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Wednesday, November 6, 2024

Some African countries have eliminated malaria. Can Nigeria do it?

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Despite global progress in the fight against malaria, Nigeria continues to battle this deadly disease.

Nigeria's fight against malaria raises questions about the nation's ability to follow in the footsteps of Egypt, Algeria, Cape Verde and Mauritius, where malaria has been successfully eliminated in Africa.

Could Nigeria achieve similar success or does its unique challenges require a new approach?

With a tropical climate and huge population, Nigeria bears a disproportionate share of the global malaria burden.

According to the World Health Organization (WHO), Nigeria accounted for almost 30 percent of global malaria cases and an estimated 194,000 deaths annually in 2021.

In communities like Kuje Area Council in the Federal Capital Territory, malaria is not only a health problem but also a threat affecting family life, education and livelihoods.

For people like Peter Zaka, a farmer and patient receiving treatment at a primary health care center in Kuje, malaria is a harsh reality. Zaka has lost two of her children to malaria in the last five years.

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“We try to protect ourselves with mosquito nets but it is not enough. Sometimes we don't have the luxury of new networks. The ones we can afford wear out quickly,” Zaka said.

Their story is tragically common in Nigeria, where malaria remains a leading cause of death, especially in rural areas, where limited access to healthcare and prevention measures are often inconsistent.

The burden of malaria in Nigeria varies significantly between regions, influenced by factors such as climate, health infrastructure and socioeconomic conditions.

According to a 2022 WHO report, the highest prevalence rates are often seen in northern and central areas, where health facilities are becoming fewer.

On the contrary, the southern regions, although also affected, may have somewhat better access to health resources.

This disparity suggests the need for targeted regional interventions that address local challenges while ensuring resources reach the areas of greatest need.

In Sokoto state in the north, for example, Mariam Abdullahi, a mother of three, faces constant worry about her children's health, especially during the rainy season when malaria cases rise.

Despite using insecticide-treated nets (ITNs), her youngest son has contracted malaria several times this year.

“Sometimes we don't have money for transportation or treatment and I have to borrow from neighbors,” said Mrs. Abdullahi.

He noted the financial and emotional toll malaria takes on families in underserved areas.

Although awareness campaigns have expanded, inconsistent use of ITNs remains a challenge.

Cultural beliefs, economic limitations and climatic factors play a role. In some communities, people avoid ITNs due to misconceptions about their safety or effectiveness, while others find sleeping with them uncomfortable, especially in the humid regions of Nigeria.

Additionally, the economic challenge of regularly replacing worn-out networks further complicates the issue for low-income households.

The Nigeria Demographic and Health Survey (NDHS) 2023-24 reveals both progress and persistent barriers.

Ownership of ITNs has increased, particularly in rural areas where ownership rates exceed those in urban regions. However, usage rates remain inconsistent.

For example, in states such as Zamfara and Kaduna, households may own ITNs but use them sporadically due to lack of awareness about proper maintenance or affordability of replacements.

The Coordinating Minister of Health and Social Welfare, Ali Pate, recently called for a review of Nigeria's anti-malaria strategies.

During a visit by Malaria Alliance partners, the RBM Malaria Partnership and the WHO Global Malaria Programme, Pate acknowledged that despite more than 70 years of efforts, Nigeria still struggles with high malaria burden.

“Nigeria continues to struggle with a high malaria burden,” he said, underscoring the need for urgent interventions.

He highlighted staggering statistics: 68 million malaria cases and 194,000 deaths annually as of 2021.

Amie Batson, president of WomenLift Health, cited the disproportionate impact of malaria on women and girls in marginalized communities.

“Women's leadership is essential to developing innovative, gender-responsive solutions, especially as we face challenges such as drug resistance and climate change,” Ms Batson said.

Empowering women to lead malaria eradication and climate-resilient health interventions could transform Nigeria's approach to the disease.

The Executive Director of RBM Partnership to End Malaria, Adekunle Charles, emphasized that traditional methods alone will not be enough to eliminate malaria.

“When it comes to malaria, the approaches that have gotten us here will not be enough to eliminate the disease forever,” he said.

Charles called for innovative solutions and collaborative partnerships across sectors.

As Nigeria strives to become a malaria-free nation, experts recommend a combination of targeted interventions and increased resources for local health systems, especially in rural areas.

Olayinka Umar-Farouk, Deputy Project Manager for Risk Communication at Breakthrough ACTION Nigeria, envisions greater community engagement through educational campaigns and increased distribution of ITNs and intermittent preventive treatment with sulfadoxine-pyrimethamine in high-risk areas.

“Addressing the emerging problem of drug resistance is critical, as is improving surveillance to monitor malaria trends and respond quickly to new threats,” said Ms. Umar-Farouk.

He said the findings of the survey suggest that while Nigeria has made commendable progress, there are still challenges to overcome in the fight against malaria.

He said that by implementing these specific recommendations, the country could make significant progress towards reducing the public health impact of malaria, improving the quality of life of millions of people across the country.

For Nigeria, achieving malaria-free status may require more than replicating the strategies of Egypt, Algeria, Cape Verde and Mauritius.

The country's unique demographic, climatic and economic conditions require a tailored approach that combines international best practices with local knowledge.

By implementing specific recommendations from health experts and harnessing the strength of community leadership, Nigeria could make significant progress in reducing the impact of malaria and improving the quality of life for millions of people.

Mr. Pate's call for a comprehensive review, coupled with community-driven approaches and gender-responsive solutions, reflects a critical push to address the unique challenges of malaria in Nigeria.

With concentrated and collaborative efforts between the federal and state governments, the private sector and international partners, Nigeria can still overcome its malaria burden and set an example for other endemic countries.

(NANCeatures)

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