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Prevention is Better than a Cure: Malaria Chemoprevention in Mali

Two-year-old Tata Wagué lives in a village in the Kayes region of western Mali, not far from the Senegal River. During the summer months, seasonal monsoons drench villages in the area with heavy rain creating mosquito breeding sites, especially around the riverbed where Tata lives. Tata and other children who are under the age of five years old are among the most vulnerable to the potentially devastating impacts of malaria with children under five accounting for 67% of deaths from malaria globally in 2019.

As the rains come, malaria infections rise. During this period of increased malaria risk, the U.S. President’s Malaria Initiative (PMI) works through Impact Malaria to support national malaria control programs (NMCPs) in Mali, Burkina Faso, Cameroon, and Niger to provide antimalarial medicines to millions of children. In Mali, Impact Malaria has supported the NMCP to reach well over one million children with Seasonal Malaria Chemoprevention (SMC) during the 2021 rainy season.

Before the heavy rains began, Tata and her grandmother, Korotoumou Samassa, were visited at home by community health volunteers who encouraged them to participate in the campaign. With close supervision, Korotoumou gave Tata her first dose of antimalarial medicine and was given the following two doses with instructions on how to administer them at home over the next two days. This process is repeated once per month for four months from July to October.

Photo caption: Tata and her grandmother outside their home. Photo credit: IM Mali, PMI Impact Malaria

Rolling out antimalarials to reach Tata and more than one million other children is no small feat, particularly during the COVID-19 pandemic. Last year the WHO updated guidelines for high malaria burden countries like Mali to ensure that life-saving malaria prevention and treatment services continued during COVID-19. One change was shifting campaigns from a single location that community-members would visit, to having community health volunteers take the medicines door-to-door to avoid large gatherings.

Preparation also involves regional microplanning that begins at least six months before the first campaign cycle. Planning workshops, refresher trainings for administering agents and supervisors, and independent monitoring helped ensure that COVID prevention measures pioneered in 2020 were replicated and improved in 2021.

Mali’s NMCP and PMI Impact Malaria collaborated with radio stations in the region to broadcast messages about the purpose and arrival of SMC, why compliance with full treatment is so important, dates and milestones for the campaign, possible adverse effects, and the need to comply with COVID-19 safety measures.

PMI Impact Malaria currently supports 11 health districts, 301 health areas, and 2,837 villages in Mali to conduct SMC and has trained 600 local supervisors and 612 antimalarial administration agents. Impact Malaria and the Mali NMCP are now expanding SMC to children between the ages of five and ten in the Koutiala, Selingue and Kadiolo districts of the Sikasso region where malaria prevalence is particularly high. Proactive malaria prevention measures including SMC are essential to safeguarding children under five. As is said in the local Bamanankan language, bana koumbè ga pissa ni bana fourakeli yé - prevention is better than a cure.

Collaboration story written by PMI Impact Malaria (IM), IM Mali, and PMI Mission in Mali

Story posted to the USAID blog on Wednesday, September 8, 2021

PMI Impact Malaria is funded and technically assisted by the U.S. President's Malaria Initiative (PMI) and led by Population Services International (PSI) in partnership with JhpiegoMedical Care Development International (MCDI), and the Malaria Elimination Initiative (MEI) at UC San Francisco.

Posted by Taylor Prochnow at 16:08
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