Building Out Vector-borne diseases in sub-Saharan Africa: the BOVA Network

Lead Research Organisation: Durham University
Department Name: Biosciences

Abstract

In the past, many infectious diseases in Europe and North America were addressed by installing clean water, good sanitation and housing. Today global health focuses on water and sanitation, but there is comparatively little research done on housing and health. This is a missed opportunity, since many important diseases transmitted by insects, occur indoors or around the home. The goal of this Network is to make communities in sub-Saharan Africa more resilient to the threat from insect-transmitted diseases; chiefly malaria, a rural disease, and diseases carried by Aedes species mosquitoes, like Zika and dengue, which are primarily urban diseases. To achieve this goal we need to find new solutions to stop mosquitoes entering houses and, for Aedes-borne diseases, to reduce the aquatic habitats in towns and cities. Whilst this may sound common sense, despite repeated attempts, we have been singularly unsuccessful in bring together experts in insect-transmitted diseases and the built environment over the past 50 years. There is an even greater necessity to break down these silos today since the World Health Organisation will launch its global strategy on the control of insect-transmitted diseases in May 2017 which advocates for the need to control vector-borne diseases by experts in vector-borne diseases working alongside those in the built environment. The BOVA Network, if funded, would be in the vanguard of this new strategy helping to protect communities in sub-Saharan Africa from these major insect-borne diseases. The Management Board that will run the Network is an extremely diverse group with experts on insect-transmitted diseases, architecture, civil engineering, town planning, development, product development, industry, health economics and community participation; from sub-Saharan Africa and developed countries. This exceptional pool of talent will allow us to link-up with larger groups of experts and the Network grant will provide the springboard for us to grow a new scientific discipline. Specifically the Network will: 1) facilitate the exchange of information about insect-transmitted diseases and the built environment between disciplines, 2) fund basic and applied research to develop and scale-up products and novel approaches to reducing the threat from insect-transmitted diseases in the built environment, 3) help build the next generation of scientists, architects, engineers and planners developing approaches to the control of these diseases and 4) to reach out to funders and those engaged in development projects, like United Nations organisations and the Development Banks to invest in the control of vector-borne diseases through the built environment. This Network is designed to help protect the citizens of sub-Saharan Africa from the threat of insect-transmitted diseases and has the potential to change the lives of millions.

Technical Summary

Despite major reductions in malaria in sub-Saharan Africa (SSA) in the past 15 years, malaria continues to be a major burden on health with 114 million people infected, 191 million clinical malaria cases and 394,000 deaths in the region in 2015. The scale of the rise in Aedes-borne diseases in SSA is uncertain, not least because until relatively recently most febrile illnesses were considered to be malaria. Today there is a growing recognition of the threat from Aedes-borne diseases including yellow fever, dengue, Zika and chikungunya. Since over 80% of malaria transmission in SSA occurs indoors, and Aedes-borne diseases are transmitted in and around the house by vectors that lay their eggs in water bodies indoors and outdoors, the focus of the Network will be on developing ways of screening houses from mosquitoes and building environments inimical to vectors. To achieve this we will bring together two disparate communities: experts on vector-borne diseases and the built environment. Our Management Board is unique in having a broad range of experts from both disciplines, and from SSA and developed countries. This Board will oversee a range of activities namely: (1) information exchange, (2) pump-priming research in the control of vector-borne diseases and the built environment, (3) capacity building in this area and (4) advocacy to reach out and expand the network in order to build a new scientific discipline and ensure its sustainability. There has never been a better time to develop this Network since it is essential to support the World Health Organisation's (WHO) new global strategy on vector control that has building inter-sectoral collaboration between the health sector and other sectors as one of its four central action pillars. In this strategy the need for strengthening collaboration between these sectors is key. Thus, if funded, the Network would be at the forefront of WHO's Global Vector Control Response and will help protect the health of millions.

Planned Impact

There are many potential beneficiaries of the BOVA Network including the citizens of sub-Saharan Africa, politicians, NGOs, UN organisations, researchers and manufacturers within and outside sub-Saharan Africa. Our work will focus on reducing malaria, principally a disease of rural areas, and Aedes-borne diseases (yellow fever, dengue, Zika and chikungunya), principally focused in urban areas, in sub-Saharan Africa. Collectively these diseases affect the health of millions and restrain economic development. The BOVA Network will provide a number of deliverables that will contribute to a reduction in malaria and Aedes-borne diseases through improvements in the built environment including:

1. Multi-sectoral action in vector-borne diseases. Multisectoral action is considered a central pillar of effective and sustainable global vector control but there have been few success stories due to the challenges of working across silos. The rich and diverse membership of BOVA's Management Board provides an opportunity to integrate both the vector-borne disease and built environment research communities acting as a flagship for multisectoral action in the field of vector-borne disease control. Thus the Network has the potential to influence international decision making at the highest level.

