Fighting on the front-line – Empowering communities to drive long-acting injectable innovation

Posted on: 24 April 2023 by Andy Sloan in LONGEVITY Blog

The latest WHO World Malaria Report indicates that Africa carries a disproportionately high burden of malaria with 95% of malaria cases and 96% of malaria deaths occurring in this region with children under 5 accounted for about 80% of all malaria deaths on the continent. It is now more important than ever that more investment in innovation and implementation of more effective prevention strategies for low- and middle-income countries.

LONGEVITY and Malaria

The malaria burden can be reduced by tackling the issue of non-adherence to current malaria prevention regimens which require taking many tablets, and adding new tools to the control strategies currently available. The LONGEVITY Project will deploy a long-acting injectable which can provide protection from malaria with just one injection a year. This will simplify drug delivery to improve adherence, reduce transmission rates and support future strategies to eliminate the disease.

Community engagement on the front line - interview with Dorothy Onyango of the Long-acting Technologies Community Advisory Board

Dorothy Onyango is the CEO and one of the founding members of Women Fighting AIDS in Kenya (WOFAK), a national non-governmental organization founded and registered in Kenya by a group of women, most of whom had tested HIV positive. Dorothy is a community expert on the Long-acting Technologies Community Advisory Board (LAT CAB) which was created in 2021 to ensure community engagement with researchers working on the development of long-acting technologies under the Unitaid-funded LONGEVITY project.

Dorothy has worked for many years with a network of TB champions fighting to prevent Tuberculosis in Kenya and wanted to further expand on this work by joining the LAT CAB to share her advocacy expertise and to network with other like-minded organisations. Dorothy is fighting on the front line to help develop innovative ways of preventing malaria cases in Africa.

You’ve worked as a community engagement advocate within malaria affected communities for many years. What do you think are the most critical shortcomings that make current malaria prevention strategies ineffective and in need of innovation?

From my engagement activities so far, several issues have been raised that suggest new innovation is required for malaria prevention. The emergence of parasite resistance to certain anti-malarial agents has presented a major barrier to successful disease management in malaria-endemic areas.

Sleeping under an insecticide treated mosquito net each night is crucial in the prevention of malaria. However, some households don’t have access to mosquito nets because their cost is more than they can afford. There are also issues around the smell of mosquito repellent and other insecticides which make them uncomfortable to sleep in.

There are also some misconceptions relating to malaria prevention and treatment medicines that results in adherence issues. Some people believe that the medicines prescribed by doctors can cause harmful side effects so they’re reluctant to take their prescribed medication. More education is needed in malaria endemic communities on the correct use of malaria medicines to encourage people to use them.

Tell me about the progress made by the LAT CAB since it began working within malaria affected communities

LAT CAB has been working on the frontline in malaria endemic areas to ensure that communities are aware of the research being done for long-acting malaria prevention medicines. We also work with healthcare workers and facilities to strengthen their capacity in diagnosis, prevention and treatment. By networking with healthcare workers, we have enabled the sharing of best practice among the communities in malaria endemic areas to reduce transmission. We are also very proud to have contributed to the policy and practice within governments in many countries affected by malaria and we have united efforts in diagnosis, prevention and treatment.  

Through the LONGEVITY project we’re aiming to reduce the instance of malaria in low- and middle-income countries by developing long-acting medicines to prevent malaria with a single administration per year. How well known are long-acting medicines and how are they perceived within the communities you’ve worked with?

Currently there is not enough knowledge on long acting medicines among the general population. However, healthcare workers have been consulted about long-acting medicines and are able to educate people on the benefits they can bring and promote their use. Much more work needs to be done to raise awareness of long-acting medicines in Africa but the LAT CAB is committed to ensuring this work is being progressed.

Healthcare providers in malaria endemic communities are often overwhelmed and short staffed. How can the LONGEVITY strategy help healthcare providers and facilities?

Better adherence to malaria prevention regimens through long-acting medicines has the potential to reduce malaria cases in Africa which will be a great achievement which can help healthcare facilities on a large scale. More specifically, they can reduce the need for multiple visits from patients to receive prevention medicines which will leave facilities with more capacity to treat others.

The WHO Africa region accounts for approximately 95% of malaria cases and 96% of malaria deaths. What are the most critical factors that prevent people in malaria endemic countries from accessing or adhering to current oral malaria prevention medicines?

There is currently very little knowledge on oral malaria prevention medicine which is a large contributor to its lack of uptake leading to high infection rates because people aren’t protecting themselves with medicines. If communities had a better understanding of malaria preventive treatments there would be much better adherence and completion rates.

Another access barrier for malaria prevention medicine is how difficult it is for some people to get to a hospital or health clinic to speak with a doctor and receive preventive medicine which needs to be taken multiple times throughout the year. In rural areas it is not so easy for people to travel multiple times so they rely on other preventive measures such as mosquito nets.

You can keep up to date with all things related to the LONGEIVTY project by signing up to our newsletter.

The LONGEVITY Project is funded by Unitaid

The project also involves critical partners and collaborators in the Clinton Health Access Initiative, Johns Hopkins University, Medicines Patent Pool, Tandem Nano Ltd., Treatment Action Group and the University of Nebraska Medical Center