Expanding seasonal malaria chemoprevention
Dr Djermakoye Hadiza Jackou, former Coordinator of Niger’s National Malaria Control Programme (NMCP), and Dr André-Marie Tchouatieu, Director, Access & Product Management, MMV (Switzerland) discuss the expansion of SMC.
1. How has the expansion of SMC helped in the fight against malaria?
Dr Djermakoye Hadiza Jackou: Post-campaign evaluation and epidemiological analysis have shown significant impact of SMC scale-up on malaria incidence amongst children aged 3 months to 5 years, although this is not uniform across implementation areas. We are investigating the reasons for this lack of uniformity.
SMC, like most other interventions in place, prioritizes children in this age group, whilst older children are left pretty much on their own. After a few years we noticed an increasing trend in the number of cases in children aged 5 to 10 years, which led us, with MMV’s help, to initiate a pilot project administering SMC to children in this age group based on the experience of countries like Senegal who have done this since 2013. This will allow us to determine the added value of extending SMC to these children.
Niger was amongst the first countries to graft other interventions onto SMC implementation. Since 2016, we have been screening for malnutrition (which is almost as much of a public health issue as malaria and affects the same age bracket), verifying immunization records, and doing research on acute flaccid paralysis in parallel with SMC.
2. What was it like to work with MMV?
Dr Djermakoye Hadiza Jackou: MMV has been a major actor in SMC since the beginning. Not only by providing campaign planning tools and adapted SPAQ formulations,but also – and especially – through its capacity to bring together different stakeholders through the SMC Alliance,39 to perpetuate what countries put in place at the outset. In 2018, Niger was honoured to host the first annual SMC review and planning meeting under the Alliance’s new approach. We hope that this collaboration will continue, for the benefit of children in Niger.
3. What value has the SMC Alliance brought in terms of knowledge sharing among partner countries?
Dr André-Marie Tchouatieu: The SMC Alliance is a group of SMC stakeholders, including implementing countries, that serves as a platform for discussion and problem-solving. The spirit of collaboration within the Alliance has been commendable, with all members sharing information for the benefit of others, reinforcing collaboration and generating new initiatives.
In 2022, the Alliance’s monitoring and evaluation subgroup developed a framework for harmonizing practices across implementing countries. The research subgroup focused on defining research questions for improving SMC implementation. The communication subgroup organized several webinars to promote SMC, with the goal of increasing interest in this intervention and ultimately diversifying funding, especially from local sources. As the Alliance includes a large pool of SMC experts, it took part in the review of the SMC implementation guide after revision of WHO guidance in June 2022, as well as the interpretation and dissemination of these new guidelines.