FG, others rethink strategies for malaria elimination
THE Federal Government has called for the utilisation of newer evidence- based tools, quality data systems, and new approaches to eliminate malaria in the country.
The Coordinating Minister of Health and Social Welfare, Prof Muhammad Pate, who addressed stakeholders in Abuja on the theme, ‘ Rethinking Malaria Elimination in Nigeria’, organised by the National Malaria Elimination Programme ( NMEP), lamented that for more than 70 years, Nigeria has been implementing programmes to eliminate malaria, and still bears 30 per cent of the global burden, with an estimated 68 million cases yearly and 194,000 deaths. Pate said there is a need to move from idealism to pragmatism, practicalise some of the concepts being canvassed and also move away from fragmentations of the past to a more coordinated approach in the sector- wide programme.
He also made a case for a shift in focus from the inputs and processes to reducing the malaria burden, including morbidity and mortality.
According to him, there is a need to ensure more dependence on local funding and self- sufficiency in local sourcing of health commodities. “A new narrative is being pursued to get all hands on deck, including governments at sub- nationals so that investment into the health sector can be optimized,” he said.
Pate noted that about 60 per cent of all hospital attendance in Nigeria is as a result of malaria adding that the disease contributes about 25 – 30 per cent to childhood mortality.
Pate observed that this is not due to a lack of political commitment or human capacity within Africa to bring an end to the scourge of malaria but, because of insufficient focus and commitment.
He argued that to eradicate malaria, Nigeria and the global malaria community must reinvent approaches to address the constraints that prevent efficient delivery of existing malaria control strategies, innovations and tools.
The minister, who noted that the Roll Back Malaria ( RBM) Initiative has achieved remarkable progress, however, said: “We have witnessed increased funding for malaria control efforts in Africa, both from domestic sources and international donors though gaps exist.”
In furtherance of commitment to the RBM and other national and multilateral frameworks, he stated that Nigeria has aligned with partners and other stakeholders to build an efficient, equitable, and quality health system, unlocking the health sector value chain and achieving health security. Pate observed that tools for the control of the disease have evolved both in quantity and quality over the years but despite the availability of new tools, commitment by countries towards the elimination of malaria could not be sustained as budgets for healthcare across countries on the continent dwindled over time, and only a few countries could achieve the Abuja targets. Pate pointed out that several novel strategies and interventions have been deployed and scaled up in the country towards the elimination of malaria, which include the introduction of artemisinin- based combination treatments as treatment, the Affordable Medicine Facility for Malaria ( AMFM) that makes antimalarial medicines available and affordable, training of community- oriented resource persons to recognise and treat malaria.
WHO Regional Director for Africa, Dr Matshidiso Moeti, who attended the Malaria Roundtable, stressed the need for a well- coordinated and harmonised malaria intervention response in Nigeria to boost efficiency, effectiveness and reduce fragmentation.
Moeti stated that discussions are still ongoing on how to introduce the malaria vaccine in Nigeria, which is a progressive process, adding that eliminating malaria requires a combination of interventions but the vaccine will make a significant impact.
The regional director observed that Nigeria is fast- tracking malaria response towards elimination given its epidemiological profile and commended the ambitious drive of the government.
She said to eliminate malaria; Nigeria needs to invest in valid data and ensure the deployment of technology, which will help the country to leapfrog the ways being used data in the health system.
While urging the Federal Government to translate present political commitment towards salvaging the health sector, she canvassed the combination of various intervention mechanisms and using data in a positive way to monitor the preval ence of the disease.
Moeti, who described Nigeria as a big complex country, stressed the need for the government to take into consideration the issue of equity in its malaria interventions and called for stronger collaboration between the federal, state and local governments. She observed that partners are working together to support countries coherently and transparently, stressed the need for Nigeria to put in place mechanisms, monitoring frameworks, and identify barriers.
Moeti commended the Federal Govern - ment for embarking on the plan to tackle health sector challenges and fast- track the elimination of malaria in the country.
Moeti emphasised the need for collective investment and effective financing in the health system.
She stated that with the increase in budget allocation, there is a decision to create a framework where the government and development partners can work more effectively and efficiently.
On his part, Minister of State for Health, Dr Tunji Alausa, observed that Nigeria has witnessed a reduction in the prevalence of malaria since some interventions such as the use of long- lasting insecticidal nets, the use of Artemisinin- based combination treatments for the treatment of uncomplicated malaria, as well as the introduction of chemo- preventive therapies for pregnant women and children below the age of five years.
The minister noted that the government is determined to scale up all interventions that added value in the past and bring on board new interventions that will facilitate malaria elimination.
Also speaking, the Permanent Secretary in the ministry, Daju Kachollom, observed that though malaria is a preventable and treatable disease, it remains a leading cause of illness and death in the country.
She stressed the need to prioritise prevention, strengthen health systems, and ensure access to effective diagnosis and treatment for all.
Senior Associate at the Johns Hopkins Bloomberg School of Public Health, Soji Adeyi, said Nigeria should increase internal funding for malaria elimination.“Reliance on external funding needs to be reduced. If this is a recurring problem what should be done is to find a new approach,” he said.
On his part, the National Coordinator of the Presidential Healthcare Initiative, Abdu Muktar, stressed the need for Nigeria to reduce dependence on drug imports, and advocated local production of drugs and medical supplies.
According to him, the local production of anti- malaria and related medication will consider the peculiarity of the country’s terrain, population, and burden and will improve access to effective treatment.