The Nigerian Institute of Medical Research (NIMR) on Sunday announced a milestone in its Safety and Antimicrobial Resistance of Mass Administration of Azithromycin (SARMAAN) project, saying about 1.4 million children under the age of five have been administered with Azithromycin.

Azithromycin is a safe and effective medication recommended by the World Health Organisation (WHO) to combat high childhood mortality rates.

The programme targets areas with under-five mortality exceeding 80 per 1,000 births and infant mortality surpassing 60 per 1,000 births.

Speaking during an engagement meeting with the Minister of Health and Social Welfare, Dr Tunji Alausa, the Director-General of NIMR, Prof Babatunde Salako, also announced that the first phase of the project has ended in six pilot states while the second one has begun.

He said the Nigerian government believes that such studies should be tested and if it give the same result, it should be adopted.

Salako said NIMR and Bill and Melinda Gates Foundation with the Federal Ministry of Health, among other stakeholders have concluded the study in six pilot states where infant mortality is more than 60 per cent, in quite several states in the north and a few down south.

He said the first phase looked at antimicrobial resistance that may follow the use of basic azithromycin because

“if we can drop mortality but increase antimicrobial resistance, that will not be good for the country.”

He said there was also the need to find out how the antimicrobial resistance behaves while mass administration of Azithromycin is on-going.

He said,“We found out that there was not an increase as expected, rather a little reduction and then it remained flat. Now seeing that, we thought we should now try to answer the mortality issue.”

He said the second phase of the study would focus on mortality reduction in the country.

He said they brought in the Minister of State for Health, Dr Tunji Alaisan, because they expect the health ministry to use the study as a policy to reduce infant mortality and under-five mortality in Nigeria.

Giving insight into the SARMAAN project, the Principal Investigator of the project, Professor Oliver Ezechi, confirmed that early results in the pilot states suggest Azithromycin is reducing infant mortality.

Ezechi, who is also the Head of Research at NIMR, said the project was part of the global efforts to prevent childhood mortality alongside other existing child survival interventions.

He said the mass administration of the drugs showed an 18 per cent reduction in child mortality in studies conducted in Niger, Tanzania and the Benin Republic.

Ezechi said the study by NIMR was to show that what those studies supported in the other countries were true through the SARMAAN project in Abia, Kebbi, Jigawa, Kano, Sokoto, Akwa Ibom states.

He said, “We did that in the last two years. We covered over 3.4 million children and the total of those given for this purpose was over 4 million doses. We’re able to show that this drug is safe in children”

He said out of the 1.4 million children who took the drug, only less than 2 per cent actually reported one side effect.

He said, “What are the side effects they reported? It is common for children who report the refusal of food because of the taste of the drug, some stewed, that’s just general.

“We are also able to show that because when you introduce antibiotics to your population, you can generate what we call antimicrobial resistance. We want to show that you are not trying to do something and creating another problem.”

He said after they introduced the drug, they measured the antimicrobial resistance level in those communities and obtained about 4.1 per cent.

He said, “Every six months, we will measure the antimicrobial resistance. We are sure that instead of going up, it was going down. So that means in the two safety parameters we measure, this drug is very good.

“We also calculated what they call cost-effectiveness. We realised that it was cost-effective. Again, we interviewed parents in those communities, health workers, and government workers, who also admitted that the drug is good.”

He announced that they have rolled out SARMAAN 11 which covers under five children.

He said, “We will enrol 600 to 700 people offering direct service. They will be paid, apart from the policy aspect of the result, we’re also generating employment, building capacity. also going to train them.

He said the SARMAAN 11 project was an expansion of the project. “We are giving the drugs to only children less than one. We are now expanding to children less than five years old. Because we demonstrated that it’s safe, we’re expanding that so that we’re able to cover up and prevent death.”

He said SARMAAN 1 reported about 99 per cent coverage.

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