Economic Report for the WHO Technical Expert Group Meeting on Intermittent Preventive Treatment of Malaria in Children

For Intermittent Preventive Treatment of Malaria in Children (IPTc) to be accepted and sustainable as a malaria control strategy it must be affordable and cost effective as well as safe and acceptable. Thus, several of the IPTc studies have included an economic component. These studies range from randomised controlled trials to operational research studies. In addition, modelling was used to supplement the information available from the trials and to provide predictions where the trials could not, for practical reasons, provide estimates. Both financial and economic costs associated with IPTc delivery have been investigated to help forecast how introducing the intervention may impact health budgets, and to help determine the cost effectiveness of IPTc compared to other malaria interventions. In this report we present the costs and cost-effective of IPTc using three different drug regimens and various delivery strategies. Across all studies, the financial cost per IPTc course range from US$0.24 to US$3.44 and the economic cost per course from US$0.31 to US$3.44. These costs are within the range of the costs associated with delivering existing malaria control interventions. The cost effectiveness of the intervention was comparable, but marginally higher than other prevention strategies, however possibilities exist for reducing the costs of IPTc by scaling up and by incorporating delivery of IPTc with the delivery of other interventions such as the distribution of Vitamin A or Community and Home Management of Malaria. Supervision, training and remuneration of CHWs and IPTc drug delivery have been identified as the main cost components and key determinants to the success of the delivery strategy. There is scope for the costs associated with supervision and training to be reduced if IPTc is integrated into existing routine activities. Alternatively, in settings where supervision and training of CHWs is weak, IPTc may offer an opportunity to strengthen both these important aspects of service delivery which will offer benefits beyond reducing malaria morbidity and mortality.