Integrated Vector Management - Biological and Environmental Control of Disease Vectors - page 184

fed on pit latrine waste, are to be used as a
commercial animal food source, it is essential to
determine whether they accumulate toxins
present in human faeces, such as heavy metals
(Diener et al ., 2011).

entomologist or vector control focal point who
guides the planning and implementation of
vector control in the context of IVM (Mnzava et
al ., 2011), such plans should be expanded
elsewhere in the world.
Globally, there is a shortage of training in
medical entomology and, more specifi cally, for
entomologists involved in public health
programmes. This need has been addressed by
several postgraduate institutions worldwide that
have included training in IVM as part of their
curriculum. For example, the London School of
Hygiene and Tropical Medicine (LSHTM) runs a
Master of Science (MSc) module entitled
'Integrated Vector Management' that is a
compulsory requirement for one of their MSc
courses, MSc Medical Entomology for Disease
Control, but can also be taken as an optional
module for several other of their face-to-face
MSc courses or as an accredited short course
(worth 15 credits; 150 notional hours).
Similarly, IVM training is provided as a modular
component in the MSc in Medical Entomology
and Vector Control course hosted jointly by the
University of Gezira and The Blue Nile National
Institute for Communicable Diseases, Sudan.
For WHO regions wishing to embark on
delivering IVM training, the WHO has produced
a guide that provides a core structure for training
curricula on IVM (WHO, 2012d). The guide was
developed through fi eld-testing in two specialized
workshops aiming to equip postgraduate
operational entomologists with the necessary
knowledge and skills to support capacity
building and application of the IVM approach
(WHO, 2012d). Both of the workshops ran in
2010, one was hosted by the Asian Collaborative
Training Network for Malaria, in Manila, the
Philippines, and the other by International
Centre of Insect Physiology and Ecology,
Nairobi, Kenya. The general curriculum is
composed of six modules addressing the
following topics: a basic introduction to vectors
of human disease, planning and implementation,
organization and management, policy and
institutional arrangements, advocacy and
communication, and monitoring and evalu-
ation, but it should be adapted to the local
requirements and conditions of each region
(WHO, 2012d).
Another challenge in the implementation
of IVM concerns the scaling up of vector control

10.7 Challenges in the
Implementation of IVM

The challenges and constraints in the
implementation of IVM have been fully discussed
elsewhere (Mnzava et al ., 2011). In brief, at least
for countries in the WHO Eastern Mediterranean
Region (mainly comprising those of North
Africa and the Middle East), these include: (i) a
lack of commitment to include IVM into a
national health policy; (ii) a reluctance to extend
the mandate of existing disease-specifi c
programmes to include other vector-borne
diseases; and (iii) complacency of countries with
low vector-borne disease burdens (yet at risk of
newly emerging vector-borne diseases) (Mnzava
et al ., 2011). Nevertheless, the WHO fully
endorses an IVM strategy and is making ef orts
to ensure its implementation at the national
level. For example, recent WHO publications
have provided valuable information for countries
and public health professionals wishing to plan
and implement an IVM programme (WHO,
2012a,b).
However, a subject that has been touched
on (WHO, 2012b) but is perhaps less well-
documented, yet is critical to the success of an
IVM programme, is the appropriate training
required for the focal person responsible for IVM.
Obviously, the position holder requires good
generic organization and communications skills
in order to liaise between all of the stakeholders
involved. In addition, a range of specifi c skills
and training are necessary to enable the focal
person to make an informed contribution to
technical and operational components, such as:
(i) assessing the epidemiology of diseases; (ii)
identifying the vectors involved in transmission;
(iii) the selection of appropriate vector control
management; and (iv) the monitoring and
evaluation of the programme. Although there
are plans to strengthen capacity in vector
control and entomology in the WHO Eastern
Mediterranean Region, where it is expected that
each country will have at least one well trained