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

• Published in: Malaria Journal
• Main Authors: Carlos Chaccour, N. Regina Rabinovich
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2017
• Subjects: Ivermectin; Endectocide; Regulatory pathway; Malaria; Policy; Anopheles; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-017-1803-2; https://doaj.org/article/44c0a15e603e4676b2034ad6b65966dc

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.