Abstract:
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Vector control is a task previously relegated to products that
(a) kill the mosquitoes directly at different stages
(insecticides, larvicides, baited traps), or (b) avoid/reduce
human-mosquito contact (bed nets, repellents, house screening),
thereby reducing transmission. The potential community-based
administration of the endectocide ivermectin with the intent to
kill mosquitoes that bite humans, and thus reduce malaria
transmission, offers a novel approach using a well-known drug,
but additional steps are required to address technical,
regulatory and policy gaps. The proposed community
administration of this drug presents dual novel paradigms;
first, indirect impact on the community rather than on
individuals, and second, the use of a drug for vector control.
In this paper, the main questions related to the regulatory and
policy pathways for such an application are identified. Succinct
answers are proposed for how the efficacy, safety,
acceptability, cost-effectiveness and programmatic suitability
could result in regulatory approval and ultimately policy
recommendations on the use of ivermectin as a complementary
vector control tool. |