By Adonis Byemelwa
Malaria remains one of Africa’s most persistent and deadly health challenges. Each year, millions of lives are affected, and children under five remain the most vulnerable. While World Mosquito Day has passed, its message continues to resonate.
The day commemorates the discovery, 125 years ago, that malaria is transmitted by Anopheles mosquitoes—a revelation that reshaped global health strategies and inspired decades of research into prevention. Among the breakthroughs that followed, long-lasting insecticidal mosquito nets became a cornerstone of malaria control, halving infection rates in the first two decades of this century.
However, progress has slowed in recent years. The COVID-19 pandemic disrupted health services, while biological threats such as rising insecticide resistance, compounded by climate crises and humanitarian emergencies, have strained prevention efforts. Funding gaps persist, leaving many vulnerable communities at risk. In this context, innovations such as dual active-ingredient mosquito nets are emerging as critical tools to outsmart evolving mosquito populations.
To explore these developments, the Pan African Visions Bureau Chief in Tanzania held an in-depth Q&A with Duncan Kobia Athinya, Senior Technical Manager at Vestergaard, focusing on new-generation malaria prevention tools, African-led scientific innovation, and the path toward equitable access to life-saving interventions.
Malaria continues to be one of Africa’s most pressing health challenges. Could you share how the situation has evolved over recent years, especially with rising insecticide resistance, and why innovations like dual active-ingredient mosquito nets are so critical now?
Malaria control has achieved remarkable milestones over the past two decades, largely thanks to long-lasting insecticidal nets. But in recent years, progress has slowed. Multiple factors contribute to this slowdown, including the lingering effects of COVID-19 service disruptions, climate-related emergencies, humanitarian crises, and persistent funding shortfalls. One of the most pressing challenges is insecticide resistance. Most vector control tools have historically relied on a single class of insecticides—pyrethroids. Mosquitoes have gradually evolved to resist their effects, reducing the efficacy of conventional mosquito nets. This has created an urgent need for innovation. The first breakthrough has come in the form of dual active-ingredient nets. These nets incorporate two complementary modes of action, increasing their effectiveness against resistant mosquito populations. The rise of insecticide resistance makes these innovations more than just a scientific advance—they are essential tools for protecting communities and ensuring that malaria control efforts remain effective.
Vestergaard recently introduced PermaNet Dual, your first dual active-ingredient mosquito net. Can you walk us through what makes this technology different from traditional nets and how it changes the game for malaria prevention across Africa?
PermaNet Dual is a groundbreaking development because it combines two active ingredients that attack mosquitoes in different ways. Chlorfenapyr disrupts the mosquito’s energy system, while deltamethrin, a pyrethroid, attacks its nervous system. This dual-action mechanism makes it far harder for mosquitoes to survive exposure, even in regions where resistance has been documented. Field trials in Tanzania and Benin have shown that dual active-ingredient nets reduce malaria transmission by over 50% compared with standard pyrethroid-only nets. In certain settings, the reduction could reach as high as 75%. The World Health Organization has issued strong recommendations for their use in areas where pyrethroid resistance is widespread. Scaling up these nets has been a priority. Demand from African countries has been unprecedented, and collaboration with partners like the Global Fund has enabled the production of 40 million quality-assured PermaNet Dual nets within a year of the WHO recommendation. These nets are now rolling out across the continent, providing a strong foundation for other malaria interventions and helping communities regain the ground lost in recent years.
Collaboration seems to be at the heart of these breakthroughs. How have partnerships with African governments, institutions like KEMRI, and research centers like Ghana’s Noguchi Institute accelerated the development and deployment of these life-saving tools?
African governments and scientists are central to the malaria control ecosystem. From designing and testing new tools to governance and scale-up, their involvement ensures that innovations are practical, effective, and locally relevant.
