As storms sweep across the Sahel, African children will periodically swallow anti-malaria drugs to halt the disease regardless of whether they have it, like tourists visiting malaria-ridden countries. Public health experts have protested this preventative measure for decades, fearing it will cause widespread drug resistance to the treatment within a few years, reducing the number of cures to one.

However, large clinical trials recently demonstrated that the measure averts 75 percent of severe malaria cases. Further, thousands of children who were usually rendered bedridden from malarial fevers throughout the rainy season were able to study instead. In comparison, the leading malaria vaccine turned out to temporarily reduce malaria by a disappointing 30 percent. Last year, the World Health Organization recommended the rollout as a method to curb some 655,000 malaria deaths per year. Now, Senegal, Mali, Chad, Nigeria, Niger and Togo are implementing the program, in which children take monthly doses of the anti-malarial medication, sulfadoxine-pyrimethamine and amodiaquine (SP+AQ).

Will the results of these rollouts be as stunning as in clinical trials where individuals were closely monitored? Or, will it be less efficacious and cause resistance to yet another malaria drug with little payoff? The answers will be collected in real time, with West African and European scientists monitoring resistance to SP+AQ.

Science writer Amy Maxmen was in Mali and Senegal to meet with these scientists and observe the rollout of chemoprevention and the roadblocks it meets along the way.

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Amy Maxmen is a freelance science journalist who covers infectious diseases, evolution, genetics, public health, science policy and more for the likes of Nature, Nova, New...

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