Vestergaard’s R&D team is dedicated to developing new textile solutions
Vestergaard is a family-owned global health company dedicated to improving the health of vulnerable groups, especially those in low- and middle-income countries. Known for its PermaNet long-lasting insecticidal nets (LLINs) to prevent malaria, the company has manufactured more than 800 million PermaNet bed nets, protecting an estimated 1.6 billion lives in malaria-endemic countries. In an interview with Fibre2Fashion, Head of R&D Tie Lan talks about medical and disease control textiles, especially bed nets and hermetic storage bags.
How have advancements in medical and disease control textiles impacted the global efforts to prevent and control the spread of infectious diseases in recent years?
Textiles for infection control have had impacts on a list of diseases. At Vestergaard, we believe in the important role textiles serve in solving some of the most significant global health issues. The long-lasting insecticidal bed net (LLIN) has played a pivotal role in reducing incidents of malaria, and this year we are within reach of producing and distributing our one billionth PermaNet LLIN – a significant milestone that we have achieved thanks to the continuous and collective commitment of our funders, partners and colleagues worldwide.
Our blue Tiny Target tool has contributed to the near elimination of sleeping sickness cases, and LifeStraw, a portable membrane microfilter for drinking water, has had a significant impact on the eradication of guinea worm as well as diarrhoea prevention.
The long-lasting insecticidal net (LLIN) is a core, highly cost-effective prevention tool in the fight against malaria. This vector-borne infectious disease impacts hundreds of millions of lives worldwide.
Since 2004, almost 2.5 billion LLINs have been delivered to malaria-endemic countries around the world, of which 2.2 billion (87 per cent) were supplied to sub-Saharan Africa (World Malaria Report 2022). From 2000 through 2020, the percentage of the at-risk population sleeping under an LLIN increased from 2 per cent to 43 per cent, as per the World Health Organization. This rapid scale-up of bed net distribution is credited as one of the largest contributors to the impressive drops seen in malaria incidence since the turn of the century, estimated to have averted 68 per cent of malaria cases between 2000 and 2015, as per an article published in Nature Journal.
Vestergaard’s knowledge of textiles, together with its technical expertise in disease control and prevention, has been applied to control the tsetse fly and has contributed significantly towards eradication efforts of sleeping sickness (Human African Trypanosomiasis) which threatens over 56 million people in high-risk areas. Tiny Targets are small blue and black cloth targets that are treated with insecticide (Deltamethrin) and attract and kill tsetse flies when they land on the cloth. They have been shown to reduce tsetse fly densities by more than 80 per cent in Chad, Ivory Coast, the Democratic Republic of the Congo (DRC) and Uganda.
What are some of the key properties that medical and disease control textiles should possess in order to effectively combat pathogens and protect both individuals and communities?
Medical and disease control textiles require specific properties to combat pathogens and protect both individuals and communities effectively. Some of these attributes include stability, non-toxicity, comfort, and breathability.
In malaria-endemic regions such as tropical and subtropical areas, LLINs provide a crucial first line of defence against malaria by providing a physical barrier between the malaria-carrying Anopheles mosquitoes and people, enhanced by the chemical barrier the insecticide provides. This safeguards individuals from a potentially infectious mosquito bite as well as curbing overall malaria transmission within communities by reducing the number of mosquitoes. Most importantly, the products should be safe, comfortable to sleep under, and easy to use and care for during their lifecycle to ensure maximum uptake and continued usage in the communities where they are distributed.
In addition, the products should be affordable to ensure accessibility to as many end users as possible, including in low- to middle-income communities in malaria-endemic countries, with the support of international donor funding.
The key properties required of a long-lasting insecticidal net to protect against malaria include the following:
(1) A net with physical properties that are appropriate and comfortable for users, including adults, children, and infants, to sleep under and can withstand daily wear and tear in the household.
(2) The insecticide that is treated on the net is designed to offer mosquito-killing protection for up to three years, and
(3) The insecticide and formulation on the net must be safe and offer long-lasting protection to an estimated product lifetime of three years. Even as holes may develop, as the mosquito makes contact with the net as it looks for a human host to bite, it will continue to pick up a lethal dose of insecticide.
Can you discuss any novel materials or technologies that are currently being researched or developed for use in medical and disease control textiles and how they could potentially revolutionise the field?
There are several novel materials and technologies that are currently being researched or developed for use in medical and disease control textiles. Vestergaard R&D and manufacturing teams have been innovating with yarns from recycled polyester resin to develop more sustainable, long-lasting nets. We are also evaluating novel textile treatment technologies which use less water and reduce chemical waste to lower the environmental footprint of our manufacturing and to ensure we are not contributing to plastic and/or chemical pollution.
