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

Despite global progress in the fight against malaria, Nigeria continues to struggle with this deadly disease.

Nigeria’s struggles against malaria raise questions about the nation’s ability 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 large population, Nigeria bears a disproportionate share of the global malaria burden.

According to the World Health Organization (WHO), Nigeria accounted for nearly 30% of global malaria cases and approximately 194,000 deaths annually as of 2021.

In communities like Kuje Area Council in the Federal Capital Territory, malaria is not only a health problem but also a threat that affects family life, education and livelihoods.

For people like Peter Zaka, a farmer and patient receiving treatment at a primary health care center 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 is 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, where access to healthcare is limited and prevention measures are often inconsistent.

The burden of malaria in Nigeria varies significantly from region to region, influenced by factors such as climate, healthcare infrastructure and socioeconomic conditions.

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

In contrast, the southern regions, although affected, may have somewhat better access to healthcare resources.

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

In the northern state of Sokoto, for example, Mariam Abdullahi, a mother of three, faces constant worries about her children’s health, especially during the rainy season when malaria cases increase.

Despite the use of insecticide-treated nets (ITNs), her youngest child contracted malaria several times this year.

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

She emphasized the financial and emotional impact of malaria on families in deprived areas.

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

Cultural beliefs, economic constraints and climatic factors all play a role. In some communities, people avoid ITNs because of misconceptions about their safety or efficacy, while others find them uncomfortable to sleep on, especially in the humid regions of Nigeria.

In addition, the economic challenge of regularly replacing used nets further complicates the issue for low-income households.

The 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 exceed those in urban regions. However, utilization rates remain inconsistent.

For example, in states such as Zamfara and Kaduna, households may own ITNs but use them sporadically due to lack of awareness of proper maintenance or the affordable price of replacements.

The Coordinating Minister of Health and Social Protection, 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 despite over 70 years of efforts, Nigeria still struggles with a high burden of malaria.

“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, noted the disproportionate impact of malaria on young women and girls from marginalized communities.

“Women’s leadership is critical to developing innovative and gender-sensitive solutions, especially as we face challenges such as 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 Executive Director of RBM Partnership to End Malaria, Adekunle Charles, stressed that traditional methods will not be enough to eliminate malaria.

“When it comes to malaria, the approaches that have gotten us this far will not 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 health systems, particularly in rural areas.

Olayinka Umar-Farouk, Deputy Project Director, Risk Communication at Breakthrough ACTION Nigeria, reviews increased community engagement through education campaigns and increased distribution of ITNs and intermittent sulfadoxine-pyrimethamine preventive treatment in high-risk areas.

“Addressing the emerging problem of drug resistance is essential, as is improving surveillance to monitor malaria trends and respond quickly to new threats,” Ms Umar-Farouk said.

She said the survey results suggest that while Nigeria has made commendable progress, there are still challenges to overcome in the fight against malaria.

She said that by implementing these targeted recommendations, the country could take significant steps towards reducing the impact of malaria on public health, improving the quality of life for millions of people across the country.

For Nigeria, achieving 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 require a tailored approach that combines international best practices with local perspectives.

By implementing targeted recommendations from health experts and harnessing the power of community leadership, Nigeria could make significant progress in reducing the impact of malaria and improving the quality of life for millions.

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Mr. Pate’s call for a comprehensive review, along with community-led approaches and gender-sensitive solutions, reflects a critical push towards addressing the unique challenges of malaria in Nigeria.

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

(NANfeatures)