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Malaria: Why Nigeria is far from winning despite global progress

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By Chioma Obinna


ON this year’s World Malaria day, with the theme: “Zero malaria starts with me”, findings show that      Nigeria needs to prioritise investment, improve the environment and the quality of drugs, if it must go beyond recognising the day to celebrate the reduction of malaria burden in the country.

Findings from the research have shown that a Nigerian child is likely to die from malaria, diarrhoea, water-borne diseases or malnutrition before his fifth birthday.

Malaria is a preventable disease that costs less than $1 to treat sadly, according to the World Health Organisation in its 2019 message, its latest World malaria report showed that no significant gains were made in reducing malaria cases in the period 2015 to 2017.

Nigeria- map

In Nigeria, malaria control has been stalled by various factors. According to the 2015 Malaria Indicator Survey, MIS, one in four children under five years tested positive to malaria.

The number represents a 35 per cent decline since the previous MIS in 2010 when more than 40 per cent of children tested positive for the disease.  Also, the 2017 World Malaria Report revealed that 182 million Nigerians were at risk of infection.

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However, the latest report according to the National Coordinator, National malaria Elimination programme, NMEP, Dr Audu Mohammed, quoting the World Malaria Report of 2017 indicates that Nigeria contributes 27 per cent of the 216 million malaria cases and 24 per cent of the 445,000 malaria deaths.

About three out of 10 persons having malaria in the world live in Nigeria; 1 out of 4 deaths from malaria globally occur in Nigeria and over 54 million malaria cases recorded annually for the last three years.”

But it has not been all gloomy; Nigeria also recorded appreciable success in its fight against malaria. For instance, the 2015 Nigeria Malaria Indicator Survey, NMIS, report showed that there was a marked reduction in malaria prevalence among children under five.

That  year, Nigeria recorded a 35 per cent decline in malaria cases in five years with only 25 per cent of children under the age of five testings positive for the disease in 2015 compared to 40 per cent in 2010. However, despite some of the successes recorded, millions of Nigerians and communities are still ravaged by the disease. According to the WHO in 2018, sadly, these appreciable successes are being eroded.

Nigeria and 10 other countries accounted for about 70 per cent of all malaria cases and deaths. The report also revealed that there were 3.5 million more cases of malaria reported in these 10 countries compared to the previous year with Nigeria substantially contributing to the disease burden. Although, the WHO report acknowledged that global reductions in malaria cases, critical health watchers are of the view that Nigeria is far from winning the malaria war.

In the past, malaria-spreading mosquitoes only attack at night; now they also operate in the day time.  Mosquitoes are everywhere because the environment suits their existence.  Many drainages are blocked by heaps of refuse. This promotes breeding ov mosquitoes.

While investigations show that treated nets remain the most effective and cheapest tool to prevent malaria, sadly, the 2015 Malaria Indicator Survey, MIS, show that only 69 per cent of households across the country own at least one ITN. The  WHO recommends100 per cent universal ownership.

According to the WHO, fake and substandard anti-malarial drugs contribute to malaria deaths. It is no longer news that most of the ACTs are failing.  Many Nigerians keep complaining of treating malaria over and over with ACTs without result, an action that has driven many people back to traditional medicine  as remedy for malaria.

A study was done by the Nigerian Institute of Medical Research, NIMR,   not fewer than 20 states of the country are currently facing resistant mosquitoes.  In the views of the Deputy Director, Research and Head, Malaria Research Group, NIMR,  Dr Sam Awolola, Nigeria is far from being malaria free.  “We are not close to elimination. We are still scaling up our intervention for malaria control. We are far from pre-elimination. Going by our slide, that is, the index used to measure the progress; we are still at 27 across the country.

Before you talk about elimination, you must be close to five per cent. It took us between 12 and 15 years to move from 40 to 27. You can do your calculation if it took us almost 15 years to get here, how long it will take us to get to five per cent?”, Awolola said.

If the message by WHO is anything to go by, for a  malaria-free Nigeria, the country must adhere to the urgent call to action to get malaria back on track by re-strategising in the campaign by scaling up of prevention, treatment and more investments to protect its citizens, particularly,  women and children.

The country also needs to promote the campaign:  “Zero malaria starts with me,” a grassroots a campaign that aims to keep malaria high on the political agenda, mobilise additional resources, and empower communities to take ownership of malaria prevention and care.

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