Pregnancy registries: a step towards better antimalarials for women

Malaria in pregnancy is associated with serious health risks to the mother and unborn child. Although 125 million pregnancies around the world are at risk of malaria each year1, treatment and prevention options for this population are limited. Most antimalarial treatments currently indicated for adults are not suitable for pregnant women due to a lack of safety data.

During the clinical development of new antimalarial drugs, pregnant women are systematically excluded from clinical trials. This practice aims to protect the
mother and the baby, but it also prevents the generation of data that could optimize pregnancy outcomes, and deprives pregnant women of existing, potentially well-tolerated and efficacious treatments.

As part of its mandate, MMV is prioritizing data collection to increase the number of appropriate antimalarial options for women throughout pregnancy. MMV has been facilitating the establishment of pregnancy registries in malaria-endemic countries across sub-Saharan Africa in collaboration with the Liverpool School of Tropical Medicine (LSTM), and the Worldwide Antimalarial Resistance Network (WWARN), with initial financial support from the Swiss Agency for Development and Cooperation. These registries aim to collect information on the effects of antimalarials on pregnant women, in particular the newest ACTs, dihydroartemisinin-piperaquine (Eurartesim®) and pyronaridine-artesunate (Pyramax®), to generate high-quality safety data, and to improve therapeutic options for this population. The evidence gathered is intended to support policy change and inform WHO guidelines.

1. Dellicour S. et al., “Quantifying the number of pregnancies at risk of malaria in 2007: a demographic study” Plos Med; 7(1), 2010).