‘Malaria will be eliminated in Nigeria despite challenges facing health care delivery system’
Audu Bala Mohammed, national coordinator, National Malaria Elimination Programme (NMEP) in this interview with IFEOMA OKEKE, speaks on steps NMEP is taking towards eradicating malaria in Nigeria. Excerpts:
The most talked about conversation within the health sector in Nigeria at the moment is Covid-19; how do you think the malaria conversation can be added to it?
Given that the common clinical symptoms of SARS-CoV-2 infection, such as headaches, body aches, fatigue, and fever, are also applicable to malaria infections any discussion regarding Covid-19 should include malaria. This becomes all the more important given the confusion among the populace including those that are knowledgeable about the difference between the two infections especially in their management. Within the programme, we are using Interpersonal Communication (IPC) sessions, which is a core strategy of malaria at the community level to increase awareness of both malaria management and Covid-19 preventive measures. We have suggested increased case finding and community level diagnosis of Covid-19 using the malaria community distribution of commodity platforms; incorporating Covid-19 risk and awareness into malaria survey forms and promoting testing, so that a negative malaria test can heighten the consideration for Covid-19.
Malaria has affected a number of African countries for quite a while; what activities are currently being taken to combat the illness amidst the Covid-19?
The National Malaria Elimination Programme (NMEP) has developed and is implementing a business continuity plan for the rest of this year, prioritizing interventions, streamlining campaign activities (for both Long Lasting Insecticidal Nets and Seasonal Malaria Chemoprevention), and developing appropriate messaging including risk communication based on the evolving pandemic. The initial risk assessments were with the potential disruption of implementation of preventive interventions such as LLINs, and SMC which are to be implemented in campaign modes and which require several pre-implementation planning activities – such as training, micro-planning and social mobilization. However, with time, we have made efforts to circumvent these challenges by leveraging on the use of online platforms to conduct some of the planning steps revising guidelines to minimize risk of COVID-19 transmission. Using these methods and guidelines SMC campaigns are being conducted in the Sahelian States and LLIN campaign is currently on-going in Osun State. Case management of malaria is continuing in health facilities across the country, including prompt diagnostic testing and treatment, which are being delivered safely and appropriately, although there have been disruptions in the supply chain management system which are being addressed.
With more focus on Covid-19 by the government, do you think there is a chance for the provision of malaria supplies?
In 2019, Nigeria accounted for 25 per cent of the world’s malaria cases and continues to have one of the highest burdens of malaria today. During the initial lockdown phases due to Covid-19 there were serious concerns about how far behind Nigeria might fall in the fight against this pernicious disease. Current modelling suggests that if malaria services are disrupted we might be drawn back to the malaria situation 20 years ago. Advocacy measures at national, state and LGA levels in addition to engagement with private sector organizations are being conducted highlighting these issues, and governments at all levels are being requested to fund key activities of the malaria response. NMEP and the RBM partnership will continue to work together with state health teams and communities to ensure that malaria stays high on the political agenda.
With the diverted attention from malaria to Covid-19, do you think malaria can still be eradicated in Nigeria?
Malaria will still be eliminated in Nigeria irrespective of the challenges that currently face the health care delivery system including the Covid-19 pandemic but it may take a slightly longer time. We are still far from elimination even without the pandemic coming in. The National Malaria Strategic Plan 2014 – 2020 had set a target of achieving pre-elimination by 2020 but the NDHS 2018 results indicate national malaria prevalence at 23 percent with some States above 50 percent. Only Lagos State is closest to the pre-elimination stage.
Prior to the Covid-19 pandemic, some other nations had been trying out a form of malaria vaccine, is it something Nigeria is considering?
Yes, the vaccine has been piloted in three countries Malawi, Ghana and Kenya with WHO support and the outcomes are being analyzed and evaluated. Nigeria is willing to consider every innovation including use of vaccines once there is adequate evidence that it works and can be deployed safely and in a cost-effective manner.
Based on your knowledge and association with malaria organisations, do you think that their activities can help Nigeria in combating malaria?
As reflected earlier the RBM partnership in Nigeria made up of several organisations and civil rights groups including the private sector are working with NMEP, state health teams and communities to ensure that malaria services continue and that malaria stays high on the political as well as public agenda. Some of these organisations are implementing partners supporting delivery of malaria services to all nooks and crannies of the country.