Some African countries have eliminated malaria. Can Nigeria do so?

In spite of global advances in the fight against malaria, Nigeria continues to grapple with this leading killer disease.

Nigeria’s struggles against malaria raise questions about the nation’s capacity to follow in the footsteps of Egypt, Algeria, Cape Verde and Mauritius where malaria has been successfully eliminated in Africa.

Could Nigeria achieve similar success, or do its unique challenges require a new approach?

With a tropical climate and a vast population, Nigeria carries a disproportionate portion of the global malaria burden.

According to the World Health Organisation (WHO), Nigeria accounted for nearly 30 per cent of global malaria cases and an estimated 194,000 deaths annually as of 2021.

In communities like the Kuje Area Council in the Federal Capital Territory, malaria is not just a health concern it is also a threat that impacts family life, education and livelihoods.

For the likes of Peter Zaka, a farmer and patient receiving treatment at a primary healthcare centre in Kuje, malaria is a harsh reality. Mr Zaka has lost two of his children to malaria in the past five years.

“We try to protect ourselves with mosquito nets but it’s not enough. Sometimes we can’t afford new nets. The ones we can afford wear out quickly, “, Zaka said.

His story is tragically common in Nigeria, where malaria remains a leading cause of death, particularly in rural areas in the face of limited access to healthcare and prevention measures are often inconsistent.

Nigeria’s malaria burden varies significantly across regions, influenced by factors like climate, healthcare infrastructure and socioeconomic conditions.

The highest prevalence rates are often seen in northern and central areas, where healthcare facilities are fewer and far between, according to a 2022 WHO report.

In contrast, southern regions, while also affected, may have somewhat better access to healthcare resources.

This disparity suggests a need for region-specific interventions that address local challenges while ensuring resources reach areas of greatest need.

In Sokoto State in the north, for example, Mariam Abdullahi, a mother of three, faces constant worry about her children’s health, especially during the rainy season when malaria cases surge.

In spite of using Insecticide Treated Nets (ITNs), her youngest child has contracted malaria multiple times this year.

“Sometimes, we don’t have the money for transport or treatment, and I have to borrow from neighbours,” Mrs Abdullahi said.

She pointed out the financial and emotional toll malaria takes on families in underserved areas.

While awareness campaigns have expanded, the inconsistent use of ITNs remains a challenge.

Cultural beliefs, economic constraints, and climate factors all play roles. In some communities, people avoid ITNs due to misconceptions about their safety or effectiveness, while others find them uncomfortable to sleep under, especially in Nigeria’s humid regions.

Additionally, the economic challenge of regularly replacing worn-out nets further complicates the issue for low income households.

Nigeria Demographic and Health Survey (NDHS) 2023-24 reveals both progress and persistent barriers.

ITN ownership has increased, particularly in rural areas where ownership rates outpace those in urban regions. However, usage rates remain inconsistent.

For example, in states like Zamfara and Kaduna, households may own ITNs but use them sporadically due to a lack of awareness on proper maintenance or affordability of replacements.

The Coordinating Minister of Health and Social Welfare, Ali Pate, recently called for a review of Nigeria’s malaria strategies.

During a visit by Malaria Alliance partners, RBM Malaria Partnership, and the WHO Global Malaria Programme, Mr Pate acknowledged that in spite of over 70 years of efforts, Nigeria still struggles with a high malaria burden.

“Nigeria is still struggling with a high burden of malaria,” he said, stressing the need for urgent interventions.

He highlighted staggering statistics: 68 million malaria cases and 194,000 deaths annually as of 2021.

Amie Batson, president of WomenLift Health, mentioned the disproportionate impact of malaria on women and young girls in marginalised communities.

“Women’s leadership is essential for developing innovative and gender-responsive solutions, especially as we face challenges like drug resistance and climate change,” Ms Batson said.

Empowering women to lead in malaria eradication and climate-resilient health interventions could transform Nigeria’s approach to the disease.

The Chief Executive Officer of RBM Partnership to End Malaria, Adekunle Charles, emphasised that traditional methods alone will not suffice to eliminate malaria.

“When it comes to malaria, the approaches that have gotten us this far won’t be enough to eliminate the disease for good,” he said.

Mr Charles called for innovative solutions and collaborative partnerships across sectors.

As Nigeria strives to become a malaria-free nation, experts recommend a combination of targeted interventions and increased resources for local healthcare systems, especially in rural areas.

Olayinka Umar-Farouk, deputy project director, Risk Communication at Breakthrough ACTION Nigeria, canvasses enhanced community engagement through education campaigns and increased distribution of ITNs and intermittent preventive treatment with sulfadoxine-pyrimethamine in high-risk areas.

“Addressing the emerging drug resistance issue is critical, as is improving surveillance to monitor malaria trends and respond to new threats swiftly,” Ms Umar-Farouk said.

She said the survey’s findings suggest that while Nigeria has made commendable progress, there were still challenges to overcome in the fight against malaria.

She said that by implementing these targeted recommendations, the country could make significant strides toward reducing malaria’s impact on public health, improving the quality of life for millions across the country.

For Nigeria, reaching malaria-free status may require more than replicating the strategies of Egypt, Algeria, Cape Verde, and Mauritius.

The country’s unique demographic, climatic, and economic conditions necessitate a tailored approach that combines international best practices with local insights.

By implementing targeted recommendations from health experts and leveraging the strength of community leadership, Nigeria could make significant strides in reducing malaria’s impact and improving the quality of life for millions.

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Mr Pate’s call for a comprehensive review, coupled with community-driven approaches and gender-responsive solutions, reflects a critical push toward addressing Nigeria’s unique malaria challenges.

With focused, collaborative efforts among the federal and state governments, private sector, and international partners, Nigeria may yet overcome its malaria burden and set an example for other endemic countries.

(NANFeatures)