Special report: What Nigeria needs to do to keep winning the war against malaria

Special report: What Nigeria needs to do to keep winning the war against malaria

Editor's note: One of the major challenges to people's health globally, especially in the African continent is Malaria. Despite efforts being made by the African governments to eradicate the disease completely, the deadly disease still persists in Nigeria and many African countries.

In this report, Olajide Adelana, reports on what Nigerian government needs to win war against Malaria in every nook and cranny of the countries.

There are news that are not surprising to an ordinary Nigeria anymore. The scourge of malaria, for example, is one of them. Despite efforts by successive administrations in Nigeria and even interventions by development partners, Nigeria is still battling with the deadly disease.

Even though it is a globally recognised health challenge with more than one million new cases recorded each year, Nigeria’s share of the disease burden is alarmingly too high not to call for concerns. An estimated 24 per cent of malaria cases are recorded in Nigeria – the highest disease burden in the world.

To make matters worse, Nigeria’s environment has been regarded as one of the biggest factors promoting the breeding of mosquitoes, the causative agent of malaria. The entire population lives in malaria-endemic regions with poor drainage systems swallowed up in heaps of refuse around cities and communities.

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It has not been all doom and gloom. Nigeria has also recorded appreciable success in its fight against malaria. For instance, the 2015 Nigeria Malaria Indicator Survey (NMIS) report showed that there was a marked reduction in the prevalence of the disease among children under five.

In that year, Nigeria recorded a 35 per cent decline in malaria cases in five years with only 25 per cent of children under the age of five testing positive for the disease in 2015 compared to 40 per cent in 2010.

However, despite some of the successes recorded, millions of Nigerians and communities are still ravaged by the disease.

According to the World Malaria Report published by the World Health Organisation (WHO) in 2018, Nigeria and 10 other countries accounted for about 70 per cent of all malaria cases and deaths.

The report also revealed that there were 3.5 million more cases of malaria reported in these 10 countries compared to the previous year with Nigeria substantially contributing to the disease burden.

Although, the WHO report acknowledged that global reductions in malaria cases have stalled after years of decline, experts have called on the need for Nigeria to rethink its own strategy in fighting the war against malaria.

The 35 per cent decline in malaria cases recorded in 2015 has been credited to expanded malaria prevention interventions, increased ownership of insecticide-treated mosquito nets among others. The strategy seems to have worked thus far until the latest setback said to be caused by increasing insecticides resistance among other factors.

To curtail this setback, the World Health Organisation and partners have launched a response that will see to the scaling up of prevention and treatment and increase investment, to protect vulnerable people from the deadly disease in concerned countries.

Nigeria is said to require a more comprehensive and decisive strategy that will factor local dynamics and terrain in its fight against malaria, experts have said.

If there is any where Nigeria can draw inspiration in ensuring that malaria’s back is put to the ground, it would be in the way it dealt with the spread of Ebola virus in 2014, says Lawal Yusuf, a scholar in public policy and global health at the Blavatnik School of Government, University of Oxford, United Kingdom.

Yusuf believes there are many lessons inherent in Nigeria’s response to Ebola and how it became the first country in West Africa to end the disease within its borders. These lessons are vital in knowing how to and how not to fight against malaria, Yusuf suggested in an online article.

According to the scholar, Nigeria should mobilise resources across its health systems as it did during the Ebola outbreak for her to win the fight against malaria.

“We mobilized staff at the emergency operations center established for polio eradication to rapidly identify and contain infectious patients, and engaged highly trained medical personnel to care for them. It was an example of what we are capable of when we deploy our health resources effectively to respond to emergencies.

“The same strategic deployment of resources is key to tackling other health challenges – including ever-present threats like malaria, which causes about as many deaths every week as the thirty years of Ebola outbreaks summed together.”

He queried why people are still dying of the disease when there are effective tools to address the disease.

“Bed nets can prevent mosquito bites. Sprays can control mosquito breeding and movement. Diagnostics are available to confirm infections. Effective drug.s cure millions of people each year.”

For Yusuf, Nigeria’s fight against malaria needs to take a different approach. In addition to strengthening her health systems and mobilizing resources, Yusuf said Nigeria must enthrone a “distribution strategy” not only for drug.s, but also for people and information.

This could not be truer since Nigeria still grapple with personnel deployment in rural areas despite having significant human resources for health at her disposal. Nigeria is estimated to be losing 2000 medical doctors yearly to countries such as the United Kingdom, United States, Canada, Australia, United Arab Emirates (UAE), and South Africa.

Health workers are disproportionately concentrated in urban cities where less people live compared to rural areas. This leaves drug.s and diagnostics in the hands of people who are largely untrained to use them properly.

But these problems are not unknown and same goes for strategies employed by government to up rural dwellers’ appreciation of basic preventive measures against malaria. With substantial support coming from international partners, Nigeria can be applauded for sustaining the war against malaria but what matters most would be a conscious overhauling of its healthcare system to recognise, appreciate and bring quality health services closer to its largely rural populace.

For starters, efficient primary healthcare, and expanding National Health Insurance coverage are top on the bucket list, experts and policy makers have argued.

It is believed that when these reforms are carried out, Nigeria would better appreciate the relationship that exist between a healthy population and productivity of its economy, says Oby Ezekwesili, former vice president, World Bank and presidential aspirant in the forth coming general elections in a televised debate on Saturday, January 19.

However, to carry out these reforms and sustain them require huge investments in the entire value chain of the health sector, a task which may be little difficult for the country to undertake at a time when revenue from oil –major source of income –has continued to dwindle and in fact, toy with the country’s economy, plunging it into recession at one point and recently out of it.

Meanwhile, Legit.ng had previously reported that in its plan to eradicate the lingering presence of malaria across the country, the federal government made a clear move to deploy nuclear technology to tackle the killer disease.

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The minister of science and technology, Ogbonnaya Onu, made the disclosure on Tuesday, January 22, when answering questions from ambassador of the Democratic People’s Republic of Korea, Jon Tong Choi, in Abuja.

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