HEKIMA

Malaria remains a leading cause of mortality in sub-Saharan Africa, especially among children under five, who suffered from severe anemia and after hospital discharge face a high risk of re-infection or death after hospital discharge.

“The current approach, post-discharge malaria chemoprevention (PDMC) using a three-month antimalarial pill regimen, has limitations, particularly around adherence and short protection duration”, says Professor Simon Kariuki, a leading malaria researcher and director of research at the KEMRI, the Kenya Medical Research Institution – a key partner of the University of Bergen in this project.

The project HEKIMA seeks to address these limitations by testing monoclonal antibodies (Mabs) as an alternative PDMC approach that could offer extended protection with a single dose.

The project has recently received 12 million NOK from the Research Council of Norway.

A collaborative effort

The project’s objective is to generate evidence on the cost-effectiveness, community acceptability, and health system feasibility of implementing Mabs-based PDMC across Kenya, Uganda, and Malawi. 

“Structured around the EPIS (Exploration, Preparation, Implementation, Sustainment) implementation framework, HEKIMA aligns closely with an NIH-funded trial assessing the efficacy of the treatment. This interaction between projects ensures that the efficacy findings are immediately translated into a relevant frame for policymaking and practical decision-making”, says Oddvar Kaarbøe, professor at University of Bergen and leader of the HEKIMA project.

By combining efficacy data from the trial with applied implementation research, HEKIMA aims to equip policymakers with a comprehensive, timely evidence package to inform future PDMC strategies.

HEKIMA is a collaborative effort, project owner is UiB and it’s co-led by KEMRI in Kenya and TRUE in Malawi.

“This project leverages a long-standing collaboration in epidemiological and implementation science between the University of Bergen (UiB), KEMRI, and TRUE, centered on developing effective antimalarial prophylaxis for children”, says Kaarbøe. 

Supports the most vulnerable children across sub-Saharan Africa

The HEKIMA project plays a critical role in supporting the PDMC consortium’s mission to remain at the forefront of malaria prevention interventions. 

“By rigorously evaluating monoclonal antibodies (Mabs) as a potential alternative to the standard PDMC pill regimen, HEKIMA generates essential, time-sensitive evidence that informs guideline development and policy implementation. This work is structured to address practical challenges, such as cost-effectiveness, community acceptability, and health system readiness, which are central to determining whether Mabs could offer a viable, long-term solution”, says Kaarbøe. 

HEKIMA’s alignment with the EPIS framework ensures that its findings are immediately applicable to decision-makers, enabling the PDMC consortium to provide updated, evidence-based recommendations that can be quickly adopted into national and regional malaria prevention policies:

“Through this approach, HEKIMA ensures the PDMC consortium remains responsive to emerging interventions, supporting agile policy adaptations that protect the most vulnerable children across sub-Saharan Africa”, Kaarbøe concludes.