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Project Overview – New Nets Project (NNP) 11th August 2020 Evidence base to support a WHO policy recommendation for Interceptor® G2 grows 25th January 2023

IVCC welcomes the publication in The Lancet of the 24-month results of an epidemiological trial in Benin, to assess the public health value of two dual active ingredient insecticide treated nets (ITNs).

The research was conducted by the London School of Hygiene and Tropical Medicine (LSHTM) in partnership with the Centre de Recherche Entomologique de Cotonou (CREC).

Over the two-year study, in an area of Benin with pyrethroid-resistant mosquitoes, BASF’s Interceptor® G2 (IG2) chlorfenapyr-pyrethroid ITNs provided greater protection from malaria compared to pyrethroid-only nets.

The results show a 46% reduction in malaria incidence in children 6 months to 10 years. Participants of any age had 43% and 39% lower odds of malaria infection at 6 and 18 months after ITN distribution.

This study follows the publication of a sister epidemiological trial carried out in Tanzania and published in The Lancet in 2022. The results of the randomised control trial (RCT) also demonstrated significant reduction in malaria prevalence over a 24-month period, with a reported case incidence reduction of 44% .

“Mosquitoes are becoming increasingly resistant to the pyrethroid insecticides used on insecticidal treated nets,” explains Professor Akogbeto, co-author of the study and Medical Entomologist at CRER in Benin, “this reduces the nets’ ability to protect people from malaria, so we must continue to develop and test new tools that have proven public health value and extend the effectiveness of existing tools against resistant mosquitoes.”

The newly published Benin study confirms the significance of chlorfenapyr as an ITN treatment to control malaria in areas with pyrethroid-resistant vectors, compared to pyrethroid-only ITNs. In both trials, analysis also indicates that individuals living in the chlorfenapyr-pyrethroid group benefitted, regardless of whether they were using a study net, suggesting a community impact of the net.

The results of the Benin study provided vital second-trial evidence that will enable the World Health Organization (WHO) to make policy recommendations on this new ITN class.

Nick Hamon, former IVCC CEO says: “Combined, the results of the epidemiological trials in Benin and Tanzania provide a robust and cumulative evidence base to support an appropriate WHO policy recommendation for Interceptor® G2. The research shows IG2 nets show a significant reduction in malaria incidence, prevalence and transmission and demonstrate good public health value.”

As during the Tanzania trial, DCT’s RoyalGuard® pyriproxyfen-pyrethroid nets were also tested in the Benin study. While the results indicate RoyalGuard® ITNs did not provide additional protection against malaria infection, there was evidence for an impact to indoor transmission. Lower net use in the RoyalGuard® group could contribute to the lack of impact, more research is needed to fully understand the results.

Both trials have been delivered through the IVCC led New Nets Project (NNP), funded by Unitaid and the Global Fund. The studies will report additional data once the 36-month period is reached and, combined with New Net Pilot evidence pilots across 5 countries, will contribute to the understanding of both Interceptor® G2 and RoyalGuard’s® product performance over time, across various endemicities and resistance profile.

UK-based social finance company MedAccess is supporting access to Interceptor® G2 nets in 14 African countries. The company’s volume guarantee has enabled BASF to reduce the price procurers pay for the nets.

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For further information contact:

Laura Roberts, Communications Manager

laura.roberts@ivcc.com

(+44) 07849 700582

Product and Project information

Efficacy of pyriproxyfen-pyrethroid long-lasting insecticidal nets (LLINs) and chlorfenapyr-pyrethroid LLINs compared with pyrethroid-only LLINs for malaria control in Benin: a cluster-randomised, superiority trial, The Lancet

Interceptor® G2

Interceptor® G2 is a second-generation ITN developed by BASF with a combination of chlorfenapyr and alpha-cypermethrin to control insecticide resistant mosquitoes. This novel mode of action in vector control exploits mosquito enzymatic systems against themselves and shows no cross-resistance to other insecticide classes. Unlike pyrethroids, the chlorfenapyr target site of activity is not the insect nervous system. Instead, chlorfenapyr acts, after being metabolized by P450 enzymes at the cellular level, by disrupting respiratory pathways and proton gradients through the uncoupling of oxidative phosphorylation within the mitochondria. The Interceptor® G2 net has a WHO prequalification listing. https://www.who.int/pq-vector-control/prequalified-lists/interceptor_g2/en/  Previously the net was evaluated and given an interim recommendation by the 20th WHOPES Working Group.

Royal Guard®

Royal Guard® is an ITN developed by Disease Control Technologies to provide vector control through both the personal protection of traditional mosquito knockdown and mortality, as well as a reduction in fecundity of any mosquitoes that manage to survive exposure to the products pyrethroid active ingredient. The intended benefit of the insect growth regulator, pyriproxyfen, is to reduce the fecundity of adult female mosquitoes and, therefore, yield an overall reduction in the vector population by inhibiting egg laying, larval-pupal transformation and the emergence of functioning young adult mosquitos. The Royal Guard® net has a WHO prequalification listing. https://www.who.int/pq-vector-control/prequalified-lists/RoyalGuard/en/

The New Nets Project (NNP)

The Global Fund and Unitaid are each investing US$33 million between 2018 to 2022 to introduce new insecticide-treated nets to fight malaria-carrying mosquitoes. The New Nets Project is working to build the evidence base around, and prime the market for, the next generation of nets, which are treated with two different types of insecticide to help improve control of mosquitoes.

