1. A serious game to aid training in Insecticide Resistance Management for malaria vector control programs in Africa Andy South @southmapr etchteam.wordpress.com

2. Talk structure 1.Why focus on Insecticide Resistance Management ? 2.Why gaming ? 3.Aim of the game 4.Game overview 5.Game development 6.How the game-model works 7.Where we are and where we are going

3. Mosquito control is central to malaria control 2 main interventions save hundreds of thousands of lives bed nets indoor spraying Both rely on just 4 classes of insecticide pyrethroids organochlorine (ddt) organophosphates carbamates All recommended bednets are treated with pyrethroids Public health consequences of failure of pyrethroids would be ‘devastating’ 1. Why IRM? GPIRM, 2012

4. Pyrethroid resistance in malaria mosquitoes resistant populations Hemingway et al., 2016. Averting a malaria disaster: will insecticide resistance derail malaria control? Lancet.Lancet. 2016 Feb 12. pii: S0140-6736(15)00417-1. doi: 10.1016/S0140-6736(15)00417- 1

5. Key Interventions Indoor insecticide residual spraying (IRS) Insecticide treated bednets

6. Determine resistance status CDC method WHO method Collecting mosquitos Insectary Entomological Monitoring

7. Interactive Simulate real world scenarios Able to advance time Understand implications Identify misconceptions Determine knowledge gaps Identify areas where traditional learning fails It’s fun 2. Why Gaming?

8. Learning Tool (promote good practice, quality data, data generation, data use, advantage of informed decisions) NOT a Decision Support Tool 3. Aim of the game For vector control staff in Africa in facilitated sessions Part of a bigger Insecticide Resistance Management learning and communication strategy

9. Learning objectives, 27, an edited selection Player to understand : different areas in a country can have different vector species benefit of using PCR ID over morphological benefit of monitoring abundance use of abundance data to time intervention different collection methods provide different information to avoid insecticides vectors are resistant to benefit of rotating insecticides available funding can limit insecticide choice

10. 4. Game overview

14. 5. Game development

16. Mosquito populations and resistance should respond in ‘realistic’ ways to support learning objectives. ResistanceSim game model simple ~ 20 lines of code quick handful of parameters can be changed to generate scenarios

17. No intervention : mosquitoes increase, resistance stays low Mosquito abundance Susceptibility 6. How the game-model works Prototype developed in

18. Effective intervention : mosquitoes decline, resistance stays low Interventions Mosquito abundance Susceptibility

19. Resistance increasing, intervention becomes ineffective. Interventions Mosquito abundance Susceptibility

22. Configuration files in google docs. Allows us to modify game behaviour without developer input.

23. Config files can be accessed independently allowing scenario testing

24. 1. Explore serious gaming to aid learning 3. Expand develop a comprehensive Insecticide Resistance Management game following stakeholder consultation 2. Determine if gaming engages staff in vector control programmes 7. Where we are and where we are going 4. Test 5. Deliver 6. Track first locally then with target audience in Africa to vector control programmes & other stakeholders and evaluate the value and impact of the game 7. Review apply learning in this and other games

25. What have been the main challenges ? Keeping it simple Playability Connectedness Time and budget limit testing

26. What might we do differently with hindsight ? Modules addressing small groups of learning objectives rather than one big simulation Focus on fewer learning objectives … after testing we’ll know more

27. Opportunities Feedback Funding to support Rollout Support for players Updates Tools for analysis of game play Repurposing the game platform for other public health challenges Collaboration Training / field programs Researchers Policy makers