Chinasa Kalu, a mother of three, recounts her harrowing experience battling a resistant strain of malaria for weeks without relief.
“As soon as I developed symptoms,” she said, “I started preparing herbal concoctions, they’re affordable. But after three days, there was no improvement.”
Kalu wasn’t alone. Her one-year-old daughter, Kate, was also battling malaria. In a desperate bid for affordable treatment, her husband, a petty trader, unknowingly purchased a substandard artemisinin-lumefantrine combination, which failed to produce any recovery. Eventually, Kalu had to visit the local health centre for treatment.
“I thought malaria treatment for children under five was supposed to be free or heavily subsidised,” she lamented. “To my shock, I was given a bill of N15,000 for my baby.”
The Case for Renewed Investment in Malaria
Malaria, an endemic disease in the African region is preventable and curable, but could be deadly without prompt diagnosis and treatment. Cases abound of preventable malaria deaths in the region, as the disease claimed nearly 600 000 lives, in 2023 alone, with an estimated 95 per cent of these deaths occurring in the WHO African region. Pregnant women and children under five years of age constitute the vulnerable group to malaria, which necessitates investment and reinvestment in funding malaria prevention programmes to safe the future generation of Africa.
World Malaria Day, commemorated on every 25 April, is an initiative of the World Health Organisqation (WHO), championed by WHO Member States in 2007, to raise awareness about the fight against malaria and encourage action to minimise impacts on vulnerable populations like Kalu’s family above. For this year’s celebration, the WHO joins the RBM Partnership to end malaria and other partners in promoting the theme, “Malaria Ends With Us: Reinvest, Reimagine, Reignite,’ a grassroots campaign that aims to re-energise efforts at all levels, from global policy to community action, to accelerate progress towards malaria elimination.
Public health experts are urging African governments to focus on malaria funding, especially in light of significant aid reductions. Top among these is the impact of U.S. aid cuts under the President Donald Trump administration, compounded by economic downturns and climate change.
According to the World Health Organisation (WHO) previous commitment to malaria prevention in the late 1990s yielded significant result, as an estimated 2.2 billion cases and nearly 13 million deaths were averted over more than two decades. But after years of steady decqlines, progress has stalled. Yet efforts to control and eliminate malaria are in jeopardy as communities and programmes face the fallout of recent funding cuts.
Nigeria Faces Worst Hit
Nigeria, with the highest global burden of malaria, accounting for an estimated 30 per cent of all malaria cases worldwide, has been a major recipient of U.S. foreign aid, receiving $1.02 billion in 2023, much of it through agencies like USAID. While the Nigerian government is said to be making plans to bridge the funding gap, stakeholders are calling for accelerated implementation to safe the at risk population.
Expressing his thoughts on the development, a Consultant Family Physician and Certified Healthcare Manager, Dr Oziegbe Oghide, acknowledged the huge impact of US funding on the Nigerian health sector over the years, the cessation of which will adversely affect malaria intervention programmes, except there are urgent interventions from government. “The USAID funding to Nigeria has primarily been to the health sector over the years and shockingly according to data constitutes about 51.7 per cent of Nigeria’s total expenditure on health from 2020-2024.
“This simply means that the effect is going to be felt by the Nigerian populace especially in the area of malaria prevention and control. The prices of common antimalarial therapy has tripled, this coupled with the harsh economic realities would lead to a possible epidemic if something drastic is not done.
“The effect is far reaching, he stated, “from the retailers of these medications who would probably go for cheaper and fake medications as a way of maximizing profits to the final consumers who may venture into other cheaper unorthodox and less effective means of treatment. On the long run, there is likely to be more morbidity and mortality.”
Also speaking exclusively with Pharmanewsonline, the Medical Director of HGJ-Victory Medical Centre, Ikorodu, Dr Olujide Joshua Sodeinde, aired his fears on how the abrupt USAID funding freeze, could badly hit the vulnerable group thereby frustrating progress made in the years past.
“It surely will be felt in the areas of malaria prevention especially in the distribution of insecticides treated nets. This usually help with malaria prevention in the vulnerable groups like pregnant women and children under five. Also with the use free drugs given to pregnant women as intermittent preventive treatment for malaria using the sulphadoxine and pyrimethamine preparations.
“The effects, though may not be seen now but if the Federal Ministry of Health do not rise up to close this gap, we may begin to see the effects as increase malaria burdens especially in under five and maternal morbidity and mortality along with malaria-related abortions, still births, and low birth weight newborns.”
Climate Change Fueling Mosquito Transmission
In her contributions, a Climatologist and Lecturer at the Department of Geography and Meteorology, Nnamdi Azikiwe University, Awka, Mrs Lizzette Njideka Ezenekwe, emphasised the impact of climate change on the transmission of anopheles mosquitoes in tropical areas like Nigeria, calling for climate smart strategies and tools to mitigate spread.
Ezenekwe, who is also a pharmacist and national publicity secretary, of the Pharmaceutical Society of Nigeria, highlighted how extremely hot climate has been detrimental n fast tracking the incubation period of anopheles mosquitoes, the primary vector of malaria.
“Temperature has an inverse relationship with the extrinsic incubation period of malaria parasite development,” she asserted. “In other words, increasing temperature shortens the time it takes for the parasites to mature. This increases the infection rate of mosquitoes.
“Land use change influence microclimatic conditions like evapotranspiration and temperature, thereby making mosquitoes more abundant. It means that in habitats or urban environments that are treeless, the environment tends to be warmer, affects indoor temperature, which shortens the gonotrophic cycle of female anopheles gambiae. The implication is increased infection rates,” the climatologist explained.
A Call to Action
The challenges notwithstanding, the professionals didn’t leave Nigerians hopeless.
For Dr Oghide, a fundamental change in Nigeria’s healthcare financing model would suffice. “The way out is for the government to increase the funding on health and as a sovereign nation, we should not always depend on other nations and foreign aids as a way out,” he quipped.
Mrs Ezenekwe, emphasised that climate change must be addressed as a major public health threat. “Leveraging satellite data and AI for robust weather and environmental monitoring, with community-centred approach are essential to prevent malaria resurgence and protect the most vulnerable populations.”
As Nigeria continues in search of sustainable solutions to malaria, experts agreed the time is now to end malaria with us. They recommended investment in climate resilience infrastructure, creation of access to healthcare at the grassroots level, with the provision of insecticides treated nets, reliable diagnostic kits and treatment to bring about reduction in morbidity and mortality from malaria.
