A report published today highlights the efforts and partnerships that were integral in expanding the reach of Seasonal Malaria Chemoprevention (SMC) 45-fold since 2013.
- Considered too complex to be feasible at scale before Unitaid pioneered introduction in 2014, SMC has prevented more than 160 million malaria infections and 700,000 deaths in children at highest risk.
- SMC reduces infections among children under five by more than 88% through monthly administration of antimalarial drugs during the rainy season, when rates of malaria typically skyrocket.
- Four in five malaria deaths occur among children under five, almost all of them in Africa.
- Today, a full course of SMC costs less than US$4 per child and the intervention is a bedrock of malaria control programs in 15 African countries, reaching a record 45 million children in 2021.
Geneva, 2 March 2023 – Ten years after implementation of the first small-scale pilot program in Nigeria began, seasonal delivery of antimalarial medicines has saved the lives of 700,000 children under five and prevented 160 million infections. A new report published today highlights the coordinated global effort that contributed to this success. This includes Unitaid’s pivotal role, whose backing built the foundations for broad implementation and increased quality-assured supplies of the key preventive drugs needed to facilitate scale-up.
Seasonal Malaria Chemoprevention (SMC) relies on a mobilized team of community healthcare workers who deliver malaria prevention drugs to children monthly during the rainy season, reaching remote communities despite downpours, flooding, and washed-out roads. Although the World Health Organization recommended SMC in 2012, many believed that at-scale implementation would be too challenging to deliver meaningful reductions in malaria rates.
According to the report, despite many countries’ efforts to advance SMC pilots, the intervention struggled to garner momentum until Unitaid stepped in. The ACCESS-SMC project, implemented by the Malaria Consortium, demonstrated delivery at scale in seven countries, reaching a quarter of all eligible children at that time. That work proved community-delivery of SMC to be a feasible and cost-effective approach, preventing more than 88% of malaria infections among children at greatest risk.
Nearly all malaria infections and deaths occur in the African region, and 80% of deaths occur among children under five, who have not yet developed immunity to the parasite. SMC was initially targeted at countries in the Sahel region, where four months of heavy rain causes malaria infections to spike.
“Despite strong interest from countries in the years following the WHO recommendation, Unitaid saw that inadequate financing and supply challenges were standing in the way of realizing the full impact of seasonal malaria chemoprevention,” said Dr Philippe Duneton, Executive Director of Unitaid. “Working in collaboration with national programs and partners, we proved that SMC is not simply feasible, but highly effective in preventing malaria, and affordable to deliver at scale – paving the way for the massive uptake we have seen as a result.”
“The scale of seasonal malaria chemoprevention in 2023 speaks for itself. The catalytic funding, provided by Unitaid through the ACCESS-SMC program led by Malaria Consortium, enabled a transformative and sustained expansion of SMC across the Sahel region,” said Dr James Tibenderana, Chief Executive of the Malaria Consortium. “The unprecedented pace and scale were possible through the leadership of national malaria programmes, working closely with their sub-national structures and the commitment of health workers and communities. The success of SMC in the Sahel has spurred the expansion of the highly effective intervention to parts of East and Southern Africa, where we are working with national programmes in Mozambique, Uganda and South Sudan to introduce and scale SMC to suitable areas.”
Inadequate supplies of properly dosed, quality-approved medicines used in SMC presented a second significant barrier to wide-scale implementation. Through support to Medicines for Malaria Venture, Unitaid has worked to bring additional manufacturers to market and develop child-friendly formulations.
Today, a full four-month course of SMC costs less than US$4 per child. This was achieved through concerted efforts to increase demand, foster healthy market competition, and optimize delivery methods, resulting in a 20% reduction in the cost of delivery by the end of ACCESS-SMC in 2018.
Over the past decade, SMC coverage has surged, reaching a record 45 million children in 2021 compared to just over 1 million in 2013. The intervention is now a cornerstone of malaria control programs in 15 African countries, and its impact continues to accelerate.
Last year, the WHO expanded their recommendations to include children over five as well as additional regions where seasonal malaria transmission occurs. The new guidance is expected to see continued growth, protecting even greater numbers of children at serious risk from malaria.
Unitaid is a global health agency engaged in finding innovative solutions to prevent, diagnose, and treat diseases more quickly, cheaply, and effectively, in low- and middle-income countries. Its work includes funding initiatives to address major diseases such as HIV, malaria, and tuberculosis, as well as HIV co-infections and co-morbidities including advanced HIV disease, cervical cancer, and hepatitis C, and cross-cutting areas, such as fever management. Unitaid is now applying its expertise to address challenges in advancing new therapies and diagnostics for the COVID-19 pandemic, serving as a key member of the Access to COVID-19 Tools (ACT) Accelerator, co-leading with Wellcome the Therapeutics Pillar and participating in the Diagnostics Pillar. Unitaid is hosted by the World Health Organization.
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