SUGGESTIONS ON HOW TO SLOW THE RESISTANCE TREADMILL
Repeated application of insecticides and drugs to fight malaria on a large scale has historically caused the development of resistance. Thus during the Global Malaria Eradication Program of the 1960’s, Sudan, Turkey, Pakistan programs of Indoor Residual Spraying cycled through as many as 8 insecticides before the programs collapsed. The drug chloroquine was used globally until resistance emerged in SE Asia, and then gradually spread westward to India and Africa. The Resistance Treadmill then caused the Eradication Progam to collapse in 1969. The Resistance Treadmill is a universal problem for public health programs which achieve widespread and intensive use of biocides and drugs.
The way to slow the Resistance Treadmill is to minimize the use of biocides and drugs by adding non-chemical control methods to the strategy. Thus the use of microbial larvicides and screening of houses, besides being very cost-effective, have the added advantage of reducing the need for such heavy application of biocides, and the repeated and global administration of precious drugs. Thus the alarming rise of resistance to drugs and biocides will at least be slowed.
Screening of houses might seem an expensive approach, but its cost should be compared with the cost of repeated spraying of insecticides. In 2009 USD this cost is about $6 per person per year. In a household of 6 people, after 10 years the amount spent on spraying is about $360 per house, enough for a good set of screens. Furthermore, the cost-effectiveness can be enhanced by starting with the houses in best condition, where it is easy and inexpensive to mount good screens on the windows.