Summary
Intermittent preventive treatment in infants (IPTi) for malaria provides preventive antimalarial medicine to children under 12 months old. It is among the most promising programs we’ve identified in our active pipeline of new interventions. Not only does IPTi appear to be highly effective at reducing clinical malaria, it’s also underutilized (more below), and the population it targets is especially vulnerable to malaria. That implies potential to open up large amounts of room for more funding if IPTi begins to be used more widely—our crude estimate is between $50 million and $200 million globally once it’s scaled—which is something we’re increasingly thinking about as we aim to direct $1 billion in cost-effective funding by 2025.
In September 2021, we recommended a small grant to Malaria Consortium and PATH to assess the feasibility and cost-effectiveness of implementing IPTi at national scale in two countries. This grant was the result of an atypical process for us: because we don’t know of any organizations currently implementing IPTi, we issued a request for information to several charities that we thought might be good candidates to do so (more below). We’re hopeful that this scoping exercise will answer some of our many open questions about IPTi, and that this intervention continues to look promising as we learn more.
What is IPTi?
Intermittent preventive treatment in infants (IPTi) for malaria is a program that distributes preventive antimalarial medicine (usually sulfadoxine-pyrimethamine, or SP) to infants, regardless of whether they have malaria, during routine immunization services. A Cochrane meta-analysis of 12 randomized controlled trials (RCTs) found that IPTi reduced cases of clinical malaria by 30%.[1]
IPTi appears effective enough that the World Health Organization (WHO) began recommending it 12 years ago, in 2010.[2] However, our research has identified only one country, Sierra Leone, that has integrated IPTi into its routine national health care practice.[3] We think this neglectedness is due in part to potentially surmountable logistical factors, such as the need to coordinate work between national malaria control programs and national immunization programs.[4] Other barriers to implementation have included the way WHO guidelines identified which settings are appropriate for IPTi[5] (though we understand from speaking with other organizations in the malaria space that these guidelines are currently under revision), and challenges with administering previously available formulations of SP.[6]
Why we’re excited about it

Effectiveness –

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