IVM is defined as a rational decision-making process to optimize the use of resources for vector control (10). It is based on evidence and integrated management, promoting the use of a range of interventions – alone or in combination – selected on the basis of local knowledge about the vectors, diseases and disease determinants. The IVM approach addresses several diseases concurrently, because some vectors can transmit several diseases and some interventions are effective against several vectors. IVM will reduce the pressure imposed by insecticides to select for insecticide resistance. The conceptualization of IVM benefited from developments in integrated pest management in agriculture, in which insecticide application has become the method of last resort. The action and inaction of other divisions of the health sector and of other public sectors and communities have important implications for disease prevalence and vector populations. Hence, IVM encourages effective collaboration within the health sector and with other public sectors, and the empowerment of communities. At national level, implementation of IVM requires a public health regulatory framework and an institutional framework. At the international level, a common strategy of support is required from the relevant United Nations agencies and donors, through inter-agency coordination and harmonized activities. The key elements of an IVM strategy are shown in Table 1.2. These elements should be supported by legislation and regulation. IVM is a step towards an integrated disease management approach that incorporates all components of disease control, including vector control, prevention, treatment and human vulnerability. Table 1.2 Key elements of an integrated vector management (IVM) strategy Element Description Advocacy, social mobilization Promotion and embedding of IVM principles in and legislation designing policies in all relevant agencies, organizations and civil society; establishment or strengthening of regulatory and legislative controls for public health; empowerment of communities. Collaboration within the Consideration of all options for collaboration within health sector and with other and between public and private sectors; application sectors of the principles of subsidiarity in planning and decision-making; strengthening channels of communication among policy-makers, vector-borne disease programme managers and other IVM partners. Integrated approach Ensure rational use of available resources by addressing several diseases, integrating non- chemical and chemical vector control methods and integrating with other disease control methods. Evidence-based decision- Adaptation of strategies and interventions to local making ecology, epidemiology and resources, guided by operational research and subject to routine monitoring and evaluation. Capacity-building Provision of the essential material infrastructure, financial resources and human resources at national and local level to manage IVM strategies on the basis of a situational analysis