Landscaping of ITN Bioefficacy

The Issue

Insecticidal treated nets (ITNs) are the cornerstone of malaria vector control and over 2 billion ITNs have been delivered to families at risk of malaria since 2004. Over the past several years, instances of concern related to reduced ITN bioefficacy have arisen at different points along the ITN lifecycle. To understand the potential scope of these issues and the relative risks along different parts of the ITN lifecycle, the Global Fund to Fight AIDS, Tuberculosis and Malaria contracted Tropical Health to conduct a comprehensive landscaping of issues that could affect the bioefficacy of ITNs prior to their delivery to households. The objectives were first, to identify issues in product manufacturing, approval, regulation, procurement, quality assurance, supply chain and deployment potentially affecting bioefficacy of ITNs, and prioritize them by their relative impact on countries’ abilities to obtain effective ITNs for use by families at risk of malaria. Second, to identify mitigating measures and recommendations for the identified issues, and finally, to explicitly look at ways in which quality assurance processes might be improved to proactively identify and prevent quality issues. The landscaping was restricted to issues arising prior to distribution of the ITNs.

Our Approach

Tropical Health conducted a stakeholder mapping to establish a list of key informants across a range of expertise and stakeholder groups, then conducted 44 remote interviews. Over 300 documents were reviewed to gather evidence on ITN bioefficacy issues detected at the different stages of the ITN lifecycle. Findings from the document review and interviews were synthesized and presented in a narrative report, available here. Both the report and the Powerpoint presentation can be viewed on the resources page.

Our findings

Findings from the report are feeding into global discussions on ITN quality.