4 September 2012

Nigeria: The Global Fund and Nigeria's Battle Against Malaria Scourge


With the support of the Global Fund to Nigeria last week with additional funding of $217 million putting the total funds to the country above a billion dollars, Paul Obi writes on the challenges confronting the Nigerian government as it concerns surplus funding and performance of the implementation of malaria prevention programmes

In Nigeria, many persons who go to the hospital have malaria symptoms. Many health experts around the globe also believe that a reduction of malaria disease in Nigeria will help to scale down global figures of the disease.

Consequently, the Global Fund for Tuberculosis, HIV/AIDS and Malaria shares the view that more attention need to be given to Nigeria as it concerns the move to wrestle the malaria scourge. Thus, much of Global Fund financial and technical assistance has been directed towards collaborating with the Nigerian government and health organisations in putting a stop to the spread of malaria. Since 2004, the Global Fund has contributed approximately $971 million to the country. Last week, officials of the Global Fund arrived Abuja, Nigeria in continuation of the drive to once more expedite action in malaria prevention programmes.

At the signing ceremony, Deputy Executive Director of the fund, Debrework Zewdie, said the funds would target efforts on reducing morbidity and mortality associated with malaria. Zewdie alongside a high delegation from the Global Fund office from Geneva, Switzerland, told the gathering made up of top government functionaries that the $167 million and additional $50 million is meant to assure the international community that Nigeria is a worthy partner in the fight to eradicate malaria.

"The Global Fund is taking steps to increase the impact of its investments. During a transformation of the fund's grant management structure this year, Nigeria was identified as one of the 20 'high impact' countries that is now receiving special attention.

"The fund is also devising a new funding model that is expected to ensure strategic investment in programmes that can be most effective, as the malaria control programme in Nigeria, with this, we have to prove skeptics wrong who say Nigeria is too difficult in the fight against malaria," Zewdie explained.

She told journalists that with the funding of Nigeria's malaria program now put at about $1.5 billion, the fund will adopt a new mechanism that will monitor the process of implementation with the hope of ensuring accountability and transparency.

Minister of Health, Prof. Onyebuchi Chukwu, while commending the giant strides made by the fund said: "As you know, the Global Fund to fight HIV/AIDs, Tuberculosis and Malaria (GFATM) has been supporting the implementation of interventions targeted at reducing the burdens of the three diseases HIV/AIDS, Tuberculosis and Malaria. The support of the Global Fund has invariably resulted in the scaling up of interventions against these three diseases and with the solid collaboration from the Government of Nigeria we are beginning to see substantial reductions in the morbility and mortality of these scourges."

Chukwu observed that, "these concerted efforts galvanised by the National Malaria Control Programmes and in collaboration with partners, multilateral and bilateral agencies as well as the indigenous organisations have halted and begun reversal of the large number of morbility and mortality previously unleashed by this deadly scourge and which significantly contribute to our poor health indices. So in addressing the Malaria challenge, we are by that tackling the challenge of achieving the core health related MDGs; i.e. MDGs 4, 5 and 6."

Friends of Africa, a private sector group with interest in deepening governance within the African continent and Dangote Group partners in the fight against malaria, also resolved to support the Federal Government Malaria Prevention Program as part of their commitment to eradicating the disease from the continent.

Board Chair, Friends of Africa and CEO of Access Bank, Aigboje Aig-Imoukhuede, who attended the event stated that the donation of $217 million by the Global Fund to the Nigerian government in the fight against malaria is a demonstration of commitment of the global body to the Nigerian course. The Board Chair in his presentation said: "as Board Chair of Friends of Africa, we assure you of all the support and partnership needed to ensure the successful implementation of all Global Fund projects in Nigeria." While applauding Global donation by the Fund, he observed: "This grant, further presents us another opportunity to save more lives and ensure that malaria deaths in Nigeria are reduced to the bearest minimum."

Aig-Imoukhuede further urged the government to show leadership and commitment in the fight against malaria by committing more funds as a measure to remove Nigeria from list of countries with malaria burden.

Speaking also, the Coordinator of the National Malaria Control Program (NMCP), Dr. Chioma Amajor, assured of government readiness to ensure that the next phase of malaria prevention program is effectively implemented. Amajor added that, given recent achievement in the program, the funds will help in accelerating the implementation process, which will lead to the target goals. On his part, WHO Country Representative, Dr. David Okello, applauded the efforts of the Global Fund, stating that, "if you want to eradicate malaria in Africa, come to Nigeria,"

The ceremony which also had in attendance Minister of State, Health, Dr. Muhammed Pate, the ministry's Permanent Secretary, Mrs. Fatima Bamidele, Dr. Bright Ekweremadu of SFH, the World Bank, WHO, Dangote Group among other organisations, provided an ample opportunity to move fast in ensuring thorough implementation of the funds.The $217 million dollars presented by the Fund Deputy Executive Director, Debrework Zewdie is expected to be implemented within two years duration, $68 million will go to NMCP, while $99 million dollars will be disbursed to the Society for Family Health (SFH). With the donation, and starting from previous funding of $971 million since 2004, the Fund's total funding to Nigeria is now put at about $1.2 billion, one of the highest funding to countries made by the Global Fund.

With the donation of the funds to the Nigerian government, observers will be waiting to grade the performance between such huge sum and the actual implementation. Though, the government through the National Malaria Control Program has made tremendous efforts in prevention of the disease, the desired results is still far off from stemming the tide of malaria among Nigerians. The distribution of about 47 million Long Lasting Insecticide Treated Nets (LLITN) to Nigerians, remains one of the pilot projects that has worked favourably in Malaria prevention. This time, the authorities should go beyond distribution of nets, a new strategy for rural communities and the interior where malaria scourge is intense should be formulated to bring about drastic reduction of the disease.

From the body language of the Global Fund, as expressed by Zewdie, the body will not take it lightly on the issue of transparency and accountability. She told journalists at the signing ceremony that the Nigerian government including Society for Family Health must balance the utilization of the fund and implementation. This, NMCP Coordinator, Amajor assured that the agency primary responsibility is to see to the detailed and discreet implementation of the programme.

Nigeria's responsibility in managing many of the health scourges is increasing by the day. A situation that is giving global health experts a source for concern, as evidenced in the last World Health Assembly (WHA). When donors and citizens become aware of such enormous funds, they expect to see results, possibly, outright reduction or eradication of diseases, in this case, malaria.

Therefore, it is time for the government through NMCP to put teeth to action in fighting malaria to a standstill. Again, it is not too late for authorities at the Federal Ministry of Health, NMCP and Society for Family Heath to show that Nigeria can deliver and 'prove skeptics wrong'. By 2014, there should be concrete proof that the $217 million has performed in all critical areas surrounding malaria. And going by the recent brouhaha concerning the Global Funds accountability in funding of projects around the world, it's incumbent on officials to marry the $217 million with results. Good performance is the key word here and should be the target goal.

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