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Malaria: new strategies against an old foe

CONTENT

Outsmarting mosquitoes

Attacking malaria from all angles

Two ingenious projects to control mosquitoes

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Outsmarting mosquitoes

Malaria-carrying mosquitoes constantly adapt to survive. The most deadly mosquitoes in Africa feed indoors from dusk to dawn, but they also bite outdoors, and are beginning to bite earlier in the day. Our strategies must keep one step ahead of them.

The video below shows how Unitaid and partners are outwitting mosquitoes to stop malaria:

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Attacking malaria from all angles

Unitaid's malaria portfolio reached more than US$ 300 million in 2018 and is on track to hit US$ 400 million in 2020, helping to advance WHO's Global Technical Strategy for Malaria for 2016-2025.

Our catalytic investments are finding the best innovations, demonstrating their effectiveness and value for money, and laying the foundations for countries and funding partners such as the Global Fund and PMI to introduce them on a massive scale.

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Two ingenious projects to control mosquitoes

Regina Rabinovich (ISGlobal) and John Grieco (University of Notre Dame) describe how anti-parasitic drugs and new repellents can deal with malaria-carrying mosquitoes.

Imagine a future where people in countries hardest hit by malaria could take a pill that kills mosquitoes when they bite them. Or where a small plastic sheet could drive mosquitoes away from inhabited areas, including refugee camps. That future might be closer than you think.

Innovations such as these could soon be deployed to bolster conventional methods of fighting mosquitoes. We talked to two of our grant implementers about the latest scientific advances and what they could mean for the global fight against malaria:

A pill to kill biting mosquitoes

Dr. Regina Rabinovich's team is out to prove the effectiveness of ivermectin pills as part of a US$ 25.3 million grant to ISGlobal. Mosquitoes die if they bite humans or livestock treated with ivermectin. The project is focused on sub-Saharan Africa, whose Anopheles mosquitoes are considered "the gorilla of the species" in terms of aggressiveness and adaptability.

The medicine has been used for the last 30 years to treat other parasitic diseases, but this is the first time a drug has been used to kill mosquitoes that transmit malaria.

"Ivermectin could complement approaches that don't manage to tackle mosquitoes," says Rabinovich.

Even standard ways of fighting mosquitoes have their drawbacks: bednets get torn, mosquitoes may not land on insecticide-treated surfaces, and long-used insecticide sprays are no longer effective because mosquitoes have grown resistant to them. Meanwhile, mosquitos take advantage of opportunities presented by inhabited areas: they feed at night on the livestock in family compounds and on people gathering outdoors in the evenings.

An important element of ISGlobal's project is explaining clearly to people taking ivermectin that the drug will not stop them, individually, from getting malaria, nor is it a malaria treatment. Rather, it is a vector-control tool, for the entire community, to reduce the mosquito population. Therefore, people should be aware they can still get malaria. "We will make sure communities understand that whenever they have fever, they need to get care."

A repellent fit for crises

Unitaid's project with the University of Notre Dame is testing a new kind of slow-release repellent that could provide valuable protection for displaced people living in temporary settlements.

Dr. John Grieco explains that the small plastic sheets release a chemical into the air that drives mosquitoes away.

Because they are light and simple to use, spatial repellents could prove effective in humanitarian crises such as natural disasters or armed conflicts which force refugees to live in camps.

"Spatial repellents can protect people from malaria where it's not practical to use other tools, such as in refugee camps," says Grieco.

A US$ 33.7 million grant to the University of Notre Dame seeks to demonstrate the efficacy of these innovative products in reducing malaria.

Grieco said Unitaid's support for the project is especially valuable because there is little funding available for much-needed innovations in vector control.

The two new malaria projects seek to complement anti-malaria initiatives that Unitaid also supports, including new-generation insecticide-treated bednets, long-lasting indoor insecticide sprays, and better medicines to treat and prevent the disease.

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