Despite ongoing efforts to combat malaria, it has continued to be a major public health issue in Nigeria, making it mandatory for government to change its approach and look inwards, a move yet to be seen, DAVID MAXWELL writes.
In response to the growing burden of malaria driven by parasite resistance to conventional antimalarial medicines, the World Health Organization, WHO, recommended, in 2001, the adoption of Artemisinin-based Combination Therapies, ACTs, in countries where Plasmodium falciparum malaria had developed resistance to traditional treatments such as chloroquine, sulfadoxine-pyrimethamine, and amodiaquine.
While Nigeria has implemented various interventions—including the distribution of insecticide-treated bed nets and indoor residual spraying—significant challenges persist in ensuring their widespread and consistent use. According to the WHO, Nigeria recorded nearly 67 million malaria cases in 2022, accounting for 27 per cent of the global malaria burden. The country also contributed 31 per cent of global malaria deaths and 38 per cent of all deaths in children under five. These statistics are not merely numbers; they reflect the profound suffering and immeasurable losses endured by families across the nation.
Three years on, it is evident that these figures have continued to rise, seemingly unchecked, prompting serious concerns about the efficacy of current malaria control efforts. Some reports have pointed to a lack of political will and insufficient funding for malaria-related interventions, particularly when compared to other public health priorities such as COVID-19.
Nigeria has, therefore, remained at the forefront of the global malaria crisis, consistently recording the highest rates of infection and fatalities for several years. Despite the launch of a national malaria strategic plan in 2015—which aimed to reduce the disease to pre-elimination levels and achieve zero malaria-related deaths by 2020—the country continues to bear the highest burden of the disease worldwide.
The human and economic toll of malaria in Nigeria is staggering. The disease contributes to high rates of mortality and morbidity, causes extensive loss of productive work hours, and imposes considerable out-of-pocket expenses on families. Furthermore, the government allocates substantial resources to malaria treatment and prevention, thereby placing additional strain on an already overstretched healthcare system.
Although malaria is both preventable and treatable, it remains a formidable challenge. Over recent years, various initiatives have been launched, each aspiring to steer Nigeria towards a malaria-free future. In 2020, the National Malaria Elimination Programme, MNEP, introduced the ‘Malaria Control to Malaria Elimination’ campaign, aiming to reduce malaria prevalence to below 10 per cent by 2025. In 2022, the government announced the deployment of innovative tools, including a malaria vaccine and insecticide-treated nets, to enhance its response. The following year saw the introduction of the ‘Zero Malaria Starts with Me’ campaign—a grassroots initiative designed to engage communities in prevention efforts.
Yet, the statistics continue to paint a bleak picture: malaria remains rampant, with Nigeria shouldering a disproportionate share of the global burden. It is indisputable that Nigeria requires decisive and sustained action to combat the disease effectively. This entails a comprehensive, multi-pronged approach that addresses the root causes of malaria while harnessing the strengths and collaboration of all relevant stakeholders.
A critical aspect of this strategy is the urgent need to strengthen the nation’s healthcare infrastructure. Many Nigerians, especially those in rural areas, still lack access to even basic healthcare services. Investment in health facilities, the provision of diagnostic tools and treatments, and the training of healthcare personnel are essential steps toward making malaria prevention and treatment accessible to all.
This is why some stakeholders have called for a paradigm shift in tackling the malaria scourge, foremost among whom is Professor Benjamin Amodu. A 1980 graduate of Industrial Pharmacy from Nigeria’s prestigious Ahmadu Bello University, Zaria, and a professor of phytomedicine from the Triune Biblical University, USA, he has remained a leading advocate for the use of alternative medicine.
On the scourge of Malaria across the length and breadth of Nigeria, he says: “it can be tackled through cooperation, and I’ve repeated said it that we are willing to partner with the government with our United Nations, UN endorsed product, SABMAL, and bring this malaria burden under control, so that other countries can partner with Nigeria thereby improving our Gross Domestic Product, GDP. When stories about the gains of using SABMAL in malaria prevention an cure saturates discussions not only within Nigeria, but also in the other countries that would begin to partner with us, I think the WHO would be compelled to adopt SABMAL the same way they adopted ACTs.
“Recall that in response to the increasing burden of malaria caused by parasite resistance to the conventional antimalarial medicines, WHO, in 2001, recommended the use of artemisinin-based combination therapies, ACTs, in countries where Plasmodium falciparum malaria is resistant to the conventional antimalarial medicines such as chloroquine, sulfadoxine-pyrimethamine, and amodiaquine. So are you telling me that when this same WHO discovers a treatment which not only beats the ACTs in treatment, but is equally effective in prevention, they would turn a blind eye to it?
“Mind you, my work with Professor Emeje on SABMAL, was investigated across the 156 Commonwealth Countries to see if it was copied or stolen from any previous work, but it was discovered and subsequently certified to be original to us. So what else do we need?”
He said that with mass production of SABMAL and other products, Nigeria would climb up from the bottommost position in the malaria burden. According to him, “while the current anti-malaria vaccine being pushed by the WHO has only 26% efficacy, SABMAL was discovered to have 67% efficacy. So all it would take for this product to gain a wide international acclaim is just for the Nigerian government to be proud of its own and push it to the world.”
Though Nigeria struggles with malaria, there are success stories from other African countries to learn from. Algeria and Mauritius have successfully eliminated malaria, demonstrating that it is indeed possible, making it imperative for Nigeria to move beyond the rhetoric and focus on action. The newly established advisory board and ministerial task force on malaria elimination must translate their mandates into measurable outcomes. This means setting clear targets, establishing accountability mechanisms, and regularly monitoring and evaluating progress.
However, as government continues to turn a blind eye to the possibility of eradicating malaria in Nigeria with the use of home grown treatment options, about three out of 10 persons having malaria in the world lives in Nigeria; 1 out of 4 deaths from malaria globally occur in Nigeria and the country accounts for over 54 million malaria cases recorded annually for the last three years.
Also, Nigeria and 10 other countries account for about 70 per cent of all malaria cases and deaths worldwide, with indicators showing that Africa’s giant is far from winning the malaria war.
