Mitigating Antimalarial Resistance Consortium in South-East Africa

Project Information

MARC SE-Africa

Grant agreement ID: 101103076

DOI

10.3030/101103076

EC signature date 31 March 2023

Start date 1 April 2023

End date 31 March 2027

Funded under

• Health

Total cost

€ 4 170 631,25

EU contribution

€ 4 170 631,25

Coordinated by

UNIVERSITY OF CAPE TOWN
South Africa

Periodic Reporting for period 1 - MARC SE-Africa (Mitigating Antimalarial Resistance Consortium in South-East Africa)

Reporting period: 2023-04-01 to 2024-09-30

Summary of the context and overall objectives of the project

Gains achieved in reducing the burden of malaria and advancing its elimination are now threatened by the independent emergence and local spread of drug-resistant malaria, particularly in East Africa. Protecting the efficacy of the current first-line malaria treatments, all of which are artemisinin-based, is now a top public health priority.

The Mitigating Antimalarial Resistance Consortium for South-East Africa (MARC SE-Africa) will promote the translation of evidence of artemisinin and other drug resistance of public health significance to inform better malaria policy and practice before drug resistance increases the number of malaria cases and deaths. This consortium includes 10 African and European institutions who will work together with and provide technical support to the National Malaria Programmes and their partners in the 19 endemic countries in East and Southern Africa. Working together is essential for preventing a repetition of the devastating increase in malaria cases and deaths seen previously with chloroquine resistance

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

NETWORK, LANDSCAPE AND GAP ANALYSIS:
All currently available evidence on drug-resistant malaria in SE-Africa has been compiled in 19 SE-African country reports, and summarized in a freely available dashboard, and an East African Regional Report. A social network analysis has defined significant stakeholders who may impact on efforts to mitigate the threat of drug-resistant malaria in the region.

ADDRESSING KEY EVIDENCE GAPS:
Sharing of evidence on drug-resistant malaria has been expedites, with 7 countries having shared their data before publication to date. The multi-lingual MoxieBot chatbot will guide those interested through our freely available toolkit to find over 100 globally available tools and resources to detect and respond to drug-resistant malaria.

Working together with those who have conducted relevant studies, a WWARN study group is currently being combining all available individual patient data globally to better understand the effect of different malaria parasite mutations in the kelch 13 gene on malaria treatment response, to inform more efficient resistance surveillance in future.

DETAILED REGIONAL ACTION PLAN TO RESPOND TO ANTIMALARIAL RESISTANCE: Building on evidence synthesised above, MARC SE-Africa has facilitated consensus being built with the East African Community secretariat, their national malaria programmes and their partners towards a Detailed Regional Action Plan to respond to antimalarial resistance in East Africa. Rwanda, Tanzania and Uganda are at advanced stages of finalising locally-adapted Detailed Action Plans to respond to antimalarial resistance.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

MARC SE-Africa has built on lessons learnt through the response to multi-drug resistant malaria in the Asian Greater Mekong Sub-Region and the COVID-19 pandemic to provide technical support to National Malaria Programmes in nineteen South-East African countries that will enable them to stay ahead of the threat of antimalarial drug resistance and prevent it resulting in the significant increases in malaria morbidity and mortality associated with antimalarial drug resistance historically. This multi-stakeholder consortium has the unique potential to respond promptly enough to the emergence and spread of resistance to artemisinin and partner drugs to prevent, or at least delay, antimalarial drug resistance increasing malaria transmission, treatment failure and malaria morbidity and mortality. This body of work will provide a replicable model demonstrating how evidence of antimalarial resistance can be most rapidly translated into policy and practice, in order to mitigate its effects until more effective novel antimalarials become available. It may also provide a model for dealing with other antimicrobial resistant organisms in similar contexts.

1st East African Community Meeting on Antimalarial Drug Resistance participants, Kigali, Sept 2024