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MINIMAX – minimal drug resistance & maximum child survival

MINIMAX – minimal drug resistance & maximum child survival through better community treatment of children with fever.

“Fever” is the most common symptom of the diseases that kill 10 million children per year in families around the world. The main killer diseases malaria and pneumonia both present with fever and rapid breathing and these symptoms overlap in one third of sick children in Ugandan health centers, see Figure. Fever also overlaps with diarrhea, the third killer disease. Without diagnostic tests health workers do not know which drug to give to one child out of three. In Uganda where more than 10% of children die before their fifth birthday we have found that many children dying from pneumonia had indeed first been treated with malaria drugs. And Oral Rehydration Solution is rarely given in fever treatment despite the symptom overlap with fever.

Many sick children do no have access to good quality health services. In rural Uganda we found that two thirds of febrile children were treated at home with drugs from informal drug sales in the ubiquitous private shops. However, children mostly get old and ineffective drugs from these small shops, while the drug resistance is mounting …. Yet new and effective drugs exist, but only miles away in the closest public health center. Meanwhile the nearby private sector provider is disregarded, even though this is where most mothers bring their sick children.

The objective of the Minimax project is to bring pre-packaged quality drugs to treat fever (malaria and pneumonia and diarrhoea) near the family through the private sector and community health workers in order to minimize drug resistance and maximize child survival.

In Uganda under collaboration between East Africa’s “Ivy league” Makerere University and the Swedish Nobel-prize awarding Karolinska Institutet we will:

train private drug sellers and community health workers how to use antimalarials and antibiotics and Oral Rehydration Solution and zinc rationally to treat children with fever for malaria and pneumonia and diarrhoea
introduce subsidized pre-packaged quality drugs and promote them through social marketing and accrediting drug outlets/providers
measure effects on drug resistance and quality of care and estimate lives saved
present the treatment model, its cost and effects to national ministries and international organizations