Monash University

Scaling the World Mosquito Program to prevent human disease Highly Ranked

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Project Summary

Dengue, Zika, chikungunya and yellow fever are transmitted by the same mosquito vector, Aedes aegypti, affecting millions of people predominately living in the world’s poorest communities. The World Health Organization (WHO) has identified dengue as one of the top ten global health threats of 2019. The Zika virus pandemic of 2016 had a devastating impact on congenitally infected newborns. Climate change is expected to increase the global population at risk of these diseases. The World Mosquito Program (WMP) has developed an innovative solution, using Wolbachia infected mosquitoes, that has been shown to be efficacious, highly cost-effective and acceptable to communities. We have demonstrated that we can deliver this intervention at scale in multiple countries and we have already provided protection to millions of people. We now plan to make the required transformations in our scaling pathway to make the Wolbachia method available globally to tropical communities at risk.

Problem Statement

More than half the world’s population is estimated to live in regions affected by viruses transmitted by the Aedes aegypti mosquito. In 2013, the estimated global burden of dengue was 390 million infections per year, with the problem worsening annually. Other Aedes aegypti transmitted viruses such as chikungunya and Zika inflict disease in the same regions as dengue. Outbreaks of Zika in South America in early 2016 resulted in WHO declaring the disease an international public health emergency because of concerns that it causes birth defects and has the potential to spread swiftly. Collectively, the diseases transmitted by the Aedes aegypti mosquito disproportionately impact peoples of low-income countries, exacerbating poverty and hardship and impeding economic development. Indirect costs, including loss of education and productivity, add substantially to direct healthcare costs. Currently, disease prevention efforts aim to suppress mosquito populations through removal of breeding sites and use of insecticides. These efforts are largely ineffective. Removal of breeding sites in large tropical cities is impractical, insecticide application is expensive and increasingly ineffective due to mosquito resistance. There are no specific therapeutics and no programmatically used vaccine for these diseases and the only registered dengue vaccine has considerable safety concerns.

Solution Overview

Our solution uses a naturally occurring bacterium, called Wolbachia. When Wolbachia is introduced into mosquito populations, the mosquitoes are unable to transmit viruses between people. We have measured the impact of the Wolbachia method on dengue using existing health surveillance data which shows reductions in disease incidence in different countries ranging from 46%-98%. These estimates are conservative because they don’t account for human mobility. As our Wolbachia-infected mosquito releases are undertaken over larger geographic areas, we expect to measure an even greater reduction in disease incidence. We will build on the success achieved so far to upscale our program to enable delivery of the Wolbachia method globally by: 1.Increasing mosquito production capability from current facility levels of ten million mosquitoes to hundreds of millions of mosquitoes per week and also improving the shelf life of our mosquitoes to enable more flexible distribution methods.2.Enhancing distribution and deployment capability through new partnerships to more efficiently reach many more global communities in need.3.Reducing our reliance on face-to-face community engagement activities by developing culturally appropriate scalable mass communications campaigns.4.Moving our cost base from a current average of $10 to $1-2 per person protected by driving efficiency in production, deployment, communications and monitoring costs. These improvements will enable reaching a target of 100 million people protected across 20 countries within five years. We will continue to directly measure the impact of the Wolbachia method on disease incidence using existing health surveillance systems in each country of operation.

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Project Funders

  • The Bill & Melinda Gates Foundation - 2021
  • The Wellcome Trust Limited
  • Australian Government (Australian Aid)

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