Malaria is a major cause of childhood mortality across the sub-Sahel region in Africa. Most cases occur during the rainy season. The intermittent administration of full treatment courses of antimalarial medicine during the high malaria transmission season (also known as seasonal malaria chemoprevention, or SMC) has been shown to prevent approximately 75% of all malaria episodes and approximately 75% of severe malaria episodes.1
Improving drug availability
Five hundred thirty-six million courses of sulfadoxine-pyrimethamine + amodiaquine (SPAQ) have been distributed cumulatively since launch in 2014, protecting an estimated 33 million children in 2020. This is thanks to the sustained efforts of MMV, manufacturers S Kant Healthcare and Guilin Pharmaceuticals, and other partners.
Over the past several years, access to SPAQ has continued to increase. This is thanks, in part, to ACCESS-SMC, a Unitaid-funded project co-led by Malaria Consortium and Catholic Relief Services that supported National Malaria Control Programmes in seven countries in the Sahel region to roll out and scale-up SMC, increasing access to the intervention by about 12 million children. The project ended in 2017 yet the expansion of access to SMC has been going strong ever since. During 2020, the first year of the pandemic, we saw access to SMC increased again by around 12 million children, despite COVID-19 related disruptions.
Supporting the deployment of SMC
MMV has developed an SMC Tool Kit which addresses planning, training, monitoring and evaluation needs. This tool was adapted and used by countries for their effective planning.
MMV, Médecins Sans Frontières (MSF) and Guilin Pharma have developed user-friendly packaging and SMC administration cards to support correct dispensing by healthcare workers and proper use by parents or caregivers.
As part of the SMC working group, MMV initiated and supports the convening of all SMC country planning and review meetings after each malaria season. This provides a unique platform where country progress and challenges in SMC implementation can be discussed with all stakeholders. MMV has been coordinating this SMC working group which is now part of the larger RBM country and regional support partners committee under the name of SMC Alliance.
→Learn more about the working group from the SMC Alliance website.
Extending SMC’s scope: research and access
MMV has spearheaded scientific and stakeholder input on desired attributes of next-generation SMC drugs as future alternatives to SPAQ. The data and perspectives gathered via this multi-phased process helped inform a new MMV target product profile (TPP) for chemoprevention. This work led to the identification of several combinations of potential alternatives to SPAQ. Safety studies in healthy volunteers for these new combinations are ongoing.
Additionally, MMV designed a programme called the SEAMACE (Seasonal Malaria Chemoprevention Extension) looking at how SMC can be extended in terms of coverage, eligibility, age bracket, season considered and geography. Through several projects, MMV is working with partners to generate evidence on the need to increase the SMC age limit, or to extend the duration of the intervention beyond four months in areas where modelling has shown a possible value-add. This evidence will contribute to the discussion on policy review.
→This interactive map shows the countries where SPAQ is registered.