Nigeria missing as WHO begins malaria vaccine pilot in Africa

•Evans therapeutics engage communities to achieve zero cases, deaths from infection

Despite Nigeria having the greatest burden of malaria in Africa and indeed the world, Malawi on Tuesday became the first of three African countries to launch of the world’s first malaria vaccine in a landmark pilot programme. According to the World Health Organisation (WHO), Malawi is the first of three in Africa in which the vaccine, known as RTS,S, will be made available to children up to two years of age; Ghana and Kenya will introduce the vaccine in the coming weeks.

Malaria, according to the WHO, remains one of the world’s leading killers, claiming the life of one child every two minutes. Most of these deaths are in Africa, where more than 250,000 children die from the disease every year. Children under-five are at greatest risk of its life-threatening complications. Worldwide, malaria kills 435,000 people a year, most of them children.

In Nigeria, it is estimated that Nigeria loses N132 billion yearly and records estimated 100 million cases with over 300,000 deaths yearly to malaria and its complications.Why was Nigeria not chosen? The WHO explained: “Following a request by WHO for expressions of interest, the pilot countries were selected from among ten African countries. Key criteria for selection included well-functioning malaria and immunization programmes, and areas with moderate to high malaria transmission.”

What informed the pilot studies? Proven results: Thirty years in the making, RTS,S is the first, and to date the only, vaccine that has demonstrated it can significantly reduce malaria in children. Also, as part of efforts to drive a reduction of malaria in Nigeria, in order to achieve the WHO’s 2030 elimination target, Evans Therapeutic Limited, on Tuesday, organised a community sensitisation and awareness programme in line with the 2019 theme, where some residents of Isolo Local Government were tested and treated for malaria.

The residents, who came out in their numbers underwent several health check ups to ensure they stay healthy, as well as early detection of malaria cases, where they were given anti-malaria drugs.Speaking to The Guardian, the Marketing Manager, Evans Therapeutics Limited, Sesan Adebayo, said it was necessary to sensitise the community on the burden of malaria and create awareness on the economic impact as well as the disease prevention and drug use.

He said Nigeria is still struggling with malaria elimination because of people’s attitude towards the disease and the low level of knowledge towards drug use, noting that anti-malaria drug is been abused in the country.“One of the things we have identified is that malaria is highly over diagnosed in Nigeria and many time, people use anti malaria when they don’t have the sickness. This is an environment where people have easy access to drugs; anybody can go to drugstore to purchase anti malaria drugs.

“To conquer malaria, anti malaria was made an over-the-counter drug, the only drug you can buy with out prescription and people have abused that privilege.People will walk up to drug store without conducting test to request for anti malaria drugs, with that assumption that they have malaria and then, not only will the drug refuse to work, they suffer the side effects of that medicine as well,” he stressed.He said abuse of drugs have increased anti-malaria resistant in the parasites, while he called for proper prescription and usage of the dosage in order to avoid negative implication on the health of individuals.

“If anti malaria is not properly use, the chances that the malaria parasite will develop resistant to that drug will increase,” he added.Also speaking on ways to achieve zero malaria in Nigeria, the National Sales Manager, Pharm. Gafar Yusuf said it is imperative that every stakeholder plays a collaborative role in ensuring, not only the reduction, but total elimination of malaria, ranging from the health workers, companies, government and the community members.“It is not enough to set to goals to eradicate malaria, everyone must play his or her own part in ensuring the success of achieving zero malaria,” he noted.

He said as a pharmaceutical company, whose goal is to ensure elimination of malaria among residents through its corporate social responsibility, it has brought testing and treatment of the disease to the communities, which is in line with the 2019 theme.“We don’t only manufacture but market sales of anti malaria, it is important that we collaborate with the government and the people, and reach out to the grass roots by having direct contact with the communities.

“That is why in our own small way as a company, we have carried out our anti malaria campaign in Isolo local governments, reaching out to residents and the government workers and try to make sure that they don’t only have knowledge of the parasites, but how to manage such when they have malaria,” he added.On how Nigeria can achieve near zero malaria by 2030, Yusuf lamented that the country was not able to meet nor achieve the first policy of the WHO’s Millennium Development Goal (MDG), which has now been changed to Sustainable Development Goal (SDG), noting that the country must double its efforts in putting strategies in place for its people to ensure that before 2030, it attains minimal level of the disease, if not totally.

On her part, the Medical Officer of Health, Isolo Local Government, Dr, Ajayi Temitope said Nigeria is endemic to malaria and must ensure it increases awareness on the disease as most people misdiagnose for other ailment.“People think that malaria has to do with fever and body pains; it also increases the rate of maternal and infant mortality.“People just look at malaria as ordinary because it has been with us for a very long time and so they don’t take it serious, that is why they actually have issues with taking care of this scourge because Nigeria is actually endemic.
She further stressed that Nigeria has neglected the preventive measure and focus on curative, which has contributed to the rise of the disease.
She, however, charged Nigerians to be mindful of their environment and ensures it stays clean and safe, as well as use treated mosquito nets to prevent malaria.

“Nigeria focuses on curative rather than preventive, this is why the malarial drugs are been resistant, it’s just like insecticides, once you use it for certain period of time, the organisms start creating genes that are resistant, that is what has been happening, which is why Chloroquine has been phased out over time and unfortunately, the same behaviour we had towards chloroquine is what we have putting into the rest of the antimalarials.

“Most people come down with cold which leads to fever and then they conclude they have malaria and start treating for malaria, if eventually they have malaria, the drug would be resistant, so education and environmental health would definitely go a long way rather than drugs, which becomes resistant eventually.“So people should focus more on the preventive aspect first and after that, then we can now turn to the treatment. After prevention we will discover that people don’t have to come down with malaria and then the awareness had to continue because it is not every fever that is malaria,” she added.