For example, Vestergaard has long-standing partnerships with institutions such as KEMRI in Kenya and CREC in Benin. These collaborations focus on insecticide resistance surveillance and rigorous laboratory and field trials, ensuring that products perform under real-world conditions. In Ghana, the Vestergaard-Noguchi Vector Labs (VNVL) exemplify how sustained partnerships can drive innovation. Operating for over 14 years, VNVL conducts evidence-based design and evaluation of vector control tools using mosquito populations reflective of local environments. Nigeria, home to the world’s highest malaria burden, is another example. There, collaboration with the government aims to establish a state-of-the-art regional manufacturing facility for PermaNet Dual and future-generation nets. Local production is crucial for increasing access, reducing aid dependence, and ensuring that interventions are tailored to the needs of the communities they serve. These partnerships not only accelerate product development but also strengthen local capacity, creating a sustainable framework for malaria control and beyond.
As a scientist working across multiple countries, what are some of the challenges you see on the ground when it comes to implementing new malaria prevention technologies, and how are local teams overcoming them?
Long-lasting insecticidal nets have been highly effective for over two decades, but no single solution is universally optimal. Each community has its own unique ecological, social, and logistical context. Local knowledge is therefore critical to determine the most effective mix of interventions. The approach of “sub-national tailoring” has gained traction. Instead of a blanket national policy, interventions are adapted to the local data and realities of specific regions, ensuring the highest impact. Resource constraints remain a persistent challenge, particularly this year, as malaria funding is stretched thin. Nets remain the most cost-effective indoor vector control tool, so supporting communities with education on proper use and maintenance is vital. Ensuring that people understand how to care for and deploy their nets maximizes their longevity and effectiveness, safeguarding the investment and protecting more lives.
African scientists are increasingly leading global health innovations. How does the growing role of homegrown expertise change the way malaria and other public health challenges are addressed continent-wide?
Local expertise brings enormous advantages. Scientists who live and work within affected communities are best placed to design practical interventions, culturally appropriate and effective.
Homegrown innovation also accelerates the transition from research to implementation. It builds long-term capacity, ensuring countries can respond to emerging challenges and sustain malaria control efforts independently. PermaNet Dual exemplifies this approach. Its development drew on the expertise of scientists working on the frontlines of malaria transmission. These partnerships are designed to last, creating resilient health systems capable of addressing malaria and related diseases such as lymphatic filariasis, dengue, and chikungunya. The growing leadership of African scientists shifts the narrative from aid-dependent solutions to sustainable, locally owned strategies—ensuring that interventions are not only effective but enduring.
Looking ahead, what do you see as the next frontier in malaria prevention, and how can tools like PermaNet Dual serve as a foundation for broader strategies to combat the disease?
Mosquito nets remain the cornerstone of malaria control. But innovation must continue—new active ingredients, environmentally sensitive materials, and strategies to manage insecticide resistance are essential. Vaccines are now available, and the WHO has approved spatial repellents as additional tools. While these are valuable additions, they complement rather than replace nets. Dual-action nets like PermaNet Dual provide the foundational layer upon which these other interventions can build. Looking forward, developing more dual-action nets with varied insecticides will allow rotation strategies, slow resistance, and maintain efficacy. In this way, dual-action nets are not just a breakthrough—they are a strategic platform for the next generation of malaria prevention tools.
In your view, what does achieving equity in malaria prevention look like, and how close are we to turning that vision into reality?
Equity in malaria prevention means no child should die from a disease we know how to prevent, diagnose, and treat. Sadly, lack of access remains the primary barrier. Mosquitoes and parasites continue to evolve, and the longer it takes to reach communities with effective tools, the harder the fight becomes. The 2030 malaria targets are at risk of slipping, but achieving them could save 2–3 million lives, primarily children, while boosting the GDP of malaria-endemic countries by more than US$125 billion. The ultimate vision is simple: everyone at risk for malaria should have access to a quality-assured, effective mosquito net. Achieving this will require continued innovation, strategic partnerships, and a commitment to equitable access, ensuring that every community, regardless of location or economic status, can be protected. The dream is clear, and with concerted action, it is within reach.
