Last Updated: 09/12/2025
Implementation evidence from health economics and users on preventing malaria in vulnerable children with monoclonal antibodies (HEKIMA)
Objectives
The HEKIMA project evaluates the cost-effectiveness and acceptability of monoclonal antibodies for post-discharge malaria chemoprevention (PDMC) in children across Kenya, Uganda, and Malawi. Key work packages focus on assessing the economic viability of monoclonal antibodies over traditional PDMC, exploring willingness to pay through household choice experiments, and determining health system readiness for sustainable implementation.
Malaria remains one of the deadliest threats to children under five in sub-Saharan Africa. For children recovering from severe anemia, a common consequence of malaria, the months following hospital discharge are critical. These children are at heightened risk of severe illness or death if they contract malaria again. The current WHO-recommended PDMC strategy requires families to administer three pills daily for three consecutive days each month over three months, which can be challenging to maintain. Poor adherence reduces efficacy, leaving children vulnerable to re-infections. Monoclonal antibodies (Mabs) offer a groundbreaking alternative. A single injection provides immediate protection for approximately one year, eliminating the need for adherence to pills. This is particularly advantageous for children from poorer households. Building on an ongoing NIH/CDC-funded trial in Kenya, the HEKIMA project will assess the feasibility, cost-effectiveness, and acceptability of Mabs in Kanya, and expand the results to Malawi and Uganda.
Economic Evaluations: Assess costs and benefits of Mabs compared to pill-based PDMC regimens; considering healthcare system costs, household expenses, and long-term economic impacts.
Community Acceptability: Explore caregivers’ perceptions and willingness to adopt and pay for Mabs. These findings will guide pricing strategies and ensure accessibility and equity.
Healthcare Infrastructure: Evaluate readiness of healthcare systems and identify barriers such as logistical challenges, supply chain limitations, and training gaps. This informs solutions to strengthen system capacity for Mabs delivery.
Policy Engagement: Collaborate with ministries of health and WHO to ensure findings contribute to actionable recommendations. Early engagement with policymakers aims to accelerate the integration of Mabs into national malaria prevention strategies.
Jan 2025 — Dec 2029
$1.09M
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