Global plan for insecticide resistance management in malaria vectors

Adequate, sustainable human and financial resourcesmust be available for global and local IRM strategies.Human and technical capacity: Capacity-building is requiredboth in malaria-endemic countries and for partner organizations toensure that they can support countries.Requirements within countries. Entomological capacity and otherspecialized skills, such as epidemiology, statistics and expertisein insecticide resistance, are required to design monitoring plans,interpret data and make decisions about the IRM strategy. (Seesection 1.4.2) Capacity to implement IRM strategies should gobeyond the selection of a strategy and alternative insecticidesto the planning and implementation of strategies; for example,training staff to do rotations or mosaics.Requirements within partner organizations. Organizations musthave sufficient capacity to provide support to countries. The areasin which capacity-building is required are:• Advisory services: Advisory services should be availableto countries, particularly for analysis of data and decisionmakingon IRM strategies. WHO, together with relevantpartners, will be important in this capacity.• Support for planning: All partners with experience invector control planning should make resources availableto countries for preparing IRM plans and monitoringinsecticide resistance.• Research and evidence: WHO should convene a group ofexperts that can review new science and evidence andrevise recommendations accordingly. Countries rely onWHO to consolidate information and provide up-to-dateguidelines on IRM.• Dissemination of IRM strategy: Implementing agenciesand partners should ensure that they have capacity todisseminate IRM strategies within countries.• WHOPES: The capacity of WHOPES and collaboratingcentres should be strengthened to ensure a timelyresponse to new vector control tools.Financial resources for increased costs associated withIRM.Funding is required for insecticide resistance both for countriesto implement IRM strategies and monitor insecticide resistance,and for research into insecticide resistance, and research anddevelopment of new insecticides and vector control tools.Insecticide resistance monitoring. Costs are associated withincreasing entomological capacity, the equipment for testing(including susceptibility test kits, use of laboratories for moleculartesting, paying for the support of research institutions), and trainingof staff to collect and test vectors.IRM strategies. Integration of IRM strategies into vector controlprogrammes may increase costs for non-pyrethroid insecticides(the alternatives, besides DDT, are significantly more expensive atcurrent prices), training staff for different vector control strategies,such as rotations and mosaics, and other programme costs.In order to maintain vector control coverage, near-term fundingwill have to increase to cover the costs associated with monitoringinsecticide resistance and implementing IRM strategies.Potential sources of funding. All potential sources of funding shouldbe considered by countries, although domestic governments anddonors will naturally play an important role. Donors should stressthe long-term importance of monitoring insecticide resistance bymaking a monitoring programme a condition of any large grant forvector control. Ideally, they should also provide additional fundingfor this activity. National malaria control programmes shouldconsider re-allocating a portion of their vector control budgets toconduct monitoring or implement urgently needed IRM strategies.Accelerated funding. The idea of acceleration has been suggestedso that action can start immediately after the launch of the GPIRM.WHO will work with partners to discuss the options, which includea catalytic fund to initiate entomological monitoring and strategicsupport for IRM strategies in countries considered by the group tobe of high priority.Research. Although research on insecticide resistance is alreadytaking place, continued funding for this is needed. One of the firsttasks in implementing the GPIRM will be to establish researchpriorities.71