NIGERIA’S shoddy handling of preventable and curable diseases continues to expose its ineffective leadership and institutional rot. One of these debilitating diseases is malaria fever. The Federal Ministry of Health has confirmed again that the incidence and deaths are rising. This is deplorable because malaria is one of the wasting diseases that the country ought to have conquered with a focused and genuine investment programme in research and development.
Nigeria needs to imitate countries that have been certified malaria-free by developing novel malaria-fighting tools and ramping up innovations to end the cycle of the disease. Malaria, according to the World Health Organisation, is a life-threatening disease caused by parasites that are transmitted to sufferers through the bites of infected female anopheles mosquitoes.
The fresh insight by the Minister of Health, Osagie Ehanire, that nine persons die of the disease every hour in the country further depicts the sorry state the disease has put Nigeria in. It should push the government to devise effective containment and eradication strategies. Ehanire made the assertion through a representative during a courtesy visit to the Ogun State Deputy Governor, Noimot Salako-Oyedele, to seek the state’s support for the fight against malaria in Ogun.
The minister said, “In Nigeria, malaria kills nine to 10 persons every hour. The disease remains a major public health challenge. It constitutes a huge epidemiological burden and continues to cripple the economic development in the region.” This is depressing.
This paints a pitiful picture of the country’s waning battle against malaria. As it is with other treatable diseases, Nigeria falters at every opportunity to deal the disease a fatal blow. The WHO notes that children under five are the most vulnerable to malaria. In 2019, this group accounted for 67 per cent (274,000) of malaria deaths globally.
The World Malaria Report notes that six countries accounted for more than half of all malaria deaths worldwide. Sadly, Nigeria ranks first with 25 per cent. Alarmingly, it retains the position without outstanding efforts to cast off the debasing status. Other countries are the DR Congo (11 per cent), Tanzania (5.0 per cent), Burkina Faso, Mozambique, and Niger (all 4.0 per cent). In the past two decades, some countries have earned the official WHO certification for malaria elimination. These are the United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010), Armenia (2011), Kyrgyzstan (2016), Sri Lanka (2016), Uzbekistan (2018), Paraguay (2018), Argentina (2019), Algeria (2019) and El Salvador (2021).
An independent research reports that malaria accounts for over 40 per cent of the total monthly curative healthcare costs incurred by Nigerian household. With low health insurance coverage and a derelict health system, out-of-pocket treatment is high, thus depleting household income. Being a high-burden country, malaria reduces annual economic growth in Nigeria by 13 per cent. It accounts for 30-50 per cent of in-patient hospital admissions and 50 per cent of out-patient hospital visits.
In June 2021, the WHO announced the certification of China as malaria-free. Terrifyingly, only four out of the 47 countries that make up the WHO Africa region have conquered malaria. They are Algeria, Mauritius, Lesotho, and Seychelles. Countries that have achieved three consecutive years of zero indigenous cases are eligible to apply for a WHO certification of malaria-free status.
Really, Nigeria has what it takes to attain the status and join other countries to achieve malaria elimination by 2030 as part of the UN Sustainable Development Goals. But lack of the political will to prevent and reduce malaria transmission forecloses required efforts to stamp out the febrile illness. It is instructive that the 1998 Roll Back Malaria project designed to reduce malaria burden by at least 50 per cent through evidence-based interventions, and the 2005 Abuja Declaration to ensure ramping up malaria control interventions, were not fully utilised by the country to achieve their intended goals. From that time and now, no significant result was achieved.
Instead, many of the donated insecticide-treated mosquito nets found their way into the hands of dishonest public officials who diverted them to their cronies to sell. Urgently, the nation’s health authorities should initiate plans for vector control with states joining hands to pragmatically expand the scope of health delivery across their domains. States owe their people the responsibility of ensuring adequate healthcare to tackle the decay in the sector. Leaders must also set a good example by ending medical tourism in the drive to make the sector robust to attain cogent results in the fight against malaria.
Nigeria can no longer afford to carry on without practical endeavours to find a lasting solution to the disease which continues to ravage its population. Its research agencies, especially the Nigerian Institute of Medical Research, should partner local and international agencies to produce a vaccine for malaria and drugs for some of the neglected tropical diseases.
Early this year, the news of a candidate vaccine with high hope cheered countries with a high burden of malaria. The vaccine, R21/Matrix-M, spearheaded by Oxford University, United Kingdom, not only showed 77 per cent efficacy in trials in Africa, but is also said to be the first to reach the 77 per cent efficacy target set by the WHO. Amid this commendable feat, the country’s research institutes neither improved on the invention nor discovered a rival drug. Things cannot continue this way.
Besides, poverty and illiteracy have been identified as among the drivers of malaria. To this extent, the federal and state governments should intensify efforts on advocacy, invest massively in technology and investments to combat the disease and ensure clean environments and healthy lives for the people. They should partner the private sector for judicious funding to ramp up malaria vector control interventions.
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