•Disease that endangers your life
By Doris Obinna
Malaria is a major public health concern in Nigeria, with an estimated 68 million cases and 194, 000 deaths due to the disease in 2021. Nigeria has the highest burden of malaria globally, accounting for nearly 27 per cent of the global malaria burden. The risk of transmission exists throughout the country, all year round.
Today, April 25, 2024, the world commemorates World Malaria Day, an international observance while recognizing global efforts to control malaria. Globally, 3.3 billion people in 106 countries are at risk of malaria.
World Malaria Day was first recognised globally in 2007 and celebrated for the first time in 2008. This year’s theme: “Accelerating the fight against malaria for a more equitable world,” in recent years, progress in reducing malaria has ground to a standstill. According to World Health Organisation (WHO), “not only does malaria continue to directly endanger health and cost lives, but it also perpetuates a vicious cycle of inequity.
“Malaria occurs mostly in poor, tropical and subtropical areas of the world. Africa is the most affected due to a combination of factors: A very efficient mosquito (Anopheles gambiae complex) is responsible for high transmission.”
In January 2024, Cabo Verde was declared malaria-free by the WHO making it the third country in Africa to be declared malaria-free, after Mauritius (in 1973) and Algeria (in 2019).
In 2023, just four member states accounted for nearly half of global malaria cases: Nigeria (27 per cent), the Democratic Republic of the Congo (12 per cent), Uganda (5 per cent), and Mozambique (4 per cent). Across the continent, 1.27 billion individuals are at risk of malaria infection.
This year, WHO joins the Result Based Management (RBM) partnership to end malaria and other partners in highlighting barriers to health equity, gender equality and human rights in malaria responses worldwide – as well as concrete measures to overcome them.
The estimated number of global malaria cases in 2022 exceeded pre-COVID-19 pandemic levels in 2019, according to WHO’s 2023 World malaria report. Several threats to the malaria global response are highlighted in the report, including climate change.
Speaking, a public health expert, Dr Sunday Olaleye, states that the most common malaria in Nigeria is plasmodium falciparum (Pf), which is the dominant malaria parasite in Nigeria though P. vivax (Pv), P. ovale (Po), and P. malariae (Pm) are also endemic.
“In terms of humidity, Nigeria has vegetation that favours the reproductive stages of the parasite in the mosquito. Altitude also plays a role. And, in most of Nigeria, the altitude allows the mosquito to fly around without much difficulty. Only the Mambilla Plateau is considered relatively malaria free in Nigeria.
Most vulnerable persons
“The most vulnerable are persons with no or little immunity against the disease. In areas with high transmission (such as Africa south of the Sahara), the most vulnerable groups are: young children, who have not yet developed partial immunity to malaria.
“Not only does malaria continue to directly endanger health and cost lives, but it also perpetuates a vicious cycle of inequity. People living in the most vulnerable situations including pregnant women, infants, and children under five years of age, refugees, migrants, internally displaced people, and indigenous peoples continue to be disproportionately impacted.
“Rural populations in the African region living in situations of poverty and with less access to education are the most impacted. In view of the current trajectory, critical 2025 milestones of the WHO global malaria strategy for reductions in malaria cases and deaths will be missed.”
Affordable treatment
“Everyone has the right to quality, timely, and affordable services to prevent, detect, and treat malaria, yet this is not a reality for all. Infants and young children continue to suffer the greatest mortality; in 2022, an estimated four out of five malaria-related deaths in the African Region were among children under five years of age.
“An inequity in access to education and financial resources further exacerbates risk: children under five years of age from the poorest households in sub-Saharan Africa are five times more likely to be infected with malaria than those from the wealthiest households.
“Pregnancy reduces a woman’s immunity to malaria, making her more susceptible to infection and increasing her risk of severe disease and death. Gender inequalities, discrimination and harmful gender norms heighten her risk of contracting the disease. If untreated, malaria in pregnancy can cause severe anaemia, maternal death, stillbirth, premature delivery, and low-birth weight babies.
“Climate change and humanitarian emergencies, including natural disasters and conflicts in malaria-endemic countries, are displacing populations making them vulnerable to the disease. These and other at-risk groups continue to be excluded from the services they need to prevent, detect and treat malaria, hindering progress on achieving the vision of a malaria-free world,” he stated.
Fight against malaria
WHO reiterated, “on World Malaria Day, let’s “Accelerate the fight against malaria for a more equitable world” through: ending discrimination and stigma, engaging communities in health decision-making, bringing health care close to where people live and work through primary health care, addressing factors that increase malaria risk as well as including malaria control interventions in universal health coverage.”
