...Experts insist achievement of MDGs hinged on ground-breaking findings
In the face of the sweeping malaria scourge which results in the deaths of about one million people annually, most of them in sub Saharan Africa, leaders across the continent have evolved strategies which they believe would bring about maximum prevention.
Worthy of note is the African Summit on ‘Roll Back Malaria’ which held in Abuja April 25, 2000, and was attended by representatives of 44 countries across the world. They all agreed to develop mechanisms that would facilitate the provision of reliable information on malaria to decision-makers at household, community, district and national levels, to enable them take appropriate actions.
Other key decisions included reducing/waiving taxes and tariffs for mosquito nets and materials, insecticides, anti-malaria drugs and other recommended goods and services needed for malaria control strategies; increasing support for research (including operational research) to develop a vaccine and improve existing ones. However, with malaria remaining one of the three infant killers in Nigeria and accounting for about 60 percent of outpatient visits and 30 percent of hospitalisations, experts have called for an integrated system of management and research funding for malaria prevention in the country.
Wellington Oyibo, consultant medical parasitologist, College of Medicine, University of Lagos, while speaking with BusinessDay, described malaria as a major threat to public health and economic development in Nigeria. Oyibo disclosed that even as efforts towards eradicating malaria had continued, parasite resistance to the most commonly used and affordable anti-malaria drugs were developing rapidly, adding that insecticide resistance to the vector was also an evolving problem.
He hinted that of all the malaria vaccines - RTSS, which was created in 1987 and clinical evaluation, which began in 1992 and is ongoing in some East African countries, had been recording some level of success. “Funding malaria research amounts to millions of dollars. However, developed nations, through the support of government, international agencies and the Bill & Melinda Gates Foundation, have continued to fund the development of malaria vaccine for malaria endemic countries. Sadly, such funds are far less when compared to funds budgeted to support the treatment of illnesses like cardiovascular diseases, diabetes, etc,” he said. Vaccine trials are conducted in countries like Kenya, Tanzania and Senegal. But that is not the case with Nigeria, where inadequate infrastructure (like power) makes research difficult. Also, in countries where such trials for malaria are conducted, medical research institutes derive huge benefits because they receive all the assistance they need to effectively carry out research.
For Shilaj Chakravorty, consultant pathologist, BT Health and Diagnostic Centre, Lagos State University Teaching Hospital (LASUTH), Ikeja, investment in malaria control is saving lives and reaping far-reaching benefits for countries where the malaria parasite is endemic. “Factors such as increasing urbanisation disproportionate to infrastructure, drug-resistant malaria, insecticide-resistant mosquitoes, inadequate vector control operations and public health practices encourage the increase of malaria parasite,” added Chakravorty, while maintaining that without sustained funding and continuous research, the significant contribution of malaria control towards the achievement of the Millennium Development Goals (MDG) could be reversed.
It would be recalled that the Global Fund to Fight AIDS, Tuberculosis and Malaria and the nation’s Federal Ministry of Health, in October 2009, signed a malaria grant to the tune of $285 million over a two-year period. The Global Fund took a flexible approach by signing, in July 2009, an interim agreement to allow for the timely distribution of 3.4 millions bed nets in line for a mass distribution campaign planned for December, 2010. Other contributors include the World Bank, DFID, USAID, UNITAID, and UNICEF. With these funds committed to fighting malaria in Nigeria, reducing the malaria burden by 50 percent this year and 75 percent by 2015 should be achieveable.
Folake Ademola- Majekodunmi, national coordinator, National Malaria Control Programme (NMCP), Federal Ministry of Health, stated that providing health information and education would enable Nigerians make the right decisions about their health. “We are placing two mosquito nets in every household in Nigeria. These are not just the traditional mosquito nets as we used to know it. They are long-lasting nets that have been treated with insecticides. The major difference that the nets offer is that they do not just repel mosquitoes, they kill mosquitoes’ dead. They are called LLIN (Long Lasting Insecticidal Nets),” Ademola-Majekodunmi stated. Meanwhile, there is indeed hope if African malaria researchers could become more adept at not only providing global leadership in malaria research and mentoring young scientists for the next generation, but also at taking advantage of the current funding opportunities to propose ground-breaking projects that are internationally competitive for long-term sustainability.
True, the control of malaria is a long-term objective and the sharing of resources and competencies is crucial to its achievement, but a massive infusion of funds for capacity-building, infrastructural development and day-to-day research activities from the governments and international donor agencies will foster an environment for synergy with a common goal: the control of malaria.
On the community front, environmental management to deal with mosquitoes will ensure they do not breed in water logged areas. Perhaps, proper hygiene and sanitation around dwelling places can be employed. Also, massive investment in mass mobilisation and communication will ensure people do what is right in their localities. That way, mosquitoes will have no habitat where they can breed.
By Alexander Chiejina
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