The Pharmaceutical Society of Nigeria (PSN) wishes Nigerians , more than ever, a Malaria free life as the world grapples with the COVID-19 pandemic.
Pharmacists, the most accessible healthcare professionals, are upscaling their act in the prevention and treatment of malaria , since malaria infection is a risk factor and will increase the case fatality of COVID-19 and about 97% of the population is at risk of malaria infection. Plasmodium falciparum is the most prevalent malaria parasite in Nigeria accounting for 99.7% of estimated malaria cases.
Children under the age of 5 years, pregnant women and immunocompromised persons are most vulnerable. Children aged under 5 years accounted for 67% (272 000) of all malaria deaths in 2018, worldwide.
World Malaria Day is observed on 25 April each year to draw global attention to the burden of malaria, a preventable and treatable disease that threatens half the world population. The theme, ‘ Zero Malaria begins with me’, sustained from World Malaria day 2019, is catalysed by WHO and the RBM Partnership to End Malaria. The day educates citizens in malaria endemic countries on the following :
- Simple malaria prevention methods
- Need for investment toward malaria eradication
- Commitment of community, national and global leaders to ensure ending malaria remains a priority on the global agenda
As COVID-19 pandemic challenges the entire world, the importance of strong health systems to fight deadly infectious diseases like malaria, becomes more obvious.
Continuous improvement against malaria can only be achieved with increased investment, and World Malaria Day presents an opportunity to remind world leaders of their commitments to end this preventable and treatable disease. There is need for increased funding to cover all those at risk of malaria infection and improve on research and development. Innovative strategies to end extreme poverty will impact positively on efforts to contain public health challenges like malaria, emerging and reemerging ones like COVID -19 and Ebola.
Globally, malaria elimination net is widening, with more countries moving towards the goal of zero malaria.
In 2018, 27 countries reported fewer than 100 indigenous cases of the disease, up from 17 countries in 2010. Over the last decade, 10 countries have been certified by the WHO as malaria-free, with Algeria and Argentina making the 2019 list. These two countries over the last decade, strengthened malaria surveillance systems that every case of malaria was rapidly identified and treated. With free malaria diagnosis and treatment in both countries, everyone received the services needed to prevent, diagnose and treat the disease. According to the WHO Director General, their success should be a model and inspiration for all malaria-endemic countries.
Where are we as a country?
Nigeria is far from becoming malaria free but is making remarkable progress.
According to WHO , world malaria report of December 2019, Nigeria, came from almost 153 000 deaths in 2010 to about 95 000 deaths in 2018, accounting for almost 24% of all global malaria deaths. In all of the 11 malaria endemic countries, at least 40% of the population at risk were sleeping under long-lasting insecticidal nets (LLINs), the highest percentage being in Uganda (80%) and the lowest in Nigeria (40%). Providing Free nets and improvement in electricity supply will positively impact on the use of LLINs.
In pregnant women receiving doses of intermittent preventive treatment (IPTp3) in 2018, Nigeria’s coverage was about 30% or less and ranked also one of the lowest.
Nigeria needs to rethink her budget and investment in infrastructure especially the health sector for stronger and robust health care systems which can withstand pressure in the face of a pandemic.
As in previous years, the United States of America (USA) was the largest international source of malaria financing, providing US$ 1.0 billion (37%) in 2018. Highest individual donors like Bill and Melinda Gates are also Americans.
The present COVID-19 pandemic is a drama rehearsal of the worst to come. Most world leaders today are more national than global oriented. Several countries shot their doors to export of Personal Protective Equipment (PPE) and Active Pharmaceutical Ingredients (API) within the pandemic. America has threatened to halt her part of WHO funding of about 12% of WHO’s annual spending. We need to get to work now. We cannot continue to depend on handouts.
Malaria is a disease of under development and poverty, that is why it has taken forever to develop Vaccines against malaria, which may not be the priority of the West. RTS,S/AS01 (RTS,S) is the first and, to date, the only vaccine that shows it can significantly reduce malaria, and life-threatening severe malaria, in young African children. The clinical trial is yet to come to Nigeria.
While we commend the proactive initiative of the CBN for the 100 Billion Pharma industry intervention funds, and hope for a timely disbursement devoid of unnecessary bureaucracies, we note that there are still a lot of gaps in funding Research and development. The National Institute for Pharmaceutical Research and Development (NIPRD) and the Schools of Pharmacy in Nigeria have all it takes to make Nigeria a hub for APIs but grossly underfunded. Unless we take charge of malaria interventions, elimination and eradication of the disease may not be near.
Deliberate attention should be paid to the community Pharmacists who provide over 60% of the malaria interventions in our country. Government should structure single digit, less encumbered loans to assist the business aspect of the Practice to improve availability and access to medicines.It is a core responsibility of government to ensure affordable Pharmaceutical care for its citizens. Drugs are lifesaving special commodities and should not be allowed to compete with luxury items for high interest loans. Malaria rapid test kits should be dropped at community Pharmacies for free testing of patients prior to commencement of chemotherapy.
The Pharmaceutical Society of Nigeria, through her technical groups, has continued to invest in the capacity development of Pharmacists for delivery of world class Pharmaceutical care to consumers of healthcare in Nigeria. Pharmacists are ever ready to offer their expertise for greater health of Nigerians.
Once again, Pharmaceutical Society of Nigeria pledges her commitment toward a malarial free Nigeria and world.
Pharm (Mazi) Sam Ohuabunwa OFR, MON, NPOM, FPSN
President, Pharmaceutical Society of Nigeria.