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. Cost Effectiveness
Data
in Market
interventions
Tom McLean | May 2017

2. Building Partnerships  Creating Solutions  Saving Lives
IRS market shifts to non-pyrethroids BUT…………
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0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
2011 2012 2013 2014 2015
PeopleProtected(Millions)
IRS in Africa Number of people protected
Pyrethroids Total Total Non Py
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
2011 2012 2013 2014 2015
Commodityvalue($Millions)
IRS in Africa Commodity Market value $
Millions
• IRS market constrained by funding availability• Shift to non pyrethroids
• Balance of investment shifts from
implementation to commodity
• Overall coverage falls
• Countries withdrawing from IRS
Data from Abt and PMI, In preparation for publication
Mosquitoes Susceptible in 2010 Resistant by 2012
• Surveys of 824 children under-five.
• Data collected on IRS, ITN ownership and usage,
fever in children under-five and anti-malarial
treatment.
Caveats:
• Not controlled, no confidence intervals.
• EIR falling throughout.
• High Net usage until 2013?

3. Building Partnerships  Creating Solutions  Saving Lives
Reversing the spiral What is required to grow the market.
The Market for 3rd Generation IRS
Underlying Causes of Shortcomings
Market Shaping Intervention
NgenIRS

4. CRT in Mozambique – Update May 2017
A cluster randomized trial (CRT) to determine the
public health impact & incremental cost-
effectiveness of IRS with Pirimiphos-Methyl
(Actellic®300 CS, Syngenta AG, Basel Switzerland) in
communities with high levels of LLIN access and
pyrethroid resistance.
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Mopeia District
Arm 1: 43 Clusters
LLINs Only
Arm 2: 43 Clusters
LLINs + IRS
Active Cohort
• Monthly RDTs
• 774 per arm
• Health behavior & HH
spending data
Cross Sectional Surveys
• April 2017 & April 2018
• 385 per arm
• Community prevalence
• Health behavior & HH
spending data
Enhanced Passive
Surveillance
• Cases registration by
village
• Health facility incidence
measure
• Health Systems costs
Ento Surveillance
• 10 total surveillance sites
operational
(5 in IRS villages and 5 in
non-IRS villages)
• Ento surveillance costs
through PMI/AIRS
Dissemination
• Study protocol presented
@ ASTMH
• Protocol manuscript in
revision
• Interim analysis in process
Costing
• Implementation costs
through PMI/AIRS
• Cost per case averted
through:
• Health facility cost
(HF incidence)
• Societal cost
(community
incidence)

5. Building Partnerships  Creating Solutions  Saving Lives
Impact Of Market intervention So Far
• Year 1 2016
• Four Countries Participating
• Number of people protected with 3GIRS rises from 3.8 to 5.9 Million 2m Extra people protected (56%
increase)
• Forecasting Process Established
• Year 2 2017 Forecast
• 14 Programmes Participating
• Forecast 18.4 Million people protected under the project
• A further 15 Million people protected with 3GIRS as a result of falling prices
• Forecast Guarantee brings down IRS commodity prices
• Second 3GIRS Product available to launch late 2017
• Cluster randomised trial under way
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