Despite huge funds being expended, coupled with the promises ongoing vaccine trials hold, Nigeria’s plan to reduce malaria prevalence and mortality to 10 percent by 2025 may join the list of government’s unachieved targets, leaving citizens susceptible to the disease that claims thousands of lives every year.
Despite the enormous funds being expended and the promises that the ongoing malaria vaccine trials hold, Nigeria’s plan to reduce malaria prevalence and mortality to 10 percent by 2025 may join the list of the government’s unachieved targets.
Malaria claims thousands of lives every year in Nigeria. Even though health authorities claim that remarkable progress has been made in the last decade, Nigeria did not make the list of countries projected by the World Health Organisation (WHO) with the potential to stamp out malaria by 2025.
So far, 24 countries have interrupted malaria transmission for three years or more by the end of 2020 of which 11 were certified malaria-free by WHO. The health organisation said even though each country’s elimination journey is unique, the common and key drivers of success are strong Primary Health Care (PHC) systems that ensure access to malaria prevention, diagnosis and treatment services, without financial hardship, strong political will, robust data system and strong community engagement.
Health analysts who spoke to BusinessDay scored Nigeria low on these important drivers that are absent in some cases, which could stall the country’s progress significantly. Findings also show that many of the 30, 000 PHCs across the country are at different levels of rot.
WHO stressed that malaria-endemic countries must first demonstrate the political will to drive success in all areas of endeavours.
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Nigeria has in the past developed plans aimed at eliminating malaria but has consistently missed the targets. Olufemi Babalola, president, Guild of Medical Directors said the Nigerian government has not demonstrated the needed political will.
He said, “Even if trillions of naira is injected into fighting malaria nothing will be achieved without political will first. Nigeria can eliminate malaria even in the next two years with the right commitment and common sense measures taken. It is not rocket science, the vector is the mosquito. Government and all stakeholders must ensure that the breeding ground of the malaria vectors is totally eradicated, then malaria incidences will drop.”
It would be recalled that in 2008, the National Malaria Control Programme (NMCP) set a target to reduce 50 percent of the malaria burden by 2013. Afterwards, there was the National Malaria Strategic Plan (2014-2020), with the goal to reduce the burden of the disease to pre-elimination level and bring malaria-related mortality to zero.
By the end of 2020, Nigeria was not among the countries listed by WHO that achieved the 2020 milestones of reducing malaria incidence and deaths. The listed countries are; Botswana, Ethiopia, the Gambia, Ghana, Namibia and South Africa.
Currently, there is the National Malaria Strategic Plan (NMSP 2021-2025) with the target to achieve a parasite prevalence of less than 10 percent and reduce mortality attributable to malaria to less than 50 deaths per 1,000 live births by 2025.
The Minister of Health, Osagie Ehanire said the implementation of the New Strategic Plan will cost N1.89 trillion Naira. According to him, about 63.1 percent of the total amount will be used to support chemoprevention, diagnosis and treatment while 35.9 percent will be used for vector management, and about N352 billion is required for the year 2021 programme implementation. But this comes as Nigeria currently faces dire financial straits.
Ehanire confirmed that government may not have the required amount due to the “prevailing economic circumstance” and solicited support from the private sector, corporate organisations and patriotic individuals.
Nigeria has spent huge resources to eliminate malaria and continues to lose even more. The Federal Government puts the financial loss due to malaria annually at an estimated N132 billion in the form of treatment costs, prevention, and the loss of man-hours.
Despite this, the country is still highly endemic to the disease, and alone, contributes 27 percent of the global malaria cases and 23 percent of global malaria deaths, according to the World Malaria Report 2020. In 2018 the numbers stood at 95,000.
Statistics show that Malaria is a risk for 97 percent of Nigeria’s population, and it is estimated that 100 million malaria cases are recorded in the country every year with over 300, 000 deaths.
Even though significant progress is being made, especially in the development of vaccines, experts say vaccines are not the only solution, but an added tool that must be implemented with other health measures that must incorporate WHO-recommended core interventions.
Ifeanyi Nsofor, a health analyst at the Nigeria Health Watch stressed that malaria must not be seen as a problem of the health sector alone. For instance, he noted that government and non-governmental organisations have delivered millions of nets to households but are underutilised for some reasons.
According to him, the government must ensure a steady supply of power especially in hot areas for people to use these nets conveniently and also ensure access to water supply to promote hygiene measures.
He stressed that environmental sanitation is key and government must focus on prevention rather than treatment.
Nsofor also said the health facilities particularly PHCs must be made accessible and functional and the distribution of long-lasting insecticidal nets sustained.
At least 75 percent of the population need to use these nets to achieve herd protection.
Matshidiso Moeti, WHO regional director, said the elimination of malaria in West African countries starts with moving from seeing malaria as a health problem to understanding that the disease is a threat to socio-economic development, and requires a multi-sectorial response.
