Antimalarial drugs for children

A child dies every minute of every day from malaria, mostly in Africa.¹ Over three quarters of global malaria deaths occur in children under 5 years old,² making it a priority to prevent and treat malaria amongst this vulnerable population. 

Infants and children are particularly vulnerable to malaria. Unlike adults that have grown up in endemic regions, they have yet to develop the necessary immunity to defend themselves against the disease. The malaria parasite, once it has infected a child, multiplies exponentially, destroying red blood cells, leading to fever, vomiting, diarrhoea and anaemia. If not treated within 24 hours, malaria can progress to severe illness, including convulsions and coma, and can result in death. 

However, children are not just little adults. Medicines, including antimalarials, are absorbed and metabolized differently in children and should be adapted for their weight and age. Antimalarials can be bitter, so children often vomit or spit out the medicine and do not receive a complete curative dose.  

MMV and partners have developed several child-friendly formulations (see them below). In addition, MMV is working with other organizations as part of the PAMAfrica consortium to develop  the first malaria treatment for children under 5kg.  

Preventive malaria treatment for children in Africa  

Seasonal Malaria Chemoprevention (SMC) is the intermittent administration of a curative dose of antimalarial medicine to children, regardless of whether they are infected with malaria.  A WHO-recommended preventive strategy, SMC currently involves the administration of SPAQ (SP and amodiaquine). It is designed to protect children under 5 living in areas with seasonal malaria transmission.   

Today, SMC is being implemented in 17 African countries. Over 700 million doses of SPAQ have safeguarded the lives of young children since 2013. Its use has risen – from just 1 million in 2013 to a record 49 million children in 2023 – significantly reducing the burden of this deadly disease. The success of SMC led WHO to recommend its expanded use for any child at high risk of severe malaria in Africa, irrespective of age and geography.  

Always refer to the latest WHO guidelines for chemoprevention. 

Learn more about SMC. 

1. Malaria in Africa, UNICEF, July 2022
2. WHO World Malaria Report 2022