In the article, she talks about the importance of not allowing insecticide resistance to derail the advances that have been made in reducing the number of cases and deaths from malaria and other vector borne diseases seen over the last few decades. In the case of malaria data shows that 81% of the reduction in cases has been because of vector control, particularly the scale up of insecticide treated bed nets and indoor residual spraying (IRS). Professor Hemingway also points to the fact that IRS coverage of between 60% and 80% would have a greater impact on reducing the time taken to eliminate Visceral leishmaniasis than halving the time taken to start treatment, although the best results would no doubt come from the combination of the two.
The over reliance on pyrethroid insecticides has exposed them to intense selection, by which mosquitoes have become increasingly resistant. Professor Hemingway looks at the successes of IVCC in countering that problem by engaging with industry to develop new compounds to be used as public health insecticides and generating a robust pipeline to take them to market.
When looking at insecticide treated bed nets, one of the key tools in the reduction of malaria cases, Professor Hemingway talked of the importance of recording data to ensure that we understand the true picture of how resistance is impacting on their effectiveness, and on the effectiveness of the next generation of nets. The top priority is to ensure that current IRS and bed net interventions remain viable and that new compounds, to which there is no current resistance, are introduced in combination.
Professor Hemingway concludes that for any advances to make a difference in disease control, manufacturers need clarity on route, time and cost to market for products with a public health benefit. It is essential that the process becomes more transparent, efficient and streamlined and that while new technologies could reduce the reliance on insecticides, they will not be simple technically or logistically to roll out effectively.
Janet Hemingway
Science 24 Nov 2017:
Vol. 358, Issue 6366, pp. 998-999
DOI: 10.1126/science.aaj1644