E-DRUG: Eradication of Malaria in Nigeria: A myth or reality?
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Kindly permit me to initiate a discussion on the eradication of Malaria in
Nigeria through your widely read, educative and interactive E-drug forum.
Inspite of the various Malaria control and eradication programmes by the
Government of Nigeria and Development partners, malaria still remains the
highest contributor to the alarming morbidity and mortality rates in
Nigeria.
UNICEF (2001) estimates that about a quarter (26%) of all mortality in under
5year olds are from malaria. In our study of causes of mortality and
morbidity
in the Nine (9) Niger Delta Development Commission States, about half of the
deaths recorded in selected health institutions were attributable to
malaria.
The socio-economic consequences of malaria are well spread. Apart from the
huge amount spent on preventive measures by individuals, government and
developmental partners, a colossal amount of money is spent on diagnosis and
treatment of the over 50million cases of malaria seen yearly in Nigeria.
When
this is costed and added to the man- hours lost as a result of malaria, a
significant strain is placed on the Nation's Economy.
The Commission on macroeconomics and health has made a clear link between
poverty and health. The malaria problem is greatest in the resource poorest
regions of the world.
Various malaria control efforts have been put in place in Nigeria since the
1950s, the early efforts focused on vector control and sanitary inspection.
A
renewed response to malaria began in the 1990s, which focuses mainly on the
widespread use of Insecticide Treated Bed Net (ITNs), promotion of
chemoprophylaxis in pregnancy and environmental changes. These have had very
little impact because of the emergence of resistant strains of plasmodium
falciparium which reduced the efficacy of routine but cheap medications and
the resistance of vectors to effect of insecticides.
A recent publication in the Thisday Newspaper titled "Malaria: when politics
kills" by Thompson Ayodele of the Institute of Public Policy Analysis,
suggested the need to go back to the use of Dichloro Diphenyl
Tricloroethane
(DDT) which was effectively used to eliminate the malaria vectors in North
America and Europe as a solution to the scourge. It also stated that DDT is
currently in use in South Africa, Uganda, Kenya and Mauritius.
The issues now are:
Why was DDT abandoned in Nigeria inspite of its proven efficacy even in the
host countries of our Development partners?
Is it true that DDT is currently used in South Africa, Kenya, Uganda and
Mauritius to eliminate the malaria vector? If yes, why not Nigeria?
Is it not better to re-introduce DDT and save Nigeria the stress of wasting
approximately N500m annually on malaria programs that have not and may never
achieve the much desired eradication effect?
If "NO" to DDT, are there no other alternatives capable of achieving similar
success stories as in Europe and North America with less negative
environmental effects?
How can we move malarial control from the boardrooms of Developmental
partners
and Governments to the communities to ensure sustainability and eventual
success?
regards
Anthony Modupe
Consultant Pharmacist
LAYE MEDICAL Ltd
(Health Management Consultants)
laye@phca.linkserve.com
[Indeed, South Africa did re-introduce DDT spraying, but together with
impregnated bednets and artemether-lumefantrine as a new firstline
treatment. The 3 actions together reduced malaria morbidity with 70% in one
year. WB]
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