Share this page

Seasonal malaria chemoprevention

In March 2012, the World Health Organization (WHO) issued a policy recommendation for a new intervention against P. falciparum malaria in children under five years old - seasonal malaria chemoprevention (SMC).

SMC is a highly effective intervention to prevent malaria in those most vulnerable to the disease’s effects. It involves administering up to four monthly doses of antimalarial drugs to children aged 3-59 months during peak malaria transmission season.

The objective is to maintain therapeutic anti-malarial drug concentrations in the blood throughout the period of greatest risk. This will reduce the incidence of both simple and severe malaria disease and the associated anaemia and result in healthier, stronger children able to develop and grow without the interruption of disease episodes. SMC has been shown to be effective, cost effective and feasible for the prevention of malaria among children in areas where the malaria transmission season is no longer than four months. Since it was approved by the WHO, SMC has been found to prevent up to 89 percent of malaria cases.

An estimated 28-34 million children are eligible for SMC, the vast majority of whom live in the Sahel region. Areas eligible for SMC are those where:

  1. the majority of malaria transmission falls within a short rainy season of no more than four months. Since a maximum of four ‘cycles’ of SMC can be given (giving children protection for four months) the intervention is not suitable for areas with a longer rainy season or where malaria transmission is spread over a longer period.
  2. where resistance to the SMC drugs is low. This means that the current SMC drugs can be used in the Sahel, but means SMC is unfeasible in areas of seasonal transmission in southern Africa.

The potential for SMC is enormous – from saving lives and reducing illness to preventing school absenteeism and boosting economic growth. If all children eligible for SMC had access to it, some 175,000 lives could be saved each year, and 18 million malaria cases prevented.


We have been leading the way on SMC globally, initially through our pilot project in northern Nigeria and later through our UNITAID funded ACCESS-SMC project. 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.

We are supporting countries to prepare to deliver SMC. This ranges from developing high level plans and policies at central level, right down to identifying the number of health workers needed in each remote village. 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 who administer the SMC drugs and town criers who inform communities about SMC. As with the ACCESS-SMC project, we are supporting countries with a wide range of knowledge and expertise, including supply chain management, health worker training, community mobilization and safety monitoring.

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 government supply chain agencies to ensure the SMC drugs will flow through the system from arrival in country down to the point of distribution, and that they are monitored and kept secure.

We assist in the training of community health workers to administer SMC (as well as their supervisors and other health staff), put in place the logistics for delivery and mobilization of volunteer community health volunteers. We also conduct social mobilization and disseminate public health and behaviour change communications materials to inform communities of SMC and how their children can access it. 

For more information, please see:

Technical brief - Seasonal malaria chemoprevention at scale, saving lives

Technical brief - Sauver des vies – la CPS à grande échelle

To find out more about our ACCESS-SMC project, click here or to watch our short films about the project

Sign up for our newsletters here: