Nigeria: FG, States Must Be Committed to Malaria Eradication

25 April 2024

Today, March 25, is World Malaria Day, held each year to raise global awareness of the life-threatening disease. With this year's theme, 'Accelerate the Fight Against Malaria for a More Equitable World', it is also a day to highlight the need for better political intervention in malaria control and prevention.

Instituted by the World Health Organisation (WHO) member states during the World Health Assembly of 2007, the day was celebrated for the first time internationally in 2008. It was influenced by the Africa Malaria Day, which has been marked by African governments since 2001, on this day.

The Malaria Plasmodium parasite spreads through the bites of infected female Anopheles mosquitoes, was discovered in 1880 by Alphonse Laveran, a military doctor in France's Service de Santé des Armées (Health Service of the Armed Forces) in then Constantine, today's Algeria.

The disease is most prevalent in tropical and sub-tropical regions, especially sub-Saharan Africa. In 2021, sub-Saharan Africa accounted for almost 95% (234 million) of all global malaria cases and 96% (593,000) of all related deaths. In 2021, four countries led by Nigeria, the Democratic Republic of Congo, Niger Republic and Tanzania, accounted for over 50% of global malaria deaths.

And because it is endemic in Nigeria, where over 76% of the population live in high transmission areas, it remains the leading cause of death among children under five, with an estimated 95,000 annual child deaths. The figures in 2021 showed that Nigeria had an estimated 68 million cases and 194,000 deaths due to the disease. And this has had devastating effects with the National Malaria Elimination Programme (NMEP) estimating that the disease costs Nigeria $660 million annually.

To combat it, Nigeria has had the National Malaria Strategic Plan (NMSP), the Nigeria End Malaria Council (NEMC), and the National Malaria Elimination Programme (NMEP) all geared towards achieving the NMSP goal of eradicating malaria by 2025. Clearly, it has fallen short of the NMSP 2021-2025 goal of reducing malaria deaths to less than 50 per 1,000 births, or achieving a parasite prevalence of less than 10% by 2025.

The good news is that malaria is preventable and curable. It is not contagious, but it is fatal without prompt diagnosis and effective treatment, meaning that it can be prevented by avoiding mosquito bites and taking the right dose of medicines.

Over the years, the Nigerian government has received support and funds for malaria control from the Global Fund, USAID's President's Malaria Initiative (PMI), UK's Department for International Development (DFID), now replaced by the Foreign, Commonwealth & Development Office (FCDO), non-governmental organisations (NGOs), World Health Organisation and private sector companies, especially in the extractive industry.

In addition, Nigeria has secured loans from the World Bank, the African Development Bank and the Islamic Development Bank for the eradication of malaria.

These have led to the provision of long-lasting, insecticide-treated mosquito nets, indoor insecticide spraying campaigns, the latest drug therapies to treat infections, prevention and community education campaigns.

However, these initiatives have not rolled back or eradicated malaria as required. What has been lacking is not just sustained local funding, but a strong political commitment at the federal and state levels. Therefore, we at Daily Trust, call for renewed political will and provision of needed funding.

We also call for concerted efforts towards prevention and cure through multi-disciplinary approach involving social and behavioural scientists and the incorporation of community stakeholders and their belief systems.

We call out the National Orientation Agency (NOA) to lead all public and private media organisations to assist in constantly creating awareness on the prevention and eradication of the disease.

We call for the reintroduction of vector control, including the use of insecticide-treated nets (ITNs) and spraying to kill mosquito larvae and indoor spraying. In addition, because antimalarial medications don't come cheap anymore for the average Nigerian, we also call for subsiding malaria testing and drugs.

We also call for a wholesome review of the nation's healthcare sector to develop new interventions and control measures in a healthcare system restructured, strengthened and made ready to face the challenges of malaria elimination.

Governments must commit to scaling up funding for malaria control, the same way they aggressively pursued HIV/AIDS and COVID-19 prevention and control. New emphasis should also focus on research.

Furthermore, it is time to go back to the basics. Hygiene should be taught in schools and community levels with focus on mosquito control through the removal of their breeding sites and larvae, starting with the clearing of bushes, water containers, abandoned tyres and flower pots around houses and other buildings.

This is because once mosquitoes find less habitable hosts, the transmission of the parasite will reduce drastically. And the federal government must accelerate the rollout of the antimalarial vaccine in Nigeria, being the global epicentre of mosquito and its disease, malaria. After all, the federal government on April 17, 2023, approved the introduction of the R21 malaria vaccine, which has 80% efficacy in preventing malaria in children.

It is a failure of leadership over the years that Nigeria is not leading global efforts in the race for malaria vaccine. The government must do more. Deliberate efforts must be made to bring down the price of malaria drugs while looking towards total eradication of the disease. Nigeria must take this disease seriously and work towards ending it now.

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