2020 saw the launch of activities for ICARIA, a project that will evaluate an innovative strategy to reduce child mortality in the poorest countries of the world. After a year of preparation, we recruited the first participants to the trial in the northern province of Sierra Leone. We are currently extending the study to 15 primary health centres in three districts of the province. The aim is to enrol a total of 20,560 participants. The five-year project, funded by the Bill & Melinda Gates Foundation and “la Caixa” Foundation, will evaluate the impact of giving azithromycin together with intermittent preventive malaria treatment to children, through the expanded program on immunisation.