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What we need to do to eliminate malaria in Nigeria

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Against the backdrop of the World Malaria Day, held earlier this week, PROF. DENNIS N. ARIBODOR, a Public Health Parasitologist and Founder of Malaria Eradication & Safe Health Initiative of Nigeria, who is a don in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka, Anambra State, offers ideas of what Nigeria should do to eliminate the deaded disease which recent WHO study has identified as an underrated mass killer. He writes:

AS THE global community marks the year 2022 World Malaria Day 2022 under the theme “Harness Innovation to Reduce the Malaria Disease Burden and Save Lives,” it is important to reflect on what Nigerians need to do to achieve malaria elimination in the nearest future. The battle against malaria, a very ancient scourge, can only be won by deliberate efforts and actions by relevant stakeholders led by our political leaders, who shall rely on evidence from the scientific community with support from the civil society organisations (CSOs).

    Before delving into what we need to do to eliminate malaria in Nigeria, it is important to state that malaria is one of the most severe public health problems worldwide. It is a leading cause of death and disease in many developing countries, where young children and pregnant women are the groups most affected.

  In 2020, malaria caused an estimated 241 million clinical diseases, and 627,000 deaths. An estimated 95% of deaths in 2020 were in the sub-Saharan African. Nigeria carries the world’s highest burden of malaria disease and death.   

   According to the World Health Organisation (WHO, 2020), Nigeria had the highest number of global malaria cases (27 %) and accounted for the highest number of deaths (23 % of global malaria deaths). Malaria is transmitted all over Nigeria; 76 % of the population lives in high transmission areas while 24 % of the population lives in low transmission areas.  The transmission season can last all year round in the south and is about three months or less in the northern part of the country.  The primary vector for the transmission of malaria across most of the country is the mosquito called Anopheles (An.) gambiae s.s. and the predominant parasite species is Plasmodium falciparum, which  causes severe malaria and death.

   Malaria imposes substantial costs to both individuals and governments. Costs to individuals and their families include purchase of drugs for treating malaria at home; expenses for travel to, and treatment at dispensaries and clinics; lost days of work; absence from school; expenses for preventive measures; and expenses for burial in case of deaths. Costs to governments include maintenance, supply and staffing of health facilities; purchase of drugs and supplies; public health interventions against malaria, such as insecticide spraying or distribution of insecticide-treated bed nets; lost days of work with resulting loss of income; and lost opportunities for joint economic ventures and tourism. Direct costs (for example, illness, treatment, premature death) have been estimated to be at least US $12 billion per year. The cost in lost economic growth is many times more than that.

   In view of the above, the following are what Nigerians need to and should do to achieve malaria elimination in the nearest possible future as some countries have done in the recent past:

   Identify priority activities for funding for malaria elimination in collaboration with communities for sustainability and ownership; generously budget for malaria control activities at the community, local, state and federal government levels; ensure timely release of malaria budget for the execution of planned activities; monitor progress of malaria control activities to ensure that objectives are being achieved; take leadership and ownership of the battle to eliminate malaria by depending less on development partners and indeed direct support of partners to areas of need; enlist the support of the private sector; support periodic research especially for home-grown innovation and eco-friendly malaria control strategies and put surveillance systems in place post-elimination era.

   With adequate mobilisation of Nigerians by the political leadership of the country, the malaria elimination project can be launched with a target set for zero malaria. This will require serious work on inter-ministerial partnership and partnership with all stakeholders, including the civil society organisations, the private sector and development partners.

   Apart from averting diseases and deaths, resources shall be freed for other developmental projects when malaria in eliminated.  Nigeria can join the league of African countries such as Lesotho, Lybia, Tunisia, and Algeria that eliminated malaria between 2012 and 2019. China achieved hers in 2021.

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