The Federal Government, through the National Malaria Elimination Programme (NMEP) has concluded plans to subsidise malaria diagnostic tests and medicines in a bid to reduce the cost of treatment and improve access to quality-assured commodities for vulnerable Nigerians in rural communities.

The initiative, known as the Affordable Diagnostics and Medicines Facility for Malaria (ADMFM), will initially target the private sector, particularly patent and proprietary medicine vendors (PPMVs), in underserved communities.
The programme, which has over N2 billion funding from the World Bank-supported IMPACT project, is expected to provide about four million diagnostic test kits and nearly two million treatment courses.
The National Coordinator of the National Malaria Elimination Programme (NMEP), Dr. Nnenna Ogbulafor, disclosed this in Abuja, said that the initiative was designed to make malaria diagnosis and treatment more affordable.

She stressed the importance of testing before treatment, noting that fever could be caused by several illnesses and should not automatically be treated as malaria.

Ogbulafor observed that once malaria was confirmed through diagnosis, patients would be given appropriate treatment with artemisinin-based combination therapies (ACTs).

She said: “Affordable means that the government is subsidising part of the cost of malaria diagnostic tests and treatment. With what the government is doing, incentives are coming in to bridge the gap and make diagnosis and treatment affordable. It is important to note that this is for the private sector. So, the initial phase is going to the private sector, particularly the PPMVs. This initial phase is also looking at the underserved”.

“When we talk about the underserved, we are looking at rural areas. So, these medicines are going to be mainly available in communities where malaria is worst hit. We are also targeting ACT-1 and ACT-2. What we mean by ACT-1 and ACT-2 is that they are meant for children under five and up to 12 years old, who are among those worst affected by malaria”.

Ogbulafor disclosed that the initial intervention would be implemented in Borno and Ekiti states, with plans to subsequently expand to Abia, Ondo and other World Bank-supported states.

Obulafo said the limited funding necessitated a phased approach but expressed hope that state governments and the End Malaria Council, chaired by Alhaji Aliko Dangote, would support the expansion of the programme to more communities.

According to her, the private sector was being prioritised because available data showed that about 50 per cent of Nigerians seek care first in private facilities when suffering from febrile illnesses.

She said: “If we have these affordable medicines, there is testing and there is treatment. You test, and if you find that it is malaria, they can take the appropriate treatment.”
Og­bulafor said ensuring that every suspected malaria case is properly diagnosed and that confirmed cases receive effective and affordable treatment was critical to Nigeria’s efforts to eliminate the disease.

She stressed the need to move away from presumptive treatment, insisting that malaria case management must be driven by testing, confirmation and appropriate treatment.

“Effective malaria case management begins with accurate diagnosis,” she said, noting that quality-assured malaria rapid diagnostic tests and other appropriate diagnostic tools were essential for distinguishing malaria from other febrile illnesses.

According to her, the availability of affordable antimalarial medicines at healthcare delivery points was equally important to achieving effective case management.

She explained that the ADMFm provides an opportunity to strengthen the country’s malaria commodity ecosystem by addressing access, affordability, availability, quality and sustainability.

The NMEP coordinator, however, cautioned that affordability should not be viewed simply as a reduction in the price of commodities.

She said sustainable affordability required interventions across the entire value chain, from manufacturing and procurement to distribution, service delivery and access by the final consumer.

Og­bulafor also called for greater attention to local manufacturing, technology transfer and the creation of viable markets for quality-assured health commodities.

“Nigeria has enormous potential to strengthen local production of essential health commodities,” she said, adding that a sustainable ADMFm should stimulate local manufacturing while strengthening regulatory capacity and ensuring reliable markets for locally produced products.

She identified government, development partners, private-sector players, healthcare providers, civil society organisations, communities and the media as critical stakeholders in the success of the initiative.

According to her, government must provide policy direction, financing, regulation and coordination, while development partners can contribute technical expertise and financing.

