Use of Data for Malaria Vector Control Decision-Making : The Model of the Zambia Insecticide Resistance Management Technical Working Group Emmanuel Chanda 1 , Mulenga Musapa 2 , William Brogdon 3 , Janet Hemingway 4 , Mulakwa Kamuliwo 1 , Peter Mumba 2 , Michael Coleman 2,4 1 Ministry of Health, National Malaria Control Centre, Lusaka, Zambia, 2 Zambia Integrated Systems Strengthening Programme, Lusaka, Zambia, 3 Centres for Disease Control and Prevention, Atlanta.GA. USA, 4 Liverpool School of Tropical Medicine. L3 5QA, Pembroke Place. Liverpool, United Kingdom 15 th November, 2012
Background • Malaria is leading cause of morbidity and mortality • Endemic throughout Zambia • An. gambiae s.s, An. arabiensis & An. funestus • WHO Global Strategic Framework for Integrated Vector Management • Global Plan for Insecticide Resistance Management (GPIRM) 2
Vector Control Measures Indoor Residual Spraying Insecticide Treated Nets IRS Coverage 2003 - 2011 Population covered and structures sprayed 8000000 7000000 6000000 5000000 4000000 3000000 2000000 1000000 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 Year of Implementation # of housing structures sprayed Population protected 3
Trends in Insecticide Resistance 4
Multidisciplinary IRMTWG TAC ZEIRMN • • Academic and Research Line ministries: – LSTM – Health, • – MTC Provincial • District – CDC – Agriculture – TDRC – Environment, – JHMRI • Environmental regulatory body • Implementing partners • Entomological Society of – ZISSP Zambia, – WHO/NMCC/MoH • Chemical Suppliers • Funders: • Pest Control Operators – USAID/ PMI • NGOs TAC: Technical Advisory Committee 5 ZEIRMN: Zambia Entomological and Insecticide Resistance Monitoring Network
Resistance Monitoring 6
Policy Change Insecticide used 2010/11 Insecticide used 2011/12 7
Geocoding of Structures Earmarked for IRS 8
Lessons Learned • IRTWG is useful model for addressing challenges of IRM – NMCC coordination of group critical – Engagement of broad set of stakeholders increases buy-in – Having engaged in process, funders more ready to deal with increased costs associated with policy change • It is critical to have quality, localized data – Investment in spatial and temporal mapping important – Insecticide resistance mapping facilitates rational IRS policy change • Engagement of the NMCC staff in entomological monitoring important – Facilitates ownership, policy change 9
Challenges, Conclusion & Way Forward Challenges • Funding implications • Skepticism surrounding scientific findings • Lack of local financial support Conclusion • Need for more funding — external, internal • Ongoing investment needed in localized data collection/sharing • Significance of coordinated response among stakeholders to share data for policy change Way Forward • Strengthen coordination of IRMTWG • Routine resistance data collection • Assess gene flow and underlying mechanisms, impact on efficacy of interventions • Advocate for political will and financial commitment • 3 rd Workshop to be held on 26 th November 2012 in Lusaka 10
Thank You! 11
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