Accelerating To Zero in Haiti

After coming close to wiping out malaria in the 1960s and 1980s, Haiti is once again at the doorstep of defeating the mosquito-borne disease. In 2018, malaria cases in Haiti fell below 10,000 for the first time in decades – the result of sustained political will within Haiti and coordinated support from global stakeholders.

Among these stakeholders are the UN Foundation’s Nothing But Nets campaign (UNF/NBN) and the Malaria Zero alliance, and malaria-control innovators such as Bayer. Last year, UNF/NBN and Malaria Zero teamed up with Bayer to launch an indoor residual spraying (IRS) campaign in rural Haiti, using a groundbreaking new insecticide: Fludora® Fusion. Bayer donated 100% of the Fludora® Fusion supply needed for the campaign, which has protected more than 50,000 at-risk Haitians from malaria.

In November and December, a team of Malaria Zero sprayers applied Fludora® Fusion to 10,476 households in Grand Anse, a remote region in southwest Haiti that carries the country’s greatest malaria burden. This insecticide provides malaria protection for up to one year and kills mosquitoes that transmit malaria on contact, including mosquitoes that are resistant to other insecticides.

The sprayers successfully completed the campaign during a tumultuous time in Haiti. National political protests raged throughout 2019, at times paralyzing Haiti’s economy and its transportation links. In the face of these challenges, we are so grateful to Bayer for moving forward with the Fludora® Fusion donation (valued at over $70,000) and expedited air shipment –a critical step in ensuring the success of this campaign.

This IRS campaign will dramatically drive down malaria cases in Grand Anse and, as part of a package of targeted interventions, has the potential to interrupt malaria transmission entirely throughout the region. Wiping out malaria in Grand Anse would be a huge step towards complete elimination in Haiti and the neighboring Dominican Republic, which would effectively make the entire Caribbean a malaria-free region.

The preliminary data from the campaign have been promising. In December, Malaria Zero tested the efficacy of the insecticide on treated walls one week post-spraying. In 100% of cases, the mosquitoes died after being exposed to the Fludora® Fusion-treated walls. Four months later, more mosquitoes were exposed to the treated walls; and over 95% died within 24 hours, demonstrating the effectiveness of Fludora Fusion for IRS-based operational malaria vector control in Haiti.

These results come as little surprise: in 23 previous trials across sub-Saharan Africa, Fludora® Fusion proved highly effective against 15 mosquito resistant strains and on 33 different surfaces. Fludora® Fusion is the first-ever IRS insecticide to combine two active ingredients with different modes of action, providing optimum effectiveness under conditions of insecticide resistance. 

While not anticipated when the project started, the long duration of the insecticide is particularly beneficial while Haiti prepares for a potential COVID-19 outbreak. Due to the COVID-19 pandemic, health systems around the world are struggling to maintain other essential health services as they address this emergency. Prevention of malaria through vector control will reduce cases and help relieve pressure on Haiti’s health system as it is taxed by this novel challenge.

Bayer is one of several agrochemical companies committed to developing next-generation vector control products that last longer, work on most surfaces, and kill malaria-carrying mosquitoes that are resistant to existing insecticides.

On World Malaria Day 2018, Bayer – along with fellow Nothing But Nets partners Sumitomo, Syngenta, and BASF, and other agrochemical companies – signed the ZERO by 40 declaration, which reaffirmed their long-term commitment to research and develop innovative vector control tools.

Supported by the Innovative Vector Control Consortium and the Bill and Melinda Gates Foundation, ZERO by 40 brings these companies together under a common set of principles and around one overarching goal: to eradicate malaria by the target year of 2040.

To learn more about how Haiti is accelerating progress against malaria, click here.