Latest news from the REACH Network of African-led research institutions, Ministries of Health, policy advocates, and implementation partners working together to reduce preventable child mortality through evidence-based, equitable, and scalable solutions.

I am delighted to congratulate my dear friends and colleagues in Burkina Faso following the Ministry of Health’s official approval of the scale-up of mass prophylactic administration of azithromycin to all children aged 1–59 months in targeted high-mortality regions.

This decision is a remarkable achievement, resulting from the hard work and dedication of the REACH MIRAMA study team, whose research clearly demonstrated both the feasibility and life-saving potential of integrated azithromycin interventions for child survival.

Scale-up will begin in 2026, with phased implementation starting in the regions where under-five mortality remains highest.

This is a major milestone for REACH in Burkina Faso and testament to the vision and leadership of the Ministry of Health and the Burkinabé government, the tireless efforts of frontline health workers, and the collaboration of all partners who have supported this journey.

Above all, this moment demonstrates that REACH can move successfully from research to national adoption - a clear sign that together we are building the foundations for sustainable scale-up across West Africa and beyond.

Congratulations, my friends - this is truly outstanding work!

As our REACH grows, so will the demand for azithromycin and the need to ensure a reliable and sustainable supply chain. 

I am very happy to share with you the news that the REACH Network and our partners at the International Trachoma Initiative (ITI) are welcoming Aurobindo Pharma as a new supplier of azithromycin for child survival.

A leading generics manufacturer based in Hyderabad, India, Aurobindo will provide ALZYL 200 Azithromycin for Oral Suspension. The company has proven production capacity and this is yet another important marker for the future of REACH.

The impact of our progress is already tangible. Nigeria received its first shipment of 500,000 bottles, equivalent to 2 million doses, for its September/October distribution campaign. 

This expansion of supply chain capacity comes at a perfect time, as REACH programmes scale up in Burkina, as well as in Mali, Niger, and Nigeria.

The LAKANA trial set out to answer a critical question: could azithromycin save more lives if given only to the youngest infants, as recommended in the 2020 WHO guidelines?

The findings now provide a clear answer. Administering azithromycin solely to children aged 1–11 months does not produce a measurable reduction in mortality in high-burden settings. This stands in contrast to the strong and consistent evidence of mortality reduction among children aged 1–59 months.

Building on this evidence, CVD-Mali, in close partnership with the Ministry of Health and Social Development, is continuing to scale up the REACH program, targeting children aged 1–59 months - the age group where the intervention has demonstrated the greatest and most reliable impact on child survival.

Coordinated by CVD-Mali and Tampere University, LAKANA stands as a landmark in African-led research, informing global child survival policy and shaping the evidence base for action.

Heartfelt thanks to all partners on this important study, and congratulations to the team on publishing your results in the prestigious New England Journal of Medicine!

National expansion and increased supply also mean that we need our regulatory and oversight procedures to keep pace with developments on the ground. 

And in this, too, the REACH Network is taking huge strides. 

The Advisory Panel on Azithromycin for Child Survival (APACS) convened for the first time on 29 August, implementing our shared commitment to sustainability, responsible drug stewardship, and equity. 

Established jointly by the REACH Network and ITI, APACS provides independent expert advice on the safe, effective, and equitable use of azithromycin for child survival.

The panel provisionally approved Niger’s request for azithromycin allocation in 2026, meaning that all seven regions in the country will be covered, with nearly 10 million doses of azithromycin to be distributed. 

APACS members also gave careful consideration to mortality thresholds, antimicrobial resistance surveillance, and the operational realities of mass drug administration.

This is vital, of course, as we look to ensure that REACH interventions remain responsible, equitable, and effective at scale.