Friday 13 July 2012

Global malaria cases: Is Nigeria highest contributor?

This year’s World Malaria Day’s theme focused on gains and safety of lives through investments in malaria control. However, Nigeria seems not to be getting it right judging from its newest appellation as the world’s leading contributor to the global malaria cases, writes EMMANUEL ADENIYI.

The list is endless; Roll Back Malaria Partnership, Presidential Malaria Initiative, National Malaria Control Programme, Malaria No More and many other government agencies. They are either public or private establishments with the primary goal of combating the scourge of malaria in Nigeria, yet the nation’s malaria statistics is scary.

With 30 per cent rate of childhood mortality, 11 per cent rate of maternal mortality, loss of about N132 billion annually, high susceptibility of Nigerians to the scourge of malaria and a reduction in the nation’s gross domestic product (GDP) due to the ailment, Nigeria is just a nation in the throes of an endemic public health challenge.

Mr Kunle Ogunsakin would not agree less to the foregoing. His wife, Ruth, lost her eight-month-old pregnancy to malaria in Ibadan, after waiting many years to have her first child.

“We waited for seven years trusting God for a child before this conception. My wife went through many tests before she was diagnosed of acute malaria. All efforts to save the pregnancy failed as it came down exactly eight months after she took in.

“Honestly, I can’t say what went wrong. Could it be because of the drugs administered on her or the severity of the ailment? I can’t say precisely, because the doctors at the private hospital where she was treated kept reeling off medical jargons,” the middle-aged man said.

Aminat Ocheja, an indigene of Ajaaka in Igalamela/Odolu Local Government Area of Kogi State, was not so lucky. Though pregnant, she was said to have complained of a slight headache and bought anti-malaria drugs at a chemist's having presented her doctor's prescription there. She never lived to tell the rest of the story as the single mother of two died shortly after taking the drugs.

Malaria, no doubt, is a perennial bugbear to many homes in the country, and possibly ranks as one of the major killer diseases in Nigeria.

In his speech at the 2012 World Malaria Day in Abuja, the Minister of Health, Professor Onyebuchi Chukwu, painted the endemic nature of malaria when he revealed that Nigeria had the highest malaria cases worldwide, noting that it made about 23 per cent contribution to malaria cases globally.

According to him, “Malaria is a major public problem in Nigeria; Nigeria contributes a quarter of malaria burden in Africa. Over 90 per cent of the country’s 167 million population is at risk.”

The malaria day, which was celebrated with a theme, “Sustain Gains, Save Lives: Invest in Malaria”, afforded the minister to state various intervention efforts made by the Federal Government to control the ailment.

The efforts, which include distribution in 30 states of the federation 47 million Long Lasting Insecticidal Nets (LLINs), and huge investments in malaria control, are said to be inadequate.

“Which sustainable gains have been made in malaria control in the last few years? How many lives have been saved, and why are they calling for more investments when they can’t justify the ones they have received so far?

“Why the proliferation of organisations with spurious claims of combating malaria? Who fund these organisations, and if their claims are genuine why the alarming rate of malaria infections and mortality in the country? These questions certainly beg for answers. You will realise if you probe further that these organisations are drain pipes through which government’s revenue is wasted,” a source in the Federal Ministry of Health stated.

A public health practitioner, Dr Thomas Agoi, believed that the nation’s health institutions, health practitioners and government had not done the needful to control malaria in Nigeria.

He disclosed that poor awareness programmes about the ailment, high poverty level in the country, fake anti-malaria drugs in market and lack of properly articulated strategy to arrest the situation had made stakeholders in malaria control inefficient.

“It will interest you to note that many Nigerians are still ignorant of the causes, prevention strategies and treatment of malaria. We should not be talking about this at this age. We should be researching into how to develop effective means of stamping it out.

Government pays lip service to controlling it as well. What about socio-economic issues that prevent people to live decently? What about inadequate health facilities and incessant industrial actions often embarked on by health workers? All these indices are intertwined and point to a fact that there may not be any meaningful solution in sight, except the ministerial distribution of insecticides nets.”

When asked about the President’s Malaria Initiative’s (PMI’s) malaria control strategies of the use of insecticide-treated mosquito nets (ITNs), indoor residual spraying (IRS), intermittent preventive treatment for pregnant women (IPTp) and early diagnosis and treatment, many who spoke with Sunday Tribune blamed the ineffectiveness of the strategies on lack of accessibility and high cost of purchasing nets and drugs.

Mrs Alice Owoade said that a family-size ITN cost between N4,500 and N5,000 in the hospital where she works as a nurse. “Though some of the nets are distributed free of charge to pregnant women and nursing mothers in government hospitals, they don’t go round.

“It is also disturbing to know that many people don’t use the nets. They complain of heat while sleeping in them, and as such stop using them.

A lot of people also prefer to use herbs rather than recommended medications for malaria treatment. It is not that the PMI’s strategies are ineffective, our people’s attitude towards public health issue is poor and doesn’t help matters.”

Alhaja Oladejo Minsurat told Sunday Tribune at Bode herbs market in Ibadan that she preferred taking herbs and concoction to orthodox drugs, noting that she sometimes used the drugs as well.

A female banker, who preferred anonymity, said she would never use Western medications, saying their chemical compositions always leave negative effects in humans.

She said she had come to purchase roots and herbs that would be used in making local medication for her sick daughter.

Alhaja Aramide Alagbo, Mama Ibeji Alagunmu and Mrs Ramota Adebisi, all sellers of herbs and concoctions at the market, said that many buyers, especially those having malaria often thronged the market to make purchases.

“With the number of people we receive here everyday, it is an indication that many prefer our local medication to orthodox medicines. If you have malaria, STDs and other diseases, we have herbs and concoction that can cure them immediately. There is no fake in what we sell and the herbs are readily available,” Alhaja Aramide noted.

They urged government to explore local medicine as an alternative way of controlling malaria, adding that malaria has a peculiarity that requires their expertise too.

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