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Global Fund and Unitaid Welcome WHO Recommendation for Insecticide-treated Nets With Dual Active Ingredients
14 March 2023
GENEVA – The Global Fund to Fight AIDS, Tuberculosis and Malaria and Unitaid welcome WHO’s recommendation for the widespread use of a new class of mosquito net that uses two active ingredients – pyrethroid and chlorfenapyr. The new net has demonstrated approximately double the protection against malaria provided by the standard pyrethroid-only nets in areas where mosquitoes have already developed resistance to pyrethroids.
Randomized controlled trials in Tanzania and Benin over a two-year period demonstrated that the dual active ingredient insecticide-treated nets reduced malaria infections by approximately 50% among children between the ages of 6 months and 10 years.
Children and pregnant women are particularly vulnerable to malaria. According to the 2022 World Malaria Report, almost 80% of malaria deaths occur in children under 5. Most of the remaining deaths occur in children under 10 and pregnant women, especially in sub-Saharan Africa.
“This shows how we can accelerate impact by embracing innovation,” said Peter Sands, Executive Director of the Global Fund. “The issuance of guidance by WHO is critical to influencing broad uptake of the new nets and to combat growing insecticide resistance across Africa, where nearly all malaria infections and related deaths occur.”
“Widespread use of insecticide-treated nets is credited with nearly 70% of the reduction in malaria cases achieved in Africa in the first 15 years of this century,” said Dr. Philippe Duneton, Executive Director of Unitaid. “But as mosquitoes have grown increasingly resistant to the insecticides, the efficacy of this critical tool has dwindled. Unitaid is delighted to contribute to efforts to quickly add a powerful new tool to our malaria-fighting arsenal.”
Growing pyrethroid resistance in mosquitoes is likely to be a major contributor to the plateauing progress against malaria seen in recent years. With additional setbacks caused by disruptions and delays to services from the COVID-19 pandemic, the malaria response is in desperate need of new tools to kick-start progress.
The New Nets Project, a joint Unitaid and Global Fund-supported initiative with US$33 million invested from each agency, played a catalytic role in the introduction of the new nets, including market interventions to support affordability. Led by Innovative Vector Control Consortium (IVCC), the project – with its unique design of parallel collection of epidemiological and entomological data and cost-effectiveness studies – significantly reduced the timeline for entry of the new nets into the market and wide-scale adoption.
The respective national malaria programs were closely involved at each stage of the project. They invested the necessary leadership, resources, and technical expertise throughout the evidence-gathering stages of the project and will now be actively engaged in tailoring new tools and interventions to their unique contexts.
The New Nets Project, over four years between 2018 and 2022, has deployed over 35 million nets across the 14 countries that account for nearly 70% of all malaria cases and deaths worldwide, providing protection to more than 60 million people so far. The countries covered include Benin, Burkina Faso, Burundi, Cameroon, Côte d’Ivoire, Democratic Republic of the Congo, Ghana, Liberia, Malawi, Mali, Mozambique, Niger, Nigeria, and Rwanda.
Within the framework of the New Transition Initiative (2021-2024), the Global Fund continues to invest US$50 million in catalytic funding to support the transition to the new generation nets, help scale them up and, ultimately, achieve price decreases so that as many people as possible can benefit from them. An estimated 38 million nets will be distributed as part of this initiative.
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