El 12 de mayo de 2017 celebramos en la Fundación Ramó Areces una jornada con IS Global y Unitaid sobre enfermedades transmitidas por vectores, como la malaria, entre otras.

1. New approaches for the control of vector-
borne diseases
Professor Steve Lindsay
Bringing innovation to the front line: new tools to advance the
global response to vector-borne diseases, Madrid, Spain
12th May 2017

2. ∂
Outline
• Global Vector Control Response
• Combining interventions
• Interventions for today & in the future
• Opportunities in the built environment

3. ∂
Vector-Borne Diseases
Combined global distribution of malaria, dengue, lymphatic filariasis,
leishmaniasis, Japanese encephalitis, yellow fever and Chagas disease.
Today more than 80% of the world’s population is at risk from at least
one VBD, with more than half at risk from two or more
0 1 2 3 4 5 6 VBDs
Golding et al. 2015 BMC Medicine 13:249

4. ∂
Vector-Borne DiseasesVector-Borne DiseasesWHO’s Global Vector Control Response

5. ∂
Combining interventions

6. ∂
How IVM works
Method A Method B
Disease X
Multiple methods against
a single disease

7. ∂
Interventions in the health sector
• Long-lasting insecticidal nets
• Indoor residual spraying
• Larval source management
• New tools

8. ∂
So what’s new?
• New actives;
• New combination nets;
• Novel tools e.g. Wolbachia-
infected mosquitoes, toxic sugar-
baited traps;
• Potential future solutions e.g.
gene drive population suppression
& alteration

9. ∂
Why is it important that we bring
vector control into one programme?
• The same intervention can be effective
against multiple vector-borne diseases e.g.
treated nets against malaria & LF; larval
source reduction against all Aedes-borne
diseases
• Save on surveillance costs
• Same infrastructure & personnel can support
multiple disease control
• Breaks down silos

10. ∂
Long-term vision
Malaria &
LF
malaria
& LF
malaria dengue
Mosquito
abatement &
emerging
diseases

11. ∂
How do we make it work?

12. ∂
First, establish a governance network to support IVM

13. ∂
Interventions Organisations involved in implementation
Health education & promotion Schools, work places, the media, drama groups,
religious / community groups
LLINs / IRS / insecticide treated sheeting
or tents
NGOs, UN, National/regional control programme
Drainage Dept. of Public Works
Drain clearance Youth clubs who collect rubbish to sell,
community members
Drying out of breeding sites Dept. of Forestry / community participation
Swampland restoration Dept. of the Environment
Filling & levelling Dept. of Public Works
Maintenance of irrigation channels Farmers & Ministry of Agriculture, irrigation
authority
Intermittent irrigation Farmers & Ministry of Agriculture, irrigation
authority
Improved housing NGOs, microfinance initiatives, Dept. of Housing
Larval surveys / application of larvicides Schools / community groups/ municipal
corporations/public health staff
Improvement of environmental sanitation NGOs, Dept. of Public Works, municipalities
Interventions outside the health sector

14. ∂
Integrated Vector Management:
is a type of adaptive management
2. Selection of
vector control
methods
3. Needs &
resources
4. Implementation
5. Monitoring
& evaluation
1. Disease situation
• Epidemiological assessment
• Vector assessment
• Stratification
• Local determinants of disease

15. ∂
Opportunities in the built environment

16. ∂
Increase in modern housing in malaria endemic
areas, 2000-2015
Pete Gething, Sam Bhatt & Lucy Tusting, 1st draft
2015 Change

17. ∂
Screening houses: new designs reduce indoor
mosquito entry & keep the house cool
Knudsen & von Seidlein

18. ∂
Predicted distribution of Aedes aegypti in 2015
Cities >1M inhabitants Aedes aegypti distribution
Nick Golding unpublished

19. ∂
Larval source reduction
Solid waste management to remove water containers –
particularly tyres

20. ∂
Larval source reduction
Provision of constant piped water to
reduce water storage at home

21. ∂
Sustainable development goals (SDGs)
making cities and communities…
safe, resilient and sustainable’.

22. ∂
Summary
• GVCR is a potential game-changer in
the way that vector control is carried out
globally
• Smart control is essential using
combinations of tools appropriate for the
local situation
• Don’t forget interventions in the built
environment

23. ∂
Acknowledgements
Particular thanks to:
Nick Golding
Tessa Knox
Jakob Knudsen
Hilary Ranson
Nfale Sagnon
Alfred Tiono
Lucy Tusting
Lorenz von Sedlein
Raman Velayudhan
Willem Takken
Anne Wilson