NIGERIA joins the rest of the world to mark the World Malaria Day today, underscored by its recent approval of the R21/Matrix malaria vaccine produced by the Serum Institute of India. This is fitting, given the country’s status as the most malaria-afflicted worldwide, and accounting for the highest number of deaths from the deadly disease. In an otherwise sub-par performance, the outgoing regime of the President, Major General Muhammadu Buhari (retd.), can claim this as a rare progressive step that should be vigorously followed through by its successor.

The Director-General, National Agency for Food and Drug Administration and Control, Mojisola Adeyeye, explained that Nigeria’s approval for the vaccine trials was part of measures to prevent clinical malaria in children aged between five and 36 months. Ghana had beaten Nigeria to the tape by being the first African country to approve the vaccine. Nigeria should surpass its smaller neighbour by more aggressive follow-up measures such as better funding, dogged trials, testing, revitalisation of all malaria control programmes, and domestic research and development in vaccines and medicines.

Malaria is an acute febrile illness caused by the plasmodium parasite that spreads to humans through the bite of infected female anopheles mosquitoes. It comes with high fever, chills, and appetite loss among others. According to the World Health Organisation, each year, 290 million persons worldwide are infected.

Referred to as “the epidemic of the poor,” the European Alliance Against Malaria, an NGO, laments that most of the victims are from poor countries. “It kills a child every 30 seconds, and some three million people a year, the large majority in sub-Saharan Africa,” it said. Unquestionably, the deadliest animal to humans therefore, is the anopheles mosquito, not the lion, tiger, snake, or shark!

Tragically, Nigeria is the “undisputed World Champion” in malaria affliction. The World Malaria Report revealed that Africa has the highest share of the global malaria burden with four countries recording over half of malaria deaths worldwide. These are Nigeria (31.3 percent), Congo DR (12.6 per cent), Tanzania (4.1 per cent), and Niger Republic (3.9 per cent).

Though vulnerable because of its tropical climate that enables mosquitoes to thrive, successive Nigerian governments bear responsibility for the persistence of the disease and its debilitating impact.

Apart from the social trauma of sickness and loss of lives, researchers say “malaria contributes to economic stagnation, poverty, and a poor physical and intellectual workforce.” Africa loses an estimated $12 billion of GDP through malaria, slowing down growth by 1.3 percent each year. The WHO estimates the average economic burden of malaria as a percentage of household budget in Nigeria at 8.23 percent, compared to 3.12 percent in India. Malaria-related absenteeism from work and productivity losses average $1.1 billion in Nigeria annually.

About 53 million cases (affecting one in four residents) occur in Nigeria yearly: and 81,640 die, according to another study; this represents nine deaths from malaria every hour!

Given this reality, Nigeria should take the lead in innovative research and preventive measures to combat the avoidable but curable disease. But lack of commitment to seeing through eradication and control programmes, corruption, and sheer incompetence, coupled with the shambolic health care delivery system, have seen malaria on the march.

Nigeria’s over 60 research institutes have not made any matching breakthrough. Domestic eradication efforts have similarly floundered. But between 1955 and 2023, the WHO listed 103 countries that after three consecutive years of zero new cases, are eligible for its malaria-free certification. Eight are in Africa: Algeria, Lesotho, Mauritius, La Reunion, Seychelles, Libya, Morocco, and Tunisia. Eradication is, therefore, not rocket science; what it takes are vision, good governance, responsible leadership and collaborative efforts by the federal, state and local governments. This way, China reduced its previous burden of 30 million cases annually to zero, eradicating the disease by 2021.

Nigeria’s control efforts are defeated by the country’s leadership failure; several programmes have crashed, sabotaged by corruption, gross inefficiency and government bureaucracy. From the Roll Back Malaria, National Malaria Elimination Programme, National Malaria Control Programme, National Malaria Strategic Plan to the new Nigeria End Malaria Council, the strategies, and interventions showcase the country’s perennial “one step forward and two steps backwards” syndrome.

In 2014, the United States government donated mosquito-treated nets to some states in the country to be distributed free to poorer households in addition to other handouts from other donor agencies. Many of the nets soon found their way to markets for sale, stolen by officials and health workers. Six such felons who worked with the Kebbi State ministries of health and local government were arrested by the police in 2018 for diverting two truckloads of the items. Anti-corruption agencies and NGOs should checkmate corruption in malaria campaigns. Culprits should be made to face the full wrath of the law.

There should be a multifaceted and multi-layered eradication and control approach. LGs should revive and revitalise sanitary inspections, desilt and clean gutters, weed bushes, prevent water stagnancy, and embark on rigorous campaigns for vector control and spraying of pesticides.

Nigeria imported anti-malarial drugs worth N65.98 billion and N43.47 billion in the third and fourth quarters of 2021 respectively, according to the National Bureau of Statistics. Totalling N109.46 billion in six months, the drugs were imported from India, China, Germany, US, Pakistan, and The Netherlands. The Minister of Health, Osagie Ehanire, said Nigerians spend N480 billion yearly on the treatment, prevention, and manpower of malaria.

Combating the disease is rendered herculean by the passiveness of the states and LGs. They must take the lead, adopt exceptional initiatives, and sign on to national programmes to defeat the disease. Brazil’s latest programme, National Malaria Elimination Plan 2022, aims to reduce malaria cases to less than 68,000 by 2025, the number of deaths to zero by 2030, and eliminate the disease altogether by 2035. Nigeria should similarly harmonise all its programmes, incorporating the vaccine initiative, involve all tiers of government, and target eliminating the disease in the next one decade.

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