Strengthening public health pesticide management in countries endemic with malaria or other major vector-borne diseases: an evaluation of three strategies
Henk van den Berg
1
Rajpal S Yadav
0
Morteza Zaim
0
0
Vector Ecology and Management, Department of Control of Neglected Tropical Diseases, World Health Organization
,
Geneva
,
Switzerland
1
Laboratory of Entomology, Wageningen University
,
PO Box 8031, Wageningen 6700EH
,
the Netherlands
Background: Public health pesticides has been the mainstay control of vectors of malaria and other diseases, and public health pests, but there is increasing concern over how these pesticides are being managed. Poor pesticide management could lead to risks to human health and the environment, or diminish the effectiveness of interventions. Strategies for strengthening the management of public health pesticides, from manufacture to disposal, should be evaluated to propose future directions. Methods: The process and outcomes of three strategies were studied in five regions of the WHO (African Region, Eastern Mediterranean Region, South-East Asia Region, Western Pacific Region, and American Region) and 13 selected countries. These strategies are: regional policy development, in-depth country support and thematic support across countries. Results: Consensus, frameworks and action plans on public health pesticide management were developed at regional level. Country support for situation analysis and national action planning highlighted weaknesses over the entire spectrum of pesticide management practices, mainly related to malaria control. The thematic support on pesticide quality control contributed to structural improvements on a priority issue for malaria control across countries. Conclusions: The three strategies showed promising and complementary results, but guidelines and tools for implementation of the strategies should be further improved. Increased national and international priority should be given to support the development of policy, legislation and capacity that are necessary for sound management of public health pesticides.
-
Background
Malaria and other vector-borne diseases, notably dengue,
lymphatic filariasis, leishmaniasis, and Chagas disease,
together with domestic pests, continue to be a major
problem for global public health [1], causing immense
suffering and preventing people from escaping poverty.
Vector control, aiming to reduce vector populations or
vector-human contact, plays a major role in the
prevention, control or elimination of malaria and most other
vector-borne diseases [2,3].
The use of public health pesticides (i.e. vector control
pesticides, household insecticides, and professional pest
management pesticides [4]) has been the mainstay
control of vectors of malaria and other diseases, and other
pests, in or around human habitation [5,6]. However,
there is increasing concern over how these pesticides are
being managed, particularly in resource-poor countries.
Poor pesticide management could pose risks to human
health and the environment, or reduce the effectiveness
of interventions. Recent reports have indicated an
unregulated trade in substandard pesticide products [7,8],
rapid development of insecticide resistance in malaria
vector populations [9-11], and the existence of large
stockpiles of obsolete vector control insecticides [12].
Particularly, the scaling-up of vector control
interventions such as indoor residual spraying and long-lasting
insecticidal nets for malaria control have, in many
countries, led to insecticide resistance, leaving programmes
with a reduced number of available insecticide options.
An additional problem is that the capacity for
evidencebased decision making on vector control interventions is
weak in many countries, leading to suboptimal
interventions and waste of valuable resources [13,14].
Integrated vector management, defined as a rational
decision-making process for the optimal use of resources
for vector control, is being promoted by the World
Health Organization (WHO) as the preferred approach
for increasing the efficiency, effectiveness, sustainability,
and environmental soundness of vector control [15,16].
Several examples of IVM exist [13,17-19]. The integrated
vector management approach applies equally to the
control of domestic pests. As insecticides have a dominant
role in current strategies of vector and pest control,
there is a significant overlap between pesticide
management and integrated vector management. Hence,
improvement in how insecticides are being selected, used
and evaluated will have immediate benefits for the control
of vectors and pests. This elementary role of pesticide
management for achieving health outcomes (e.g. reduction
in pesticide poisoning, reduction in malaria incidence)
deserves increased attention in advocacy at national and
international level.
The International Code of Conduct on Pesticide
Management (referred to as: Code of Conduct) provides a
voluntary and globally accepted standard for effective
lifecycle management of agricultural and public health
pesticides [20]. The life-cycle concept of pesticide manageme (...truncated)