It’s not often that we think of scientists as heroes. More often than not they are portrayed as being a bit geeky, possibly dangerous. But last year, I began to see them in a different light.

I was in a meeting of scientists, quite a few of them chemists. One of our industrial partners was explaining how they were getting on with the search for a new chemical compound to kill mosquitoes.

Frankly, I didn’t understand most of the discussion because it was highly technical, but I saw a picture emerging of the amazing  battle that these scientists were engaged in every day.

To my highly untrained unscientific mind it sounded like this (please forgive me scientists everywhere, I’m a journalist):

‘We tried to add a blob onto the left quadrant of the compound but that didn’t work so we wrestled a grommet from another compound, and looked at how other scientists had tackled the problem in a completely different area. We lassooed some wild elements and added them to the mix, herding a whole tribe of unique components into the circle. And this strange compound seems to work.’

I know that sounds crazy, but that’s what it sounded like. What touched me was the sense of a battle. These scientists, as it were, struggling to defeat a powerful enemy that was fighting back in every direction.

That’s where the idea of Heroic Chemistry came from. It grew when I visited Burkina Faso and saw the work local scientists are doing at our field trial sites. Not only are they testing the new compounds to see if they work where it matters, where malaria is endemic, but they’re also testing to see if local insecticide-resistant mosquitoes are affected by the new compounds. And African scientists, who live with the problem on their doorstep, are also beginning to see new patterns of mosquito behaviour and think about completely new solutions. These are people who’ve suffered from malaria every year of their lives so they know the battleground well.

It’s all very exciting. We are not too far away from having several new designed-from-scratch insecticides available to fight malaria. According to a group of leading academics (Bhatt et al, Nature.com 2015) insecticide treated bed nets and indoor residual spraying with insecticides are responsible for the biggest part of the gains in the battle against malaria over the past 15 years. Nearly 78% of the cases averted are due to vector control, which means about 500 million people protected from malaria.

That’s why the work these scientists are doing is heroic. It really does have the potential to change the world as we know it. Millions of liveswill continue to be saved, millions of children will grow up into healthy productive lives, some of the poorest countries in the world will reap the economic benefits of a healthy population.

That’s why I wanted to make this film. To say thank you to the scientists who, behind the scenes, make it all happen. You’re my heroes.

Mosquito resistance to insecticides remains a growing concern, according to WHO estimates revealed at the American Society of Tropical Medicine and Hygiene meeting in Atlanta recently.

WHO reports 60 countries have recorded mosquito resistance to at least one of the four insecticides used in long-lasting insecticide treated nets (LLINS) and indoor residual spraying (IRS) since 2010. Of these, 49 countries have reported resistance to two or more insecticide classes. WHO says that if resistance continues to intensify, the mosquito-killing capacity of LLINs and indoor residual spraying may steadily weaken.

This would be a tragedy for sub-Saharan Africa where acclaimed research last year demonstrated that LLINs accounted for about 78% of the substantial malaria gains over the past 15 years or so. (Read more about this here.)

If the battle against malaria is to continue to drive back this scourge from sub-Saharan Africa, the need to continue to develop new public health insecticides is paramount. Fortunately, due to the foresight of leading vector science academics who saw the potential threat over 15 years ago, the Bill & Melinda Gates Foundation and other forward thinking funders have invested appropriately in the search for new public health insecticides. IVCC was established in 2005 as the only vector control focused Product Development Partnership (PDP) and has worked closely with world-leading vector scientists and agro-chemical companies to design and develop novel public health insecticides targetted precisely at killing the mosquitoes that transmit malaria.

Professor Hilary Ranson, one of the world’s leading authorities on insecticide resistance, warned earlier this year that pyrethroid resistance is the biggest biological threat to malaria control in Africa. (Read about this here.) Together with other leading specialists in this area she says that the urgent need for new vector control products is apparent,  and the new vector control products that are in the pipeline must be rationally deployed in order to slow down future resistance developing.

IVCC has a healthy pipeline of novel vector control tools, itself a product of consistent commitment by public health funders and industrial partners to finding a solution to the global threat of insect-transmitted diseases.

*The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. S Bhatt, et al.

Although I have never lived in Africa, I’ve travelled there enough times to have a reasonable feel for the place. Urban Africa, busy, chaotic and unsafe contrasts enormously with the friendliness and warmth of Africans in rural communities, who despite their obvious hardship, will ask me to stop and share a cup of bitter tea with them.   The remote villages I visit lack many of the conveniences that we take for granted.   Mostly, there’s no running water, electricity is occasional and the air at dusk is filled with smoke as food is prepared and cooked in family compounds. Living is basic, but there’s a strange contrast between pinging money using mobile phones with crushing caterpillars to eat and livestock living amongst families with crowds gathering around flat screen TVs to watch Champions League football.

Life can be exceptionally tough.  Basic food may be available year-round for most so while there may be little excess it looks like no one starves.  There’s not much money and that’s ok when hard work is the main price for food, but the lack of access to a modern healthcare infrastructure can mean that when disease hits, there can be no money to pay for treatments, and this can devastate families and villages without warning.

90% of malaria cases occur in sub-Saharan Africa, and kills over 400,000 people every year – the vast majority of which are children under five.

