Antimalarial drugs for pregnant women

MMV is devoting particular attention to the needs of pregnant and lactating mothers and their babies, for whom options are currently limited. In 2021, more than 13.3 million pregnant women in Africa contracted malaria, mainly in the World Health Organization (WHO) sub-regions of West and Central Africa.¹

Consequences of malaria in pregnancy  can be catastrophic. A mother’s immunity to the parasite is reduced by the biological and physiological changes of pregnancy, increasing her susceptibility to infection and her risk of severe illness and death.² Furthermore, the accumulation of parasites in the placenta can lead to adverse outcomes for the child. Plasmodium falciparum malaria is associated with a shocking one in ten maternal deaths in malaria-endemic countries, as well as a three to fourfold increase in the risk of miscarriage.³ Malaria in pregnant women can also result in low birth weight and premature birth, which increase the risk of neonatal mortality and can have lasting developmental consequences for the growing child.

Preventive malaria treatment for women in Africa

WHO recommends Intermittent Preventive Treatment in pregnancy (IPTp), a type of malaria chemoprevention, to prevent and reduce the impact of malaria on pregnant women and their children.

Malaria chemoprevention, whereby medicines are used to prevent malaria infection and its consequences, is a powerful way to reduce the toll of this disease. Malaria chemoprevention involves administering antimalarial medicines to populations at heightened risk if infected. An important example of a medicine used for malaria prevention is sulfadoxine pyrimethamine (SP.) SP is a well-tolerated, efficacious, and affordable medicine used alone or in combination with other drugs to prevent malaria in infants, children, and pregnant women.

Pregnant women living in areas of moderate to high malaria transmission in Africa should receive 3 or more doses of SP starting as early as possible in the 2nd trimester, to be administered at monthly intervals up to the time of delivery. Updated WHO guidance now recommends that all pregnant women living in malaria-endemic areas take IPTp-SP as of the second trimester regardless of the number of pregnancies (previously, it was recommended only during a woman’s first and second pregnancies). Always refer to the latest WHO guidelines. 

Coverage of IPTp in 2021 remained low at 35%, well below the target of 80%.⁴ One of the reasons for this gap relates to supply-side issues around quality-assured SP. These can be bridged by strengthening local manufacturing capability to improve the quality and increase the quantity of regional supplies of this medicine.

For more information about how MMV is working to reduce the malaria burden for pregnant women, download MMV's MiMBa strategy. 

_{1. World Malaria Report, 2022}

_{2. Schantz-Dunn J & Nour NM “Malaria and pregnancy : a global health perspective” Rev Obstet Gynecol. 2(3):186–92 (2009), PMCID: PMC2760896} 

_{3. Saito M et al. “Deleterious effects of malaria in pregnancy on the developing fetus: a review on prevention and treatment with antimalarial drugs” Lancet Child Adolescent Health. 4(10):761- 74 (2020), doi: 10.1016/ S2352-4642(20)30099-7}

_{4. World Malaria Report, 2022}