Averting a malaria disaster: will insecticide resistance derail malaria control?

Abstract

World Malaria Day 2015 highlighted the progress made in the development of new methods of prevention (vaccines and insecticides) and treatment (single dose drugs) of the disease. However, increasing drug and insecticide resistance threatens the successes made with existing methods. Insecticide resistance has decreased the efficacy of the most commonly used insecticide class of pyrethroids. This decreased efficacy has increased mosquito survival, which is a prelude to rising incidence of malaria and fatalities. Despite intensive research efforts, new insecticides will not reach the market for at least 5 years. Elimination of malaria is not possible without effective mosquito control. Therefore, to combat the threat of resistance, key stakeholders need to rapidly embrace a multifaceted approach including a reduction in the cost of bringing new resistance management methods to market and the streamlining of associated development, policy, and implementation pathways to counter this looming public health catastrophe.

The changing global landscape of health and disease: addressing challenges and opportunities for sustaining progress towards control and elimination of neglected tropical diseases (NTDs)

“…While there is no doubt that vector control should be a key pillar of NTD interventions, the challenges of emerging insecticide resistance in Anopheles populations in Africa, pose a threat to the continued impact of bed nets and LLINs (Hemingway et al 2016). Furthermore, there has been limited recognition of the role of vectors and the need to increase the focus on transmission control.…”

“…An irony upon which it is worth reflecting, is that a single new chemical entity effective against vectors, as synthetic pyrethroids have been over several decades, will impact on all vectors of infectious agents. Hence, it could be argued that proportionately more resources should be devoted to the search for new vector control products given the extent of pyrethroid resistance (Hemingway et al 2016). Targeting vectors will have the most effective impact on transmission control and contribute proportionately more to elimination.…”

Pollutants and insecticides drive local adaptation in African malaria mosquitoes

“…Effective strategies for managing insecticide resistance that has reached a critical tipping point among malaria vectors on the continent are urgently needed (Hemingway et al 2016;Ranson and Lissenden 2016). In addition, considerable evidence suggests that insecticide resistance has much deeper consequences on the mosquito biology by interfering with other key biological functions such as the immune system, which in turn profoundly affects the fitness of the vector and its efficiency to transmit the pathogen (vectorial capacity) (Alout et al 2013(Alout et al , 2014(Alout et al , 2016.…”

Biological Control of Mosquito Vectors: Past, Present, and Future

“…Insecticide-treated bednets have played a very important role in the reduction of Plasmodium falciparum infection prevalence in malaria endemic Sub-Saharan Africa, which has seen the incidence of clinical disease fall by 40% between 2000 and 2015 [11]. However, bednets are only effective against mosquitoes that bite during the night and concern is growing that insecticide resistance, particularly due to the most commonly used class of pyrethroids, could reverse this trend and lead to rising incidence of malaria and increased fatalities [12]. As insecticide resistance is now widespread in a number of mosquito species [6,8,9], there is a growing need for novel, cheap, and reliable mosquito control strategies [13,14,15].…”