Malaria vector control and personal protection.

Malaria transmission rates and risks can be greatly reduced by vector control, mitigating high malaria incidence and prevalence rates. Methods and strategies for malaria vector control (MVC) have been well documented by WHO, although its implementation varies widely. Technical guidelines for MVC strategies and materials are readily available, but the status and role of MVC have not been reviewed and redefined in terms of programme management and resource allocation. There are huge changes since November 1993 when the last WHO Study Group reviewed vector control for malaria and other mosquito-borne diseases, following the 1992 adoption of the Global Malaria Control Strategy. Operationally, with reform of the health sector in many countries, the centrally managed and vertically structured malaria control programme (MCP) has been superseded by a community-based and decentralized one. This poses challenges for effective implementation of MVC strategies. Therefore it became evident that the role of vector control in malaria control needs to be reconsidered to develop a strategic framework for MVC implementation by national malaria control programmes and other partners. This report of a WHO Study Group on Malaria Vector Control and Personal Protection reviewed the current vector control strategies and their effectiveness in various operational and eco-epidemiological settings, and identified challenges for implementation in different health systems. An outline strategic framework for strengthening malaria vector control implementation was developed. The process of deciding about which mosquito control method is appropriate in a given situation should be guided by an analysis of the level of malaria endemicity and vector bionomics, the eco-epidemiological setting, the health management system and an estimate of the programme sustainability. This report also provides a basis for the development of a strategic framework for strengthening malaria vector control implementation.