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EDITORIAL

Malaria Eradication: The Algeria, Argentina Example

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World Health Organisation (WHO)

The World  Health Organisation  (WHO) recently declared Algeria and Argentina free of malaria. The North African country and its South American counterpart have both become the second group of countries in their respective continents  to end the malaria scourge after Mauritius in 1973 and Paraguay in June 2018 respectively.

To achieve this status, the two countries have gone three years without any new native transmission of the mosquito-borne disease. Algeria has no new case since 2013 while Argentina has not recorded a fresh transmission of the infection since 2010.

The disease is a major global health concern. Since 1955 when  the United States of America eradicated malaria,  WHO had stated its goal to eradicate the parasitic disease and about 60 countries and territories have now achieved the status.

Malaria was first discovered in Algeria in 1880 by a French doctor, Dr Charles Louis Alphonse Laveran, and since then it has killed tens of millions of people worldwide, with over 90 percent of the sickness and deaths occurring in Africa. Year 2017 figures showed that there were 219 million infections in 87 countries, and 435,000 deaths.

Unfortunately, Nigeria is the most malaria-endemic country in the world. In 2017, the country accounted for 25 percent of the global malaria disease burden.

It is estimated that at least a half of the country’s 200 million population suffer at least one infection a year, with about 300,000 people succumbing to the disease, higher than the estimated 215, 000 that die of HIV/AIDS yearly in the country, with a big chunk of this number being under-five children.

Enough cannot be said about the devastating effects of malaria on the well being and economy of both the individual and the country as a whole. Hundreds of billions of Naira in medical bills are incurred every year by Nigerians in treating the infection, and countless numbers of man-hours are lost to the disease as a huge chunk of the workforce skip work for several weeks  in a year or work at reduced capacity because of ill-health related to malaria. 

But these losses can be averted for Nigeria and other countries because the disease is both preventable and treatable.

Malaria is a vector-borne disease; its vector is the female anopheles mosquito, so vector control is the best way to stop or reduce the burden: to eliminate disease, one has to eliminate the mosquito which transmits the disease from one infected person to another. And while the effort to eliminate mosquito through environmental control action is on, health officials must track all cases of the disease, diagnose and treat quickly in order to contain further transmission.  This means a concerted effort by government, individuals and health care givers at all levels working together.

That is exactly what Algeria and Argentina did to get to where they are. The two countries improved their surveillance on the disease and this enabled them to quickly identify and treat every case of malaria.

To show the importance they attached to this cause, both  countries also provided their citizens free diagnosis and treatment which ensured that every one was able to access the services they needed to prevent, detect and cure the disease.

Algeria took the step to ensure good training for its health workforce. It also provided malaria diagnosis and treatment through universal health coverage and ensured a quick response to disease outbreaks, thereby denying mosquito the chance to transmit the disease from one person to another.

In Argentina’s case, its quest to malaria-free status started in the 1970s. In addition to what Algeria did, Argentina deployed  its health workers to attack the vector with insecticides in homes and surroundings.

The South American country even collaborated with its neighbours in its fight against malaria. Between 2000 and 2011, it partnered with the Government of Bolivia to spray insecticides in more than 22, 000 homes in border areas and conduct widespread malaria testing.

As demonstrated recently by both Algeria and Argentina, the malaria scourge can be ended with targeted approach.  Nigeria should copy the models followed by the two countries and tackle the problem with the same determination and single-minded purpose. At the moment, its approach is half hearted. Its preventive measure of supplying insecticide-treated nets to every home has not recorded the needed success.

Nigerian health authorities must start with sensitising the entire citizenry on how to stop mosquitoes from breeding in their areas by not allowing stagnant water in open containers and by keeping their general environment clean.

We agree with Dr Matshidiso Moeti, WHO regional director for Africa, that Algeria has shown the rest of Africa that malaria can be beaten through country leadership, bold action, sound investment and science. As the  country most affected by the killer disease,  Nigerian scientists should spearhead the search for a malaria vaccine. A success in this will sound the death knell for the disease.

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