Malaria is a vector-borne disease transmitted by the female Anopheles mosquito. Given this mode of transmission, vector control is a fundamental element of any malaria control and elimination strategy. Effective vector control interventions, such as insecticide-treated bed nets (ITNs) and indoor residual spraying with insecticide (IRS), reduce transmission between mosquitoes and humans and have led to dramatic declines in malaria around the world.
However, insecticide resistance and low effective coverage of ITNs and IRS are growing threats to the sustainability of these interventions. In some areas that have achieved high coverage with ITNs and/or IRS, transmission persists due to mosquitoes that evade these interventions and bite and rest outdoors, a problem known as residual transmission. Examples of successful malaria elimination demonstrate that, in most cases, malaria cannot be eliminated with one anti-mosquito intervention alone.
New and/or underutilized, effective vector control tools and approaches are urgently needed to target residual transmission and accelerate progress towards malaria elimination and eradication. The MEI addressed these key gaps in evidence and research through support from the Parker Foundation.
The MEI’s Portfolio of Work to Understand the Gaps and Opportunities for Innovative Vector Control included:
- A systematic literature review to assess the availability and quality of evidence for supplementary vector control tools, beyond ITNs and IRS, and to identify gaps for further research.
- Geospatial modeling and mapping to identify the drivers and distribution of residual malaria transmission in Africa using geospatial modeling.
- A technical note on the potential role of aerial spraying for malaria elimination.
- A series of case studies that collate best practices on mosquito control program management, intersectoral collaboration, and community engagement, among other areas, from mosquito control programs across geographic and economic settings.
- Transmission modeling to estimate and optimize the impact of novel vector control tools on malaria transmission in diverse eco-epidemiological settings.
Fundamental to effective vector control implementation is sufficient entomological capacity and surveillance that can generate robust entomological intelligence to guide decision-making on locally-tailored, evidence-based, cost-effective vector control strategies. Entomological surveillance provides a temporal understanding of vector species, specific population dynamics, and behavioral traits that have impact on disease transmission, intervention effectiveness, and residual transmission. This intelligence guides intervention selection and deployment in time and space and provides a platform to evaluate complementary strategies and tools. In elimination settings, entomological surveillance becomes increasingly important in foci of transmission to target and eliminate pockets of remaining transmission. Critical to gathering this intelligence is increased capacity at the national and subnational levels.
The MEI is working to address these key gaps in entomological surveillance and capacity through support from the Bill & Melinda Gates Foundation.
The MEI’s Work on Entomological Surveillance and Capacity Building includes:
- Developing an entomological framework for national malaria programs that supports and guides routine entomological surveillance in low-transmission settings, entomological foci investigation as part of surveillance and response for elimination, and identification and characterization of residual transmission.
- In collaboration with national malaria programs and local research institutions, expanding regional and country level entomological capacity and entomological surveillance activities in southern Africa.
- Providing technical assistance and support for vector control and entomological capacity building and surveillance in southern Africa through the Elimination 8 (E8) regional initiative.
- Expanding vector control technical assistance, coordination, and capacity building in Asia Pacific through the Asia Pacific Malaria Elimination Network (APMEN) Vector Control Working Group (VCWG).