Trends

Resistance to pyrethroid insecticides, the only class available to treat bed nets, is now ubiquitous in African malaria vectors and resistance to other insecticide classes used for adult mosquito control is increasing.

Critical knowledge gaps impede estimates of the impact of this resistance on malaria transmission but multiple observational studies suggest a rapidly worsening situation.

New approaches to tackle pyrethroid resistance are urgently needed; this will require new products, a more rapid and robust approach to their field evaluation, and acceleration of access to these products where the malaria control challenges posed by resistance are greatest.