Navigating Supply Challenges to Save Children from Malaria

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The U.S. President's Malaria Initiative (PMI)'s Success in Delivering 8,571,824 Malaria Preventative Treatments Every Year in the North and Far North Regions of Cameroon.
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In the North and Far North Regions of Cameroon, the rainy season brings both joy and concern. The rain transforms the landscape, making it lush and fertile for crops to thrive. However, with the rain also comes mosquitoes and the threat of malaria. Mothers in these regions worry, especially for their young children who are most vulnerable. These areas have the highest malaria burden in Cameroon, with over half of malaria-related deaths occurring in children under five. To protect these children during the high malaria risk period from June to October, the Cameroonian government runs annual campaigns for seasonal malaria chemoprevention (SMC), providing preventive medicines to eligible children.

In order for the SMC campaign to be successful, timely procurement and delivery are crucial. Since 2018, the U.S. President's Malaria Initiative (PMI) has been working with the Ministry of Health in Cameroon to support SMC campaigns in the North and Far North regions. PMI, through the USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) project, is responsible for procuring and delivering high- and low-dose sulfadoxine-pyrimethamine plus amodiaquine (SPAQ) preventative treatments. As the U.S. Government contractor for the supply of malaria health commodities, GHSC-PSM overcomes many challenges, including insecurities due to the risks of highway robberies, kidnappings, threats from terrorist groups, and navigating bad roads in remote communities - to ensure that malaria medicines are available in health facilities on time for distribution by community health workers.

Over the course of the 2023 SMC campaign, a total of over 9.4 million SPAQ doses were pre-positioned on time across 448 health areas in 47 districts in the North and Far North regions. This quantity was sufficient to ensure the administration of 8.8 million doses over four or five preventative treatment cycles to children. The use of epidemiological data between 2016 and 2023 shows that the SMC campaign has contributed to a significant decline in the number of malaria cases in children and related deaths.

Dr. Nai Esaie, District Head for Tchollire, in particular, expressed his satisfaction with the logistics put in place to ensure the availability of SPAQ before the start of the campaign as this has allowed them to adhere to the prescribed schedule, ensuring that no child has been left unprotected due to stockouts.

Despite the challenges with the bad roads and floods, we are motivated by two things to keep going, the desire to improve our performance and the opportunity to contribute towards saving lives."  - Boubakari, Chief of Bureau of a third-party logistics (3PL) provider contracted by GHSC-PSM to transport SPAQ from the regional warehouses to the health areas. 

 



 Before USAID’s GHSC-PSM project assumed management of SPAQ for the SMC campaign in 2018 with funding from PMI, the process was overseen by the National Malaria Program, with support from various partners. There were delays in supplies reaching the regional level, often coinciding with peak malaria transmission season. Inadequate storage conditions were observed before distribution, lacking a designated warehouse. Distribution plans were prepared, with districts collecting SPAQ from the regional level, and transportation was arranged for those unable to pick up supplies. Subsequently, districts managed distribution plans, and health areas retrieved their stock from the districts with challenges in quantity allocation resulting in delays for some health areas. Since GHSC-PSM took over, timely availability of sufficient medicines for the campaign have been ensured, and Dr. Djele Sali, Regional Coordinator for the National Malaria Control Program in the North region, commended the work.

GHSC-PSM provided crucial support to the National Malaria Program by developing national distribution plans, managing commodities at regional warehouses, and contracting logistics providers for transportation. During the 2023 SMC campaign, through effective monitoring and coordination, GHSC-PSM facilitated the successful delivery of products to all health areas and districts ahead of schedule.

Through GHSC-PSM, the U.S. President's Malaria Initiative (PMI) has supported the Cameroon National Malaria Program and significantly contributed to the fight against malaria since 2018, by ensuring the timely delivery of medication to remote areas in the North and Far North Regions of Cameroon, covering over 8 million doses every year for children under 5 during Seasonal Chemoprevention Campaigns (SMC), particularly focusing on safeguarding children's health for a malaria-free Cameroon.