Why Nigeria Will Not Meet 2030 Malaria Elimination Target –Researchers

By Sodiq Ojuroungbe

Medical researchers have warned that the failure of the Federal Government to continue the distribution of insecticide-treated nets to vulnerable populations will hinder the achievement of the 2030 malaria elimination target.

The scientists noted that despite previous successes with policies like the Artemisinin-based Combination Therapy and widespread distribution of ITNs in the mid-2000s, the lack of continued support and implementation has led to a resurgence in malaria cases.

The World Health Organisation says Nigeria has the highest burden of malaria globally, accounting for nearly 27 per cent with an estimated 68 million cases and 194, 000 deaths due to the disease.

WHO notes that more than two-thirds of Nigerians are living in communities that are prone to high transmission of malaria with the primary vector being Anopheles gambiae, Anopheles arabiensis, and Anopheles funestus.

Speaking exclusively with PUNCH Healthwise at a regional meeting of the Emerging Genomics Selection and Antimalarial Tolerance in Africa consortium in Lagos, the researchers expressed concern that the lack of distribution of insecticide-treated nets, a key intervention strategy, would undermine efforts to eliminate malaria in Nigeria.

According to WHO, over the last two decades, ITNs have contributed significantly to the progress seen in reducing malaria cases worldwide.

A 2015 modelling analysis published in Nature suggested that ITNs drove most of the declines in malaria seen from 2005–2015, especially in moderate-to-high transmission areas. However, progress since 2015 has slowed.

Worried about the high burden of malaria in Nigeria, the researchers stressed that without the sustained distribution of ITNs and a return to comprehensive preventive measures, Nigeria’s battle against malaria would be difficult.

A Deputy Director at the Biochemistry Department at the Nigerian Institute of Medical Research, Dr. Oluwagbenga Aina, expressed doubts about achieving the 2030 malaria eradication target, citing Nigeria’s current status as a control level rather than pre-elimination.

He lamented that the burden of malaria in Nigeria had increased compared to the early 2000s, largely because those critical interventions had not been sustained.

He stated that the discontinuation of some key measures, such as the distribution of ITNs and environmental spraying, had contributed to the resurgence of malaria cases.

The researcher stressed the importance of reintroducing all the preventive measures that were previously in place, including the distribution of ITNs to pregnant women and children.

He argued that restoring these interventions was crucial for reducing malaria prevalence in the country.

He also emphasised the need for community engagement in malaria prevention, including educating the public about keeping their environments free of stagnant water to reduce mosquito breeding sites.

According to him, the distribution of ACT in public hospitals, which was once free of charge, had also diminished. This reduction in access to essential treatment and diagnostic tools, he said, had made it more difficult for people to get proper malaria treatment.

He stated, “I don’t think we can meet that 2030 target. Nigeria right now, we are in control level. We’ve not got into pre-elimination talk less of eradication.
“Eradication is still far. What we need to do is to go back to when the policy was changed to ACT in 2005. After the policy was changed a lot of things were deployed in controlling malaria including insecticide-treated nets were given to people. They were spraying their environment with insecticide. And other preventive methods were also given.

“But right now we found out that the burden of malaria has gone up compared to 2001, 2002, because all these interventions they put in have gone down, they are no more doing it.

“For us to have a reduced burden of malaria, all those interventions we had in those years need to be brought back. With that one in place, the malaria burden will go down in Nigeria.

“But for us to be talking about eradication. Eradication cannot be achieved in 2030, the way things are going now.”

He further said, “We need to deploy all the control measures that we had before by supplying people with the insecticide-treated net that they were given to pregnant women and children before. There should be what they call a community engagement in telling people how to control malaria in their area; their gutter must not be stagnant, everything must be flowing, it should not be stagnant.

“In those days when you go to the hospital, you’ll be given a free ACT. ACT was given free in the public hospital but now I don’t think they have free ACT any longer because they are not supplying them. And also the test kit that we’re given that we use to test malaria if one has malaria or not is no more being given. So, people go to buy.

“With all these things people are finding it difficult to get all these things for them to treat malaria but if they can bring back all these things that are mentioned, I am sure the malaria burden will go down. Even if we can’t eradicate it, we will be able to control it.”

Also, the lead principal investigator for EGSAT, Professor Alfred Ngwa emphasised the importance of concerted efforts to eliminate malaria, citing the need for increased funding, surveillance, and monitoring to track the spread of drug-resistant parasites.

The professor pointed out that malaria control efforts must not only focus on treatment but also prevention strategies, such as the use of insecticide-treated nets and indoor residual spraying, to reduce transmission and mosquito populations.

The researcher expressed the need for a coordinated effort in malaria control, stressing that tackling drug resistance and improving treatment efficacy requires collaboration across countries, sustained funding, and comprehensive public health strategies.

He, however, called on the government to prioritize the distribution of insecticide-treated nets and other interventions to achieve the 2030 malaria elimination target.

On his part, a molecular biologist and immunogenomics genomic at NIMR, Dr. Ajibayi Olusola, emphasized that malaria transmission in Nigeria is persistent and year-round, particularly in the southwestern region.

He noted that effective malaria control efforts must address this continuous transmission.

Olusola said the EGSAT project involves testing the efficacy of new antimalarial drugs, including those that combine various active ingredients, to find the most effective treatments for the Nigerian context.

He stressed the importance of the EGSAT project’s findings in shaping malaria control policies and interventions in Nigeria.

The researcher expressed hope that the project’s outcomes will significantly contribute to reducing malaria and improving treatment strategies in the country.

SOURCE: Punch Healthwise