Biology Reference
In-Depth Information
Jo Lines*
London School of Hygiene & Tropical Medicine, London, UK
11.1 Introduction
growing threat especially in Africa (Ranson
et
al
., 2011). For these reasons, new vector control
interventions are urgently needed.
Many new vector control interventions are
intended for use in public health disease control
programmes. It is therefore important, during
the development process, to have a clear
understanding of the evidence that will be
needed to justify the adoption and imple-
mentation of the new intervention by publicly
funded disease control programmes. The primary
aim of this chapter, therefore, is to explain how
this question is likely to be seen from the point of
view of the public health practitioner, as opposed
to that of the product developer. The analysis set
out here represents a personal view: it is based on
the author's experience in public health practice
as well as academic research, but it does not
represent the position of any institution.
The current chapter focuses on malaria
control, and on new vector control technologies,
as opposed to new commercial products within
the established technological categories of
vector control (IRS, LLINs, larvicides, etc.), for
which clear standards and testing methods are
already published by the WHO Pesticide
Evaluation Scheme (WHOPES;
http://www.
Over the last 10 years, there has been a massive
scaling up of vector control interventions,
especially those directed against malaria under
the Roll Back Malaria Partnership. This
increased investment in malaria vector control
has been built on the evidence established
through fi eld trials and pilot implementation
projects of a particular vector control tech-
nology: long-lasting insecticidal nets (LLINs)
(RBM, 2008). In the year 2011, global spending
on LLINs and commodities for indoor-residual
spraying (IRS) reached US$750 million (WHO,
2011). It was estimated that in the previous
decade, antimalaria interventions as a whole
had prevented approximately 1 million deaths,
the great majority of them attributable to LLINs
and IRS (RBM, 2011; Eisele
et al
., 2012).
However, these interventions are not
perfect. Both IRS and LLINs work by killing
mosquitoes that come into houses to feed, and
they are less ef ective in settings where a large
part of malaria transmission occurs outside the
home, as for example in the forests of South-east
Asia and some parts of Latin America. Moreover,
they are both vulnerable to the evolution of
insecticide resistance, which is currently a
* Jo.Lines@lshtm.ac.uk
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