Implications of public-health insecticide resistance and replacement costs for malaria control: challenges and policy options for endemic countries and donors

Abstract

Millions of people rely on public-health insecticides for malaria prevention. Yet growing insecticide resistance may threaten malaria control programs through decreasing e ffectiveness and possibly unsustainable cost-increases. Insufficient investment by s takeholders in the search for new public-health insecticides in recent decades has left malaria control programs with limited alternatives with which to manage resistance and maintain program effectiveness. While alternative insecticides are available, short of an unforeseen, significant increase in funding, their higher cost would compel programs to reduce malaria control coverage, leading to increased mortality and morbidity. In order to limit these negative effects on cost and coverage, we propose that policymakers and malaria stakeholders consider adoption of existing policies from successful efforts to secure reduced prices and increased access to other essential health interventions.