The malaria scourge can be tackled

It is no surprise that during this year’s annual stakeholders’ national review and planning meeting on Seasonal Malaria Chemoprevention (SMC) implementation, the nation was greeted again, with statistics showing the high burden of the disease.

Year in year out, Nigeria bemoans the havoc malaria wreaks on the country.

According to the Minister of Health, Osagie Ehanire, Nigeria continues to bear the highest burden of malaria globally with over a quarter of all cases and deaths, representing “27 percent and 27 percent respectively as reported in the most recent World Malaria Report.”

Similarly, in 2019, the same Report showed that Nigeria accounted for 23 per cent of cases; the highest deaths from the disease globally.

To reduce the burden of malaria deaths in the country, the Minister urged Commissioners for Health of implementing states to harness their commitment to improving SMC and insecticide-treated nets campaign implementation in their respective domains. Seasonal Malaria Chemoprevention (SMC) involves intermittent administration of full treatment courses of an anti-malarial medicine to children, particularly in areas of high transmission. This has lessened the effects of malaria thereby minimizing the proportions of children that progress to life-threatening severe malaria and reducing the incidence of anaemia and deaths.

Although the figures on malaria cases and deaths in Nigeria may have been heightened by disruption in access to effective malaria prevention/diagnosis and anti-malarial treatment, aggravated by COVID-19; the “malaria challenge,” issued by the World Health Organisation (WHO) Director-General in 2019 calling on the global health community to ramp up investment in the research and development of new malaria-fighting tools and approaches for malaria eradication is relevant and worthy of support.

While urging the Commissioners for Health of implementing states to harness their commitment to improving SMC strategy and insecticide-treated nets campaign implementation in their respective domains as advised by the Minister, there is the need to have a continuous 360 degrees intervention on prevention and treatment because despite the SMC strategy, Nigeria according to the most recent World Malaria Report still accounts for 25 per cent of world’s death, which is higher than the 2019 figure by two per cent.

It is imperative therefore that Nigeria optimises a mix of interventions to avert malaria cases and deaths. Against this, the Federal Ministry of Health (FMoH) should set targets for verifiable indicators across the three levels of government response towards reducing the malaria burden, using the latest World Malaria Report.

The ministry should set targets for the traditional medicine department it created in 2018 to find a cure for malaria. Also, FMoH and NIPRD should rise up to the occasion and undertake scientific research to generate evidence for the safety, efficacy and quality of the traditional medicinal products and practices, particularly those on malaria since anecdotal evidence suggests that there are traditional medications for malaria and there is no need reinventing the wheel.

Essentially, there is a baseline, because most Nigerians, especially those living in rural and hard-to-reach communities do not have access to orthodox medicine and usually use local herbs for malaria treatment. Furthermore, it is estimated that about 75 per cent of the populace still prefer to solve their health problems through traditional health healers. Obviously, home-grown solution for the prevention and cure of malaria is relevant to the majority of Nigerians. Nigerian health authorities can do a lot more along this line to eradicate malaria.

Thus NIPRD can also work with states that have established traditional medicine boards because what is needed now is stepping up action in the area of “research and development” to modernise and standardise them; and working with the National Agency for Food and Drug Administration and Control (NAFDAC) and PMG-MAN for good manufacturing practices in order to ensure stable and well-preserved products, uniform and accurate dosage and properly-labelled herbal medicines.

Herbalists should also be encouraged to register their proven and efficacious standardised herbal preparations with NAFDAC, while NAFDAC should ensure that the medical products discovered undergo rigorous scientific analysis/clinical test before being endorsed for use. 

In addition, there is the need for collaboration among relevant institutions for the seamless integration of traditional medicine proven to be safe and effective into the health system; development of regulation and guidelines for the control of traditional medicines, training of technical personnel working in research, controlling activities and the conservation of medicinal plants, especially those facing extinction due to over-use, bush burning, drought and urban development.

On prevention, Nigeria should key into the models in Ethiopia and Western Kenya, where studies showed how mosquito repellent plants in and around residential areas, which also beautify the environment and freshen the air, can be used to control malaria. The National Institute for Pharmaceutical Research and Development (NIPRD), Pharmaceutical Society of Nigeria (PSN), the Pharmaceutical Manufacturers Group of the Manufacturer’s Association of Nigeria (PMG-MAN), Traditional Medicine Practitioners, FMoH and Federal Ministry of Science and Technology (FMST) should relate to Nigerians on their progress in the search for a home-grown solution to malaria cure.

Finally, with the recent endorsement of the long-expected first malaria vaccine, RTS, S/AS01 (RTS,S), by the World Health Organisation (WHO), children in sub-Saharan Africa and in other regions with moderate to high Plasmodium falciparum transmission will, for the first time, get a respite from deadly malaria affliction. Nigeria should pursue the global vaccine alliance, Gavi, which said it had approved nearly $156 million in funding to roll out the malaria jabs to children in sub-Saharan Africa.