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Severe malaria: scaling-up life-saving treatment

There are around 5.6 million cases of severe malaria every year, leading to around 627,000 deaths, mostly of children under 5.

In 2011, the World Health Organization (WHO) recommended injectable artesunate as the preferred treatment – it saves more lives than previous medicines. The problem is many health facilities in malaria-endemic countries still use old treatments.

By raising awareness, securing funding, training health-care workers and quantifying the need, Medicines for Malaria Venture (MMV) and partners are increasing the uptake and use of injectable artesunate across the malaria-endemic world, starting with Nigeria.

Saudat’s story: small ripples can make big waves

Saudat was 3 years old when she was admitted to Murtala Mohammed Specialist Hospital (MMSH) in Kano state, Nigeria. She was unconscious, with convulsions and a temperature of 38.9°C. She had severe malaria. Her life was at risk.

Injectable artesunate was administered immediately, and then regularly for a period of 48 hrs. Two days later, Saudat gained consciousness and was put on a regimen of artemether-lumefantrine, an oral artemisinin combination therapy (ACT), to cure her. Injectable artesunate had helped reduce the severity of malaria and saved her life.

“Working in malaria, and especially in access and delivery of antimalarials, is challenging,” said Pierre Hugo, a member of MMV’s Access and Delivery team. “Seeing Saudat recover so quickly was amazing. It’s hugely satisfying to see a product that we have supported put to use, and truly humbling to meet the health-care providers who save lives on a daily basis.”

Injectable artesunate is a product of Guilin Pharmaceutical. MMV helped Guilin bring its production to standards required by WHO for prequalification. In November 2010, injectable artesunate was granted prequalification by the WHO. Since then, MMV and Clinton Health Access Initiative (CHAI) have been working to increase the uptake and use of this life-saving medicine in Nigeria.

Dr Binta, Head of Paediatrics at MMSH, the busiest referral hospital in Kano, a state in northern Nigeria, informed MMV that, based on Saudat’s and a handful of other cases’ positive response to treatment, her department has switched to injectable artesunate for all admitted cases of severe malaria. Furthermore, the Hospital Management Board has started to procure this life-saving medicine for other hospitals in the state to treat many more severe malaria patients – small ripples can make big waves.

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