With less than one month left until the end of 2020, Nigeria is yet to meet its six-year targets for malaria control, which focused on creating a malaria-free Nigeria.
The 2014-2020 National Malaria Strategic Plan (NMSP) had ambitious goals, including reaching pre-elimination status for the disease (less five per cent which can be interpreted as less than 5000 cases per 100,000 people) and zero mortality from the disease.
But these targets are far from being met, with COVID-19 taking them more off-track.
According to the World Health Organization (WHO), Nigeria still accounted for 25 per cent of the world’s malaria cases in 2018, with 53 million cases.
Children are the worst affected. The prevalence of malaria (according to microscopy) among children aged 6-59 months was 23 per cent that same year; down from 42 per cent in 2010, with an average decline of 2.3 per cent per annum, according to the 2018 National Demographic and Health Survey (NDHS).
For 2020, it cannot be said with certainty whether these numbers have further declined and if targets have been achieved or not because the COVID-19 pandemic prevented the Malaria Indicator Survey being conducted. However, judging by the most recent NDHS, these targets are unlikely to have been met.
And nowhere is this more evident than in Kebbi State.
Kebbi State as a case study
Malaria rates in Kebbi are the highest in the country, especially in children, with NDHS data showing that 52 per cent of children under 5 were infected in 2018.
The northwestern Nigerian State has had the highest number of malaria cases in the country for the past five years, though numbers have shown some decline in that time.
There are many reasons for this burden, including a lack of government support, cultural attitudes towards the disease and now the COVID-19 pandemic.
A health expert in Kebbi who pleaded anonymity for fear of victimisation, added that the high cases of malaria in the state are attributable to the lack of skilled health workers and irrigation farming (this creates a breeding ground for mosquitoes), as well as socio-cultural factors like illiteracy and poverty leading to poor understanding of the disease in local communities.
This last point defeats target four of the strategic plan, which aimed to provide adequate information to all Nigerians such that at least 80 per cent of the populace habitually takes appropriate malaria preventive and treatment measures as necessary by 2020.
Amina Aliyu, a community health extension worker at Primary Healthcare Ambursa in Kebbi, said the people of Kebbi struggle with malaria, especially the children. The community has received Artemisinin Combination Therapy (ACT) from the government over the years as treatment, she said, but has not received mosquito nets for over two years. Patients are advised to purchase their nets from the marketplace by health workers at the clinics.
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