A switch to injectable artesunate for the treatment of severe malaria could save an additional 12,000 lives per year in Nigeria
MMV and the Clinton Health Access Initiative (CHAI) are working in close collaboration with the State Ministries of Health in five Nigerian states (Kano, Kaduna, Akwa Ibom, Rivers and Lagos) and the Federal Capital Territory, Abuja, to plan, execute and evaluate the scale-up of injectable artesunate for the treatment of severe malaria, with a particular focus on the most vulnerable – children under 5 years.
Nigeria has one of the highest malaria burdens in the world. In 2010, 489,000 severe malaria cases were reported, resulting in 200,000 deaths.1 In April 2011, Nigeria became the first country to update its treatment guidelines to recommend injectable artesunate in preference to quinine for the treatment of severe malaria following the release of the compelling clinical evidence showing a 22% survival benefit of treatment with injectable artesunate.2 A switch from injectable quinine to injectable artesunate for the management of severe malaria could save an estimated additional 12,000 lives in Nigeria every year.
The objectives of the newly announced two-and-a-half year initiative are to accelerate policy change, adoption and uptake of injectable artesunate via:
- Communicating the advantages of injectable artesunate over quinine for the treatment of severe malaria
- Securing seed donations and sustainable funding for procurement of WHO-prequalified injectable artesunate
- Logistical support for procurement of injectable artesunate
- Training health care workers and quantifying procurement needs, to help address the gaps in uptake
- Monitoring and evaluating the impact of the project to offer a viable model for scale-up in all remaining states
To date, five states have signed a Memorandum of Understanding with CHAI and the review process to add injectable artesunate to the Essential Medicines List (EML) of each state is underway. Two of the most influential states (Lagos and the Federal Capital Territory) have already made the update. Additionally, MMV and CHAI have established a Severe Malaria Advisory Group of leading Nigerian doctors specializing in malaria to provide guidance and support to the project.
George Jagoe, Head of MMV’s Access and Delivery initiatives commented, “By focusing the initial efforts of MMV and its partner CHAI in six states or territories, it is hoped that not only more lives will be saved in those states, but that our actions will catalyse the adoption of the drug in neighbouring states – turning recommendation to reality and saving the lives of more vulnerable people.”
2. Dondorp AM et al. ‘‘Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial’’. Lancet. 376 (9753):1647-57 (2010).