With malaria causing an estimated 1 million deaths and a further half billion clinical cases every year among African children, a United Nations-backed consortium has received $16 million in grants from the Bill & Melinda Gates Foundation to evaluate a promising new strategy to control the disease in infants.
Announcing the grant today, the Intermittent Preventive Treatment in Infants (IPTi) Consortium said it would conduct five studies in Africa using existing antimalarial drugs to protect infants from the worst effects of the disease. Under this approach, infants receive an antimalarial drug three times during their first year at the time of routine immunization, whether or not they have malaria. Two studies in Tanzania have shown that IPTi reduces malaria and anaemia in the first year by up to 60 per cent.
The Consortium, an alliance of the UN World Health Organization (WHO), the UN Children's Fund (UNICEF), and leading research centres in Africa, Europe and the United States, hopes to quickly resolve outstanding scientific questions to allow widespread use of IPTi in Africa, with sufficient data in hand by early 2006 for a policy recommendation.
IPTi has the potential to become a major tool for malaria control because it can be given at the time of routine vaccinations delivered through the Expanded Programme on Immunization (EPI), one of the best-functioning systems of regular health contact with young children in Africa.
Because of increasing resistance in parts of Africa to the current standard antimalarial drug sulphadoxine/pyrimethamine, two trials – in Kenya and northern Tanzania – are testing different combinations of drugs. Research in southern Tanzania addresses implementation issues that must be resolved before IPTi can be introduced on a large scale as a routine health intervention. WHO will assess whether IPTi has any effect on an infant's immune response to EPI vaccines.
By the end of 2008, the Consortium will have generated additional information on the choice of an antimalarial drug, the relationship between IPTi and the development of drug resistance, the impact of IPTi on the development of malarial immunity, and an assessment of cost-effectiveness, acceptability, mortality impact and community effectiveness.