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.
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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.