Seasonal Malaria Chemoprevention in Mali

An Effective Intervention or an Unsustainable Burden?

Abstract

Malaria presents an enormous health challenge for children and pregnant women around the world. In Mali, malarial infections were the leading cause of premature death from 2005 - 2016. The high incidence of malaria in Mali is partially attributable to its location within the Sahel region of Africa, where the annual rainy season correlates with peaks in malaria transmission. In 2012, Seasonal Malaria Chemoprevention (SMC) was recommended by the World Health Organization (WHO) to combat this seasonal spike in infections. As SMC interventions are now undergoing a major transition in funding, we believe that this a crucial time to evaluate the cost-effectiveness and sustainability of this project. Through our evaluation, we find that SMC interventions in Mali achieved their 80% coverage goal and reduced the incidence of malaria by 49%, all while maintaining a cost-effective price per round of SMC for each child (under US$5). Major obstacles that persist for this intervention are the lack of integration with local health systems and potential effects on adaptive immunity. Overall, SMC is a successful short-term strategy for combating malaria, however, the verticality of funding, logistical burden of annual treatments, and risk to adaptive immunity pose serious challenges to the sustainability of the project.