Integrated vector management (IVM)- An Introduction

Integrated Vector Management is a systematic process of making decisions aimed at efficiently utilizing available resources for proper control of vectors. It adheres to the management approach of making vector control more effective, economically sound, ecologically sustainable, and impacting, using the available tools and resources. This is an integrated system that is key in the controlling vector-borne diseases.

Advocacy, social mobilization, strengthening regulatory and legislative frameworks for public health, community empowerment, and collaboration between the health sector and other relevant sectors in planning and decision-making are among the key elements of IVM. The initiative also emphasizes efficient use of resources allocated to vector control, evidence-based strategies, and capacity-building.

Although various components of IVM have been implemented either in isolation or in combination across different settings, there is a felt requirement for an overall document that spells out the IVM concept, its elements, and disease-specific strategies. The NVBDCP aims at effective vector control by applying evidence-based biological, chemical, and environmental interventions separately or in combination as needed and as effectively using resources by the area concerned.

Cooperation with public and private agencies is attempted to be made for stimulating community involvement in vector control activities. Similar control measures are adopted to control vector-borne diseases like malaria, kala-azar, Japanese encephalitis, dengue, chikungunya, and lymphatic filariasis. The strategy encompasses all possible means-with or without the use of insecticides-to handle vector populations and prevent transmission of disease. It also involves inbuilt mechanisms for insecticide resistance monitoring and management.

The control and protective measures would be mainly through IRS, which targets adult mosquitoes, source reduction, chemical and biological agents to treat breeding sites, and personal protection using ITNs/LLINs.

At the central level, the Directorate of the National Vector Borne Diseasese Control Programme plays a key role in formulating policies and strategic plans for the states and the Union Territories to implement. The infrastructure for these interventions is provided by the states/Union Territories, with financial resources shared between central and state governments in accordance with established policy.

The existing disease-specific vector control programs and surveillance services must emphasize integration within the decentralized health system. This approach requires the development of new skills and capacities for effective analysis and decision-making. While the presence of medical entomologists in each district is critical, it is often not the reality. In such cases, health or public health staff at district, PHC (Primary Health Centre), sub-centre, and village levels should be trained in the technical, operational, and managerial aspects of IVM to enhance their capabilities and reduce reliance on centralized expertise.

There should also be a strong connection between vector control and vector surveillance activities under IVM, both at central and local levels. This integration brings health services closer to the community, increases the motivation of health staff, and makes vector control more sustainable, as local decision-makers become more accountable for the outcomes.

The strategy of IVM gives special attention to involving the health sector in the broad thrust plus other relevant sectors and civil society with well defined roles and responsibilities for all participants. The health impact assessment of the current as well as new projects will be conducted so that the potential risks from vector-borne diseases are clearly identified and addressed appropriately. All departments engaged in construction activities must be sensitized to adopt appropriate strategies or technologies that prevent breeding of vectors.

At the state and district levels, the partnerships involve active participation, capacity building and advocacy. However, this does not exempt vector control units from the general responsibility of vector control. The unit is still required to acquire skills needed to enable them to facilitate partnerships and guide activities. On the other hand, other stakeholders including civil society organizations and communities among others are called upon to play fundamental roles in the vector control activities.

The IVM strategy will be provided with technical support by central and state governments. It is tools or technologies and their inclusion or exclusion, which would be taken forward based on research and documented evidence. Operational research done for programs could support modifications in the guidelines and also in resource management. Thus, operational research will be an essential support from Indian Council of Medical Research and NCDC. The Technical Advisory Committee (TAC) considers expert group deliberations before any final decision is made on implementing a strategy or new tool within the program.