Great gains have been made in the fight against malaria and wide spread vector control initiatives have played a major role. However, insecticide resistance threatens to reverse these fragile gains.

At present there are three main techniques used to prevent mosquitoes from transmitting malaria. Long lasting insecticide treated bed nets (LLIN) are used extensively to kill mosquitoes and prevent them from biting. Indoor residual spraying (IRS) is also used to cover homes with insecticide to kill the insects and larvicide destroys mosquito larvae before they mature.

The problem is that vector control is highly dependent on the use of pyrethroids, which are the only class of insecticides currently recommended for bed nets and also a primary agent used in indoor spraying.

"We need to maintain the political momentum and the appetite for change or we risk reversing years of progress” Professor Hilary Ranson

At the moment, there are few, cost-effective alternatives to pyrethroid based sprays and no alternatives at all to the pyrethroid treated nets. “In some regions of Uganda and Burkina Faso where we have a high coverage of bed nets, we’ve seen incidence of malaria remain static or even increase,” explains Professor Hilary Ranson, Professor of Medical Entomology, Liverpool School of Tropical Medicine. “If we don’t respond the trajectory is going to be pretty bleak.”

Scientists have been exploring treating nets with an additional synergist to offer increased efficacy, but while these may help maintain control in the short term it’s certainly not a long-term solution. “We’re getting to the point where the existing tools we have aren’t fit for purpose,” says Ranson. “We need to maintain the political momentum and the appetite for change or we risk reversing years of progress.”