Implementation of the global plan for insecticide resistance management in malaria vectors: progress, challenges and the way forward

Abstract

In recent years, there has been an increase in resistance of malaria vectors to insecticides, particularly to pyrethroids which are widely used in insecticide-treated nets. The Global Plan for Insecticide Resistance Management in malaria vectors (GPIRM), released in May 2012, is a collective strategy for the malaria community to tackle this challenge. This review outlines progress made to date and the challenges experienced in the implementation of GPIRM, and outlines focus areas requiring urgent attention. Whilst there has been some advancement, uptake of GPIRM at the national level has generally been poor for various reasons, including limited availability of vector control tools with new mechanisms of action as well as critical financial, human and infrastructural resource deficiencies. There is an urgent need for a global response plan to address these deficits and ensure the correct and efficient use of available tools in order to maintain the effectiveness of current vector control efforts whilst novel vector control tools are under development. Emphasis must be placed on enhancing national capacities (such as human and infrastructural resources) to enable efficient monitoring and management of insecticide resistance, and to support availability and accessibility of appropriate new vector control products. Lack of action by the global community to address the threat of insecticide resistance is unacceptable and deprives affected communities of their basic right of universal access to effective malaria prevention. Aligning efforts and assigning the needed resources will ensure the optimal implementation of GPIRM with the ultimate goal of maintaining effective malaria vector control.

Priorities for Broadening the Malaria Vector Control Tool Kit

“…This problem is exacerbated by the fact that there is a very limited selection of chemical insecticides approved for public health use; at present pyrethroids are the only insecticide class used on a wide scale on bed nets and account for two-thirds of the total product (by area) used in IRS for malaria control [4]. Accordingly, physiological (and to a lesser extent behavioral) resistance is now widespread across mosquito species and populations, threatening the effectiveness of the frontline insecticide-based interventions [1,5]. Second, the current core tools are most effective against Anopheles vectors that feed and rest indoors and exhibit a preference for feeding on human hosts during nighttime [2].…”

Vaccines to Accelerate Malaria Elimination and Eventual Eradication

“…This issue is particularly relevant in the light of the spread of anopheline resistance to insecticides and the potential time bomb of resistance to artemisinin combination therapies (ACTs) crossing into Africa (Ashley et al 2014;Mnzava et al 2015).…”

Optimizing Strategic Insecticide Resistance Management Planning in Malaria Vectors

“…Given the backdrop of escalating resistance and limited vector control tools, as well as global finances that continue to fall short of estimated requirements for malaria control and elimination [2] and restricted entomological capacity [190], there has been some progress in the implementation of the GPIRM [191]. A successful IVM programme includes actions along five key strategic elements that can be harnessed for addressing the pillars of the GPIRM pertinent to country-level strategic planning and implementation.…”