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Developing an expanded vector control toolbox for malaria elimination
  1. Gerry F Killeen1,2,
  2. Allison Tatarsky3,
  3. Abdoulaye Diabate4,
  4. Carlos J Chaccour5,6,
  5. John M Marshall7,
  6. Fredros O Okumu1,8,
  7. Shannon Brunner3,
  8. Gretchen Newby3,
  9. Yasmin A Williams3,
  10. David Malone9,
  11. Lucy S Tusting10,
  12. Roland D Gosling3
  1. 1Environmental Health and Ecological Sciences Department, Ifakara Health Institute, United Republic of Tanzania
  2. 2Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
  3. 3Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, California, USA
  4. 4Institut de Recherche en Sciences de la Santé/Centre Muraz, Bobo-Dioulasso, Burkina Faso
  5. 5Instituto de Salud Global, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
  6. 6Instituto de Salud Tropical, Universidad de Navarra, Pamplona, Spain
  7. 7Divisions of Biostatistics and Epidemiology, School of Public Health, University of California, Berkeley, California, USA
  8. 8School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
  9. 9Innovative Vector Control Consortium, Liverpool, UK
  10. 10Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
  1. Correspondence to Dr Gerry F Killeen; Gerry.Killeen{at}


Vector control using long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) accounts for most of the malaria burden reductions achieved recently in low and middle-income countries (LMICs). LLINs and IRS are highly effective, but are insufficient to eliminate malaria transmission in many settings because of operational constraints, growing resistance to available insecticides and mosquitoes that behaviourally avoid contact with these interventions. However, a number of substantive opportunities now exist for rapidly developing and implementing more diverse, effective and sustainable malaria vector control strategies for LMICs. For example, mosquito control in high-income countries is predominantly achieved with a combination of mosquito-proofed housing and environmental management, supplemented with large-scale insecticide applications to larval habitats and outdoor spaces that kill off vector populations en masse, but all these interventions remain underused in LMICs. Programmatic development and evaluation of decentralised, locally managed systems for delivering these proactive mosquito population abatement practices in LMICs could therefore enable broader scale-up. Furthermore, a diverse range of emerging or repurposed technologies are becoming available for targeting mosquitoes when they enter houses, feed outdoors, attack livestock, feed on sugar or aggregate into mating swarms. Global policy must now be realigned to mobilise the political and financial support necessary to exploit these opportunities over the decade ahead, so that national malaria control and elimination programmes can access a much broader, more effective set of vector control interventions.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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  • Handling editor Seye Abimbola

  • Contributors GFK, AT, LST and RDG conceived the study. GFK, AT, AD, CJC, JMM, FOO, SB, GN, YAW, DM, LST and RDG all contributed substantively to the literature identified and interpreted, and to the logic and presentation of the content. GFK acts as guarantor for the manuscript, which he drafted in consultation with the other authors. All authors critically reviewed and approved the final manuscript.

  • Funding Financial support for this study was kindly provided by the European Union through the Seventh Framework Programme (FP7/2007-2013 grant agreement 265660) and the Parker Foundation through a gift to the Global Health Group Malaria Elimination Initiative at the University of California at San Francisco. Individual authors were also supported by the following personal awards: a Wellcome Trust Intermediate Research Fellowship (FOO: award number 102350/Z/13/Z), a Ramón Areces Foundation Fellowship (CJC) and a Skills Development Fellowship (LST: award number N011570) jointly funded by the UK Medical Research Council and the UK Department for International Development.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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