2. Information exchange. In order to develop a new discipline of vector-borne diseases and the built environment we will expand the network by reaching out to potential stake holders using: (a) a BOVA Network website describing the work being undertaken and providing a platform by which new members can join, (b) an annual meeting where stake holders can share information about their research and develop new ideas, (c) by members of the Network presenting talks at international conferences and to local-decision makers, (d) at annual meetings of the Roll Back Malaria work stream on vector-borne diseases and the built environment and (e) the publication of scientific articles in high impact peer-reviewed journals.

3. Evidence-based decision making. The World Health Organisation will only make policy recommendations for new tools and approaches provided there is sufficient supporting evidence. We will use the BOVA Network to strengthen the case for recommending house screening as an intervention against malaria by submitting a portfolio of evidence to the Vector Control Advisory Group of WHO, who will review this information. If successful, Member States would encourage screening against malaria, which would reduce malaria transmission. In addition, research findings that result from pump priming funds dispersed to grantees will add further evidence to support the uptake of building interventions as protection against vector-borne diseases.

4. Development of new products and approaches.
The Management Board has numerous members with expertise in improving health in developing countries through innovative product design, novel architectural designs, and changes in the built environment. These individuals will help facilitate the development of research proposals submitted for funding and will be allowed to submit their own research proposals for funding.

5. Sustainability
The 3-year project period is relatively short for establishing a fully functional pathway of new vector control interventions focused on the built environment, so it is important to seek further funding during the project period in order to maintain momentum. It is for this reason that we have allocated funding for members of the Network to hold small workshops to develop ideas for further funding. We will also provide funds for the collection of baseline data that will help individuals develop strong proposals.

We view the BOVA Network as the catalyst for launching a new discipline for reducing the impact of vector-borne diseases by changes to the built environment. The potential for impact is huge.
 
Description We have described how changes to the design of rural houses in sub-Saharan Africa influences mosquito entry by malaria vectors.
Exploitation Route These results may change the way people build houses in sub-Saharan Africa.
Sectors Construction

 
Description Co-Chair of the 2nd Meeting of the Multi-sectoral Working Group, RBM, Geneva, Switzerland, 4-5th February 2019.
Geographic Reach Multiple continents/international 
Policy Influence Type Membership of a guideline committee
 
Description Co-Chair of the 6th Vector-borne diseases and the built environment work stream for Roll Back Malaria's Vector Control Working Group. Geneva, Switzerland, 30th January-1st February, 2019.
Geographic Reach Multiple continents/international 
Policy Influence Type Membership of a guideline committee
 
Description Expert Review Group on proposed methods for determination of non-inferiority of ITN and IRS products.
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in a advisory committee
 
Description Invited member. 1st Roll Back Malaria Multi Sectoral Working Group Meeting.
Geographic Reach Multiple continents/international 
Policy Influence Type Membership of a guideline committee
 
Description Presentation to Fifth meeting of the WHO technical expert group on malaria vector control (VCTEG) on housing as an intervention against malaria (15 Nov 17)
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in a advisory committee
 
Description Healthy housing and reducing infectious disease 
Organisation Royal Danish Academy of Fine Arts
Country Denmark 
Sector Academic/University 
PI Contribution Expert advice on the behaviour of malaria mosquitoes in and around houses. Experimental design.
Collaborator Contribution Royal Danish Academy of Fine Arts, School of Architecture, Design and Conservation - advice on architectural design and building materials in relation to health homes. Mahidol Oxford Tropical Medicine Research Unit - medical advice, advice on public health interventions
Impact This is at a preliminary stage, we are looking for funders. It is multidisciplinary involving architects, medical entomologists, clinicians and epidemiologists.
 
