By Zayamu Hassan
Dr. Aminu Magashi Garba, is the Coordinator of the Africa Health Budget Network (AHBN) based in Abuja, Nigeria. In this interview with select journalists in Abuja on the occasion of the World Malaria Day, the public health expert, bared his minds on a range of issues including why despite the efforts of government, malaria is still high in Nigeria. He also proffered solution on how the government can end malaria. Excerpts.
Why does it seem that many of our interventions to address malaria in Nigeria have not yielded the desired result?
First and foremost, we need to understand what are those interventions? And why are they not yielding the desired result.
In tackling Malaria, we have to combine the issue of the vector (mosquito) that is transmitting the parasite and also using effective quality drugs, prevention of malaria through prophylaxis and also through addressing the environment.
So, from my understanding as a public health physician, many people in Nigeria visit the hospital because of malaria when it’s already severe. So, we spend a lot of time at home even when we start having the symptom or the sign without going to hospital. Most people allow it to become very severe then they start going to hospital and at that time, more effort needs to be put in place to treat the patient.
So, delay in going to the hospital is one of the challenges because we are not able to address the malaria burden in Nigeria.
Now, another way that already we are doing in this country is using the insecticide treated bed nets and also Indoor Residual Spray (IRS) to kill the mosquito which is the transmitting agent. Although the government is trying through the Global Fund and many other partners to provide the bed nets free of charge, you can go to many communities even when they are given the bed nets, many of them don’t use it or they are not using it in the right way. This also is one of the challenges we are facing
Then the IRS which destroys the mosquitoes is very erratic in Nigeria. It is not every community or every state that are investing in procuring the spray. It is not an intervention that is done all over the places, it is just a handful of area or handful of community and the malaria is all over the place.
These are some of the challenges why the intervention that you have mentioned are not working properly in Nigeria.
What does FG need to do to end malaria?
So, I would like to encourage massive awareness creation regarding causes of malaria, signs and symptoms, prevention and treatment. This could be done through the mass media, one-on-one, working with community structures, promoting jingles, both in English, pidgin English and also the local languages to educate the public about the malaria burden and what to do to reduce the malaria transmission.
Other things we need to also do is to ensure that the preventive chemotherapy is all over the country.
For example, when I say chemotherapy, it is the use of drugs, either one or a combination to prevent malaria infections. For instance, we should be giving the chemotherapy which is prophylaxis to our infants to actually prevent malaria, intermittent preventive treatment of infants. Also, our pregnant women when they go for antenatal care, they should also be given anti-malaria as a prophylaxis and also the seasonal malaria chemo-prevention is also very key.
As you are aware, malaria is more prominent in our society during the rainy season, because that’s when you see water being stagnated and also being collected in one place and that is a potential breeding place for mosquito.
So, at that kind of seeds season, we should also be able to provide chemo prevention and also provide mass drug administration to all the vulnerable people like under-5 children, the pregnant women, the sickle cell patients, and other vulnerable people.
This will also help us in ensuring that we’re able to eradicate the disease, or at least, reduce the burden of malaria to the barest minimum.
What are the best sustainable preventive measures that could be applied on the home front?
There is already vaccines for malaria, and so far, it has been recommended by the World Health Organisation (WHO) and can be given to children who are living in malaria endemic environment which Nigeria is one of them.
I will like to encourage the Nigerian Government to ensure that all our children are also vaccinated against malaria.
It doesn’t mean that those children will not get malaria, but it has shown that significantly, it will reduce severe and deadly malaria among young children.
Also, on the home front, we have to ensure constant and regular environmental sanitation. Unfortunately, that is something that we are not doing or we are not doing properly.
For example, like I mentioned earlier, during the rainy season, we allow water to collect in one place. We allow water to be stagnated because we have poor drainage system. In this kind of situation, we’ll have to improve our environmental practices and sanitation to ensure that our drainages are working very well so our water will not be stagnated in one place to promote the breeding of mosquito.
We also have to ensure that all our children and pregnant woman sleep under insecticide treated bed nets that will protect them and reduce the chance of malaria infection.
Another issue is the early diagnosis and treatment of malaria. Like I mentioned earlier, most people go to hospital when they already have severe malaria.
The way to prevent malaria is to ensure that we go to hospital when we start filling the symptoms, and also for early diagnosis and treatment. This will also reduce the malaria burden in Nigeria.
Many Nigerians say they treat malaria almost on a monthly basis because of the recurrence of the disease. What could be the cause of this?
I can hazard a guess. I’m sure you’re aware of what we call anti malaria drug resistance. Now, this normally happens when people start using malaria drug treatment. And just because they recover and then refuse to complete the treatment. It could also be the fact that some people use expired drugs. Also, using expired drugs, substandard drugs, low quality drugs, these could lead to malaria drug resistance, which will not allow malaria to go away.
What is your message for the World Malaria Day?
One, we need to invest in environmental sanitation and also improve our environmental practices. We should not allow our drainage system to be contaminated or to be blocked. That will reduce water gathering in one place and also water becoming stagnated to promote the mosquito transmission of malaria. We should improve our hygiene and environmental sanitation and also environmental practices.
As a message to the Nigerian government, they should invest more in malaria. We should put adequate funding in our annual budget, both at the national and state levels so that malaria drugs and treated bed nets and the Indoor Residual Spray can all be procured to ensure that we have a mass awareness campaign for malaria all over the country.
And also, we should ensure that during the rainy season we do a lot of investment in malaria, to ensure that our children, pregnant woman, and also all the vulnerable groups are protected against malaria.
