Towards Ending Malaria For Good

Every April 25, the world observes World Malaria Day, one of the eight official global public health campaigns currently marked by the World Health Organisation (WHO). World Malaria Day, an offshoot of the Africa Malaria Day was established in May 2007 by the 60th session of the World Health Assembly, WHO’s decision-making body. The day was established to provide “education and understanding of malaria” and spread information on “year-long intensified implementation of national malaria-control strategies, including community-based activities for malaria prevention and treatment in endemic areas.” On this day, global efforts to combat the malaria scourge are recognised. The theme of this year’s commemoration is ‘End Malaria for Good.’ Ahead of the commemoration today, the WHO yesterday disclosed that Ghana, Kenya and Malawi will pilot the world’s first malaria vaccine from 2018, offering it for babies and children in high-risk areas as part of real-life trials. It is an injectable vaccine called “Mosquirix”. The WHO said the vaccines was developed by British drug maker GlaxoSmithKline (GSK) to protect children from the most deadly form of malaria in Africa.

Malaria, one of the leading cases of death especially among children under the age of five and pregnant women, is caused by parasites that are transmitted to people through the bites of infected mosquitoes. Malaria is caused by Plasmodium parasites that are spread to people through the bites of infected Anopheles mosquito vectors. Of the 5 parasite species that cause malaria in humans, Plasmodium falciparum is the most deadly. According to statistics, nearly half of the world’s population is at risk of malaria. In 2015, there were roughly 212 million malaria cases and an estimated 430,000 deaths, the vast majority of them babies and young children in sub-Saharan Africa. Sub-Saharan Africa continues to carry a disproportionately high share of the global malaria burden. In 2015, the region was home to 90 per cent of malaria cases and 92 per cent of malaria deaths. Global efforts in the last 15 years cut the malaria death toll by 62 per cent between 2000 and 2015. In Nigeria, the disease is responsible for 60 per cent outpatient visits to health facilities, 30 per cent childhood deaths, 25 per cent of deaths in children under one year and 11 maternal death. The financial loss due to malaria annually is estimated to be about N132 billion Naira in form of treatment costs, prevention, loss of man-hours etc, yet, it is a treatable and completely evitable disease. These statistics are startling and disturbing and should be a case of concern to stakeholders. World Malaria Day is therefore an avenue to highlight the need for continued investment and sustained political commitment for malaria prevention and control. Medical experts have over the years advised that early diagnosis and prompt treatment of malaria prevents deaths. It also contributes to reducing malaria transmission.

The theme for this year’s World Malaria Day is apt as it captures the entire essence of the campaign over the years, which is to bring the malaria scourge to an end. It is in the light of this that we welcome the vaccine initiative by the WHO, which we consider a practical and radical approach towards ending the scourge. According to the WHO, the pilot programme will assess whether the Mosquirix’s protective effect in children aged five to 17 months can be replicated in real-life. It will also assess the feasibility of delivering the four doses needed, and explore the vaccine’s potential role in reducing the number of children killed by the disease. Interventions in the form of diagnostic testing and treatment have since 2000 seen to the reduction of deaths caused by malaria but to bring it to an end, prevention, which is the step being taken by the WHO is where all stakeholders should be focusing their attention. The WHO said Malawi, Kenya and Ghana were chosen for the pilot due to several factors, including having high rates of malaria as well as good malaria programmes, wide use of bed-nets and well-functioning immunisation programmes and that each of the three countries will decide on the districts and regions to be included in the pilots. It also said high malaria areas will get priority since these are where experts expect to see most benefit from the use of the vaccine.

The premise on which the WHO based its choice of the three countries for the pilot underscores the need for other countries, including Nigeria, to initiate new malaria programmes where they do not exist and strengthen existing ones to position themselves for such interventions. The National Malaria Control Programme (NMCP) has been in operation in the Ministry of Health but perhaps needs to tailor its programmes towards proactive interventions. Existing strategies have not been helpful in getting the intervention required to end the scourge and so must be redeveloped to cater to the needs of the people. Access to diagnostic testing and treatment should be seen not only as a component of malaria control but as a fundamental right of all populations at risk.

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