Bias & Neglect - Public Health Insecticides & Disease Control

17 Dec 2023
Africa Fighting Malaria Insecticides are a vital component of disease control. To a great extent the modern insect-borne disease burden of hundreds of millions of human infections results from failures to use the chemicals we characterize as public health insecticides (PHIs). The modern arsenal of PHIs is antiquated and limited to just 12 insecticides, most belonging to just one class of insecticides (pyrethroids). The process of becoming antiquated occurs as a result of failure to invest in research and development of new PHIs. In reality, both the failure to make safe and effective use of PHIs and the failure to develop new and more effective PHIs are due to environmental opposition, limited valuable markets, considerable regulatory hurdles and weak public health advocacy; conditions which prevail even now. Indeed, even as disease control spending by aid agencies increases by orders of magnitude, disease rates may increase as investment in insecticides is neglected. United Nations agencies such as the World Health Organization (WHO), donor nations, the private sector, and research foundations should urgently prioritize investment in the search for new PHIs, as well as support advocacy efforts to promote the use of safe and effective man-made chemicals in disease control programs.

Africa Fighting Malaria is calling on the WHO, donor agencies, and other stakeholders to:

-Dramatically increase funding into the search for insecticides specifically designed for disease vector control;

-Undertake a regulatory impact assessment to establish the additional and unintended costs of new anti-insecticide regulations, with emphasis on how new regulations impede development of new PHIs;

-Address and reform the regulatory and in-country registration procedures that discourage investment in PHIs;

-Consider legislation to create incentives for the development of insecticides for public health;

-Invalidate the World Health Assembly resolution 50.13, which calls on countries to reduce reliance on the use of insecticides for disease control. Pass a new resolution establishing the importance of insecticides in disease control and calling for new public and private investment in PHIs;

-Invest in training and employing scientists, entomologists, and public health professionals skilled in vector control in countries endemic for vector borne diseases, particularly malaria and dengue;

-Recognize that PHIs have modes of action other than toxicity and that these play a vital role in disease control; and

-Support advocacy efforts to communicate and explain the urgent need for new PHIs, reduce the barriers to their deployment, and better represent the voices of people at risk from insect-borne diseases.

Unless all stakeholders invest considerable effort to create the right set of incentives for the development of new vector control insecticides and for investment in the personnel to use these insecticides, any talk of malaria elimination will remain the lazy rhetoric of public health advocates and politicians.

Full report is available at https://www.fightingmalaria.org/pdfs/phibiasandneglect.pdf