode of action of chlorfenapyr means that insecticide resistance based on target site insensitivity in the insect nervous system and other mechanisms shows no cross resistance to chlorfenapyr. The mosquito mortality rates generated by Interceptor® G2 are similar to the rates generated by standard pyrethroid LLIN 10 years ago when most mosquitoes were fully susceptible to pyrethroids”
This publication marks the first of several trials of Interceptor® G2 carried out in African trial sites in Benin, Ivory Coast, Burkina Faso and Tanzania. BASF has submitted the Interceptor® G2 dossier to the WHO Pesticide Evaluation Scheme for interim recommendation expected in March 2017.
David Malone, IVCC Technical Manager, said: “Africa has become a net using culture. Insecticide treated nets are the most important tool we have to prevent malaria. This new technology demonstrates that insecticide treated nets will continue to be an essential weapon in the fight against malaria in the future despite pyrethroid resistance.”
The development and evaluation of Interceptor® G2 is the result of partnership between the BASF SE of Germany, the London School of Hygiene & Tropical Medicine, and IVCC.
The full publication can be found at Plos One:
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0165925
Science Magazine this month (October 2016) features an excellent article about the work of IVCC and Liverpool School of Tropical Medicine (LSTM) in fighting insecticide resistance in mosquitoes.
The article, by Science contributing correspondent Kal Kupferschmidt, highlights the threat to malaria reduction by growing insecticide resistance. It points to the critical work of IVCC and LSTM in ‘evaluating new weapons to fight mosquitoes’. LSTM does this through its vector biology programmes, and IVCC through working with industrial agrochemical giants to create innovate new insecticides that will combat insecticide resistance.
IVCC’s CEO, Nick Hamon, emphasises the challenge of keeping industrial companies engaged in developing new insecticides when the potential market for new public health insecticides is small. The future is hopeful, however, as he points out three potential new insecticides will shortly be moved into the final testing stages.
Read the full article here:
Still Time to Battle Insecticide Resistance 22nd November 2016Insecticide treated bednets are highly effective at reducing malaria transmission, despite the rise in insecticide resistance, according to a study carried out by the WHO. But this is not grounds for complacency, according to the President of the American Society of Tropical Medicine and Hygiene, Dr Stephen Higgs. ‘This study provides encouraging news that we have not yet run out of time in battling insecticide resistance’, he said. ‘However, we must take advantage of the time we now have to invest in research, and generate new tools that will allow us to finally defeat this complex and challenging disease.’
The WHO research across five countries showed that people who slept under a long-lasting insecticide treated net (LLIN) had significantly lower rates of malaria infection than those who did not use a net. This was consistent with recent research conducted by the Centers for Disease Control and Prevention (CDC) which showed that insecticide treated bednets provided significant protection to children in an area of Malawi with considerable malaria transmission and low levels of insecticide resistance. The research found that the insecticide treated bednets still kill mosquitos even in areas where there is known resistance.
Dr Pedro Alonso, Director of the WHO Global Malaria Programme said that the key finding of the study is that treated nets continue to be a highly effective tool in the malaria fight. ’The study supports WHO’s call for achieving universal coverage of long-lasting insecticide treated bednets for all populations at risk of malaria,’ he said.
According to the WHO World Malaria Report 2015, mosquito nets have been the most important malaria control tool in sub-Saharan Africa, accounting for an estimated 69% of cases prevented through interventions since 2001. Since 2000, malaria case incidence has declined by 37% globally and malaria death rates have fallen by 60%. In sub-Saharan Africa, the region most heavily affected by malaria, cases and deaths have fallen by 42% and 66%, respectively.
Following the study Dr Alonso has called for a global strategy for comprehensive control of disease carrying insects to be high on the agenda for the 2017 World Health Assembly. He said there is a growing need for sustainable approaches supported by enhanced expertise to aid the fight against malaria and other insect-borne diseases. WHO continues to highlight the urgent need for new and improved malaria-fighting tools to accelerate progress towards global elimination goals and is calling for greater investments in vector control interventions, improved diagnostics and more effective medicines.
IVCC is at the forefront of the fight against disease carrying insects. Intensive research since 2005, with global leaders in insecticide development, has produced a promising pipeline of new anti-mosquito tools currently under development. WHO is revising its process for reviewing and recommending new malaria vector interventions in order to fast track their route to the field.
WHO World Malaria Report 2016 Highlights Key Role of Vector Control 14th December 2016Despite growing mosquito resistance to insecticides, vector control remains the main way of preventing and reducing malaria transmission, says the WHO in its recently released World Malaria Report 2016.
‘Long-lasting insecticidal nets are the mainstay of malaria prevention’, said Secretary General, Margaret Chan, adding that the WHO recommends their use for all people at risk of malaria. ‘Across sub-Saharan Africa, the proportion of people sleeping under treated nets has nearly doubled over the last 5 years’, she said.
The report spotlights a number of positive trends, particularly in sub-Saharan Africa, the region that carries the heaviest malaria burden. It shows that, in many countries, access to disease-cutting tools is expanding at a rapid rate for those most in need.
Although excellent progress has been made, in 2015 there was still a global tally of 212 million cases of malaria and 429 000 deaths. Gaps in coverage are reported for key interventions such as bed nets and in-door residual spraying, with around 43% of the population in sub-Saharan Africa still unprotected.
The progress of the past 15 years is threatened by the rapid development and spread of mosquito resistance to insecticides. Antimalarial drug resistance could also jeopardize recent gains.
Welcoming the Report, IVCC CEO, Dr Nick Hamon said, ‘The significant gains in the battle against malaria are to be applauded, but the battle is far from over. Vector control is now widely recognised as a key player in the battle and IVCC is deeply committed to ensuring it delivers the new vector control tools needed to ultimately defeat this insidious disease.’
Find out more about the World Malaria Report 2016 here.