Many villages have insecticide-treated bednets which provide proven malaria protection when sleeping at night. But there are never enough, mosquitoes can bite at times when no one is under their net and outside the home, and not everyone likes to use them.   Now and again when you ask if a householder has a bednet, they pull out an unused net, still in the bag to show.

Insecticide treated bednets not only provide personal protection through the physical barrier of the net, but the insecticide also provides effective community protection as contact with the net kills the mosquito meaning it can’t fly off and infect someone else.

However, this critical community effect which reduces the volume of biting mosquitoes, only works if the mosquito is not resistant to the insecticide.  Resistance is a huge issue today.  We are at a critical tipping point and without innovation in insecticide resistance, the huge gains in malaria reduction we have made since 2000 could rapidly unwind with devastating effect, but insecticide resistance is complex. There are different underlying mechanisms in different locations, species of mosquito and regions that impact the performance of different insecticides in different ways that makes measuring the benefits of different interventions on disease transmission complex.

That’s why the arrival of BASF’s Interceptor® G2 is so important.  This net introduces a safe and reformulated insecticide from agriculture into public health – a first in 30 years.  Because mosquitoes have not been exposed to it before, it will be effective against mosquitoes that are resistant to the insecticides that are commonly used on bednets.  Of course, this product alone will not solve the problem.  More resistance beating public health insecticides need to be developed and used in a way that preserves their effectiveness in the long term by developing and following resistance prevention strategies.

That’s why IVCC is working with companies across the world to develop new public health insecticides for bednets as well as new resistance beating formulas for spraying on the inside walls of homes, another proven and effective intervention.  We are also investigating a range of other technologies which will reduce outdoor biting.  We have a long way to go but we are hopeful that, together with our industry partners like BASF and our dedicated funders, innovation in vector control can help create a world without malaria.

Researchers at Duke University in the United States and UK based Product Development Partnership IVCC have proposed a new mechanism for stimulating public sector product development to fight malaria and neglected tropical diseases (NTDs). The Vector Expedited Review Voucher (VERV) is based on a similar proposal, called the Priority Review Voucher (PRV) that has been stimulating drug development in NTDs in the United States since it was first introduced in 2007.

“It’s about reducing inefficiency in the regulatory process, and using the gains to fix a market failure in product development to benefit society as a whole,” said David Ridley, a professor at Duke University’s Fuqua School of Business and part of the team proposing the voucher reward for approving new public health insecticides through the U.S. Environmental Protection Agency (EPA).

The team’s findings, “A Voucher System to Speed Regulatory Review Could Promote a New Generation of Insecticides to Fight Vector-Borne Diseases,” are published in the August edition of Health Affairs.

Nick Hamon, CEO of IVCC said: “Insecticides used in bednets and for treating homes have prevented millions of deaths from malaria and other diseases. But while the population of disease-carrying insects resistant to current treatments has grown, no new class of insecticides have been developed specifically for public health in the last 40 years because there is little profit opportunity to innovate in these markets.”

The Vector Expedited Review Voucher proposal would offer the company behind the new product an expedited regulatory review for a second, more profitable product intended to protect crops – as a way to encourage large agrochemical companies to invest in developing less profitable innovative products for public health use.

The VERV proposal is based on the system David Ridley, Jeffrey Moe and Henry Grabowski of Duke University proposed for the U.S. Food and Drug Administration a decade ago to encourage the development of treatments for neglected tropical diseases.

Congress made that proposal law in 2007. The FDA has issued 14 vouchers since that program began. They offer review of a drug in six months rather than the usual 10 months, which can make a huge difference to firms bringing a new product to market. Seven of the vouchers issued so far have been sold, fetching as much as $350 million.

“We brought a creative solution to drug development, and now we want to apply it to public health insecticide development,” Moe said.

Ridley and Moe partnered with Nick Hamon, CEO of the IVCC, a UK based not for profit product development partnership (PDP) that works to prevent the spread of malaria and other NTDs. IVCC is funded by the Bill & Melinda Gates Foundation, UKaid, USAID, Unitaid and The Swiss Agency for Corporation and Development (SDC).

“Medicines are an important tool in fighting these diseases, but they are not the only tool,” said Professor Moe. Whereas 65 percent of research and development funding for malaria was for drugs and vaccines, only 6 percent was for vector control, according to the paper. Similarly, the market for vector control insecticides is significantly less than $1 billion, while agricultural chemicals exceed $47 billion in annual sales. The development of a novel insecticide from discovery through to launch can cost between $100-$250m can take up to twelve years, making a return on investment in vector control almost impossible. Awarding a VERV gives an innovator company an opportunity to generate a financial return on an agricultural product as well as reducing the time to market of critically important products.

The Vector Expedited Review Voucher (VERV) proposal incorporates lessons learned through 10 years of the FDA Priority Review Voucher program, by proposing that ensuring that projects that gain a voucher are truly novel and will go where they’re needed.

“Not a week goes by in which we don’t discuss ways we can make the voucher review program better,” Ridley said.

Ridley, who also works with Duke’s Margolis Center for Health Policy, said he expects to see more of the vector review vouchers to be used by the companies that win them, because the industry is dominated by larger players that are less likely to sell to competitors.

“However, we might be surprised,” he said. “There could be companies we’ve never heard of that receive investor funding and develop products because of the potential value of a VERV. That’s one of the beauties of prizes like this – you don’t pick the winners in advance.”