BY 2015, it is expected that the world would witness reduction in morbidity and mortality by 75 percent. With malaria still on the rampage, this might not be visible for Africa as huge global efforts is yet to translate into total victory. In this interview, Dr. Chioma Amajoh, Deputy Director, Roll Back Malaria, Federal Ministry of Health, laments what she describes as the absence of political will to fight the disease.
She also stressed on the need to internalise behavioural change mechanism in keeping environments clean. This according to her, is critical in the war against the disease. Amajoh, who is also known as ‘Mama Malaria’ spoke to CHARLES KUMOLU.
IT was reported that by the end of last year, the world was expected to attain 80 percent coverage for treatment and distribution of bed nets; reach pregnant women with preventive treatment for malaria, have these goals been met and what does malaria control association seek to achieve?
First of all, we are looking at issues concerning vector resistance to insecticides because if they are no longer resistant to certain insecticides, we should not use those insecticides. In Nigeria we have established a reference lab and Sam Awolola is the consultant. In February this year, Awolola and I were in Geneva for the Vector Control Working Group of WHO and a three-day meeting was organised. We all agreed that we need this Mosquito control association as a symbol and as a tool to monitor pestal control activities. We are also looking at integrated type of management and statistics for monitoring mosquitoes control.
We later decided to launch our own Nigeria chapter and this association is expected to even go beyond monitoring pestal resistance and cover the issue concerning the control of the disease. If we must eliminate malaria, we must control the mosquitoes.We cannot eliminate mosquitoes anywhere, because even in the countries were they have eradicated malaria , mosquitoes are there. They are living organisms there. We are going to inaugurate to birth this association and that’s the reason we have so many experts.
We have eight functionalconsolidated labs established in the country already. And NIMR is now the reference laboratory. The experts on this are also here. We have researchers in the university supporting vector resistance technology and they are all here. We have these development agencies that will support and we have the private sector. And of course we also have even within the public sector some related line ministries, the environment, the water resources, the agriculture were they use 78 percent of them in public health we only use about 16 percent.
But this association has just been inaugurated, and purposely, we just decided to allow it to be democratic, because the next thing will be what is the vision, what are the objectives. We know the objectives which I have told you. But we want the experts to all agree on the mission, agree on the vision and it has to be in line with what we said.
What will be the role of the private sector in this?
They have a major role. Already, the private sector are our partners in Role Back Malaria. One fact to note is that the Role Back Malaria partnership in Nigeria works with contacts. Each partner works in each area of its operative advantage. The private sector is concerned about their profit, but they are also bringing money to support the programme. So in this association they have a stake. They will now know the insecticides that are not working. Those of them that are bringing in this insecticides, of course the regulative agencies will reorganise the logistic effects to make their insecticides effective or look for alternatives.
We have biological agents, we have insect growth regulator inhibitor that are not insecticides. We have genetic names so that they will get back to their lab and do more because they know that we will refuse those chemicals. They have to be part of this so that they will be aware of the way forward.
Each time government talks about controlling malaria what readily comes to mind is our prevailing dirty environment. This has been as old as malaria itself. Why is it that stakeholders haven’t focused on the factors that cause malaria instead of focusing on how to manage the disease?
We always talk about vector resistance chemicals, we always talk about medicine, parasite resistance to drugs. But nobody talks about the human resistance. If you keep your environment clean, I keep my environment clean, and disallow water, we will get better results. Its not spirits who make the environment dirty, its human beings who does that. People could drink their water from the sachet, banana, yoghourt and dispose it anywhere they like. And that brings me to another line of commitment as individuals even children should be committed and put these things were they belong.
In the western world there are regulations if you keep your environment clean, I keep mine too there would have been little or nothing on the causes of malaria. Even in industrial areas, if they do what they are supposed to do, the water will flow, the drains will be covered and we will have little or no problem. Even the sachet water which is discarded and the rain falls on it, the water remains on it and the mosquitoes will breed.
So, what is the way forward?
The way forward is for all of us to internalise behavioural change mechanism in keeping our environment clean. We need your support to help us to voice it and let people not just ask ;how much am I getting for doing this. Our resolve to do this has to be fueled by passion. when we do it, it would consolidate the gains we have recorded in the fight against malaria.
What is your position on this belief in most quarters that malaria has not been eradicated like it been done in some Western countries because it is business for some stakeholders. Hence, an end is not in sight for the disease?
Should it be business? 91 percent of malaria resides in Africa. Political will is the problem. If our governments can muster the political will to fight malaria, the disease will be on its way out of Africa. We have what we call ALMANAC, African Leaders Alliance Against Malaria.
It is a stakeholders forum and at the global level, Joy Kumati is the head. They are telling African leaders that we now have a scorecard where the progress countries in the campaign against malaria is reflected. When you look at your scorecard, you will know were you stand. Let there be more money on research and malaria made as a priority by governments. If we are waiting for the international community or the donor agencies to come and help us, it would not address the issue totally.
So I do not see it as a business If we must achieve the Millenium Development Goals,MDGs, we must subdue this disease. If you look at the eight MDGs, you will discover that malaria is a disease of poverty. And one of the goals is eradication of poverty, achieve basic primary education, because if you don’t change that woman, who is a caregiver, no matter what you do to help her, there would still be problems.
Thirdly, the empowerment of women. If you can empower that woman, so that when her child is ill, she will take the child to the hospital without delay. Malaria kills because, it is not detected early and they are not given adequate treatment. There is also the delay of 24 hours before going to the hospital, which can kill. And of course it contributes to child mortality, – children under five.
There is also the need to improve maternal health. Eleven percent of maternal mortality in Nigeria is due to malaria and its complications. Three hundred thousand children die of malaria annually and we call it common malaria. And we still be talking about HIV/AIDS and other diseases. If we maintain healthy environment,it will go a long way. And we still need partnership. This is the way we can achieve goals. So, I do not see it as business. I am an example of someone who has a passion for the fight against malaria. And that was how I got that name ‘Mama Malaria’.
Mine is basically on how we can fight the disease and achieve goals at the end of the day. We are doing this and people are seeing it. Our worry is why should this disease which is preventable, curable become a threat. I am sure that we will get there.