Malaria: Its Human Impact, Challenges, and Control Strategies in Nigeria

Malaria is one of the most serious health problems facing the world today. The World Health Organization estimates that over 300 million new cases of malaria arise every year, with approximately two to three million deaths resulting from contraction.

Malaria is endemic in tropical Africa, with an estimated 90% of the total malaria incidence and deaths occurring there, particularly amongst pregnant women and children.

More specifically, malaria is causing various problems in Nigeria. Malaria is the only vector borne disease to be placed on World Health Organization’s Disability Adjusted Life Years (DALYS ) list.

It is important to look at health problems like malaria that grossly affect the morbidity and mortality rates, as well as the economy of a developing country, such as Nigeria.

Nigeria has a population of about 198 million people. Meanwhile, the large percentage of this population lives in extreme poverty in rural areas, without access to potable water and adequate healthcare.

The World Health Organisation had in its message to commemorate the “World Malaria Day 2018” said that Nigeria is yet to be listed among African countries who have made significant progress in eliminating malaria.

Dr Matshidiso Moeti, the WHO Regional Director of Africa, said that 14 countries with the world’s biggest malaria problem were in Sub-Saharan Africa.

She said that these countries still accounted for 80 per cent of the global burden of malaria with 194 million new cases and 410,000 deaths recorded in 2016 alone.

Moeti said that some countries in the region have witnessed a decrease in malaria cases and deaths showing significant potential to eliminate malaria by 2020.

According to Moeti, Ethiopia, Madagascar, Senegal, Gambia and Zimbabwe are among 16 countries globally that witnessed a decrease in malaria cases and deaths by more than 20 per cent between 2015 and 2016.

She said that Algeria, Botswana, Cape Verde, Comoros, South Africa and Swaziland could potentially eliminate malaria by 2020.

The WHO regional director expressed concern over the slow pace of progress in some African countries with significant gaps in the implementation measures to eliminate the disease.

Moeti said international and domestic funding for malaria prevention and control has also stagnated in the region.

“Some countries in the African region recorded the biggest rise of malaria testing in the public sector from 36 per cent of suspected cases in 2010 to 87 per cent in 2016.

“Over half the people at risk of malaria across sub-Saharan Africa have been sleeping under insecticide-treated nets for the past five years indicating some success in behaviour change and outreach campaigns.

“This progress needs to be sustained. Eliminating malaria requires above all political leadership at the highest level as well as leadership of programmes, resource mobilisation, inter sectoral and cross-border collaboration.

“We are ready to beat malaria but the pace of progress must be accelerated to achieve a 40 per cent drop in global malaria cases and deaths by 2020 compared to 2015 levels,” Moeti said.

Also, the Minister of Health, Prof. Isaac Adewole, had said that despite the fact that a lot of progress has been made in the past few years, malaria still remain a major public health problem in Nigeria.

Adewole had reminded that the celebration of the World Malaria Day dates back to the historic gathering of African Heads of State in 2000 where over 44 countries, bilateral and multilateral organisations who were in attendance, agreed on the target of halving the burden of malaria in Africa by year 2010, adopted the framework for monitoring progress and evaluating outcome.

“It is indeed sad that malaria though preventable, still remains a major Public Health problem in Nigeria and constitutes a major barrier to social and economic development,” he said.

The minister however, assured that the “Government is concerned about this and is working hard to improve the quality of care and increase access to anti-malaria commodities particularly amongst the poor.

We are also working towards securing additional funding to close the existing commodity gap and move Nigeria towards elimination.

“I must inform you that malaria control activities in the country are guided by the National Malaria Strategic Plan (NMSP: 2014-2020), which was recently reviewed to make it more responsive to our vision of a malaria-free Nigeria.”

He noted that the malaria epidemiology for Nigeria is changing; adding that a recent mapping by the “LINK Project” of The London School of Hygiene demonstrated a 50 per cent gradual shift from hyper and holo-endemic to meso-endemic pattern between 2000 and 2015.

According to him, 92 per cent of the population now lives in areas with a prevalence rate of between five per cent and 39 per cent.

He said this is similar to the results of the 2015 Nigeria Malaria Indicator Survey (NMIS) which showed a remarkable reduction in malaria prevalence from 42 per cent to 27 per cent which is a commendable stride in government’s efforts to stem malaria.

The result of the nation’s malaria indicator survey shows that all is not well with Nigeria’s malaria elimination programme.

It is commendable that the USAID Country Director, Michael Harvey, and the Minister of Health, Prof. Isaac Adewole, and other stakeholders have identified some shortcomings of the programme.

The Federal Government should go ahead and address these shortcomings. The government should also ensure that mosquito nets are manufactured in the country and sold at affordable prices. We deplore a situation in which we continue to import mosquito nets.

The mosquito nets should be made in such a way that they will be suitable to our harsh climatic condition.

Many Nigerians do not use mosquito nets because of the harsh weather. The mosquito net is also seen by many Nigerians as an ineffective tool to check mosquito.

Apart from the extant malaria control measures, government should think of biological control as done in some countries. Government can introduce organisms that feed on the female mosquitoes that transmit malaria parasites.

Curbing mosquito breeding places like stagnant waters, clogged drainages and dirty surroundings will also go a long way in keeping the disease at bay.

All the three tiers of government must work together to ensure the success of the nation’s malaria elimination programme. All healthcare providers should play their part in this regard.
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