SMC scale-up significantly reduces child mortality in the Sahel

MMV welcomes the critical body of evidence gathered on the considerable and positive impact of SMC at scale published in The Lancet.

10 May 2021

The safety and effectiveness of Seasonal Malaria Chemoprevention (SMC) in reducing malaria mortality in children has been demonstrated in a large observational study, recently published in the peer-reviewed science journal, The Lancet.

This study evaluates the ACCESS-SMC project, funded by Unitaid (2014-2018) and led by Malaria Consortium in partnership with Catholic Relief Services and other partners, including MMV.

Malaria hits children the hardest

Malaria continues to take a terrible toll on the lives of children under five years—in 2019, 67% of the 409,000 people who died were children under the age of five—and is a major cause of childhood death across the sub-Sahel region in Africa.1 Since 2012, the World Health Organization (WHO) has recommended malaria chemoprevention during the rainy season, when most of the malaria infections in children occur.

Study authors call for a wide rollout of SMC programmes in the Sahel region

Authors of the study evaluating the ACCESS-SMC project believe that the evidence garnered should help overcome barriers to scaling up this high-impact intervention across countries in the Sahel during the rainy season and call for its extensive rollout across the Sahel region. The study also showed that the intervention was cost-effective, at an estimated $3.80 per child for the full four months of treatment.2

As defined by the WHO, SMC is the intermittent administration of full treatment courses of the antimalarial medicine SPAQduring the malaria season to prevent malarial illness. Over 2015–2016, the estimated reduction in confirmed malaria cases at outpatient clinics during the high transmission period in the seven countries in the study ranged from 25.5% in Nigeria to 55.2% in The Gambia.

MMV works to meet the unmet medical needs of children

MMV has been an active member of the project, which was initiated in 2014, supporting the rollout of SMC campaigns by National Malaria Control Programmes (NMCPs) in the seven study countries.4 The ACCESS-SMC project was completed in 2018, and MMV continues to support SMC scale-up in the Sahel region.

“We are proud to have contributed to the success of the ACCESS-SMC project,” said Dr. Andre-Marie Tchouatieu, Director Access and Product Management, MMV, “and strongly believe SMC programmes should be rolled out throughout the Sahel region, where they have shown exceptional results in saving the lives of young children. The joint skills of consortium partners and global partnership networks supported our work with manufacturers to reinforce and diversify supplies of child-friendly SMC medicines like SPAQ in response to growing demand from the seven study countries. We recognize the enormous need to prevent children from getting malaria, and we are also working to develop a new generation of medicines in the event SP+AQ falls prey to resistance.”

SMC programmes continue to protect millions of children since 2012

Given the effectiveness of SMC programmes, NMCPs and their partners on the ground have supported the administration of 86 million SMC treatments in 2019 in 13 countries across Africa’s Sahel region, protecting an estimated 21.5 million children, compared to 0.2 million in two countries in 2012. However, over 8.3 million eligible children did not have access to the intervention needed to protect them through the high-risk rainy season and many did not receive the full treatment required.

Appreciating the urgent need to close this gap and optimize the delivery and effectiveness of SMC, The University of Thiès led a consortium including MMV, the London School of Hygiene and Tropical Medicine and WHO-TDR to strengthen the capacity of NMCPs to conduct implementation research and adapt SMC to the local context.

1. WHO. World Malaria Report 2020.

2. The tablets are given over 3 days – two are taken on the first day, one on the second and one on the third, once a month for 4 months during the malaria transmission season to children aged between 3 and 59 months

3. Sulfadoxine-pyrimethamine plus amodiaquine

4. The UNITAID-funded ACCESS SMC Consortium includes: the Malaria Consortium (prime recipient), Catholic Relief Services (joint lead), MMV, Management Sciences for Health, Speak Up Africa and the London School of Hygiene & Tropical Medicine.