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In 2019, BIMCP evolved into the Bioko Island Malaria Elimination Project (BIMEP), with ambitions to ultimately interrupt malaria transmission on Bioko. Progress has been extraordinary: the . The significant body of operational research, data and knowledge that BIMEP has produced over the years can hopefully be used to inform malaria control in other countries.

“Many funders of malaria interventions look for innovations such as genetically modified mosquitoes and vaccines,” explains Guillermo García, Director of International Programs at MCD Global Health, a nonprofit public health organisation and BIMEP partner. “We are exploring those strategies too. Yet, there are proven tools such as indoor residual spraying that have reduced transmission and even eliminated malaria from certain countries, and these need continued support.”

How intelligent use of data improves IRS delivery

In recent years, indoor residual spraying — which involves applying insecticides to interior walls and ceilings of homes — has fallen out of favour to control malaria, as it is often seen as costly and resource-intensive. However, its use on Bioko proves how it can be applied in a more economical, resource-efficient but effective way, says Carlos Guerra, Chief Science Officer, MCD Global Health.

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“Thanks to our robust geo-referenced data, we know how many houses have been sprayed and therefore what fraction of the population has been protected,” says Guerra. “We can measure impact, challenges and gaps in coverage. We know where the people most at risk are, and we can guide our teams in the field more precisely. So, while indoor residual spraying has not traditionally been a simple strategy to deploy, we’ve shown that by leveraging data it can be much more cost-effective.”

This type of data-driven delivery is an innovation in itself — one that should give confidence to funders that IRS is indeed a viable and important solution. Plus, new interventions won’t be successful overnight. They will need to be implemented in settings that already have a range of ongoing tried and true malaria controls.

Importance of partnerships in malaria control

Although Bioko Island is still a long way from achieving malaria elimination, MCD Global Health and its funding partners in the BIMEP — including the Government of Equatorial Guinea and companies in the energy sector — have achieved much over the last two decades, creating an effective landscape to test innovations alongside robust classic malaria strategies. “Obviously, no one organisation can tackle this on their own,” says Guerra. “Malaria control is hard.”

For programmes around the world, it’s been made harder with the withdrawal of US funding. “One of the biggest challenges we have is funding,” admits Guerra. “On Bioko Island, we can be optimistic that funding for malaria interventions will remain. For interventions in the rest of the world, we can’t — and unfortunately, malaria doesn’t stop because funding stops.”

“There are only a handful of tools in the malaria control toolbox,” García agrees. “We must secure funding for those interventions we know work while looking for alternative strategies that may be more effective. If we can stop people dying from malaria, then that is the motivation for all of us to keep going.”

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Paid for by MCD Global Health