As the count down to the 2021 World Malaria Day on April 25, begins, Nigerian officials and their counterparts in other African countries should not relent in the campaign to kick out malaria in Africa by promoting the use of insecticide-treated mosquito nets, maintaining a healthy environment, and ensuring that health workers properly diagnose and treat patients with malaria.
By Anthony Isibor
MALARIA is one of the most deadly fevers in history behind HIV, Tuberculosis, cancer, and recently coronavirus. Malaria is caused by bites from the female Anopheles mosquito. Through the bite, the plasmodium, which is the virus responsible for malaria, is transferred into the human bloodstream.
According to the World Health Organization, WHO, malaria is the leading cause of child mortality and death in pregnant mothers in the world.
The WHO launched the global malaria eradication program in the 20th century, which resulted in the eradication of malaria in 79 countries worldwide. These are mainly in Eurasia, Australia, northern America, and northern Africa with the exception of Turkey and countries in middle Asia, including Azerbaijan, Georgia, Kyrgyzstan, and Tajikistan).
The eradication of malaria from Europe was officially declared in 1975 and was achieved via the drainage of wetland and stagnant water, chemical treatment of patients, biological control of the mosquito larvae using the fish Gambusia holbrooki, improvement of the water system and sewage infrastructure.
According to the WHO, “one child dies from malaria every 2 minutes”. For this reason, WHO developed policy recommendations to prevent, diagnose and treat malaria. With regard to its prevention, WHO recommends the use of mosquito bed nets treated with long-lasting insecticide and indoor spraying to control the numbers of infected mosquitoes.
By the end of 2006, nearly all 45 countries in the WHO African Region had adopted the policy of providing free insecticide-treated nets to children and pregnant women, but only 16 of these countries aimed to cover the whole population at risk.
Another prevention measure consists in giving at least two treatment doses of anti-malarial drugs during pregnancy to decrease the impact of malaria in pregnant women and newborns. This preventive method is only used systematically in 33 countries of the WHO African Region.
The main method of preventing malaria in high-risk areas with one or more malaria cases per 1000 inhabitants per year is the use of insecticide-treated bed nets and the spraying of insecticide on the inside walls of the house.
Since 2004, the supply of conventional insecticide-treated nets, ITNs, which are assumed to be effective during one year, appears to have increased in the African, South-East Asia, and Western Pacific WHO Regions.
In all regions of the world, indoor spraying is typically used only in locations where risk is the highest. In 2006, indoor spraying protected more than 100 million people, including 22 million in the WHO African Region and 70 million in India alone.
Today, however, malaria has become an exclusive problem of Africa and third-world countries.
Africa has remained the most vulnerable to malaria due to the availability of a conducive breeding atmosphere for mosquitoes; the presence of stagnant water, uncleared grasses, and bushes around residential houses, dirty gutters, and poverty are some of the factors encouraging the decades of protracted battle towards the achievement of a world free of mosquito.
Since then, the WHO In partnership with international agencies has made huge commitments both in materials and in finances towards the total eradication of malaria in the world.
It was in pursuit of this goal that the World Malaria Day, WMD, was established in May 2007 by the 60th session of the World Health Assembly. April 25 each year was set aside to provide “education and understanding of malaria” and spread information on “year-long intensified implementation of national malaria-control strategies, including community-based activities for malaria prevention and treatment in endemic areas.
WHO, which is at the forefront in the eradication of malaria introduced the Roll Back Malaria campaign, targeted at the total eradication of malaria by 2030. And had since continued the fight against the disease.
Through concerted efforts of Artemisinin Combination Therapy, Asian Development Bank, Asia Pacific Leaders Malaria Alliance, Asia Pacific Malaria Elimination Network, Australian Agency for International Development, Cambridge Economic Policy Associates, Creditor Reporting System, Development Assistance Committee, UK Department for International Development, Elimination Eight Regional Initiative, Elimination of Malaria in Mesoamerica and the island of Hispaniola, European Union, Gulf Cooperation Council, Global Malaria Action Plan, International Development Association, Inter-American Development Bank, International Financing Facility for Immunisation, Low Income Country, Lower Middle Income Country, Overseas Development Assistance, Organisation for Economic Cooperation and Development, Pan-American Health Organisation, President’s Emergency Plan for AIDS Relief, President’s Malaria Initiative, Public-Private Partnership, University of California, San Francisco, Upper Middle Income Country, United Nations Children’s Fund, United States Agency for International Development, and World Health Organization, the world has in the last decades recorded huge progress in the fight against malaria.
From the contributions of these donor agencies and international bodies, much success has been recorded in the fight against malaria. There have been mass sensitization, the provision of mosquito-treated nets and huge amounts of monies have been spent on research into finding a cure for the diseases.
As stated by Maha Taysir Barakat, Board Chair, RBM Partnership to End Malaria, “In most parts of the world, a child who gets malaria today has a better chance of survival than at any other point in history.
“Ending malaria represents one of the greatest opportunities to improve child and maternal health and mortality and contribute to SDG 3: to ensure healthy lives and promote well-being for all ages. This report highlights the importance of further integrating malaria interventions – including prevention, diagnosis, and treatment – into our health systems to reach those in most need, yet also to strengthen global efforts to achieve universal health coverage,” he said
According to Barakat’s report, “more than half of all countries are now malaria-free and another 49 countries registering less than 10,000 cases. Timor Leste, Iran, and Malaysia recorded zero cases of malaria for the first time in 2018, an achievement China and El Salvador also attained for the second consecutive year.
“Over the past two years, four countries have been certified as malaria-free, and more countries than ever are now within reach of elimination. This progress puts the world on track for at least 10 countries to reach the 2020 elimination milestone of the global malaria strategy.
