In the SEACAT evaluation, there will be a comprehensive evaluation of the phased introduction of combination antimalarial therapy at provincial and national level in Mozambique, Swaziland and South Africa .

This potential, and its cost effectiveness need to be evaluated in Africa where the burden of malaria disease contributes significantly to underdevelopment.  To ensure that results are sustainable and generalisable, national and provincial malaria control programs must primarily be involved and responsible for implementation and evaluation of such a change in malaria treatment policy.

In the South East African Combination Antimalarial Therapy (SEACAT) evaluation, there will be a comprehensive evaluation of the phased introduction of combination antimalarial therapy at provincial and national level in Mozambique, Swaziland and South Africa (KwaZulu Natal, Mpumalanga and Northern Province).In vivo resistance, molecular markers of resistance, gametocyte carriage, drug utilisation and cost effectiveness will be evaluated at each site at baseline and biannually, over a period of 6 years.

The strong partnership established between researchers and malaria control programme management provides a sound basis on which to build and sustain this evaluation.  The Lubombo Spatial Development Initiative (SDI) provides a legal and logistical framework for collaboration between Mozambique, Swaziland and South Africa. The evaluation of malaria treatment policy regionally is mandated under the SDI.

Concurrent separately funded projects evaluating drug safety, gene flow, the policymaking process and further development of the geographic and malaria information systems will strengthen this evaluation significantly.  A shared database and repository of specimens will be created to allow correlation between in vivo, in vitro and PCR markers of resistance, and evaluation of the impact of antimalarial therapy on the intensity and distribution of malaria transmission. 

In keeping with the Roll Back Malaria Initiative and the Multilateral Initiative in Malaria, local training and capacity building will underpin each component of the evaluation, to ensure both the sustainability and the generalisability of the findings.  Wherever possible, neighbouring countries will be involved in this capacity building as it is expected that this evaluation will inform the future role of combination anti-malarial therapy in Africa.