Reducing Malaria Burden Requires New Research on Insecticides, Opinion Piece Says

In order to make progress in the global fight against malaria, "we must improve research funding for public health insecticides," Roger Bate of Africa Fighting Malaria and a Legatum Fellow at the American Enterprise Institute writes in a Monitor opinion piece. According to Bate, insecticides are the "most important" tool to prevent malaria and other vector-borne diseases; however, the international global health community has been reluctant to invest in insecticide research.

According to Bate, "Characteristics that make good public health insecticides are not necessarily shared by modern agricultural or industrial insecticides." For example, DDT is no longer widely used in the agricultural sector because it biodegrades slowly and accumulates in biological systems. However, "[w]hen sprayed inside houses, DDT protects all inhabitants from malaria for approximately one year -- no alternative lasts as long at the same cost," he writes. Bate continues that insecticide-treated nets are "less effective than generally assumed because ITN distribution does not equate with consistent use." In addition, although ITNs have "undoubtedly saved thousands of lives, mosquitoes are becoming increasingly resistant to the insecticides used on them, partly because the same chemicals are used in farming," Bate writes. He adds that recent studies have found evidence of insecticide resistance in Benin and Uganda, where no-cost ITN distribution has occurred for more than 10 years.

Bate writes that although governments and international organizations "spend billions on research into new vaccines and drugs, they invest very little in the search" for new public health insecticides. In addition, research into new insecticides primarily occurs in the private sector, which has developed every major insecticide since 1940. However, the market for public health insecticides is about 1.3% of the total insecticide market, according to Bate. He writes that although most major insecticide producers -- such as Bayer and Syngenta -- are "pleased" to sell public health insecticides, "they lack financial incentives to develop products specifically for that sector." In addition, the cost of research and development into agrochemicals has risen 500% over the past 20 years, according to a report from the Boston Consulting Group that is supported by the Bill & Melinda Gates Foundation.

According to Bate, environmental groups such as the Pesticide Action Network have encouraged countries to reduce reliance on insecticides by replacing the chemicals with "'environmentally sound and socially just alternatives.'" These measures, which could include reducing breeding opportunities and using fish to eat mosquito larvae, "can work -- but only under specific circumstances," Bate writes. He continues, "Exclusively relying on these techniques addresses the risks of man-made chemicals but gives scant consideration to the far more dangerous disease threats." According to Bate, international aid groups "have been reluctant to defend insecticide spraying," and the World Health Organization "has offered no leadership in the struggle to identify and invest in more effective insecticides."

Bate writes that the Gates Foundation is "the only organization to have seriously supported the effort" to develop new public health insecticides by granting $50 million in 2005 to the Innovative Vector Control Consortium. Bate writes, "Promisingly, the initiative has begun investigating compounds to replace the current crop of insecticides, working with major manufacturers (notably Bayer and Syngenta) to bring new products to the market." However, documents indicate that IVCC is not researching repellency, "which seems misguided," Bate writes. According to Bate, with the exception of the consortium's efforts, "very little research is being done" on public health insecticides, and the recent economic downturn "has made investment and risk-taking difficult." However, Bate concludes that "if malaria deaths are to end, politicians, businessmen, celebrities and activists must devote their efforts to creating an environment that encourages investment in new" public health insecticides (Bate, Monitor, 3/1).