Description Trial steering committee of study measuring impact of improved housing and larval source management 
Organisation University of Amsterdam
Country Netherlands 
Sector Academic/University 
PI Contribution Prof Lindsay has been asked to sit on the trial steering committee of a project to measure the impact of improved housing and larval source management on malaria transmission
Collaborator Contribution The study is being run by the University of Amsterdam
Impact There are no outputs or outcomes yet as the study is still in progress.
Start Year 2017
 
Description Architecture exhibition of screened doors 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This was an exhibition showing the development of screened doors for keeping mosquitoes out whilst keeping the house cool.
Year(s) Of Engagement Activity 2018
 
Description BOVA Network Twitter presence 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact BOVA Network Twitter presence @bovanetwork
Year(s) Of Engagement Activity 2017,2018
 
Description BOVA Network website 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact BOVA Network website
Year(s) Of Engagement Activity 2017,2018
URL http://www.bovanetwork.org
 
Description BOVA Newsletter sent quarterly to network members 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact BOVA Newsletter sent quarterly to network members including information on BOVA activities and news from the field - the distribution list is expanded as the network membership grows
Year(s) Of Engagement Activity 2017,2018
 
Description Co-Chair of the 2nd Meeting of the Multi-sectoral Working Group, RBM, Geneva, Switzerland, 4-5th February 2019. 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Co-Chair of the 2nd Meeting of the Multi-sectoral Working Group, RBM, Geneva, Switzerland, 4-5th February 2019. This is a relatively new working group. Task was to agree a consensus statement and priorities for establishing multi-sectoral collaboration.
Year(s) Of Engagement Activity 2019
 
Description Co-Chair of the 6th Vector-borne diseases and the built environment work stream for Roll Back Malaria's Vector Control Working Group. Geneva, Switzerland, 30th January-1st February, 2019. 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Co-Chair of the 6th Vector-borne diseases and the built environment work stream for Roll Back Malaria's Vector Control Working Group (VCWG). Geneva, Switzerland, 30th January-1st February, 2019.
Drew up a plan of work for the VCWG for the coming year.
Year(s) Of Engagement Activity 2019
 
Description Distribution of information on BOVA Network at 14th International Conference on Urban Health, Coimbra, Portugal (26-29 Sept 2017) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Colleagues from co-partner in this grant University College London distributed 100+ flyers on the BOVA Network and pump priming call to attendees of the 14th International Conference on Urban Health, Coimbra, Portugal held 26-29 Sept 2017
Year(s) Of Engagement Activity 2017
 
Description Invited speaker and panellist 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited speaker & panellist. The Global Vector Control Response and inter-sectoral action, NTDs and the built environment. Royal Society of Tropical Medicine and Hygiene Annual Meeting on Neglected tropical diseases and their most challenging intersections. Royal College of Physicians, London, 19-20th September, 2018.
Year(s) Of Engagement Activity 2018
 
Description Invited speaker at the Royal Danish Academy of Fine Arts, School of Architecture, Design and Conservation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited speaker. Building out vector-borne diseases. Africa: Rethinking Architecture and Design. KADK Copenhagen, Denmark, 8th March, 2018. Challenged postgraduate students and professional practitioners to think how they might design houses which protect people in Africa from vector-borne diseases such as malaria.
Year(s) Of Engagement Activity 2018
 
Description Invited speaker university seminar 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Undergraduate students
Results and Impact Invited speaker. Is housing protective against malaria in sub-Saharan Africa? Department of Biosciences, Durham University, Durham, 13th November, 2018.
Year(s) Of Engagement Activity 2018
 
Description Invited speaker university seminar 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Undergraduate students
Results and Impact Invited speaker. Is housing protective against malaria in sub-Saharan Africa? Department of Life Sciences, University of Warwick, Warwick, 12th October, 2018.
Year(s) Of Engagement Activity 2018
 
Description Invited speaker, university seminar 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Invited speaker. Is housing protective against malaria in sub-Saharan Africa? Malaria Centre, London School of Hygiene & Tropical Medicine, London, 15th January, 2019.
Year(s) Of Engagement Activity 2019
 
Description Membership of international policy group 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Co-Chair of the 6th Vector-Borne Disease and the Built Environment work stream for Roll Back Malaria. Geneva, Switzerland, 30th January- 1st February, 2019.
Year(s) Of Engagement Activity 2019
URL https://endmalaria.org/our-work-working-groups/vector-control
 
Description Membership of international policy group 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Co-Chair of the 5th Housing and malaria work stream for Roll Back Malaria. Geneva, Switzerland, 7th-9th February, 2018.
Year(s) Of Engagement Activity 2018
URL https://rollbackmalaria.com/wp-content/uploads/2017/08/Steve-Lindsay_Lucy-Tusting_Housing-work-strea...
 
