On December 2, 2016, Chad, the last country to finish the SMC round, completed its fourth cycle. This marked the last ‘implementation’ day of the ACCESS-SMC project, which is scheduled to end on August 31, 2017.
After reaching 3.2 million children in 2015, provisional estimates reveal ACCESS-SMC has reached approximately 6.4 million children across the seven target countries this year. Preliminary administrative coverage results illustrate a good year of implementation, with an adjusted average of 95.4 percent. The challenges encountered in Nigeria and Chad during the first and fourth cycle, due in part to logistics delays related to the introduction of the dispersible formulation, were offset by major improvements in Niger, where revised delivery approaches in urban areas resulted in an increase of coverage in 2016 consistently above 80 percent.
The dispersible formulation was very well received by beneficiaries, their caretakers, and by the community distributors who reported a considerable improvement in the ease of use. Gone are the days of laboriously using a mortar to crush hard, bitter pills for just one child, which took minutes at a time. The sweet, dispersible formulation takes just under 30 seconds to dissolve in a small amount water, a great improvement for administration at-scale. A health worker in Mali couldn’t be more precise: “Eh, c’est rapide ça!” (This is fast!)
While Malaria Consortium and Catholic Relief Services teams worked with national health authorities in the field to implement SMC at scale, other ACCESS-SMC partnerships were busy finalizing some of the important preliminary research results. These findings were presented in November at the ASTMH conference in Atlanta, Georgia USA. Among the highlights, preliminary impact results were presented that seemed to confirm the scale at which SMC can protect children under five from contracting malaria. The number of malaria cases reduced by 24 percent in Chad to 66 percent in The Gambia, with Burkina Faso and Mali showing reductions just under 50 percent.
Experts also discussed the financing required each year to keep SMC, a relatively inexpensive intervention, sustainable. In addition to advocating for a continued increase in resources to reach eligible children in areas that have not yet benefitted from the treatment, this implementation must also be integrated within the regular government health spending plans.
With areas in the Sahel having the highest incidence of malaria in the world, and the effectiveness of the scale-up now proved, it is time to look towards reaching all 25 million eligible children whose lives would be saved by SMC.
As ACCESS-SMC draws to a close, we are happy to confirm that other funding streams will continue ACCESS-SMC’s work in the countries and districts served by the project during these past two years. I would like to personally congratulate all the ACCESS-SMC regional and country teams, from all partners and research institutions. Of course, I want to highlight the role of the key frontline actors, the national health authorities, who, under the guidance of their respective National Malaria Control/Elimination Programs, managed to prevent malaria affecting hundreds of thousands of children in Burkina Faso, Chad, Guinea, Mali, Niger and Nigeria and The Gambia.
On this positive note, I would like to wish on behalf of ACCESS-SMC management and Malaria Consortium a Merry Christmas, happy holidays (for those lucky enough to have some!) and an excellent start to 2017, with more work towards preventing malaria in the Sahel.