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Review
. 2017 Apr 24;16(1):162.
doi: 10.1186/s12936-017-1803-2.

Ivermectin to reduce malaria transmission III. Considerations regarding regulatory and policy pathways

Carlos Chaccour  1   2   3 , N Regina Rabinovich  4   5
Affiliations
Review

Ivermectin to reduce malaria transmission III. Considerations regarding regulatory and policy pathways

Carlos Chaccour et al. Malar J. .

Abstract

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.

Keywords: Anopheles; Endectocide; Ivermectin; Malaria; Policy; Regulatory pathway.

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Figures

Fig. 1
Fig. 1
Overlap between selected onchocerciasis and malaria endemic areas in Africa. a Estimated prevalence of palpable Onchocerca nodules in the 20 African Programme for Onchocerciasis Control countries in 2011 as described by Zouré and colleagues [41]. b Plasmodium falciparum parasite rate in 2–10 years old in 2015 as described by Bhatt and colleagues [42]
Fig. 2
Fig. 2
Regulatory, policy and business model tasks related to the development of ivermectin as a complementary tool to reduce malaria transmission. The intended order is left to right but the figure should illustrate the fact that some processes will be conducted in parallel and some sequentially. PTRS probability of technical and regulatory success, WHO-PQ WHO prequalification
See this image and copyright information in PMC

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