Dr. Matshidiso Moeti is the African Regional Director of the WHO. In this exclusive interview with Martins Ifijeh, the medical administrator said with Nigeria accounting for 25 per cent of malaria cases worldwide, there is need for increased political will and funding, as well as coordinated response in addressing the deadly disease. Excerpts:
Why are we having stalled progress in the fight against malaria?
The World malaria report 2018 reinforces the message that more needs to be done to get back on track to end malaria. We made great progress in some areas, with a fall in deaths caused by malaria and promising declines in malaria incidences in India, Ethiopia, Rwanda and Pakistan.
We are particularly concerned, however, by the report’s finding that in 2017 there were an estimated 3.5 million more cases of malaria in the 10 highest burden African countries, with Nigeria accounting for 25 per cent of malaria cases worldwide.
Coverage of key interventions to prevent and treat malaria – such as insecticide-treated nets (ITNs) and anti-malarial medicines – has only marginally improved since 2015. Access to preventive therapies that protect pregnant women and children from malaria remains too low. And the burden of anaemia, especially among children who have malaria, remains unacceptably high.
Has poor funding capacity, as in the case of Nigeria, affected the fight against malaria?
Funding for malaria control in most countries remains insufficient. The overall level of resources available in 2017, although slightly higher than in 2016, continues to fall short of our annual funding targets.
Inadequate funding has resulted in major gaps in coverage of core malaria control tools that prevent, diagnose and treat malaria. In 2017, for example, an estimated half of the population at risk of malaria in Africa did not sleep under a treated net. Importantly, most ITNs distributed in recent years were used to replace old nets, resulting in limited quantities to cover additional populations.
Nigeria presently has a huge funding gap, what is your recommendation?
Strengthening country leadership and stepping up domestic financing is necessary at all levels to translate political commitments into more domestic resources and tangible action to reduce malaria cases and deaths.
At the Commonwealth Heads of Government Meeting in London this April, the Nigerian Minister of Health, Professor Isaac Adewole committed to secure $300 million in new financing from the World Bank, Islamic Development Bank and African Development Bank to cover significant bed net coverage gaps in 13 states. The application for these funds is currently underway. Once received, it is crucial that Nigeria follows through with making this happen, including using the funds when they come through as intended.
The world is at risk of squandering years of investment in the fight against malaria, it means our efforts aren’t enough, so what different approach should we look at?
At the World Health Assembly in May 2018, the World Health Organisation Director General, Dr. Tedros Adhanom Ghebreyesus, called for an aggressive new approach to jump-start progress against malaria. A new country-driven response – “High burden to high impact” – was launched alongside this year’s World Malaria Report in Maputo, Mozambique.
The approach will be driven by the 11 countries that carry the highest burden of the disease (Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, India, Mali, Mozambique, Niger, Nigeria, Uganda and United Republic of Tanzania). Key elements of the new approach include: Political will to reduce the toll of malaria; strategic information to drive impact; better guidance, policies and strategies; and coordinated national malaria response.
Catalysed by WHO and Roll Back Malaria (RBM) Partnership to End Malaria, “High burden to high impact” builds on the principle that no one should die from a disease that is preventable and treatable. The support and engagement of all partners will be critically important to the success of this country-led approach.
Do you honestly believe Nigeria can be malaria free, considering our tropical location?
This year, Paraguay became the first country in South America to eliminate malaria in 45 years and 11 countries are on track for elimination in the next two years. It won’t be easy but with increased political will, strategic information, better guidance and a coordinated national malaria response, bit by bit, even high burden countries like Nigeria can beat this disease.
Success in countries like Nigeria will translate into success globally. Through collective action – and with countries leading the way – we can achieve our common vision of a malaria-free world.
What is your advice to Nigerian government and the citizens in addressing this burden?
Continuing with the status quo will take us further off track in the fight against this deadly disease. Our new “High burden to high impact” response outlines key elements that governments and citizens must take. This should include increased political will to reduce malaria deaths, as ownership of the challenges lies in the hands of governments most affected by malaria.
Additionally, grassroots initiatives that empower people to protect themselves from malaria, like the Zero Malaria Starts with Me campaign, which launched this year in several African countries, can help foster an environment of accountability and action.