In June, South Sudan is expecting to roll out a lifesaving malaria prevention intervention that for so long has mainly been used in the Sahel. But there are concerns its use may only be short-lived in eastern and southern African countries due to high parasite resistance.

Seasonal malaria chemoprevention, or SMC, is a form of preventive malaria intervention that uses a combination of drugs — sulfadoxine-pyrimethamine and amodiaquine — to prevent malaria among children below 5 years old who account for almost 80% of all malaria deaths in the World Health Organization’s Africa region. 

SMC is the malaria prevention intervention that covers children in areas that experience seasonal malaria. In 2012, WHO recommended its scale up in the Sahel, where malaria transmission is highly seasonal, particularly during the rainy season. In the decade since its implementation, the intervention prevented more than 160 million malaria infections and 700,000 deaths in children, according to Unitaid, which has supported its scale up.

The recommendation however limited the use of SMC to the Sahel, as other regions, such as eastern and southern Africa, have high levels of parasite resistance to the combination of drugs used for SMC. 

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