April 25 every year is World Malaria Day. This year’s, themed “Zero Malaria – Draw the Line Against Malaria”, sought to highlight the successes of countries in the malaria fight; inspire a new group of countries that have the potential to eliminate the disease by 2025; and demonstrate that zero malaria is within reach for all countries.
Defeating malaria, though a global goal, matters a lot to Nigeria. Even though malaria prevalence in Nigeria has declined by 15 percent in the last decade, the disease remains a public health threat, accounting for 60 percent of all hospital visits in the country.
Nigeria, Africa’s largest economy, accounts for 27 percent of global malaria cases and 23 percent of malaria deaths, according to data from the World Malaria Report 2020.
Yet, defeating malaria is within Nigeria’s reach. This optimism is hinged on a number of factors.
First, as the world continues to deal with the havoc wreaked by COVID-19 and health debates shift towards strengthening protection against the next pandemic, there are calls for a renewed effort to finish the fight against malaria, one of the world’s oldest epidemics.
Leaders of global and national healthcare interventions are asking that the response to COVID-19 be used as a catalyst to rethink the approach towards malaria, a disease that kills over 400,000 people yearly across the world.
Peter Sanders, executive director, Global Fund to Fight AIDS, Tuberculosis, and Malaria, said recently that the tools needed to prepare and respond to any new pandemic are largely the same as required to defeat malaria.
“So, rather than predicate all the effort to make us better prepared for a pandemic, I will argue that we should build capabilities to beat a disease that is costing lives so we can simultaneously make the world better protected against future pandemics and save millions,” Sanders said.
Second, as COVID-19 has helped the world to understand the economic impact of infectious diseases, the point is increasingly being made that viewing malaria from the economic point could trigger some more seriousness in the way the disease is tackled.
For instance, Walter Mulombo, WHO country representative for Nigeria, has emphasised the need “to move from the perception of malaria as a health problem to understanding this disease as a threat to socio-economic development that requires a multisectoral response”.
Osagie Ehanire, Nigeria’s Minister of Health, said recently that in a study among the poorest malaria households, “evidence shows that household income, direct and indirect cost associated with malaria including lost work days due to illness or care for sick family members, reduced productivity and cost of healthcare accounted for 32 percent of annual household income”.
Clearly, eliminating malaria comes with economic benefits. As Abdourahmane Diallo, head of the Roll Back Malaria (RBM) Partnership to End Malaria, puts it, “Malaria-free status provides external economic benefits … enabling them to free up resources to address other health and development priorities and improve worker productivity and school attendance.”
Thankfully, some progress has been made in the search for an effective vaccine to make the nightmare wrought by malaria a thing of the past. Just last month, the world hailed the results of the trial of a malaria vaccine from the University of Oxford, which indicated it was 77 percent effective against one of the world’s most deadly diseases.
The jab, known as R21, is the first that could surpass the WHO goal of an available vaccine with at least 75 percent efficacy by 2030 and is dramatically better than the existing shots for preventing malaria. Mosquirix, the first malaria vaccine, which was initially deployed in 2015, took GSK more than 30 years to develop and was about 39 percent effective over four years.
The Oxford researchers, who are working with India’s Serum Institute and US vaccine maker Novavax, have already launched a phase 3 trial to test the vaccine in a larger population.
“With the commitment by our commercial partner, the Serum Institute of India, to manufacture at least 200m doses annually in the coming years, the vaccine has the potential to have major public health impact if licensure is achieved,” said Adrian Hill, director of Oxford’s Jenner Institute, which helped develop the Oxford/AstraZeneca Covid-19 vaccine.
Nigeria, fortunately, seems to understand the enormity of the challenge. Already, the country aims to reduce malaria prevalence to a parasite prevalence of less than 10 people and mortality attributable to malaria to less than 50 deaths per 1,000 live births by 2025, according to the new Malaria Strategic Plan 2021-2025.
We believe this is achievable if only the right things are done. Countries like Argentina, Paraguay and China have grounded the disease to zero level. In Africa, Algeria in 2019 became the third country to be certified malaria-free, after Mauritius in 1973 and Morocco in 2010. Nigeria can do the same.
