National malaria program policies for vector control interventions recommend the universal use of either insecticide treated nets (ITNs/LLINs) or indoor residual spraying (IRS) with larval source management as a supplemental intervention in certain circumstances. ITNs and IRS have been successful, being responsible for >80% of the reductions in P. falciparum malaria in Africa. In this environment with limited choices of recommended interventions, the programmatic role of vector surveillance in decision-making has been limited. However, the threat posed by increasing insecticide resistance and residual transmission has led to an anticipated rollout of new interventions incorporating new/multiple active ingredients in established and novel interventions. The vector control landscape is going to increase in complexity and this argues for increased vector surveillance to select the most appropriate vector control measures based on vector ecology and malaria epidemiology. The increasing cost (time and money) of randomized control trials (RCTs) also raises the question of whether vector-monitoring data can replace the RCT as the basis for policy recommendations on new interventions.
The vector surveillance activities of >30 malaria endemic countries in Africa, Asia, the Pacific and the Americans were surveyed. Questions on the use of vector data included “What is the status of vector surveillance in malaria national control programs?”, “Do vector monitoring tools have the precision to guide programmatic decisions on deployment of vector control interventions?” “Are vector data used today to guide programmatic decisions?”, and “Are countries’ vector control programs able to collect vector data and use it for decision-making?”
The survey responses were analysed against best practice recommendations. How vector data is being collected and used today and the limitations of the data argue for an invigoration and investment in the public health entomologist discipline to fully use vector data for decision-making, especially in countries seeking to eliminate malaria.