Description Membership of international policy group 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Co-Chair of the 5th Housing and malaria work stream for Roll Back Malaria. Geneva, Switzerland, 7th-9th February, 2018.
Year(s) Of Engagement Activity 2018
 
Description Mention of BOVA Network and funding call in Roll Back Malaria Vector Control Working Group Newsletter (04 Oct 2017) 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Mention of BOVA Network and funding call in Roll Back Malaria Vector Control Working Group Newsletter
Year(s) Of Engagement Activity 2017
 
Description Mention of BOVA Network and funding call in the American Committee for Medical Entomology Newsletter (Oct 2017) 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Mention of BOVA Network and funding call in the American Committee for Medical Entomology Newsletter
Year(s) Of Engagement Activity 2017
 
Description Mention of BOVA Network funding call in Malariaworld newsletter and on website (09 Sept 2017) 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Mention of BOVA Network funding call in Malariaworld newsletter and on website
Year(s) Of Engagement Activity 2017
 
Description Mention of the BOVA Network and funding call in the newsletter of the American Society of Tropical Medicine and Hygiene (17 Oct 2017) 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Mention of the BOVA Network and funding call in the newsletter of the American Society of Tropical Medicine and Hygiene
Year(s) Of Engagement Activity 2017
 
Description Organizer, Chair & Speaker at an international conference 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Organizer, Chair & conferences speaker at the Building Out Vector Borne Diseases symposium at the 7th Multilateral Initiative on Malaria (MIM) Panafrican Conference, Dakar, Senegal, 20th April, 2018. Advocacy for driving improvements in the built environment which can contribute to reducing malaria.
Year(s) Of Engagement Activity 2018
 
Description Planning meeting 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Planning meeting. Healthy housing and reducing infectious diseases, the Royal Danish Academy of Fine Arts, School of Architecture, Design and Conservation, The School of Architecture Copenhagen, Denmark, 27th January, 2018.
Year(s) Of Engagement Activity 2018
 
Description Presentation 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited speaker. Urbanization and slums: new transmission pathways of infectious diseases in the built environment, The National Academies of Sciences, Engineering and Medicine, Washington, USA, 13th December, 2017.
Year(s) Of Engagement Activity 2017
 
Description Presentation at 10th European Congress on Tropical Medicine and International Health. Antwerp, Belgium (16-19 Oct 2017) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Prof. Lindsay gave a plenary talk on new vector control tools mentioning the role of housing and the BOVA Network. Prof Lindsay also distrbuted flyers about the BOVA Network and our pump-priming funding call.
Year(s) Of Engagement Activity 2017
 
Description Prof Lindsay gave talk at 70th Anniversary of the MRC Unit The Gambia, Fajara, The Gambia (28 Nov 17) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Prof Lindsay gave talk at 70th Anniversary of the MRC Unit The Gambia, Fajara, The Gambia (28 Nov 17) on under-pinning work to support studies on malaria transmission in The Gambia including mention of the RooPfs trial and BOVA Network.
Year(s) Of Engagement Activity 2017
 
Description Prof Lindsay gave talk at American Society for Tropical Medicine and Hygiene Annual Meeting, Baltimore, USA (5-9 Nov 17) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Prof. Lindsay was speaker in a symposium on the World Health Organisation Global Vector Control Response. The role of housing against vector borne diseases and the BOVA network were mentioned briefly in this talk.
Year(s) Of Engagement Activity 2017
 
Description Prof Lindsay invited speaker at Royal Victoria Infirmary, Newcastle University, Newcastle, UK (1st November, 2017) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Prof Lindsay was invited to the RVI to give a talk on the BOVA Network
Year(s) Of Engagement Activity 2017
 
Description Prof Lindsay invited speaker at Urbanization and slums: new transmission pathways of infectious diseases in the built environment, The National Academies of Sciences, Engineering and Medicine, Washington, USA (13 Dec 17) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Prof Lindsay gave a remote talk on 'vector-borne diseases and the built environment' to attendees of the meeting: Urbanization and slums: new transmission pathways of infectious diseases in the built environment, The National Academies of Sciences, Engineering and Medicine, Washington, USA
Year(s) Of Engagement Activity 2017
 
Description Talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited speaker. Under-pinning work to support studies on malaria transmission in The Gambia. 70th Anniversary of the MRC Unit The Gambia, Fajara, The Gambia, 28th November, 2017.
Year(s) Of Engagement Activity 2017
 
Description Workshop organiser. Building out vector-borne diseases in Africa. American Society of Tropical Medicine & Hygiene 67th Meeting, New Orleans, USA, 29th October, 2018. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This workshop was intended to publicise the work of the BOVA Network and to encourage people to become network members. Gained some new members, not sure of exact numbers as not all will have joined up straightaway afterwards. There was a great deal of interest and positive feedback.
Year(s) Of Engagement Activity 2018