Today, April 25^th,  we recognise World Malaria Day. It is an occasion to highlight the impact that this disease has on the under-served populations in endemic countries; to galvanise global efforts to end malaria and emphasise the need for sustained political commitment and continued investment for malaria control and elimination.

Since the year 2000, the scale-up of interventions in countries, supported by global partnerships and sustained investment, has transformed the fight against malaria – preventing 2 billion malaria cases, saving 11.7 million lives, and putting eradication within reach.

However, significant challenges lie ahead. Insecticide and drug resistance, new biological threats, the impact of climate change and humanitarian emergencies, as well as funding gaps and pressure on resources threaten to stall progress toward malaria eradication goals.

The theme of this year’s World Malaria Day, ‘Innovate, Invest and Implement’, highlights the role that innovation plays, across the malaria community, to address the future challenges.

IVCC has had the responsibility of steering investments from various funding organisations over the past 15+ years into the development and delivery of new vector control tools, in partnership with industry.

Investments over the last decade have been successful, with new products (both in ITNs and IRS insecticides) developed and deployed and delivering impact in countries.

Insecticide resistance remains one of the biggest threats to achieving malaria elimination. Industry engagement and support via partnership with IVCC, have delivered innovations to address this threat.

Products such as the recently WHO-PQ listed VECTRON™ T500, a new indoor residual spray product, developed by Mitsui Chemicals Crop & Life Solutions, Inc. containing TENEBENAL™; Interceptor® G2 from BASF, a dual active ingredient net for which a WHO-GMP Policy Recommendation was just finalised; and previously WHO-PQ Listed products such as Actellic^®300CS (co-developed by Syngenta), SumiShield™ 50WG (developed by Sumitomo Chemical) and Fludora® Fusion (developed by Bayer), contain different modes of action which can be rotated by country malaria control programs, expand the available toolbox, and are critical to preserve the long-term effectiveness of insecticide-based vector control interventions.

The pipeline for the future also shows promise; particularly for resistance management – with some brand-new insecticide modes of action potentially available for use on ITNs. But it is by no means certain. Solutions to address other threats (e.g. residual transmission and outdoor biting) are needed.

Technically, it is feasible to address some of these challenges – we know how to develop and deliver the needed innovation, but it will take continued engagement and/or investment from all relevant sectors. We must deliver on the current pipeline of existing tools and at the same time identify new solutions to address emerging challenges. It is critical that this is done together with country programs and implementing partners to ensure local relevance and impact amongst the countries and people that need them.

Where there are significant economic barriers to product innovation for industry, incentives are needed to encourage innovators to support the development of public health tools. The signing of the US EPA Vector Expedited Review Voucher (VERV), championed by IVCC following a policy proposal by Duke University, into law in late 2022 is an example of an initiative to stimulate investment in the development of innovative vector control solutions to help advance malaria elimination.

Market access activities, such as the catalytic market shaping work under the Unitaid and Global Fund supported New Nets Project (NNP), are a crucially important for introducing and implementing new innovation. The NNP laid the foundation for ensuring equitable and affordable access to new dual active ingredient nets such as Interceptor® G2 and Royal Guard® (developed by Disease Control Technologies).  As we move toward the introduction of novel interventions to address challenges in the future, that there will be benefits to, indeed a need for, similar approaches.

On this World Malaria Day, IVCC highlights the challenges on the road to malaria elimination, what role vector control plays in addressing them, and echoes this year’s World Malaria Day theme of ‘Innovate, Invest and Implement’ as the crucial components necessary to end malaria.

On 28th March, Papua New Guinea Institute of Medical Research (PNGIMR) officially opened the Belna Natnat Haus, a new entomological facility in Madang province on the north coast of the country.

Named after its location in Belna and the tok pisin word ‘natnat’ for mosquito, the construction of the laboratory was a key part of a partnership between IVCC, PNGIMR, National Department of Health (NDoH), Madang Provincial Health Authority, Burnet Institute, James Cook University (JCU) and Rotarians Against Malaria (RAM).

The NATNAT programme (Newly Adapted Tools Network Against vector-borne disease Transmission) has been funded by IVCC since 2019 through funds from Australia’s Department for Foreign Affairs and Trade (DFAT).

NATNAT is led by PNGIMR, Burnet Institute and James Cook University to build the capacity in Papua New Guinea (PNG) for the rapid evaluation and adoption of new vector control tools and comprises capacity building both of facilities and skills, a range of laboratory, semi-field and field evaluations of new tools and liaison with stakeholders on the scale up of those tools shown to be effective.

The newly developed site consists of a laboratory, insectary, and a semi-field tunnel system with an experimental hut system to be completed later in 2023.

The laboratory has been operational since 2022, with staff and fixtures moving over from the old PNGIMR site in Yagaum, but the official opening was held this week and welcomed delegates from PNG NDoH, DFAT, RAM, IVCC, the local community and a range of other national stakeholders.

The Belna Natnat Haus will be an important part of the fight against vector-borne disease in a country where malaria rates are increasing and where the most commonly deployed tool (LLINs) are not sufficient on their own to combat local vector species with early, outdoor biting behaviours.

It is hoped the facility will also have a regional impact beyond PNG and plans are already underway on future development work to maximise the capability and impact of the site.

Dr Moses Laman, deputy director of the institute and project Principal Investigator said, “This facility provides a great opportunity for PNG and the Pacific region to be able to generate data that will enable NMCPs to make informed decisions, build capacity and create a conducive research environment now and into the future.”

Team in front of experimental tunnel system. Paul Daly (Burnet Institute), Leanne Robinson (Burnet Institute), Moses Laman (PNGIMR), Stephan Karl (PNGIMR/James Cook University), Rachel Farquahr (Burnet Institute).

Credit: Fred Yeomans (IVCC)

Featured image: Moses Laman, PNGIMR

Credit: Evelien Rosens (Burnet Institute)