Buying Time to Save a Life: Inness' story
On Wednesday, 8 November 2017, one-year-old Inness Kalunga from Mupula, Serenje District in Zambia fell ill.
“Inness had fever, with severe vomiting and diarrhoea. She even refused to breast feed or eat anything,” explained Inness’ mother, Silvia Mwape.
The next day, when her daughter was no better, Silvia became increasingly worried and took her to the trained local Community Health Volunteers. Given Inness’ symptoms, the Health Worker suspected severe malaria and immediately gave her a quality-assured rectal artesunate suppository (RAS). At the same time a rapid diagnostic test was done, which confirmed Inness had malaria.
“We were quickly rushed to Kabamba Rural Health Centre, 30 km away, by bicycle ambulance. The Health Worker came too,” explained Silvia. “We reached the facility hours later, around 17:30. The nurse confirmed Inness had severe malaria and she was given injectable artesunate.”
Soon after receiving the treatment, Silvia noticed an improvement in Inness’ condition. “Inness could stand on her own and became more interested in what was going on around her,” said Silvia.
The following morning, Inness was able to eat again without vomiting. She could once again play and run. Later that day she was considered well enough to be discharged. She was given artemether-lumefantrine, an oral artemisinin based combination therapy, paracetamol and multivitamins to take home and complete her malaria treatment.
Although the WHO Guidelines for the Treatment of Malaria have included recommendations for the use of RAS for over 10 years, until recently there was no quality-assured RAS product on the market, hampering its widespread availability and use. With MMV support, in December 2016, Cipla’s product received a 12-month time-limited approval from Global Fund’s Expert Review Panel (ERP) while awaiting WHO prequalification, thus enabling procurement of the medicine using Global Fund grants.
To support RAS’ uptake, in July 2017, MMV joined forces with international development organisation Transaid in collaboration with the National Malaria Elimination Center (NMEC) of Zambia on a project known as MAMaZ1 Against Malaria (MAM). The project, implemented by a consortium of partners,2 uses innovative approaches to improve severe malaria case management at facility level as well as timely case management at community level to support patient referral from the community to a health facility. These approaches include the use of bicycle ambulances to transport patients as well as community theatre involving song and dance to create awareness of malaria danger signs.
Ensuring the availability of quality-approved severe malaria treatment commodities is a crucial part of improving the case management of patients in Serenje District, Zambia, where the burden of malaria falls heavily.
Thanks to this project, baby Inness was able to receive the treatment for severe malaria that she needed to save her life.