BOHEMIA: Broad One Health Endectocide-based Malaria Intervention in Africa
BOHEMIA will evaluate the mass drug administration of ivermectin to humans and/or livestock in two African countries -Tanzania and Mozambique- during the malaria season, and will collect data on the epidemiological impact to support normative guidance, global and national policy change.
Should evidence be supportive, engagement with WHO and other key stakeholders will support the conditions for a policy recommendation, and subsequent national adoption.
BOHEMIA combines evidence generation and stakeholder engagement to enable the path for policy and implementation of ivermectin as a new vector control tool complementary to standard tools (treated bed nets and indoor residual spraying).
The world is not on track to achieve the goals proposed by WHO in the Global Technical Strategy for Malaria 2016-2030 (GTS), and currently available tools are unlikely to suffice. Vector control, our most effective strategy, is now doubly threatened by widespread insecticide resistance and residual transmission caused by mosquito behavioural adaptations that allow them to elude home-based vector control tools such as treated bed nets and indoor residual spraying.
Ivermectin is an antiparasitic drug distributed to more than 2.5 billion people over the last 30 years in mass drug administration campaigns to directly treat two Neglected Tropical Diseases (NTDs). More recently, it has been noted that ivermectin can also increase the mortality of mosquitoes that feed on treated humans or animals during a time period that can be up to 28 days, depending on the dose.
Thus, Mass Drug Administration (MDA) of ivermectin to humans and/or livestock holds potential to complement the malaria toolbox by tackling residual transmission and help the malaria community get back on track to achieve the GTS goals.