“Two of the highest burdened countries also reported significant reductions in malaria cases between 2017 and 2018, with Uganda and India reporting 1.5 million and 2.6 million fewer cases respectively. The Greater Mekong Sub-region has recorded a 76% fall in malaria cases between 2010 and in 2018, and deaths plummeted by 95%.
The report also stated that “Investments in malaria also reached US$663 million in 2018 – its largest budget to date since 2009. This investment resulted in the rollout of new tools, such as WHO’s pilot program for the world’s first malaria vaccine, RTS,S, and next-generation mosquito nets to address the biological threat of insecticide and drug resistance,” it said.
Since 2008, WHO and partners have united around a common World Malaria Day theme. World Malaria Day 2008: “Malaria: a disease without borders, World Malaria Day 2009-2010: was tagged “Counting malaria out” for 2011, it was “Achieving Progress and Impact, in 2012, “Sustain Gains, Save Lives: Invest in Malaria”, World Malaria Day 2013-2014-2015: “Invest in the future: defeat malaria”, for 2016, it was “End Malaria For Good”, World Malaria Day 2017: “LETS Close The Gap”, World Malaria Day 2018: “Ready to beat malaria World Malaria Day 2019 and 2020: “Zero malaria starts with me”.
Abdourahmane Diallo, Chief Executive Officer, RBM Partnership to End Malaria believes that “continued global investment and commitment towards a world free of malaria has been critical to sustaining the progress the malaria community has made to date – without these global efforts, malaria cases and deaths would be significantly higher.
“Now, it is essential we step up global action and financing to close the annual US$2 billion funding gap to reach those at risk with sustainable access to life-saving tools. We must also prioritize developing and scaling up new, transformative tools to stay ahead of the evolving parasite, as highlighted in two landmark reports on malaria eradication published earlier this year. It is crucial that we act now to hold leaders accountable and work together to achieve vital reduction targets save millions of more lives and end malaria for good.”
According to the World Malaria Report 2019, released by the World Health Organization (WHO), ”global malaria cases and deaths are declining, but at a slow rate: from an estimated 231 million to 228 million cases and from 416,000 to 405,000 deaths between 2017 and 2018. Importantly, estimates show that in 2018, global efforts saved almost 600,000 lives per year and prevented almost 100 million malaria cases per year compared to 2000.
These huge successes recorded in the last decade may be jeopardized by the emergence of the coronavirus, which has taken the center stage. More and more resources and medical personnel are now focused on the fight against the coronavirus pandemic at the detriment of other diseases including malaria.
Despite the poor health infrastructure in Nigeria, the war against malaria scourge in the country has recorded some impressive results.
For instance, the 14th Annual Report of the U.S. President’s Malaria Initiative, PMI, which was released in conjunction with World Malaria Day in 2020, indicated that child death rates have decreased in Nigeria by 16 percent since 2010, when the United States began providing malaria control support to the country.
During the same period, malaria prevalence has decreased by almost half – from 42 percent in 2010 to 23 percent – according to Nigeria’s most recent National Demographic and Health Survey.
Led by the U.S. Agency for International Development, USAID and implemented together with the U.S. Centers for Disease Control and Prevention, CDC, PMI works with partner countries to benefit more than 400 million people across sub-Saharan Africa and parts of Southeast Asia.
Use of long-lasting insecticide-treated bed nets, LLIN, is one of the most effective measures used to prevent malaria. Since 2010, PMI has supported Nigeria in the distribution of more than 100 million bed nets, which are now in use in 43 percent of Nigerian households, up from just 23 percent at the start of the initiative.
“Malaria is one of the leading causes of death among children in Nigeria,” said USAID Mission Director Stephen M. Haykin, who oversees PMI activities in collaboration with CDC leadership. “We are pleased to see our partnership with Nigeria has had clear success and will continue this support with proven methods of prevention and treatment against malaria.”
Nevertheless, malaria remains an onerous burden among the poorest and the most vulnerable echelons of Nigerian society. During pregnancy the disease can pose a life-threatening risk to both mothers and babies; malaria also causes adults and children to miss work and school, contributing to economic hardship.
PMI works with Nigeria’s National Malaria Elimination Program to scale up proven, cost-effective, and life-saving malaria control interventions centered around LLIN distribution, intermittent preventive treatment for pregnant women, diagnostic testing, and treatment.
“In 2019, PMI invested $70 million to help Nigeria fight malaria, distributed more than 6.9 million insecticide-treated mosquito nets, distributed 8.6 million doses of prophylaxis to pregnant women, 1.6 million doses to children during the rainy season, and 24 million doses of treatment at the facility and community levels. Additionally, 15.3 million rapid malaria tests were provided to help health workers properly diagnose and treat patients.
“Since 2010, PMI has invested $635 million to procure and distribute 57 million LLIN nets, support advocacy campaigns to encourage members of the community to sleep under the bed nets every night, and train health workers to test for malaria before treatment,” the report said.
According to the report, PMI helps to strengthen health systems and build the skills of health workers to deliver malaria services. “PMI also assists to enhance the capacity of federal and state health officials to manage malaria control activities.
“In dozens of countries, PMI helps accelerate progress toward a world safe and secure from infectious disease threats. Through investments in health systems and workforce development, antimicrobial resistance monitoring, national laboratory system strengthening, and real-time disease surveillance, PMI is supporting county capacity to effectively prevent, detect, and respond to disease outbreaks and, in turn, directly contributing to a healthier world for all,” it added
– Apr. 09, 2021 @ 18:30 GMT