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Nigeria urged to focus on malaria as other countries edge towards elimination Nigeria urged to focus on malaria as other countries edge towards elimination
(4 months later)
Donors and governments must continue to fund the fight against malaria in Nigeria, where, despite impressive progress in reducing the number of deaths, about 100,000 people still die from the disease every year, says the head of the Malaria Consortium’s Nigeria office.Donors and governments must continue to fund the fight against malaria in Nigeria, where, despite impressive progress in reducing the number of deaths, about 100,000 people still die from the disease every year, says the head of the Malaria Consortium’s Nigeria office.
Dr Kolawole Maxwell said the battle against the mosquito-borne disease had also helped strengthen the public health system in one of the countries worst hit by malaria, but a potential fall in funding constitutes a serious risk, particularly as lower oil prices hit government revenues.Dr Kolawole Maxwell said the battle against the mosquito-borne disease had also helped strengthen the public health system in one of the countries worst hit by malaria, but a potential fall in funding constitutes a serious risk, particularly as lower oil prices hit government revenues.
“We are looking inwards to see what we can do to ensure that we continue to get the attention of governments and donors to keep the funding going,” said Maxwell, who was in London for World Malaria Day.“We are looking inwards to see what we can do to ensure that we continue to get the attention of governments and donors to keep the funding going,” said Maxwell, who was in London for World Malaria Day.
Related: Malaria menace: when insecticide-resistant mosquitoes bite back | Clár Ní Chonghaile
“Nigeria is basically an economy that is based on oil. More than before, we are now being forced to start looking inwards and looking at what can we integrate and making sure we have efficiencies,” he said, noting that donor funds are still needed to switch from controlling outbreaks to elimination programmes.“Nigeria is basically an economy that is based on oil. More than before, we are now being forced to start looking inwards and looking at what can we integrate and making sure we have efficiencies,” he said, noting that donor funds are still needed to switch from controlling outbreaks to elimination programmes.
On Monday, the World Health Organisation released a report on malaria (pdf), Eliminating Malaria, calling for a global commitment to remove malaria from at least 35 new countries by 2030 – a goal it described as “ambitious but achievable”.On Monday, the World Health Organisation released a report on malaria (pdf), Eliminating Malaria, calling for a global commitment to remove malaria from at least 35 new countries by 2030 – a goal it described as “ambitious but achievable”.
Last year, for the first time, Europe had no indigenous cases of malaria, down from 90,000 cases in 1995. Eight other countries reported zero cases in 2014: Argentina, Costa Rica, Iraq, Morocco, Oman, Paraguay, Sri Lanka and the United Arab Emirates.Last year, for the first time, Europe had no indigenous cases of malaria, down from 90,000 cases in 1995. Eight other countries reported zero cases in 2014: Argentina, Costa Rica, Iraq, Morocco, Oman, Paraguay, Sri Lanka and the United Arab Emirates.
“Our report shines a spotlight on countries that are well on their way to eliminating malaria,” said Dr Pedro Alonso, director of the WHO global malaria programme.“Our report shines a spotlight on countries that are well on their way to eliminating malaria,” said Dr Pedro Alonso, director of the WHO global malaria programme.
“WHO commends these countries while also highlighting the urgent need for greater investment in settings with high rates of malaria transmission, particularly in Africa. Saving lives must be our first priority.”“WHO commends these countries while also highlighting the urgent need for greater investment in settings with high rates of malaria transmission, particularly in Africa. Saving lives must be our first priority.”
The WHO said a 60% global decline in deaths came through insecticide-treated bednets, indoor residual spraying, rapid diagnostic testing and artemisinin-based combination therapies. But it noted that mosquito resistance to insecticides used in nets and spraying is growing, as is parasite resistance to a component in a powerful antimalarial medicine.The WHO said a 60% global decline in deaths came through insecticide-treated bednets, indoor residual spraying, rapid diagnostic testing and artemisinin-based combination therapies. But it noted that mosquito resistance to insecticides used in nets and spraying is growing, as is parasite resistance to a component in a powerful antimalarial medicine.
Last year, 214 million cases of malaria were reported in 95 countries, and more than 400,000 people died of malaria. Nigeria and the Democratic Republic of the Congo still account for 35% of deaths.Last year, 214 million cases of malaria were reported in 95 countries, and more than 400,000 people died of malaria. Nigeria and the Democratic Republic of the Congo still account for 35% of deaths.
“New technologies must go hand in hand with strong political and financial commitment,” Alonso said. Funding needs to increase from $2.5bn (£1.73bn) today to an estimated $8.7bn (£6bn) each year by 2030, according to the WHO.“New technologies must go hand in hand with strong political and financial commitment,” Alonso said. Funding needs to increase from $2.5bn (£1.73bn) today to an estimated $8.7bn (£6bn) each year by 2030, according to the WHO.
Maxwell said Nigeria had made impressive progress under an eight-year, UK aid-funded support to national malaria programme. Integrating this programme into existing health systems had been critical.Maxwell said Nigeria had made impressive progress under an eight-year, UK aid-funded support to national malaria programme. Integrating this programme into existing health systems had been critical.
“When we started, around 60% of people who came to the outpatients department of any hospital were complaining of fever … Malaria places a huge burden on the health systems. It would have been so easy when we started to say, ‘OK, since this is huge, and there are resources, let’s just work on malaria.’“When we started, around 60% of people who came to the outpatients department of any hospital were complaining of fever … Malaria places a huge burden on the health systems. It would have been so easy when we started to say, ‘OK, since this is huge, and there are resources, let’s just work on malaria.’
“We could have set off doing practical systems and activities, which might have brought down malaria but at the end of the day might have destroyed the heath system,” he said.“We could have set off doing practical systems and activities, which might have brought down malaria but at the end of the day might have destroyed the heath system,” he said.
Instead, the team looked at the capacity of the health system and the people involved, and decided accordingly which tools and systems were needed, and how to integrate the campaign with the broader health system, including through data reporting and drug supply.Instead, the team looked at the capacity of the health system and the people involved, and decided accordingly which tools and systems were needed, and how to integrate the campaign with the broader health system, including through data reporting and drug supply.
The effects of strengthening the health system were evident in the way Nigeria reacted quickly to the Ebola threat, Maxwell said, and work against other diseases including polio and Lassa fever has also benefited.The effects of strengthening the health system were evident in the way Nigeria reacted quickly to the Ebola threat, Maxwell said, and work against other diseases including polio and Lassa fever has also benefited.
Maxwell said it was important to engage communities, because although incidence of malaria was declining, individual cases tended to be more acute as herd immunity was falling.Maxwell said it was important to engage communities, because although incidence of malaria was declining, individual cases tended to be more acute as herd immunity was falling.
“We don’t want a situation where the community thinks it is not malaria that is killing people but something else,” he said.“We don’t want a situation where the community thinks it is not malaria that is killing people but something else,” he said.
The private sector also needed to define its role in the battle, he said.The private sector also needed to define its role in the battle, he said.
“I’m talking about people making profits from health products, like nets and drugs. We can now engage with a population that is middle class, that have some resources, and [the private sector] can start asking them what would be their preferences in some of these commodities, and increase and expand the market.”“I’m talking about people making profits from health products, like nets and drugs. We can now engage with a population that is middle class, that have some resources, and [the private sector] can start asking them what would be their preferences in some of these commodities, and increase and expand the market.”