World Malaria Day: Experts seek new strategies to combat disease

April 25 every year is set aside to mark the World Malaria Day. This year, the theme is “Ready to beat malaria,” which is a clarion call for action to check the disease, as Nigeria suffers the world’s greatest malaria burden and accounts for a quarter of the burden of malaria epidemic globally with 97 percent of the population at risk of contracting malaria, writes Anthonia Obokoh.

Huge progress has been made over the past 20 years in reducing malaria cases and deaths but it would seem difficult to believe considering that more people still die from malaria than any other disease.

In 2016, for the first time in a decade, the number of malaria cases was on the rise and in some areas there was resurgence, according to the World Health Organisation.
The disease’s persistence is partly due to the mosquito that transmits the disease and the parasite that causes it are developing resistance to the insecticides and antimalarial drugs used to fight them, health experts say.

Despite significant efforts to reduce the prevalence and increase in net coverage, malaria remains a leading cause of morbidity and mortality in children under five years of age and pregnant women.

Nigeria suffers the world’s greatest malaria burden and accounts for a quarter of the burden of malaria epidemic globally with 97 percent of the population at risk of contracting malaria.
Findings also show that Nigeria has the largest funding gap in malaria elimination in Africa. Nigeria faces a financial gap of N504 billion ($1.4 billion) to implement its national malaria strategy by 2020, according to the 2017 World Malaria Report, a publication by the World Health Organisation (WHO).

In addition to constituting 27 per cent of malaria cases worldwide, out of 30 African countries analysed in the report, Nigeria alone accounts for 53 per cent of the $1.3 billion funding gap for essential commodities that include 76 per cent of the funding gap in Artemisinin Combination Therapy (ACT) and 86 per cent of the funding gap for Rapid Diagnostic Test kits (RDTs).
Therefore, as part of effort in marking this year’s World Malaria Day, Nigeria has renewed its efforts by committing to raise malaria up the national priority list, including securing $300 million (108 billion) in new financing from the World Bank, Islamic Development Bank and African Development Bank to help finance its national malaria strategy.

According to the National Malaria Elimination Programme (NMEP), deaths resulting from malaria have been estimated at over 300,000 per year in Nigeria, accounting for more deaths per year than HIV/AIDS and a major contributor to mortality in children and pregnant women. Moreover, Malaria accounts for 60 per cent of outpatient visits to hospitals and led to approximately 11 per cent maternal mortality and 30 per cent child mortality, especially among children less than five years.
Malaria has a clear and significant impact on Nigeria’s business sector with an estimated annual GDP loss of $1.1 billion due to malaria related absenteeism and treatment costs.

What is malaria?
Malaria is a life-threatening disease, which is caused by mosquito bites. Malaria is caused by plasmodium parasite and is transmitted in humans through the bite of Anopheles mosquito. After an infected mosquito bites a human, the parasites begin to multiply in the person’s liver. It progresses to infect and destroy red blood cells in the body.
Common symptoms of severe malaria include flu, fever and chills, deep breathing and respiratory distress, abnormal bleeding, signs of anaemia and impaired consciousness. Some cases of malaria can be controlled by early diagnosis.
The WHO says in a report that the current pace of malaria control is not sufficient as per its set target for 2020 under the WHO Global Technical Strategy for Malaria 2016-2030. The target calls for reduction in incidence of malaria cases and death rates by almost 40%.

Controlling malaria
In most malaria-affected countries and Nigeria included sleeping under an insecticide-treated bednet (ITN) is the most common and most effective way to prevent infection.
In 2016, an estimated 54% of people at risk of malaria in sub-Saharan Africa slept under an ITN compared to 30% in 2010. However, the rate of increase in ITN coverage has slowed since 2014, say the WHO Global Technical Strategy for Malaria report.
However, in many areas, access to the public health system remains low. National-level surveys in the African Region show that only about one third (34%) of children with a fever are taken to a medical provider in the public health sector.

Companies are making a difference
According to a survey carried out by the Corporate Alliance on Malaria in Africa (CAMA), a GBCHealth-led initiative to drive partnerships for malaria control and elimination. Established by Marathon Oil and Chevron Corporation in 2006, the Alliance is a unique coalition of companies from various industries, all with business interests in Africa.
The survey result show that companies are already making a difference by making data on their current activities available through means such as this CAMA/PHN survey, companies can make smarter, more targeted investments.

The companies surveyed are investing over N3.2 billion in health in Nigeria annually, approximately 40 percent (over N616m annually) of which is being directed to support malaria control. Encouragingly, companies reported an expected increase in funding for malaria control in the next five years, compared to the previous five years.

The Private Sector Health Alliance of Nigeria represents the country’s foremost private sector led coalition and is at the forefront of the Saving One Million Lives initiative. By forging solid partnerships, and focusing on innovation, advocacy and impact investments, PHN is creating landmark, innovative, health interventions and saving lives.
Proper diagnosis and management of fever is very crucial to prevent severe malaria, especially in young children. Testing can prevent the unnecessary consumption of malaria medication, which can contribute to resistance and lead to complications from not treating other fever-inducing diseases that are mistaken for malaria.

According to experts, a major problem with the prevalence of malaria is that the mosquitoes and parasites that causes and spreads disease are developing resistance to the insecticides and antimalarial drugs used to fight them. Dirty environment contributes to menace as mosquitoes breed in dirty environment.

Chris Bode, the Chief Medical Director, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos said, Nigeria is among the countries which are still unable to eradicate malaria, although there has been renewed interest in researches and innovations in diagnostics methods, drugs productions and the developments i control measures to eradicate malaria.
Nigeria’s suffer untold deaths and a huge economy loss that affects manpower. However, the country is working with other relevant partners to curtail the prevalence and control measures.
“Increase in the number of people who sleep under long-lasting insecticidal nets, or protected as well as diagnostic testing of children and treatment of pregnant women will contribute to significantly lowering incidence and mortality in Nigeria.”
To achieve these putting all efforts resources in control and providing more domestic funding to fight malaria will have a huge impact.

Key facts on malaria
Malaria is known to be a life-threatening disease, which is caused by parasites that are transmitted to people through bites of infected female Anopheles mosquitoes. Malaria can be cured and prevented.

In 2016, 91 countries and areas were going through malaria transmission.

The latest World Malaria report, which was released in 2017, says that the number of deaths caused by malaria among children under 5 years of age has reduced to 2,85,000 in 2016 from 4,40,000 in 2010.

Nearly half of the world’s population was reported to be at the risk of malaria in 2016, with most of the cases in sub-Saharan Africa. Populations in WHO regions of South-East Asia, Western Pacific, Eastern Mediterranean and Americas were also reported to be at risk of malaria.

Children under 5 years of age, infants, HIV/AIDS patients, pregnant women, mobile populations and travellers are at higher risk of developing malaria.

To protect these populations, there is a need for the National Malaria Control Programmes to take special measures.