Global efforts to fight malaria have proven tremendously successful in the last decade, especially in sub-Saharan Africa. Much of this success has resulted from the scale-up and widespread deployment of vector control interventions, such as indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs). In recent years, progress toward malaria elimination has stagnated, and increasing resistance to pyrethroids, the class of insecticides most commonly used for vector control, threatens current progress. For many national malaria control and elimination programmes, decisions about how to deploy specific interventions are becoming increasingly complex.
Most national programmes align activities with WHO guidance on achieving and maintaining universal access to core interventions, but questions remain about the best methods for layering new tools on top of existing ones to maximize programme impact across transmission settings. Decisions about when, where, and how to use each strategy, including whether to use them simultaneously in the same communities, will depend on national programmes’ goals and should be tailored to local context. This requires, among other things, an evolving evidence-base built upon impact evaluations from various disease ecologies and transmission intensities.
This thematic series will present data analysed as part of the Next-Generation Indoor Residual Spraying Project. Results from five partner countries, including Ghana, Mali, Mozambique, Uganda, and Zambia, collectively show that, in areas of moderate to high transmission with pyrethroid-resistant vectors, adding IRS with non-pyrethroid insecticides to standard LLINs provides additional cost-effective to highly cost-effective protection from malaria in a variety of settings across sub-Saharan Africa.