Let’s talk about SMC
On the 14th of November, nearly 300 people arrived at the 65th annual meeting of the American Society of Tropical Medicine and Hygiene (ASTMH) in Atlanta, Georgia USA. The symposium they came for was “Seasonal Malaria Chemoprevention at Scale: Evidence from Eight Countries.” With the second year’s distribution coming to a close for the ACCESS-SMC project, funded by UNITAID, experts gathered to share their experiences and results, which prove the feasibility of SMC interventions at scale.
Chaired by Paul J Milligan from London School of Hygiene & Tropical Medicine (LSHTM) and Ebenezer Baba from Malaria Consortium, the symposium presented new findings from surveys in eight countries. These findings compared the coverage achieved following the scale-up of SMC, and described the impact it has had on the burden of malaria in children under five.
Issaka Sagara, from Malaria Research and Training Centre in Mali, presented data that, based on preliminary results, showed a reduction of cases of malaria from 24 percemt in Chad to over 60 percent in The Gambia. This was linked to the high coverage of children who received SMC. In most countries, more than 80 percent of children were treated, and overall in the seven countries, those who received coverage of all four consecutive cycles were approximately 56 percent. Adherence to home was reported to be high, at above 90 percent.
To help better understand the impact and costs associated with delivering SMC, Colin Gilmartin from Management Sciences for Health presented “Costs of SMC at scale: assessment in seven countries.” This cost analysis across the seven ACCESS-SMC countries provided sufficient data, which was not present before ACESS-SMC was launched, to give donors and governments the confidence to mobilize and allocate fiscal resources to scale-up SMC.
Other presentations outside the symposium but generated by the ACCESS-SMC project that deserve a mention include “Implementing SMC in the context of Ebola virus disease (EVD) in Guinea” presented by Suzanne Van Hulle from Catholic Relief Services, and “Optimizing SMC in Africa: estimating the impact of increasing the number of SMC cycles on the number of children protected, the malaria burden and cost-effectiveness” presented by Matt Cairns from LSHTM. Van Hulle’s presentation demonstrated how SMC can be delivered at scale, saving lives, even during chaotic outbreaks like Ebola. Cairns examined the cost-effectives of implementing five to six cycles of SMC where the rainy season lasts a little longer than four months, which would prevent approximately 10.5 million malaria cases in young children per year.
Both the symposium and the individual presentations were well received, and mark a new phase in the evidence-generating efforts of the project, with more findings expected to be disseminated in 2017 as ACCESS-SMC draws to a close.