Last year, our seasonal malaria chemoprevention (SMC) programme reached 20 million children across Burkina Faso, Chad, Nigeria, Mozambique, Togo and Uganda, providing them with antimalarials to prevent malaria infections during the rainy season, when malaria transmission is at its peak.
The programme is made possible through philanthropic support from individuals around the world, as well as funding from donors such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Korea International Cooperation Agency and the Bill & Melinda Gates Foundation. We were delighted that our SMC programme was again recognised by the independent evaluator, GiveWell, in December as one of their top charities, underlining its effectiveness in saving lives. With this support in mind, we want to outline our plans for the coming year.
We expect to reach a similar number of children with SMC again this year, across the six countries we support. While the programme is operationally complex and dependent on a range of moving parts coming together, from security to supply chains, our experience means we can be confident of maintaining the reach of our programme over the coming year, despite the ongoing challenge posed by the COVID-19 pandemic.
We will continue to implement SMC campaigns following the COVID-19 safe implementation guidelines that Malaria Consortium developed in 2020. Broadly, this means providing community distributors with face masks and hand sanitisers and issuing guidance on how to operate in a way that reduces the chance of COVID transmission. We will also continue to be flexible in our approach, as seen last year in our decision to fill an unexpected gap in SMC coverage that had emerged in Borno state, Nigeria.
Exploring opportunities to reach more children with SMC
The effectiveness of our programme means we are continually assessing where else SMC could be of benefit. In the coming months, our research teams in Uganda and Mozambique will conclude phase two of implementation studies to assess the effectiveness of the intervention in their respective countries – where SMC had not previously been implemented. The phase one results from those studies already found that SMC works there and is feasible and acceptable.
We are actively working with national malaria programmes across Africa to identify other opportunities to expand the SMC programme and protect more children from malaria. These conversations will continue, and we hope to be able to support new countries in rolling out SMC over the course of the year.
Developing the SMC evidence base
All of Malaria Consortium’s work takes place based on rigorous inquiry and robust evidence. Within the SMC programme, we conduct surveillance, monitoring and evaluation and research to assess impact and inform SMC policy and practice.
Our research teams are also conducting pioneering studies into the future of SMC. Led by our SMC research strategy, we will seek to explore several key areas of innovation and produce evidence to allow governments and implementers to make informed decisions about future SMC campaigns. These areas of research include:
Varying the number of cycles and expanding to areas with slightly longer transmission seasons;
Integration and co-implementation with other health services;
Expansion to new geographical areas;
New drug regimens.
Strengthening the supply chain
Disruptions to global supply chains have been common across all sectors over the past year, partly owing to the pandemic. In 2022, we expect these issues to persist with delays in shipping SMC drugs from manufacturers to the countries of implementation the most likely disruption. However, we see opportunities to strengthen the supply chain in the coming year with work to enhance the way we gather, compile and reconcile stock consumption data well underway. We’re also actively working with medical stores and health authorities at national and district levels to improve integration and efficiency.
Developing our use of digital tools
Our SMC programme already uses a range of digital tools to support our campaigns including data collection platforms to carry out household coverage surveys and mobile money solutions to transfer payments to SMC implementers. We have also been piloting Reveal, a geospatial intelligence platform that helps to determine geographic areas to be reached by SMC distributors. However, gaps in the adoption of digital tools within the programme still exist and, in 2022, we are developing a digital roadmap to guide the definition of priorities and the use of resources, in line with Malaria Consortium’s broader digital strategy and the requirements of SMC-implementing countries.