Vector control for malaria: current tools and emerging challenges

Malaria continues to be among the most devastating infectious diseases globally, leading to hundreds of millions of infections each year and placing an especially heavy burden on communities in sub-Saharan Africa. Vector control was a key driver of the decline in cases and deaths between 2000 and 2015. However, progress has stalled in many endemic settings.

This review aims to provide an overview of the currently recommended malaria vector control tools in endemic countries and to examine the principal challenges associated with sustaining effective malaria control.

The most recent WHO malaria guidelines, accessed via the MAGICapp platform on 7 January 2025, served as the primary reference for current recommendations. In addition, a targeted search of peer-reviewed literature was conducted.

Malaria vector control relies primarily on insecticide-treated nets (ITNs) and indoor residual spraying (IRS). Their effectiveness depends largely on vector behaviours such as indoor biting and indoor resting. However, insecticide resistance, behavioural adaptation of mosquitoes, shifts in vector species composition, and the spread of the invasive species Anopheles stephensi pose significant challenges. Moreover, global trends such as population growth, climate change, urbanisation, and environmental change are altering malaria transmission dynamics. Although complementary tools targeting other stages of the mosquito life cycle are available, optimising coverage, durability, quality, and equitable access to ITNs and IRS remains paramount. Operational constraints, including supply chain weaknesses, funding gaps, inadequate surveillance, and limited community engagement, can undermine impact.

Malaria programmes must adapt to an evolving transmission landscape through enhanced surveillance, innovation, and data-driven strategies. Sustained investment is critical not only to address existing funding gaps but also to enable the adaptation of current strategies, drive innovation, and support the deployment of interventions in response to changing epidemiological and operational contexts.