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Integrated Vector Management (IVM)

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Integrated Vector Management (IVM) is a rational decision-making process to optimise the use of resources for vector control. The aim of the IVM approach is to contribute to the achievement of the global targets set for vector-borne disease control, by making vector control more efficient, cost effective, ecologically sound and sustainable.

Use of IVM strategies help vector control programmes find and use more local evidence, integrate interventions where appropriate and collaborate within the health sector, and with other sectors, as well as with households and communities.

By reorienting to IVM, vector control programmes will be better able to meet the growing challenges in the control of malaria, dengue and other vector-borne diseases in the face of dwindling public sector human and financial resources.

Although not a new process, global uptake of the IVM concept remains very low, due in part to the requirements for capacity and capability building at central, district and village levels, and also because of the lack of new and innovative tools (or access to current tools and strategies).

IVM & Malaria

IVM relies on a range of vector control interventions, individually or in combinations, with the primary objective of balancing efficacy and cost-effectiveness in an ecologically acceptable and sustainable manner. IVM strategies are geographically tailored by definition and depend on the availability and quality of product economic data, local vector knowledge and evidence. Therefore, vector surveillance information, as well as data on the cost effectiveness of the interventions and their underlying parameters, are key for locally-tailored IVM decision-making. If malaria eradication efforts are to succeed in the face of rising insecticide resistance, the full potential of vector control must be realised through a re-invigorated vision for IVM. A vision based on addressing systemic challenges, enhancing innovation and driving cross-sector and cross-industry collaboration.

Global financing for malaria control and elimination continues to fall short of World Health Organization’s (WHO) Global Technical Strategy for Malaria (2016-2030). The estimates for funding required, and limited commercial incentives for industry leaders compound the issue. However, working together with our partners, we are exploring an integrated IVM toolbox focused on interventions which target the vector directly. The IVM toolbox concept is the idea of selecting a set of interventions, based on evidence, for local requirements and deploying those in different combinations and in parallel to achieve additive effects. The underlying hypothesis is that by deploying multiple tools that combine different Active Ingredients (AIs) and different Modes of Action (MoA), the impact on malaria prevention will be greater. This is supported by initial research and modelling conducted by IVCC and Imperial College. There are many vector control products available today with different MoAs. Tools differ in their suitability to different disease transmission settings and geographies. How those are combined in locally-tailored IVM strategies is a critical factor in determining their effectiveness against malaria vectors.

WHO Strategy

There are five key principles of an IVM strategy outlined by WHO, which should be supported by legislation, regulation and cross-sector/cross-industry action:

  1. Advocacy, social mobilisation and legislation enabling the embedding of IVM principles in policy-design across all relevant agencies, organisations and civil society.
  2. Collaboration within the health sector, with other sectors and relevant industries.
  3. Integrated approach to the rotational use of available resources and tools.
  4. Evidence-based decision-making related to local ecology, epidemiology and resources.
  5. Capacity-building at national and local levels.

Some key challenges to address in developing better planned, more effective and resource-efficient integrated vector control, in a wide range of entomological, geographical and social backgrounds:

Firstly, the availability, quality, integration and access to data required for optimal evidence-based decision-making in IVM planning must be improved significantly.

Secondly, vector control programmes need to be further integrated within local and national health systems. It is this deepened integration, and linkages to other key sectors such as agriculture and construction, which will allow for adaptation to fast-changing macro factors, such as urbanisation, environmental degradation and climate change.

Thirdly, innovation in insecticide chemistry and the development of novel vector control technologies must accelerate to prevent escalation of the current insecticide resistance problem.

Resources

Handbook for Integrated Vector Management
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