Volume 102 Number 2s
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

    oa A Roadmap for the Development of Ivermectin as a Complementary Malaria Vector Control Tool

  • The Ivermectin Roadmappers1
  • View Affiliations Hide Affiliations
    *Address correspondence to Carlos Chaccour, Barcelona Institute for Global Health (ISGlobal), Rosello 132, Barcelona 08036, Spain. E-mail: carlos.chaccour@isglobal.org

    Disclosure: PB reports personal fees from Sanaria Inc., outside the submitted work BF has a patent 16/275,172 pending, and JJ advises the non-for-profit Foundation Mundo Sano on public health use of ivermectin-albendazole combination therapy. NRR, CCh, PRC, and MGS received funding from BMG for the development of this roadmap. NRR, CCh, and PRC are engaged in the BOHEMIA project (with funding from Unitaid) to evaluate ivermectin MDA to humans and livestock in Africa and, if results are positive, facilitate policy recommendation and national adoption. Part of their salary was funded by the BOHEMIA grant from Unitaid to ISGlobal. CCh was supported by a Ramón Areces fellowship. CJ reports part of her salary funded since February 2019 by a Unitaid grant through the University of Oxford for the BOHEMIA project. FR was a member of the Mectizan Expert Committee (MEC) at the Task Force for Global Health (TFGH) from May 2017–May 2019. Mectizan is the Merck & Co. brand name for their ivermectin tablet product that is donated to onchocerciasis and lymphatic filariasis programs. The MEC advises the TFGH Mectizan Donation Program that is involved in providing the Merck donation. SR works at IVCC, which is supported by the BMGF. RZ is supported by the President’s Malaria Initiative.

    Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the President’s Malaria Initiative.

    fn1  PB, CCh, BF, MGS, JJ, PK, KK, AL, JL, DM, LM, ChM, NRR, FR, CR, JR, PRC, HS, KX, and RZ.

    fn2   PB, CCh, BF, MGS, JJ, PK, KK, NRR, CR, PRC, KX, and RZ.

    fn3   CCh, BF, JJ, GJ, PK, KK, SM, DO, NRR, SR, FR, CR, JR, FS, HS, and RZ.

    fn4   PB, CCh, BF, MGS, GJ, KK, AL, JL, DM, LM, ChM, NRR, FR, CR, JR, HS, KX, and RZ.

    fn5Financial support: Funding for the development of this roadmap was provided by the Bill & Melinda Gates Foundation. ISGlobal is a member of the CERCA Program, Generalitat de Catalunya.


  • Publisher: The American Society of Tropical Medicine and Hygiene
  • Source: The American Journal of Tropical Medicine and Hygiene, Volume 102, Issue 2s, 6 Feb 2020, p. 3 - 24
  • DOI: https://doi.org/10.4269/ajtmh.19-0620



In the context of stalling progress against malaria, resistance of mosquitoes to insecticides, and residual transmission, mass drug administration (MDA) of ivermectin, an endectocide used for neglected tropical diseases (NTDs), has emerged as a promising complementary vector control method. Ivermectin reduces the life span of mosquitoes that feed on treated humans and/or livestock, potentially decreasing malaria parasite transmission when administered at the community level. Following the publication by WHO of the preferred product characteristics for endectocides as vector control tools, this roadmap provides a comprehensive view of processes needed to make ivermectin available as a vector control tool by 2024 with a completely novel mechanism of action. The roadmap covers various aspects, which include 1) the definition of optimal dosage/regimens for ivermectin MDA in both humans and livestock, 2) the risk of resistance to the drug and environmental impact, 3) ethical issues, 4) political and community engagement, 5) translation of evidence into policy, and 6) operational aspects of large-scale deployment of the drug, all in the context of a drug given as a prevention tool acting at the community level. The roadmap reflects the insights of a multidisciplinary group of global health experts who worked together to elucidate the path to inclusion of ivermectin in the toolbox against malaria, to address residual transmission, counteract insecticide resistance, and contribute to the end of this deadly disease.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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Supplemental Annex

  • Received : 22 Aug 2019
  • Accepted : 22 Oct 2019
  • Published online : 06 Feb 2020

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