Lessons from agriculture for the sustainable management of malaria vectors

Abbreviations: IPM, integrated pest management; IRS, indoor residual sprays; ITN, insecticide-treated net; IVM, integrated vector management; R&D, research and development; WHO, World Health Organization Provenance: Not commissioned; externally peer reviewed. Summary Points * The effectiveness of insecticide-treated bed nets and indoor insecticide sprays to control adult mosquito vectors is being threatened by the spread of insecticide resistance. * We argue for expanding beyond "insecticide monotherapy" to more sustainable integrated vector management strategies that use optimal suites of control tactics. * Experience in agriculture suggests that such integrated approaches can provide more effective and durable pest management. * This shift will require increased investment in research and translational science. * Failure to act risks a resurgence of malaria and erosion of community support and donor commitment. Current malaria vector control relies almost exclusively on killing adult mosquitoes with chemical insecticides deployed as either insecticide-treated nets (ITNs) or indoor residual sprays (IRS).