For Nigeria to achieve the World Health Organisation (WHO)’s global target of reducing malaria morbidity and mortality by 90 per cent in 2030, pharmacists say it is imperative for government at all levels to embark on environmental reengineering and usage of vector control mechanisms.
While highlighting some African countries that have progressed in the elimination of malaria, such as Algeria, which is certified malaria-free, as well as Ghana, Namibia and South Africa, which reduced malaria incidence and deaths by 40 per cent in 2020, compared to 2015, the experts pointed out that Nigeria continues to lag behind in attaining any of these milestones.
The drug specialists made their submissions during the commemoration of this year’s World Malaria Day, stressing the need for governments to treat malaria matter with all urgency in order for Nigeria, which is malaria-endemic, to recover from the socio-economic loss attributable to the condition.
Malaria has been identified as being responsible for an annual reduction of 1.3 per cent of Africa’s economic growth, while malaria-related absenteeism and production losses cost Nigeria close to an estimated 1billion dollar loss annually.
Speaking on the occasion, the President, Pharmaceutical Society of Nigeria (PSN) Pharm. (Mazi) Sam Ohuabunwa, urged governments to be intentional with town planning and discourage unauthorised constructions that disrupt waterways, while ensuring that drainages are covered to discourage mosquito breathing sites.
Ohuabunwa, in a statement made available to Pharmanews, also charged the National Orientation Agency (NOA) to rise to its obligation of health education and promotion, by embarking on continuous campaign against unhealthy practices in the community, which he said had enhanced the prevalence of malaria in the county.
“For instance, throwing empty food cans indiscriminately, overgrown bushes and blocked drainages around living homes, should be highly discouraged,” he said.
The PSN helmsman further tasked the NOA on the promotion of programmes on malaria prevention, such as the distribution and use of Long Lasting Insecticidal Nets, intermittent prophylaxis for pregnant women and evidence-based health education on the mode of malaria transmission, adding that indoor residual spraying with effective insecticide should be facilitated by the government through pharmacists.
He said: “Early and accurate diagnosis is essential for rapid and effective disease management and surveillance. Misdiagnosis allows disease progression from uncomplicated to severe. An estimated 65 per cent of Nigeria’s population live in poverty.
“Although there is the national policy on Artemisinin-based Combined Therapy (ACT), which costs about N1,200, as the first-line treatment of uncomplicated malaria, current data indicates that over 70 per cent of children treated for malaria in Nigeria received chloroquine or sulfadoxine-pyrimethamine (SP) at an average cost of N200.
“Government and corporate organisations should partner and provide free malaria rapid test kit and ACTs/SPs at community pharmacies for treatment of pregnant women and under-fives.
“The COVID-19 pandemic has made it clear that there is little or no progress in solving healthcare problems without significant investment in R&D. Government should consider our universities and research institutes as “cantonments” and find them as such, to use our rich flora and fauna to create solutions for our healthcare needs, including malaria.
“The importance of T3 “Test, Treat and Track” strategy for malaria case management by pharmacists still remains crucial in eradicating malaria in Nigeria.”
Corroborating the PSN’s position, the National Chairman, Association of Hospital and Administrative Pharmacists of Nigeria (AHAPN) Dr Kingsley Chiedu Amibor, says vector control remains the primary way to prevent and reduce malaria transmission.
“Two forms of vector control, namely insecticide treated mosquito nets and indoor residual spraying, are effective in a wide range of circumstances,” he said.
Amibor listed benefits of sleeping under an insecticide treated net to include reduction of contact between mosquitoes and humans by providing both a physical barrier and an insecticidal effect, adding that high usage of such nets within a community can confer population-wide protection resulting from killing of mosquitoes on a large scale.
“For instance, in 2019, an estimated 46 per cent of all people at risk of malaria in Africa were protected by an insecticide treated net, compared to 2 per cent in year 2000,” Amibor noted.
The AHAPN chairman, who spoke at the World Malaria Day 2021 programme, organised by the association, asserted that Nigeria needs an aggressive new approach to jump-start progress against malaria, as the country has been identified as one of the 11 counties that carry a high burden of the disease.
He advocated a “high burden to high impact response” model, which will feature “A call upon government to demonstrate the political will to reduce the toll of malaria; need for strategic information to drive impact, better guidance, policies and strategies; and a coordinated national malaria response”.