Next-generation vector control tools in the era of widespread insecticide resistance: Opportunities and limitations (review)

In this study we believe that throughout the decades vector-borne diseases (e.g. malaria, dengue, chikungunya and leishmaniasis) remain important public health problems especially in tropical and subtropical areas . Chemical insecticides have served as a traditional foundation for vector control programmes with significant effect in reducing disease burden. Despite these advancements, the rapid development and dissemination of insecticide resistance in major vectors have diminished the effectiveness of traditional vector control methods such as indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs). This scenario has triggered the advances in next-generation vector control tools that are designed to either mitigate insecticide resistance, increase durability of insecticidal effects and allow for more sustainable management of vector populations. This review combines up-to-date evidence on new chemical, biological, genetic, environmental, and digital vector control strategies and their relative effectiveness in resistance-prone environments. We summarize progress in several areas, including dual-active-ingredient nets, novel insecticide formulations, gene-drive and sterile-insect technologies, Wolbachia-based strategies and environmental management interventions prioritised with greater coordination enabled by expanded research into surveillance or modelling. We assess the available data strength, operational feasibility, economic considerations and ethical & regulatory constraints for each category. We also argue how these tools can be best integrated in a complete, multi-sectoral vector management context to delay resistance emergence and prolong effectiveness over time. Lastly, we delineate important knowledge gaps and research priorities in order to support evidence-based policy and programmatic decision-making. This review aims to improve rational deployment strategies for next-generation tools by providing a clarifying overview of the opportunities as well as the limitations of them, in an era characterised by widespread insecticide resistance.