Our R&D team is developing formulations with non-pyrethroid insecticides to tackle the challenge of insecticide resistance. We are also working on a special polymer yarn design with unique control release profiles for the active ingredients to enhance the efficacy of our LLIN portfolio. We are also exploring work with nano-coating technologies to offer additional benefits like stain-resistant fabrics to net users.
Can you provide an overview of Vestergaard’s mission and how your disease control textiles contribute to achieving that mission?
For more than two decades, Vestergaard has dedicated its innovative platform to developing, producing, and creating scalable solutions to eradicate disease and decrease malnutrition among the world’s at risk-populations. This mission is fuelled by our humanitarian entrepreneurship to create a healthier planet.
LLINs are a core component of our portfolio of human-focused solutions to these global public health challenges. Our PermaNet products are designed to be lethal to disease vectors like mosquitoes but safe for humans to sleep in and for routine handling. By ensuring reliable access to bed nets through our supply chain and distribution networks, we have been able to leverage our capabilities as a private sector organisation to develop and distribute these life-saving solutions to fight malaria to almost every malaria-endemic country in the world – extending to some of the most remote and difficult to reach regions.
Global hunger affects nearly a billion people, and approximately one-third of food produced for human consumption is either lost or wasted.
Hunger and malnutrition are the biggest risks to health worldwide — greater than AIDS, malaria and tuberculosis combined. Addressing the post-harvest loss issue is critical to achieving global food security and global development.
The ZeroFly Hermetic is a strong and cost-efficient single-layer hermetic storage bag that ensures full protection of stored dry agricultural commodities against insect infestation, mould growth, oxidation, and rancidity. It is time to prioritise achieving zero hunger by elevating future leaders of African agriculture.
In addition, in the countries where we distribute our products, more than 70 per cent of the population subsist as smallholder farmers, living around or below the poverty line. The UN’s SDG 2, which aims to “end hunger, achieve food security, improve nutrition and promote sustainable agriculture”, calls for an increase in productivity for smallholder farmers.
We developed a series of technologies to ensure smallholders have improved access to sustainable livelihoods, entrepreneurial opportunities, and productive resources. We believe our tools will empower people living in poverty and help to address the disproportionate impact of poverty on women.
Through the GroЯ model, the smallholder farmer can achieve a higher income, increased output, improved food security and complete value chain transparency. Combining post-harvest technology with a digital farm management and trading platform, GroЯ can maintain the quality and quantity of grains, seeds and pulses, track and trace their harvest, and gain the best price available.
By involving smallholder farmers in the whole value chain, we can enable them to increase their productivity and grow their net income.
How do your disease control textiles, such as PermaNet and ZeroFly, differ from other products on the market in terms of efficacy and longevity?
PermaNet sets industry standards for efficacy, safety, and quality. For example, PermaNet 2.0 is the most widely used and tested net in the world and is still the most popular net of choice in areas where misquotes remain susceptible to pyrethroids. PermaNet 3.0, developed in 2009, address the increase in pyrethroid resistance by adding the synergist piperonyl butoxide (PBO) to the formation. The introduction of PBO disrupts the metabolic resistance mechanism that resistant misquotes use to break down or detoxify insecticides. PermaNet 3.0 is a bed net like no other. It provides long-term increased efficacy and protection against pyrethroid resistance misquotes. The blue roof features a unique controlled-release design, impregnated with the highest concentration of PBO (higher than other PBO LLINs). It ensures that the right ratio of ingredients continue to migrate to the fabric surface throughout the net’s lifetime.
In March 2023, the WHO confirmed that our latest innovation, PermaNet Dual, a pyrethroid-chlorfenapyr long-lasting insecticidal net as pre-qualified. Dual active ingredient nets offer an important step to counter the threat of malaria in regions with insecticide-resistant mosquitoes. Dual is a long-lasting insecticidal net that provides the highest protection against pyrethroid-resistant mosquitoes.
Today, we have the most comprehensive range of mosquito nets on the market, each one developed over time, backed by years of research, and designed with the end user in mind. The expansion of the PermaNet portfolio reflects our commitment to increasing access to safe and effective prevention tools for malaria control and elimination.
