Malaria Consortium has implemented SMC since 2013, with a major scale-up through the Unitaid-funded ACCESS-SMC project in 2015. This work has been increasingly recognised by donors and stakeholders for its effectiveness and the opportunity it offers for donors to the programme to accomplish good with their donations. Due to the quality of its work on SMC, Malaria Consortium was awarded Top Charity status by GiveWell, a non-profit organisation dedicated to finding outstanding giving opportunities through in-depth analysis, in 2018.
Between 2015 and 2017, ACCESS-SMC supported the national malaria control programmes of seven Sahelian countries (Burkina Faso, Chad, Guinea Conakry, Mali, Niger, Nigeria, The Gambia) to scale up their SMC coverage, with Malaria Consortium and partners providing technical, logistical and financial support for its implementation.
Since 2018, despite the end of ACCESS-SMC, Malaria Consortium has continued supporting the delivery of SMC in three countries; Burkina Faso, Chad and Nigeria, with support from DFID and the Global Fund, but mainly thanks to funds raised from philanthropists. In 2018, we reached 4.1m children and we are aiming to provide treatments to 5.9m children in 2019.
Through our SMC programme, we work with malaria control programmes to deliver SMC using existing health system mechanisms as much as possible. This ranges from developing high level plans and policies at central level, right down to identifying the number of health workers and volunteer distributors needed down to the most remote locations. To ensure delivery goes smoothly, we are assisting with timelines, assigning responsibilities, developing materials and ensuring all necessary stakeholders are on board – from ministers and health officials to the community health workers and distributors who administer the SMC drugs, or town announcers who inform communities about SMC. Over the years, we have supported countries with a wide range of knowledge and expertise, including supply chain management, health worker training, community mobilization, technical supervision, and monitoring and evaluation of the impact and safety of SMC.
SMC is a time-critical intervention, and making sure the drugs are at the point of distribution in time for the rainy season is crucial. We work with international manufacturers and shipping agencies, government supply chain agencies and local custom authorities to ensure that SMC drugs transit smoothly through the system, from the manufacturing process to the shipment and in-country arrival, down to the last-mile distribution, and that they are monitored and kept secure throughout this process.
We assist in the training of volunteer community health workers and distributors to administer SMC (as well as their supervisors and other health staff) and we also conduct social mobilization, disseminating public health messages to inform communities of SMC and how and why their children should receive it.
We also recognise the need to continue to improve quality of SMC delivery, for example ensuring that the first dose of SPAQ is administered under the supervision of a trained CHW or encouraging caregivers to provide the second and third dose over the following days. We engage with national and international stakeholders to improve quality standards and we invest in operational research to continue to adapt and innovate. We also recognise the need to strengthen the evidence base of SMC through developing robust monitoring and evaluation systems, as well as exploring novel ideas for determining coverage, quality of service delivery and impact.