Angela Kangulumais, a mother and schoolteacher in Zambia, contracted malaria during her first pregnancy. She was severely weakened as a result, with her mobility and vision affected. An artemisinin-based combination therapy (ACT), prescribed at her local health clinic, helped her to recover and go on to have a healthy pregnancy. Like Angela, pregnant women across sub-Saharan Africa are particularly at risk for malaria due to physiological changes that affect their immune systems. The World Health Organization (WHO) recommends ACTs to treat malaria in the second and third trimesters.

In addition to treatment with ACTs, WHO recommends intermittent preventive treatment of malaria in pregnancy (IPTp) across the region. Scaling up IPTp could save hundreds of thousands of lives: WHO’s World Malaria Report reported that 34% of the 33.8 million pregnancies in sub-Saharan Africa were exposed to pregnancy in 2020. Yet, only one-third of eligible women received the three recommended doses of IPTp, which is administered by taking sulfadoxine-pyrimethamine (SP), a drug used for malaria prevention.

An example of MMV’s work to prevent and treat malaria in pregnancy (MiP) is its participation in the Jhpiego-led TIPTOP project, which focused on scaling up IPTp uptake by engaging community healthcare workers. MMV also works with partners to develop alternatives to SP that can be taken by women in their first trimesters and women with HIV who take antiretrovirals, as both of these groups are ineligible to take SP.

Read more about MMV’s work to prevent and treat malaria in pregnant women in its Malaria in mothers and babies strategy.

To that end, MMV staff participated in the RBM Malaria in Pregnancy Working Group (MiPWG) meeting in Accra, Ghana from 13 to 15 September. This year’s meeting, themed ‘Refresh, renew and refocus’ on MiP, was hosted by IMPACT Malaria and Ghana’s National Malaria Control Programme (NMCP), and co-chaired by the World Health Organization (WHO) and the US Center for Disease Control and Prevention (CDC).

Over the 3 days, experts from NMCPs, international organizations, non-governmental organizations and product development partnerships (including MMV) shared updates, products and new research for the prevention and treatment of MiP; disseminated and discussed good practices, challenges and innovative approaches from their countries; and determined the MiPWG’s priorities for the coming year.

I'm here to share the challenges and the ways forward in managing malaria in pregnant women. We are doing IPTp and sharing insecticide-treated nets. I want to see what other countries are doing and share the best practices from Tanzania.

 Abdallah Lusasi, National Malaria Programme of Tanzania

Participants were welcomed with opening remarks by Kristen Vibbert (Jhpiego), Secretariat of the working group, Ghana Health Service Director Patrick Kuma-Aboagye, as well as co-chairs Maurice Bucagu (WHO) and Julie Gutman (CDC). During the meeting, MMV staff Maud Majeres Lugand and Myriam El-Gaaloul also shared research updates on MMV’s work to develop and distribute malaria prevention and treatment methods in pregnant (and lactating) women.

As most countries move towards different phases of their elimination agenda, it is important to share lessons and practices from other countries. I therefore encourage all participants represented here to take opportunity of all the rich resources, connections and data available for the next 3 days and even beyond. It is only through the concerted effort of us all that we will win the fight against malaria and thus protect pregnant women and their own children.

Dr Patrick Kuma-Aboagye, Director General, Ghana Health Service

On the second day of the meeting, participants visited the Greater Accra Regional Hospital to learn about Ghana’s approaches to preventing MiP. Healthcare workers shared data collection and validation methods (a challenge in low- and middle-income settings where data collection is not always digitized), and practices for raising awareness to prevent MiP, including using insecticide-treated bed nets and receiving up to eight doses of IPTp.

Several themes were evident throughout the meeting, including challenges with stockouts of MiP commodities, the proliferation of sub-standard or artificial drugs, and the accessibility and affordability of services. At the same time, countries have also reported marked improvements in antenatal care visits, adherence to IPTp and distribution of bed nets. The meeting’s findings will further inform MMV’s drug discovery, development and access activities.