Malaria is not just a health crisis, it is a financial and developmental emergency that hampers productivity and slows down the national economy as a result of illness and death to individuals.

Malaria is not just a health crisis, it is an economic and developmental emergency that requires urgent action.

Health authorities have put the economic burden of the disease on Nigeria at US$1.6 billion annually and say that amount could rise to US$2.8 billion by 2030.

Experts believe the cost is higher if one considers the direct impact on individuals and households, considering malaria-related absenteeism and productivity losses.

“Malaria hampers productivity and slows down the national economy as a result of illness and death to individuals,” said Peter Agadive, a consultant pharmacist based in Lagos.

The disease, which is transmitted to humans by female Anopheles mosquitoes, is common throughout the country but is more prevalent in the rainy season.

The World Health Organisation (WHO) said in its 2023 World Malaria Report, that Nigeria accounts for 27% of the global malaria burden – the highest in the world – with a national prevalence rate of 22% in children five years and younger.

In the northeast region, the figure is as high as 49%.

The report said nearly 200,000 deaths occurred in Nigeria. Children under five and pregnant women were the most affected.

Dr Iziaq Adekunle Salako, Nigeria’s Minister of State for Health and Social Welfare, said: “With Nigeria having the highest malaria burden globally, the disease significantly contributes to morbidity, mortality, economic hardship, food insecurity and poverty.

“Its control and elimination are central to President Bola Ahmed Tinubu’s priority agenda, particularly regarding food security and poverty reduction.”

To address the challenge, the federal government has begun a nationwide malaria vaccination campaign, starting in the Kebbi and Bayelsa states on Monday, December 2. The other states will follow in phases.

Saliu Ibrahim, a doctor in Kebbi, the state with the highest malaria prevalence in the country, said that nearly eight in every 10 cases attended to at the government facility where he works are malaria related.

“As medical personnel, we are mostly overwhelmed as a result of the number of malaria cases we attend to every day. The number of casualties related to the diseases makes it a serious crisis that must be quickly looked into by higher authorities,” he said.

The campaign marks the official introduction of the malaria vaccine in Nigeria. It will now be included in the National Immunisation Schedule.

The vaccine is expected to provide protection to millions of children, bringing the country closer to achieving a malaria-free future.

The government aims to eliminate malaria by 2030 and has called on all stakeholders, including traditional leaders, religious groups and the private sector, to intensify efforts towards making malaria elimination a national priority.

Salako emphasised the importance of grassroots support and behaviour change, highlighting the role of traditional and religious leaders in advocating the use of insecticide-treated nets and chemoprevention [perennial malaria chemoprevention involves the administration of a full course of anti-malarial drugs], as well as vaccines.

“The arrival of the malaria vaccine is a monumental step in our national efforts to reduce malaria morbidity and mortality,” he said.

Olugbenga Mokuolu, professor of paediatrics and strategic adviser to Nigeria’s Minister of Health on Malaria Elimination, identified inadequate funding, health system weakness, including depletion of the workforce, insecurity, environmental challenges and behavioural patterns as some of the factors responsible for the country’s malaria crisis.

“We have issues with insecticide resistance, behavioural problems around inadequate use of available nets, poor diagnosis and treatment practices. While we have made progress in the fight against malaria, the challenge is that at any point in time, the resources deployed are a fraction of what is needed.

“The problem requires a multisectoral response, mobilising resources and innovative approaches to improve access to preventive and treatment tools,” Mokuolu said.

Usman Muazu a community health worker at Bolori 1 in Maiduguri, the capital of Borno State, said some people were suspicious of the malaria vaccine and preferred to take capsules instead of injections.

“The federal and Borno State governments are trying their best to combat malaria. They regularly distribute drugs. But people are wary of all vaccines. Often it is only when the illness persists and they have no other choice that they agree to being injected.

“Healthcare workers here in Bolori 1 will go door to door ensure the drugs are distributed widely.

“The malaria vaccine requires four doses. When it is the turn of Borno State, we will take the vaccine to people’s doorsteps and show them in person how to administer the drug.

“But we advise people not to rely solely on the government to cure and eradicate malaria. We tell them to keep their surroundings clean, particularly drainage systems. They need to clear any blockages. And wherever they dump refuse must be kept as clean as possible.

“We tell them that it is up to every person to do what they can to reduce the spread of malaria. It is important for parents and caregivers to keep children away from dirty stagnant water where mosquitoes breed.

“We urge traditional and religious leaders to speak to their followers. And we speak regularly to media houses encouraging them to create awareness about the dangers of malaria.”

Abba Mustapha Tijjani, a programme officer, told RNI that eradicating malaria was an enormous challenge.

“Although people fall ill all year round, it is at its worst during the rainy season. Children of five years and younger and pregnant women are most vulnerable.

“Probably our greatest challenge is that many people are suspicious about vaccines. They do not trust them. That is a problem health workers come across often.

“When our health workers go house to house, they show caregivers how to administer the vaccine so that they can administer the remaining three doses for three consecutive days. It is important that the vaccine is properly administered.”

Tijjani said the Borno State government had employed 1,000 people to distribute the drugs.

“They will go house to house to ensure every child of five and younger is vaccinated. Afterwards they will make another house call to ensure the vaccines were administered properly.”

The number of malaria cases escalated after the devasting September 10 flood that left more than half of Maiduguri and environs under water.

A mother, who asked to remain anonymous, said her neighbour lost a child to malaria after the flood.

“Less than a week after her child died, my son also fell ill. I was desperate. I was so afraid I would lose him too. Though he is well now, he has not been the same child again, especially as we do not have an insecticide-treated net. He could fall ill again at any time.”

AYSHA MUSTAPHA KOLOMI