Policies hampering Nigeria from eradicating malaria

by Odimegwu Onwumere

Little did many Nigerians know about the country’s malaria policies till
Sunday, May 26 2012, when the Environmental Health Officers Registration
Council of Nigeria (EHORECON), called for an increase in policies that
would see to the eradication of the deadly-disease known as malaria, across
the country. Debatably, 70 percent of Nigerians live lower than the world’s
poverty index and this number, invariably, patronises the Patent Medicine
Vendors (PMV), for the treatment of the pandemic, whereas the government
policies are modified only to soothe hospitals.

The country had signed the funding-conformity, which brought about $1.5
billion since 2004, when $971 million grant was approved, the total Global
Fund assistance to Nigeria. The Global Fund had given the country a grant
of $225 million (about N36 billion) to assist in the fight against malaria,
as was contained in the financial periodicals in the country of September
13, 2012. A statement in that national broadsheet, said that the Minister
of Health believed the grant was a harbinger to forming a new approach of
tackling the fight against malaria. Purportedly, he said how the money
would be utilised, adding that about N27 billion of the first grant would
be expended on the 36 states and Abuja, through what was called “public and
private sector agencies.”

The second approach was for the provision of imported insecticide treated
nets, an initiative which the minister said would cost N8 billion. A N1.6
billion counterpart funding for the implementation, the Minister said it
would be provided by the federal government.

From the speech of the EHORECON’s Registrar in Benin, Edo State, it was
disturbing that the government policies were tailored towards curative
measures instead of preventive, unlike the early 1960’s and 1970’s, when
governments at that time operated on preventive measures rather than
curative measures.

There were sanitary inspectors in the 70s and 80s and early 90s. But from
the middle of 90s to date, things went awry. Substandard drugs replaced the
sanitary inspectors. The registrar frowned at government’s approach in
spreading drugs it believed were anti-malaria to all the communities in the
774 local government areas across the country, hoping that this move would
help redeem the ‘Bubonic-plague’, but to no advantage.

Malaria is a major cause of mortality and ill-health in Nigeria and has
huge consequences for the productivity of the country. There has been
proliferation of health providers in Nigeria of recent and this seems to
put the rural poor in greater confusion of which one to believe given the
old barriers between private and public, modern and traditional and formal
and informal health providers.

In its efforts on the fight against malaria, the country has recorded
little or nothing in its eradication. Rather, the authorities have blamed
PMV, as providing a stand for patients not to go for proper medical care at
government-owned hospitals, in the anti-malarial bazaar in the country. In
a research funded by the Center for Health Market Innovations, Nigeria was
no longer a core country beaming her light towards eradication of the
epidemic in the country. In another countrywide commentary of 26 April
2013, the data is disturbing that over 300,000 Nigerians die from malaria
each year; more than in any other country on the surface of the earth and
out of this number, 250,000 is said to be children under five.

It is generally believed that given the not-too-serious approach of the
various governments in Nigeria in the fight against malaria, it has
resulted in Nigerians taking to consulting quacks, especially Patent
Medicine Vendors to buy sensitive drugs, which they erroneously believe is

When government banned chloroquine, probably the most accessible drug for
the rural dwellers, the government cited malaria parasites resistance to
the drug as the reason; however, it seems that independent investigations
have more to say to this.

According to the Country Director of JHPIEGO, a non-profit affiliate of
Johns Hopkins University in Baltimore, Maryland, USA, even the ACTs they
replaced chloroquine with, have been found to be not too effective in parts
of South East Asia.

As a country that is still having issues with electricity to enable fan and
air conditioners boost the air within an enclosure or possibly drive away
mosquitoes, the treated mosquito nets that the authorities provide have
equally not helped matters much. There are complaints that the uneasy
penetration of air through the very tiny holes in the nets has made many
people to prefer to sleep without them to avoid excessive heat.

Professionals in the health sector are arguing that the language of
communication has reduced the impact to the target audience thereby
blocking off the primary targets for many of the malaria programmes. They
argue that most of the communications are not done in the local language of
the many rural dwellers who are the primary targets of the communication in
the first place. Consequently, many people do not understand the causes of
malaria and how it could be treated. It is also said that the Nigerian
Malaria Control Programme (NMCP), an arm of the Public Health department of
the Federal Ministry of Health, is not doing well in this direction, not
minding the insecticidal nets which it boasts of distributing in the 36
states across the country.

But investigation reveals that majority of the people at the local level do
not receive the nets. It is also said that the nets end in the cities and
most time at market places after the announcement of distributing them have
been made. And this is the major reasons many Nigerians patronise PMV for
the treatment of malaria.

Many Nigerians have decried how this single virulent disease has brought
the country to public ridicule. A commentator who wouldn’t want his name in
print said that Nigeria with many universities, numerous doctors, cannot
investigate into the cause of, and the cure for malaria. The commentator
was of the view that third world countries should stop relying on the
assistance of the West in eradicating malaria, because they should also do
whatever the West did to eradicate malaria in their domains.

There was a school of thought that said the preventive concept of malaria
could have been found if not for the recklessness of those in authorities
with money provided to fight the threat. Others said that except help comes
from the African Union (AU), the malaria control strategy and policies that
the country was using are but a farce. The clarion calls are that the
entire continent should join hand in the fight against the peril.
Notwithstanding, the same school of thought said that a part of the
continent – East Africa – DDT applications had become a success in the
fight against the disease and Nigeria should borrow a leaf from there.

On the other hand, some other analysts are of the view that the
international community and the donor agencies are not happy with Nigeria,
owing to the fact that all their efforts in helping the country in the
fight against malaria, have hit the rocks. They argue that many of the
foreign donations find their way into the personal pockets of government
officials in Nigeria. Health experts contributed that the toll in
malaria-related deaths has increased across the country following the
shoddy deals with foreign donations by the authorities.

It was recallable when in 2008, the World Health Organization (WHO) cried
out that Nigeria and the war-torn Republic of Congo constituted 30 to 40

percent of malaria-related deaths worldwide. The government policies on
malaria however do not reflect the prediction of the WHO that Nigeria is
going to experience murkiness for the Millennium Development Goals (MDGs).
Not even the Roll-Back Malaria launch, which was observed by the world
10years ago in Abuja, has helped the matter. In view of this, WHO had in
2008, voted $1.2 billion to combat malaria in Nigeria and Congo.

The Director of JHPIEGO pointed out that to treat malaria with ACTs, WHO
recommends a four-point strategy to combat malaria, which include among
others education. The director was of the belief that everyone should know
how malaria is transmitted – by mosquitoes – and how it breeds in torpid
water. He equally advised that sleeping under an insecticide-treated bed
net is helpful, because when a mosquito touches it, it dies.

An expert advised that it has become imperative for the federal, state, and
local governments to devise an all-inclusive policy for the eradication of
malaria in the country. The sources of mosquito should be eradicated,
through awareness to the people. Local and herbal therapies that are well
researched should be tried and improved upon as a substitute for imported
malaria therapies.

Another specialist also posited that about 80 percent of anti-malaria drugs
in Nigeria are not effective, while imported insecticide-treated mosquito
nets hardly achieve the desired results as they are sold in urban markets
at exorbitant prices instead of being distributed free to rural communities
as intended by the government.

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