On Friday, 2 August 2024, the REACH Mali team began mass drug administration (MDA) in Baroueli, in the Ségou region, some 200km east of the capital, Bamako.
The REACH project to distribute azithromycin for child survival took a major step forward this week as Mali began rolling out its national scale-up of the life-saving intervention.
After a widespread outreach and sensitisation campaign, and with the full support of the Malian Ministry of Health and Social Development, REACH Mali teams have now begun the long and challenging task of delivering azithromycin throughout the country, as part of a major public health intervention.
REACH Mali is targeting its azithromycin distribution at children aged 1 to 59 months. To ensure that doses of the antibiotic get into as many young mouths as possible, the intervention is being integrated.
A combined package for better child health
SIAN stands for “Semaines d’Intensification des Activités de Nutrition” and is a nationwide platform which distributes Vitamin A and Albendazole supplements while also conducting community engagement and providing advice and support to ensure children receive the nutrition services they need to develop in good health.
REACH Mali will integrate its distribution of azithromycin to eligible populations as part of these child nutrition weeks, offering a comprehensive and integrated healthcare package to support the health and wellbeing of young infants and toddlers.
Making hard-to-reach populations a priority
The REACH Mali azithromycin distribution has also been specifically conceived to target areas and populations which have traditionally struggled to access healthcare and public health interventions.
The team will be working closely with government and local partners to ensure that what is often referred to as “the last mile” is actually covered towards the beginning of the intervention.
REACH azithromycin is likely to be of the greatest benefit to precisely those populations where intermittent – even inexistent – access to healthcare has led to unacceptably high levels of child mortality.
Partnerships and good will
Reaching these children will require a great deal of meticulous planning and coordination, as well as strong partnerships and political will at the local, regional and national levels.
Fortunately, the REACH Mali intervention has the backing of partners ideally placed to help get azithromycin into the communities where it stands to have the greatest impact.
REACH Mali
A long-awaited intervention
Speaking in Baroueli, Ségou, as REACH Mali roll-out got underway, Professor Samba Sow, former Minister of Health for Mali and Director of the Center for Vaccine Development (CVD-Mali), said:
“I am delighted that REACH Mali is now underway. This is a child health intervention that has been a long time in the making. It comes about as a result of extensive and significant clinical trials – both the LAKANA trial, conducted in western Mali, and the SANTÉ trial in the south-east of the country.
“This first day of azithromycin distribution in Baroueli is a major milestone as the potential of azithromycin to save young lives becomes available, at last, to all eligible children as a public health intervention.”
“It is a source of great joy that the REACH azithromycin intervention will now be rolled out to children across Mali. We are beginning in the Ségou region, but we aim to progressively cover the whole of the country in the coming months and years”, Professor Sow said during the launch.
“High child mortality has been a blight on our communities for far too long and too many children have suffered from poor access to essential care and medicines. I am particularly proud that this intervention will live up to its name: it will reach children across the country, including in areas to the east and north where instability has led to persistently poor health outcomes.”
Professor Sow will lead the REACH Mali scale-up, working closely with Mali’s Ministry of Health and Social Development.
Bucking the trend
“We are extremely proud that the REACH intervention in Mali is being implemented in partnership with the SIAN network. Nutrition and vitamin A supplementation are critical for children’s health, and the REACH program for azithromycin aligns seamlessly with this goal.
“The SIAN platform is well-established, extensive, and operates effectively. It boasts outstanding community engagement and a high level of acceptance. The network and its partners have developed strong working relationships both with communities and with the health system across Mali.”
A Network of local solutions
Adoption of the REACH azithromycin intervention in Mali is part of the wider REACH Network slate of similar interventions across sub-Saharan West Africa. Niger and Côte d’Ivoire are also in the process of preparing for the roll-out of azithromycin MDA and Nigeria too is expected to follow suit soon.
Each intervention is tailored to the specific national context and to the demands and rigours of each sub-national region.
Across all countries and regions, however, the ultimate goal remains simple: to reduce child mortality.
The entire REACH Network of partners, researchers and stakeholders congratulates the Mali team on its accomplishments and wishes them all the best as their implementation gathers pace and their intervention goes from strength to strength.
