Malaria is biting back: new insecticides are desperately needed

Just as resistance to antibiotics is threatening our future health, the rise of insecticide-resistant mosquitoes could halt progress against malaria. New insecticides are desperately needed, and public-private partnerships can deliver them, writes Nick Hamon.

Most people know that malaria is one of the world's biggest health problems, infecting millions of people in the developing world, and hitting the poorest nations of sub-Saharan Africa hardest.

The disease kills more than half a million people a year – most of them children under five.

What is less well known is the good news: the number of cases has fallen dramatically in the last decade, and deaths caused globally by the disease fell 47 per cent from 2000 to 2012, with progress even greater in Africa.

One of the major weapons in the fight against malaria has been (seemingly) very simple: bed nets treated with insecticide.

Long-lasting insecticidal-treated bed nets (LLINs) are being distributed to more and more people in sub-Saharan Africa. This hit new heights in 2014, with the World Health Organization (WHO) saying 214 million nets were delivered to countries in the region, bringing the total delivered since 2012 to 427 million.

The massive increase in distribution of LLINs and indoor residual spraying (IRS) of insecticide has helped produce huge reductions in malaria in sub-Saharan Africa. The WHO estimates that up to 3.3 million lives have been saved and hundreds of millions of malaria episodes averted. Improved drugs and diagnostics have also played a part in these gains, but insecticidal treatments play a pivotal role.

LLINs block the mosquito from getting through to bite the person – and many of those that land on the bed nets are killed off by the insecticide.

But there is a major obstacle to further progress: mosquitoes across Africa are rapidly developing resistance to these older insecticides.

My organisation, IVCC, is a non-profit product development partnership, and our aim is to develop new insecticides through alliances with commercial companies.

"The scale and complexity of the challenge, and the lack of a clear return on investment for commercial organisations means that public-private alliances are vital"

Just as in other areas of tackling the major diseases of the developing world, the scale and complexity of the challenge, and the lack of a clear return on investment for commercial organisations means that public-private alliances are vital.

This applies to the war on malaria in particular, but equally to other diseases transmitted by insects, like dengue and leishmaniasis – which also affect millions of people in developing countries.

Resistance to the old insecticides is reaching a tipping point. WHO estimates that at the current bed net coverage levels (about 50 per cent of target), resistance will lead to additional deaths of about 125,000 per year, mostly children under 5 years old, if not forestalled. No new public health insecticide has been developed in over 30 years.

Set up in 2005, IVCC is the only organisation in the world working exclusively in developing new insecticidal tools to combat insect-borne disease, including malaria. We are supported by grants from the Bill and Melinda Gates Foundation (BMGF), the Swiss government (through Swiss Agency for Development and Co-operation), the UK government (through UKAID), and the US government (through USAID).

Malaria is especially important because it also has a devastating economic effect on developing economies. It is no coincidence that malaria-endemic countries are among the poorest in the world.

Since 2005, IVCC has worked with leading scientists and agro-chemical companies to design from scratch novel chemistries that will pass the highest toxicological, environmental and human safety tests. Three new public health insecticides, each with a novel mode of action, are ready to go into full development early this year. If these products are used properly in the field they will effectively deal with the problem of insecticide resistance and lay a foundation for the eventual eradication of malaria.

IVCC urgently needs an additional $100 million to continue its insecticide development programme through to the end, and is seeking new partners to take the development of these vital tools in the fight against malaria over the finish line. The continued support of all our current funders is also essential if we are to achieve the goal of providing these desperately-needed new anti-malarial insecticides in time to avert a major malaria upsurge.

The work we have done with our industrial and academic partners since 2005 has already produced tangible and sustainable benefits with new, longer-lasting insecticide formulations already in the field saving lives. The novel public health insecticides that are moving into the final development stage will be an essential tool in the future in the battle to eradicate malaria.

About the author:

Dr Nick Hamon is CEO at IVCC. He has over 25 years' experience in product development in the crop protection and environmental science industries. Previously he was head of sustainability at Bayer CropScience, North America. Before that he worked for Bayer as vice president of Product Development and Sustainable Development and as director of Development and Technical Services, following senior positions at Aventis and Rhone-Poulenc.

He holds a PhD in Insect Ecology from Rothamstead/University of Hertfordshire and a BSc in Applied Zoology from the University of Reading. He is an adjunct Professor of Entomology at North Carolina State University.

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