ZeroFly Storage Bag is a deltamethrin-incorporated woven polypropylene bag developed for post-harvest storage of commodities, including cereal grains, pulses, oilseeds, and seeds. The active ingredient is incorporated into the individual yarns and slowly released onto the surface of the material in a controlled and sustained manner. The commodities stored in the bags are continuously protected against insect infestation for the lifetime of the product. Based on the Global Environment Monitoring System (GEMS) calculation, the Deltamethrin residues in commodities stored in ZeroFly Storage Bags are 60 per cent below acceptable daily intake (ADI).
How do you ensure that Vestergaard’s disease control textiles are safe for both human use and the environment, given concerns about the potential impact of insecticides?
Vestergaard only uses the active ingredients which are registered in WHO Prequalification programme to ensure our products are safe for human use and the environment.
PermaNet LLINs also pass full generic risk assessment model developed by WHO for vector control products, including risk scenarios such as general skin contact, possible infant mouth contact, mother’s milk to infants, and safety to the skin during handling and washing.
ZeroFly Storage Bags have undergone multi-country studies that have shown that when the commodities are stored in ZeroFly Storage Bags during the intended use period, the residues found within the grains are below the strictest maximum residue limits (MRLs) available worldwide, including: Indian Standards (0.05 mg/kg of rice, 0.5 mg/kg of grain), Codex Alimentarius (2 mg/ kg of grain), US EPA and EU country standards (2 mg/kg of grain). The product protects the commodity from damage whilst MRLs remain under the thresholds even when tested under some of the most challenging conditions the product is likely to be exposed to, such as high temperature, pressure, and moisture.
How does Vestergaard incorporate new research and technological advancements in the field of disease control textiles to improve the effectiveness of your products?
One of the main challenges to malaria control is staying ahead of mosquito evolution and growing insecticide resistance. Vestergaard’s R&D team is dedicated to developing new textile solutions to meet the needs of individuals, communities and nations facing public health challenges. The R&D activities include identifying new active ingredients and novel insecticide processes, including control releases. R&D advancements will also contribute to developing test methods suited for insecticidal modes of action and more direct measurement of insecticide on the textile surfaces, which contribute to killing mosquitoes.
In the face of growing insecticide resistance among mosquito populations, what is the strategy to maintain the effectiveness of your disease control textiles?
LLINs with two active ingredients are an effective solution for overcoming mosquito resistance. Nets with dual active ingredients kill mosquitoes more effectively by combining two different modes of action. For instance, PermaNet Dual offers the combination of an insecticide with a nerve target, such as pyrethroids, with the insecticide chlorfenapyr that disrupts energy production. With the likelihood of mosquitoes being resistant to both ingredients greatly reduced, dual ingredient nets offer an effective control of mosquito populations.
Vestergaard is also developing alternative dual active ingredient nets for possible rotating use with existing dual active ingredients. The rotation approach will reduce the environmental pressure of the insecticides, limiting the mosquito population’s exposure to a particular insecticide, and therefore slowing down the pace at which mosquitoes develop resistance.
How do you address the challenges of distributing and promoting the use of disease control textiles in remote or resource-limited areas?
We have a proven track record of on-time delivery, providing risk-free, reliable solutions for national malaria campaigns and maximising long-term impact against malaria. Thanks to our state-of-the-art manufacturing sites and quality control systems, we can produce PermaNet LLINs at scale, and in time at highest quality standards. Our dedicated customer service ensures worry-free delivery of bed nets, even when demand is high and in times of supply chain disruption.
Digital technologies are increasingly being used to improve the efficiency and effectiveness of mosquito net distribution programmes. In addition, Vestergaard is developing tools to promote the use of vector control products via mobile phone-based technology and exploring digitally tracking the use of LLIN to help monitor their use in real time.
Distributing the LLINs to remote areas is the role of our partners at international organisations such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and UNICEF. Each year, they distribute millions of mosquito nets to help prevent the spread of malaria. The distribution of mosquito nets is typically done through large-scale mass distribution campaigns and continuous distributions as well as through antenatal care services and through schools.
The Global Fund has distributed over 2 billion insecticide-treated mosquito nets (ITNs) worldwide since 2004 and in 2020, UNICEF distributed over 25 million long-lasting insecticidal nets (LLINs) in South Sudan alone.
What future innovations or developments can we expect to see from Vestergaard in the realm of disease control textiles to further combat the spread of vector-borne diseases?
We are urgently responding to the threat of widespread insecticide resistance and are developing effective next generation of PermaNet tools to overcome this issue. We are also committed to reducing the environmental impact of our products and processes with the use of re-purposed resin/textiles, and more efficient processing techniques that reduce water and energy usage, as well as reducing the level of insecticides without compromising the impact of our tools against vector populations.