She added that the private sector had an important role to play through innovation, manufacturing capacity, supply-chain expertise and market knowledge, while healthcare workers remained central to the appropriate use of diagnostic and treatment commodities.

Og­bulafor also highlighted the role of communities and civil society organisations in identifying barriers to accessing quality malaria commodities and ensuring that citizens demand quality services.

She urged the media to support the initiative through extensive public awareness, stressing the importance of ensuring that preventable malaria deaths, particularly among children and pregnant women, are reduced.

Ogbulafor urged participants at the meeting to identify barriers to affordable malaria commodities, develop practical solutions and strengthen coordination between the public and private sectors.

She commended the World Bank, malaria partners, private-sector stakeholders, the Presidential Initiative for Unlocking the Healthcare Value Chain, government agencies and state governments for supporting the initiative.

She said NMEP remained committed to working with stakeholders to strengthen malaria prevention, diagnosis, treatment and surveillance across Nigeria.

Og­bulafor described the engagement as an opportunity to move beyond discussions and establish stronger partnerships that would translate into improved access to affordable and quality malaria diagnostics and medicines.

She disclosed that the stakeholders’ engagement was being held ahead of the planned launch of the ADMFm by the Coordinating Minister of Health and Social Welfare next month.

The initiative, she said, should ultimately contribute to ensuring that no Nigerian, particularly children and pregnant women, dies from a disease that is both preventable and treatable.

In his remarks, the Head of Projects and Specialty Programme at Emzor Pharmaceutical Industries Ltd, Pharm, Sunday Agamah, said that the company had collaborated with NMEP for almost a year to provide quality and affordable malaria medicines under the programme.

He said Emzor was among the companies selected to produce the medicines and was ready to commence field distribution.

Agamah added that the company would work with selected distributors, train them on the requirements and deploy its staff in the participating states to monitor distribution and ensure compliance.

Similarly, Pharmacist Rotimi Afolaogun of Codix Group said the company would make rapid diagnostic tests available under the initiative.

He warned against treating malaria without confirming the diagnosis, stressing that accurate diagnosis was essential to ensuring appropriate treatment.

He said Codix Bio, an arm of Codix Group, would provide locally manufactured rapid diagnostic tests as part of the programme.

Also speaking, Pharmacist Jerome Dagun Joseph of Fidson Healthcare Plc said the company would produce affordable anti-malaria medicines, including AL-1 and AL-2, for underserved populations.

Joseph said Fidson was selected based on its production capacity and nationwide distribution network.

He said the company would supply registered distributors, while Sproxil would support traceability and monitoring of the products.

According to him, subsidised medicines would carry a distinctive logo on their packs to enable consumers to identify them, while distributors would be sensitised on the approved pricing structure.

Meanwhile, the Senior Special Adviser to the Coordinating Minister for Health on AIDS, Tuberculosis and Malaria (ATM), Yahubu Abdullahi, said the ADMFM was a Federal Government initiative supported by the World Bank.

Abdullahi noted that the programme involved relevant agencies of the Federal Ministry of Health, including NMEP and the National Agency for Food and Drug Administration and Control (NAFDAC), as well as private-sector pharmaceutical companies and other stakeholders.

He said an MOU was already in place among the stakeholders, while the programme was expected to take full effect following its formal launch by the Minister of Health in September.

Abdullahi said the Federal Government was already making plans to continue funding the intervention after the World Bank-supported IMPACT project ends.

He said: “We know that most of our programmes are donor-driven, while many health expenses are paid out of pocket. But the government is now coming out in full force to make medicines, treatment and basic healthcare accessible to vulnerable and deprived populations.”

He said the government was preparing to mobilise domestic resources to ensure that the programme would not collapse after the World Bank funding ends.

Abdullahi described the initial implementation as a pilot, saying the long-term objective was to transform the initiative into a national programme involving all 36 states and the Federal Capital Territory.

He stressed that the programme would not be solely government-driven, as state governments and private pharmaceutical companies would also play important roles in its implementation.