science
$16 million to evaluate promising tool to protect the most vulnerable
New hope for malaria control
in African infants
by the Roll Back Malaria Partnership
The Intermittent Preventive Treatment in Infants (IPTi) Consortium announced on July 19 that it has received grants totaling $16 million from the Bill & Melinda Gates Foundation to evaluate a promising intervention for malaria control in infants. The consortium will conduct five studies of IPTi in Africa, to be coordinated by the newly established secretariat in Barcelona, Spain. The grants are part of a $28 million commitment to support the consortium announced by the Gates Foundation in September 2003.
IPTi is a potential way of 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 the first year of life at the time of routine immunization, whether or not they have malaria. Two studies in Tanzania have shown that IPTi reduces malaria and anemia in the first year of life by up to 60 percent. IPTi has the potential to become a major tool for malaria control in Africa because it can be given at the time of routine vaccinations delivered through the Expanded Program on Immunization (EPI), one of the best-functioning systems of regular health contact with young children in Africa.
The IPTi Consortium, an alliance of the World Health Organization (WHO), the UN Children's Fund (UNICEF), and leading research centers in Africa, Europe, and the US, has developed a research and implementation agenda that will rapidly resolve outstanding scientific questions about IPTi and move the intervention into policy and practice. It is anticipated that by early 2006 the consortium will have sufficient data on which to base a policy recommendation for the widespread use of IPTi in Africa.
Malaria infection is estimated to cause more than one million deaths and approximately half a billion clinical malaria episodes per year among African children. With increasing antimalarial drug resistance in Africa there is an urgent need to develop novel approaches to malaria control, especially in infants, who are the group at highest risk of death from malaria.
The impact of IPTi on episodes of malaria and anemia is being assessed in areas of differing malaria transmission intensity, as part of ongoing research projects in Gabon, Mozambique, Kenya and Tanzania. 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 antimalarial drugs. The research project 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 IPTi Consortium will have generated additional information on the choice of antimalarial drug for IPTi, 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.
It is anticipated that with the research and implementation information generated by the consortium, IPTi may be adopted as part of malaria control policy in African countries and could have a major impact on the incidence of malaria and severe anemia in infants.
About the IPTi Consortium
The IPTi Consortium consists of leading centers of malaria research in Africa, Europe and the United States, including Albert Schweitzer Hospital, Lambaréné, Gabon; Ifakara Health Research and Development Center, Ifakara, Tanzania; Kenya Medical Research Institute, Kisumu, Kenya; Kilimanjaro Christian Medical Center, Moshi, Tanzania; Manhiûa Health Research Center, Manhiûa, Mozambique; National Institute for Medical Research, Amani, Tanzania; Centers for Disease Control and Prevention, Atlanta, USA; Hospital Clinic, Barcelona, Spain; London School of Hygiene and Tropical Medicine, London, UK; Swiss Tropical Institute, Basel, Switzerland; University of Tübingen, Tübingen, Germany and two United Nations agencies, WHO and UNICEF. The activities of the IPTi Consortium are coordinated by Dr. Andrea Egan at the IPTi Consortium Secretariat, Center for International Health, Hospital Clinic, University of Barcelona, Spain. For more information see the IPTi Consortium web site at www.ipti-malaria.org.
For further information please contact: Andrea Egan, PhD, IPTi Consortium Coordinator, Center de Salut Internacional, Hospital Clinic, Universitat de Barcelona,email: aegan@ub.edu.
To provide a coordinated international approach to fighting malaria --- a disease that kills more than a million people each year, most of them children --- the Roll Back Malaria (RBM) Global Partnership was launched in 1998 by the World Health Organization, UNICEF, UNDP and the World Bank. RBM's goal is to halve the burden of malaria by 2010.
The RBM Partnership has grown rapidly since its launch and is now made up of more than 90 partners who bring a formidable assembly of expertise, infrastructure and funds into the fight against the disease. Partners work together towards internationally agreed malaria-control objectives, coordinating their activities to avoid duplication and fragmentation and to ensure optimal use of resources.
For more information about the RBM Partnership, please visit www.rbm.who.int.
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