Malaria is often referred to as the epidemic of the poor while the disease is in large part, determined mainly by climate and ecology.
The impact of malaria takes its toll on the poorest – those least able to afford preventative measures and medical treatment.
Although all the 42 malaria- endemic countries in the WHO African region have adopted the Artemisinin- based Combination Therapy (ACT) policy, its use is still very low.
Recent data from 18 countries show that on the average, only 3% of children below five years presenting with fever received ACT within 24 hours of onset of fever.
Nigeria joined the rest of the world on the 25th of this month to mark Malaria Day and it gave opportunity to major stakeholders to meet and evaluate the strides taken so far in the country’s attempt to eradicate the disease, which medical experts tag the highest killer disease.
At the celebration, the World Health Organisation (WHO) country representative to Nigeria, Mr David Okello noted that malaria accounts for nearly 110 million clinically diagnosed cases per year in Nigeria, causes an estimated 30% of child mortality, 11% of maternal mortality and exerts a huge socio economic burden on Nigerians.
He said, “studies suggest that about 480 billion naira ($3billion) is lost annually to malaria which means that at the minimum wage of N18,000, this will pay the salaries of more that 2.2 million Nigerians for a year.”
He said intrinsic and extrinsic factors were militating against the control of malaria in the country.
According to him, “These factors cut across issues of inadequate funding, poor utilization of health care services, weak supply chain management, weak strategic information system and infrastructural challenges”.
On his part, the Minister of Health, Prof Onyebuchi Chukwu, called for re-evaluation and implementation of malaria policy in order to eliminate malaria in the country.
According to him, the country’s goal was to eliminate malaria but as long as it keeps its focus on control, it cannot achieve that goal.
The minister disclosed that seven states, including Abia, Imo, Edo, Oyo, Osun, Delta and Kogi were yet to receive the insecticide treated nets for protection against malaria under the auspices of the Roll Back Malaria Programme.
Two years ago, the federal government, sponsored by the Japanese government under Prof Babatunde Osotimehin’s administration as the minister of health, embarked on a very ambitious programme to freely distribute two insecticide treated nets to every household in Nigeria.
This was estimated to entail 62 million nets into about 31 million households nationwide.
Chukwu said though 63 million nets were earmarked for distribution, with two for each household, only 46.8 million have been distributed among 30 states leaving the above seven for future actions.
He, however, disclosed that though the programme had suffered a setback, the federal government was increasing the distribution of the insecticide treated nets from two per household to three.
Counting the gains of the Roll Back Malaria Programme, Chukwu said it has institutionalised testing with rapid diagnostic test kits and use of artemisinin combination therapy through the AMFM.
He said, “Over 12.5 million doses of ACTs were used in public sector facilities while 39.4 million doses came through the AMFM programme”.
However, a researcher at the Centre for European Environmental Law and Research, Faculty of Law, University of Bremen, Germany, Dr Ignatius Adeh, described Nigeria’s malaria situation as a pandemic.
According to statistics, malaria causes intolerable morbidity and mortality and impairs economic development and progress towards MDGs. The most vulnerable groups are pregnant women and children under five (5) of age. It is the commonest cause of outpatient visits to health facilities. Malaria incidence reported in public health facilities in 1999 was 23/1000 population, in 2007 it rose to 36.9/1000 and reduced in 2008 to 23.35/1000. In 2008, there was a slight reduction to 9,591.Malaria control contributes directly to the achievement of MDG 6 and indirectly to MDGs 4 and 5.
In combating this dreaded disease, Adeh, said there was need to adopt a holistic and integrated approach in eradicating it.
He explained that the only way to do that effectively is through a combination of environmental sanitation and malaria prevention measures as, anything short of this approach would be like pursuing one’s own shadow.
“The idea of promoting mosquito net and malaria drugs when we know that children who go to school do not wear mosquito net, adults who go to work and public places do not wear mosquito net, when you are relaxing outside your home, you don’t wear mosquito net. Mosquito nets are only a bedtime story which lasts only six to eight hours.”
According to him, the countries where they have reduced malaria sickness are those countries that enjoy relatively clean environment, including Eritrea, Komoros Island, and some Southern African countries.
His words: “These are countries that have very low malaria deaths because they have relatively stable policy on environmental sanitation and malaria prevention. Am not saying mosquito net is not a good idea but we must combine it with a good sanitation and fumigation systems. You need to ensure their inability to procreate by eliminating their habitation through better sanitation for those areas particularly slum areas and poor neighbourhoods that need them.