Gave some thought to the statement “OM spray V...

Gave some thought to the statement “OM spray V aSuppository.....I know what my preference would be as either a patient orgiving pre-referral treatment”.

Don’t think this should be the major deciding factor astreatment is lifesaving payed for by others in most cases. Under 5 year oldswill have no say and trained people will do whatever necessary to save a life.Need a medical-financial reason for preference. More about preference below.

World Malaria Report 2018 states no significant progress2015-2017 when a target of 40% reduction in malaria cases and deaths by 2020 hasbeen set. The WHO response plan – High burden to high impact: initiallyfocusing on the 11 highest burden countries that carry 70 percent of the globalmalaria burden. 10 of these countries, all of them in sub-Saharan Africa, werenot on track to meet the GTS targets, whereas India had made impressive gainsand was on track.

MMV response - 6 of the targeted countries a part of anestimated 25 million children eligible for SMC (Seasonal MalariaChemoprevention) using SP+AQ in the Sahel region of sub-Saharan Africa. 70 milliontreatments of SP-amodiaquine (SP+AP) were shipped in Jul-Nov 2018. To improvesupply, MMV has supported the submission of S. Kant Pharma’s dossier for SP+AQdispersible for WHO prequalification in July 2018.¹ This is animproved flexible solid oral dosage, taste-masked formulation as per the WHOpreference over liquid medicines.²

Back to preference, short and long term benefits by preventingmalaria (75%-89% prevention). It is an effective way to increase schoolattendance, tackle poverty, boost economies, strengthen health systems andreduce child mortality.³ Long term, cerebral malaria and severemalarial anemia are associated with long-term neurocognitive impairment inchildren. Also internalizing and externalizing behavioral problems in children.⁴

If suitable alternative drugs can be found, another 10million children could be potentially eligible in Southern Africa, where levelsof drug resistance to current SMC drugs are unacceptably high.³

Enter new generation treatment. MMV and Novartis have progressedKAF156 combined with a new formulation of lumefantrine through Phase IIb.Interim analysis on 261 patients is promising and shows no safety signal; morethan 90% of subjects show no recrudescence at 45 days. Traditionally, newmedicines are first developed for adults, after which child-friendly versionsare pursued. MMV is working to change that having begun to run studies to findthe right dose for children using a staged-down strategy during early clinicaldevelopment.¹ Expected launch in 2021⁵.

UNICEF are also systematically screening children under fiveduring preventive seasonal antimalaria treatment campaigns, an innovativeapproach that helps local partners identify malnourished children early on andprevent health complications. Number of children suffering from severe acutemalnutrition across the Sahel reaches 10-year high, more than 1.3 millionchildren to receive emergency treatment in 2018.⁶

Malaria Consortium seasonal malaria chemopreventionprogramme has been awarded ‘top charity’ status by GiveWell for the third yearin a row. GiveWell is a US-based non-profit organisation that conductsin-depth research to determine ‘how much good’ a charity programme accomplishesfor every dollar spent.⁷

Considering that about 13.6 million children could havebenefited from SMS intervention were not covered, mainly due to a lack of funding,only 22% of pregnant women, half at risk sleeping under an ITN and lessprotected by indoor residual spraying (World Malaria Report 2018) combined with1.5 million deliveries of RAS in 2018 it’s hard to see why top dollars shouldgo to ArTiMist (All IMO).

Technical problem with links.

1 https://www.mmv.org/sites/default/files/uploads/docs/news/2018_in_review.pdf

2 https://www.who.int/bulletin/volumes/95/3/16-171967/en/

3 https://www.malariaconsortium.org/media-downloads/819/Making%20the%20case%20for%20seasonal%20malaria%20chemoprevention

4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5079082/

5 https://www.indiatimes.com/news/india/india-may-get-it-s-own-malaria-drug-by-2018_-265859.html

6 https://www.unicef.org/press-releases/number-children-suffering-severe-acute-malnutrition-across-sahel-reaches-10-year

7 https://www.malariaconsortium.org/news-centre/malaria-consortium-programme-chosen-as-andlsquo-top-charityandrsquo-by-givewell-for-third-year-running.htm