AS Nigeria joins the rest of the world to commemorate the World Malaria Day today, expectations are high that the country would ramp up efforts to combat the deadly disease that exacts a high toll in lives and on the economy. It is another wake-up call to the federal, state and the increasingly ineffectual local governments to rejuvenate the Roll Back malaria programme.

In adopting the theme: ‘Harness Innovation to Reduce the Malaria Disease Burden and Save Lives,’ the World Health Organisation, which established April 25 each year as WMD in 2007, explained that this is to underscore the collective energy and commitment of the global malaria community in uniting around the common goal of a world free of malaria. Given the ravages of the disease worldwide and in Nigeria especially, this project should be strongly prosecuted and with much more resources.

Malaria, a life-threatening disease, is caused by a parasite transmitted to humans through the bite of an infected female Anopheles mosquito. It is the most deadly animal in the world in casualty rates. Through its bite, it injects the Plasmodium parasite in humans, which has five species, with P falciparum the most deadly. According to the WHO, there were 241 million cases of malaria reported worldwide in 2020. It killed 627,000 persons that year. Not surprisingly, 95 per cent of the cases were found in sub-Saharan Africa and 96 per cent of the deaths.

The World Malaria Report 2021 reaffirmed the sorry reality of Nigeria and other SSA states: 80 per cent of all malaria deaths in the region were of children under age five. This is an unacceptably high toll that should be reversed at all costs.The President, Major General Muhammadu Buhari (retd.), and the 36 state governors should take note of these figures: Nigeria, with 31.9 per cent of the total, led three other African countries to account for over half of the total global deaths. It was followed by Congo DR’s 13.2 per cent; Tanzania’s 4.1 per cent, and Mozambique’s 3.8 per cent. One study described malaria as Nigeria’s No.1 public health problem, accounting for 30 per cent of all under-five deaths, 25 per cent of deaths in infants and 11 per cent of maternal mortality.

Its economic costs are also high. Private, household expenditure on malaria treatment, the report added, “constitutes a high economic burden to households and to the health system.” The United States Centers for Disease Control declared, “Costs to governments include maintenance, supply and staffing of health facilities; purchase of drugs and supplies; public health interventions against malaria, such as insecticide spraying or distribution of insecticide-treated bed nets; lost days of work with resulting loss of income; and lost opportunities for joint economic ventures and tourism.” It estimates combined direct costs to the afflicted areas at $12 billion each year.

Besides, it retards Africa’s GDP growth by 1.3 per cent yearly. For a continent lagging behind all others in development indices, this is distressing.

But the good news is that the disease is both preventable and curable. Nigeria has to purposely trigger new, and reactivate older actions amid the WHO’s disturbing statistics.

The country has failed to utilise or maximise global interventions to reduce the disease burden. Both the 1998 Roll Back Malaria project aimed at malaria burden reduction by at least 50 per cent through precise interventions, and the 2005 Abuja Declaration to overturn malaria burden, were poorly executed. Till date, Nigeria falters and wobbles on lofty malaria eradication initiatives designed to reverse the trend. Like many other national programmes, there is no consistency in implementation as succeeding administrations and ministers often abandon ongoing activities halfway to promote empty new slogans.

Together, the federal and state governments need to implement policies to eradicate malaria. They should enforce programmes to maintain a clean environment for vector control, make insecticide-treated nets available free to homes, invest in preventive and curative medicines, and strictly adhere to the WHO regulations on malaria control.

Corrupt government officials cornered donated insecticide-treated nets that were to be distributed free and sold them for personal profit. Such acts of corruption should be prevented, exposed when they occur, and the perpetrators severely punished to serve as deterrent.

States need to equip hospitals, motivate medical workers, embark on the clearing of drainages and reactivate the campaign to retool the Primary Health Centres to turn the tide against malaria. LGs should concentrate on providing and funding PHCs, accompanied by effective sanitation activities. The sanitary inspection system that was effective in the First Republic should be revived, upgraded, well-funded and their staff trained and motivated.

Intense campaigns are needed to confront illiteracy and poverty, two factors identified as key elements among the drivers of malaria to create better living conditions at the grassroots.

Extra efforts must be made to protect under-five children from infections of moderate-to-high P. falciparum by taking advantage of the WHO-recommended RTS,S malaria vaccine. The success of the pilot programme in Ghana, Kenya and Malawi is considered an outstanding breakthrough for science, child health and malaria control.

Since 2015, the WHO has certified Maldives (2015), Sri Lanka (2016), Kyrgyzstan (2016), Paraguay (2018), Uzbekistan (2018), Argentina (2019), Algeria (2019), China (2021), and El Salvador (2021) as malaria-free. Nigeria should take all necessary measures to join this club.

Look also to Bangladesh that is set to eliminate malaria in 13 of 64 districts by initiating a high coverage chain, increased use of insecticide-treated nets and conducting rapid diagnostic tests and anti-malarial treatments, driven by substantial community health workers and health facilities.

The various governments have to fund preventive treatment during pregnancy to reduce the burden of malaria in pregnant women as experts say pregnancy reduces a woman’s immunity to malaria. Among other programmes, Nigeria should determinedly partner with the WHO Global Technical Strategy to achieve its target of reducing malaria incidence and mortality rates by 90 percent by 2030, including eliminating the illness in 35 countries. The federal and the state governments should ensure that Nigeria is one of them.

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