Nigeria got a pat on the back from the World Health Organisation (WHO) on Monday for a remarkable progress in tackling malaria scourge over the last two decades.
The global health body said the country has reduced malaria deaths by 55 percent and malaria incidence by 26 percent, between 2000 and 2021. This feat suggests Nigeria, with about 27 percent of the global burden of malaria cases, might be on track to eliminate the disease.
Matshidiso Moeti, the WHO regional director for Africa, at the unveiling of the Report on Malaria in Nigeria 2022, said malaria deaths have dropped by 55 percent, from 2.1 per 1,000 population to 0.9 per 1,000 population.
Malaria incidence also fell by 26 percent since 2000, from 413 per 1,000 to 302 per 1,000 in 2021.
What does this mean?
This implies that compared to 21 years ago when 21 out of every 10,000 people in Nigeria died as a result of malaria, only 9 out of every 10,000 died due to the disease as of 2021. It also suggests that one out of every 24 people is affected by malaria prevalence.
However, nine deaths out of every 10,000 is still death too much and the relief that Nigeria is aiming for is still far-flung.
WHO’s data shows that Nigeria with 27 percent of malaria cases leads among the four countries that account for almost half of all cases globally: the Democratic Republic of the Congo 12 percent, Uganda five percent and Mozambique four percent.
Despite the 55 percent reduction in malaria deaths, Nigeria was in the lead row of four countries that accounted for over half of all malaria deaths globally in 2021: Nigeria, 31 percent; the Democratic Republic of the Congo, 13 percent; Niger Republic, four percent; and the United Republic of Tanzania, four percent. In addition, Nigeria accounted for 38.4 percent of global malaria deaths in children aged under five years.
Data from the most recent household surveys, conducted between 2015 and 2021, were used to analyse coverage of treatment seeking, diagnosis and use of ACTs by children aged under five years, by country.
The percentage of those with fever for whom care was sought and who received a diagnosis ranged from 17.4 percent in Nigeria to 83.8 percent in Burundi.
Analysis of the trends by region shows that, in 2021, the WHO African Region was off track for both the malaria morbidity and mortality global technical strategy for malaria (GTS) milestones, by 45 percent and 47 percent respectively.
In 2020, only Cabo Verde, Ethiopia, the Gambia, Ghana and Mauritania met the GTS 2020 target, and in 2021, in addition to those countries, Rwanda, South Africa and Zimbabwe were now on track to meet the GTS 2025 target, with at least a 40 percent reduction in malaria case incidence.
Algeria certified malaria-free
But there was no difference in case incidence in 2021 compared with 2015 in seven countries, including Nigeria. Eight countries, including Nigeria showed no change in mortality rate in 2021 compared with 2015.
Moeti said the key drivers of malaria in Nigeria include the size of Nigeria’s population, which makes scaling up intervention challenging; and the suboptimal surveillance systems, which picked up less than 40 percent of the country’s malaria data.
Other factors she cited are inadequate funding to ensure universal interventions across all states; and health seeking behaviour, where people use the private sector, with limited regulation, preferentially.
Muhammad Pate, the coordinating minister of health and social welfare, stressed that governance, not finance, was a major challenge bedevilling malaria fight in the country.
He said his team intended to fix this by working with development partners and the private sector to garner resources needed to tackle the menace.
Pate promised the ministry would retrain about 120,000 health workers, and update their standards of practice.