The project will generate evidence on the efficacy and cost-effectiveness of the new dual insecticide nets to inform a WHO policy decision on dual-AI nets and guide decision-making around product procurement at the country level. It is expected that the New Nets Project – with its unique design of parallel collection of epidemiological data and cost-effectiveness studies – will significantly reduce the timeline for entry of the new nets into the market.

The U.S. President’s Malaria Initiative and the Bill & Melinda Gates Foundation are key operational and financial partners. A coalition led by IVCC is implementing the project which includes The Alliance for Malaria Prevention, Imperial College London, The Liverpool School of Tropical Medicine, PATH, PSI and Tulane University.

IVCC

IVCC is the only Product Development Partnership (PDP) working in vector control. IVCC was established in 2005, through an initial $50million grant to the Liverpool School of Tropical Medicine (LSTM) from the Bill & Melinda Gates Foundation and has since provided ongoing support for IVCC activities.  As a registered charity in the UK, IVCC is also funded by UK Aid, USAID and the Swiss Agency for Development and Cooperation to 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.  In addition, IVCC is also funded by Unitaid and the Global Fund to implement catalytic market access projects, such as NgenIRS and the New Nets Project which support the rapid and scaled deployment of innovative vector control interventions.  IVCC brings 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.

Featured image credit: PSI, Mali

IVCC’s Ambassador Pack 12th August 2020

IVCC has developed its new ‘Ambassador Pack’ which is now available digitally or in hard copy version.  The Pack contains 14 loose leaf pages which cover the broad spectrum of IVCC’s work, including Product Development, Key Highlights and Market Access workstreams.  The pack also contains an updated version of the IVCC strategy which was completed earlier this year.

View the online version of the Ambassador Pack here.

Ensuring Mosquito Net Distribution Could Halve Malaria 7th August 2020

Mosquito net distribution could help halve the number of deaths from Malaria during the coronavirus outbreak in Africa, researchers say.

There are concerns that malaria control activities – such as distributing insecticidal nets – could be severely disrupted as a result of the pandemic. Writing in Nature Medicine, Imperial’s COVID-19 Response Team estimate that malaria deaths could more than double in 2020 compared to 2019. But swift action could substantially reduce the burden of malaria and prevent joint malaria and COVID-19 epidemics simultaneously overwhelming vulnerable health systems. In the article the researchers estimate the impact of disruption of malaria prevention activities and other core health services under four different COVID-19 epidemic scenarios.

An estimated 228 million long-lasting insecticidal nets (LLINs) were due to be delivered across Sub-Saharan Africa this year, more than ever before. They estimate that if these mosquito nets are not deployed and preventative chemotherapy and case management is reduced by half for six months, there could be 779,000 malaria deaths in sub-Saharan Africa over 12 months.

If prevention activities were to stop during the outbreak, the team estimates that 200,000 deaths could still be prevented over six months if treatment of malaria is maintained. The researchers recommend that routine distributions of LLINs should be prioritised alongside maintaining access to antimalarial treatment and the use of chemoprevention to prevent substantial malaria epidemics.

 

 “It is vitally important to get malaria prevention measures out now to reduce the pressure on health systems as COVID-19 cases increase.”

Dr Thomas Churcher, Imperial’s School of Public Health

 

“In the face of COVID-19 it will still be important to ensure vector control interventions continue to be deployed as much as possible in order to not only sustain the gains already made in malaria elimination but ensure we do not have a resurgence in malaria.”

Okefu Oyale Okoko, Deputy Director/Head Integrated Vector Management Branch National Malaria Elimination Programme (NMEP) Public Health Department Federal Ministry of Health Abuja

 

“The efforts to maintain net campaigns across Sub-Saharan Africa are absolutely vital. We know how to prevent, track and treat malaria, but the strain Covid-19 puts on health systems risks hard fought for progress. This important modelling is a reminder that efforts to end malaria sit on a knife edge. Protecting people against Covid-19 cannot be pursued in isolation. Governments must see maintaining efforts against malaria as a core part of pandemic preparedness or risk a catastrophic domino effect.”

James Whiting, Executive Director, Malaria No More UK

 

Read the full article > 

 

 

For more information contact:

Stephen Johns
Imperial College London
s.johns@imperial.ac.uk

+44 (0) 20 7594 9531
+44 (0) 7792 657226

2 Billion Mosquito Nets Delivered Worldwide 16th January 2020

 

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 RBMPartnership@grayling.com 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

About IVCC

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.

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