Unitaid has made a USD 67 million grant to Malaria Consortium (MC) to implement a malaria prevention program: Achieving Catalytic Expansion of Seasonal Malaria Chemoprevention in the Sahel (ACCESS-SMC). To date, various challenges have prevented adoption at scale of Seasonal Malaria Chemoprevention in the Sahel. On the demand side, healthcare systems and funders have not shown demand for expanding the treatment at scale. On the supply side, the global market has historically not supplied treatments at the volume or in the formulations needed. The ACCESS-SMC project aimed to overcome these challenges by (i) providing SMC treatment in seven countries, and; (ii) working with market actors, including potential donors and new manufacturers, to change market dynamics.
This report evaluates programmatic implementation of the project with a particular focus on the overall progress towards the projects’ health and market objectives. Unitaid commissioned Dalberg to evaluate ACCESS-SMC. Dalberg has assessed the grant across five dimensions – relevance, effectiveness, sustainability, efficiency, and learning and risk mitigation1. We identified issues from this assessment and subsequently provided recommendations to address them. Dalberg did not conduct a data audit per se, but used interviews and document reviews to assess information consistency.
ACCESS-SMC’s design aligned closely with Unitaid’s overall mission and two of its strategic objectives. Its focus on scaling access to a recently approved form of mass drug administration to prevent malaria in children directly supported Unitaid’s strategic objective 6 – to increase access to products for the prevention of malaria – and also supported strategic objective 2. In addition, the program aligned well with Unitaid’s overall mission due to (i) its global market- based approach to scaling-up the use of anti-malaria drugs and (ii) its emphasis on reaching disadvantaged areas.
The project’s intended outcomes were relevant to the challenges facing SMC, but the logframe could have more explicitly linked activities to outputs and intended outcomes.2 Some of the objectives included at the “output” level would be more appropriate at other levels, and some project activities were not linked to output metrics. This created some difficulty to assess which activities had contributed to changes in outputs and outcomes.