In the Sahel and sub-Sahel regions of Africa, Seasonal Malaria Chemoprevention (SMC) with SP+AQ is a cost-effective solution that has been shown to prevent up to 75% of malaria episodes in clinical trial settings: high-quality SMC costs less than USD 1 per season, while inpatient care for a case of severe malaria is estimated to cost USD 12–75.1,2,3
Thanks to the ACCESS-SMC project led by the Malaria Consortium, 73 million courses of SP+AQ were shipped to 12 countries in 2016,4 enough to protect 18 million children during the malaria season; the product is manufactured by MMV's partner Guilin Pharmaceutical, currently the sole supplier of prequalified SP+AQ.
Dr Yacouba Sawadogo tells us about the SMC programme in his country.
1. What were the biggest challenges to the implementation of SMC and how did you overcome them?
First of all, there was a delay in the arrival of the commodities in some districts, which we overcame by redistributing stocks from other districts. Also, the child-friendly dispersible formulation wasn’t available in the quantities required and so we prioritized it for the 3 to 11-month-old children, while the tablets − which are more bitter − were administered to the older children. Even so, we needed to find and fund a supply of sugar to encourage them to take it. Coordination of the implementation required continuous consultation with the partners.
2. What has been the impact of SMC in Burkina Faso to date?
In 2016, SMC was implemented in 54 heath districts across 11 of the 13 regions in Burkina Faso. In these regions, it has decreased malaria cases by 45% in children below 5 years of age.
3. How was the dispersible formulation of SP+AQ received in practice?
The dispersible formulation is a clear advantage with children as they willingly accept it, so it’s easier to administer and there is minimal wastage. Based on this we are considering adopting the dispersible formulation exclusively for SMC in Burkina Faso.
4. What are the next steps for the implementation of SMC in Burkina Faso?
With funding from the Malaria Consortium, UNICEF, PMI/USAID and the World Bank, we plan to implement SMC in a total of 58 districts in 2017. Eventually, we hope to achieve 100% coverage, as the whole country is eligible.
- Cairns M et al. “Estimating the potential public health impact of seasonal malaria chemoprevention in African children.” Nat Commun. 3:881 (2012).
- WHO/GMP Technical Expert Group On Preventive Chemotherapy, Geneva 4–6 May 2011. Report of the technical consultation on seasonal malaria chemoprevention.
- Lubell Y et al. “Cost-effectiveness of parenteral artesunate for treating children with severe malaria in sub-Saharan Africa.” Bull World Health Organ. 89(7):504-12 (2011).
- Burkina Faso, Cameroon, Chad, Gambia, Guinea, Ghana, Guinea Bissau, Mali, Niger, Nigeria, Togo, Senegal.