Malaria, according to the Centre for Disease and Control (C.D.C), is defined as a serious and sometimes fatal disease caused by a parasite that commonly infects a certain type of mosquito which feeds on humans. Its symptoms include weakness with high fevers, shaking chills and flu-like illness. Malaria is caused by five species of the parasite belonging to the genus Plasmodium. Four of these namely Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae and Plasmodium ovale – are human malaria species, which are spread from one person to another by female mosquitoes of the genus Anopheles.
It is a major public health issue. Over 250 million cases and over 800,000 deaths annually. It is endemic in Africa, and Nigeria has the highest number of malaria cases globally. Its “evil” effects and unpleasant impacts are prominent and also noticeable. It is responsible for 60% outpatient visits to health facilities, 30% childhood deaths, 25% of death in children under one year and 11% maternal death. Over 85% of cases are in children under 5 years old and highly prevalent in pregnant woman too. These are sensitive populations that determine the measure of growth and fertility in the society. It has been responsible for significant increase in under 5 mortality rates, miscarriage and maternity mortality rates. About 132 billion naira is lost to malaria annually in form of treatment costs, prevention and payable working hours. It causes loss of between 1 to 5% of total Gross National Product in Nigeria. Malaria is one of the epidemics recognized and expected to be eradicated in the Sustainable Development Goals by 2030.
The readiness to combat the dreaded disease – Malaria, is however faced with a number of challenges, some of which are perennial, and thus, holistic and vibrant measures needed to be taken to tackle them. These challenges have found their ways into prevention, diagnosis, treatment and total eradication of the disease. Notwithstanding, opportunities are available and many still evolving to battle the disease, tackle the challenges and promote the health of inhabitants of endemic areas.
A major challenge observed in endemic areas is poverty. Recently, a presidential aide reported that 67% of the Nigerian population are living below poverty line. This determines the environment the poor live in, the quality of food they consume and their lifestyle. Poor citizens generally stay in rural areas and lack basic amenities such as electricity, good water source, clean environment, bad drainage systems and accessibility to proper healthcare system. Mosquitoes, the disease-carrying organisms, are known to be “darkness-friendly”, survive and reproduce geometrically in bushy areas and water-logged or stagnant drainage system. Also, unavailability of diagnostic tools, medications and professionals to handle the condition at the early stage would worsen the condition.
The opportunities available and that would help surmount the problems poverty has caused to the progression of malaria will go a long way if sustained. The government, individual elites and Non-Governmental Organization are key players in provision of the opportunities which includes; creation of jobs and skill acquisition trainings to boast income, provision of low cost housing and resources needed to keep the environment healthy, enforcement of sanitation, and ensuring the proper functioning of Primary Health Care centres where people can receive medical attention.
The other challenge is education. The orientation needed about the disease has not reached some people and it has not been fully accepted by others. Many people, especially the non-formal educated citizens needed to be sensitized more. There are still adherents to various myths and belief about the disease. Such erroneous belief includes; malaria is a lifelong disease with no cure, natural products like garlic repels mosquitoes, that like certain viral infections, malaria only lasts to complete its cycle, seeking treatment from unqualified personnel or in unstandardized herbal formulations.
The opportunities to the challenge of education is the growing number of interested stakeholders in spreading information about the disease condition – prevention and treatment, in languages and methods understandable and acceptable respectively. Also, the availability of Long Lasting Insecticide Nets (LLINs), provision and promotion of preventive therapy in pregnant women, routine enlightenment on steps to take upon observing symptoms and provision of rapid test kits have been good outputs. Development and introduction of Artemisinin-Combination Therapy has allow for improved outcomes in the population, especially in cases of (early) drug resistance. The impact of the combination therapy is quick recovery from malaria. The media has also played important role in creating awareness using different communication channels.
Corruption is another disheartening challenge facing the war against malaria. The healthcare system hosts some corrupt individuals who use their position to institute anomalies into processes. Equipment, tools and funds meant for malaria programs are sometimes diverted for personal use. This action causes a setback for the program, as it prevents implementation of planned procedures and achievement of set objectives.
Opportunities evolving to cure the cankerworm of corruption is in adequate and continuous monitoring of processes. And, most importantly evaluation of programs as and when due. These steps should be carried out by external and superior officers, so as to properly checkmate appropriation of resources. And, ultimately, sustain the program.
The other evolving opportunities in readiness to beat malaria is the fast recognition of efforts of endemic countries through research supports. For example, African Network for Drugs and Diagnostics Innovation (ANDi) has identified roles of African countries in discovering new medicinal products with the ethnopharmacological heritage.
In conclusion, the readiness to beat malaria is in building on the available and evolving opportunities to surmount the perennial and persisting challenges. The task involves a collective efforts of everyone. Because, it would help improve the quality of lives, reduce death rates and achieve dreams.
While this write-up is not the total representatative of challenges and opportunities towards beating malaria, issues mentioned here can not be overlooked.