In 2013, Nigeria founded its National Malaria Elimination Programme, or NMEP, with an overall aim to reduce malaria deaths and achieve a parasite prevalence of less than 10% by 2025. However, recent global malaria data indicate that this target is hardly attainable.
Of the estimated 263 million cases of malaria worldwide in 2023, Nigeria accounted for approximately 26%, ahead of the Democratic Republic of Congo, Uganda and Ethiopia, according to the latest global malaria report by the WHO. The statistics are even grimmer when it comes to the global malaria deaths, with Nigeria shouldering nearly 31%—the highest burden for any single country.
The recent figures mirror data from the past two years, which consistently reported Nigeria’s malaria burden at 27%. Again, in the summer of 2022, the country launched the Nigeria End Malaria Council, or NEMC, to reiterate its commitment to stamp out the jungle fever. Progress has remained stagnant nevertheless.
From unclean environments to inadequate healthcare, a myriad of factors contribute to the astonishing bloom of the Anopheles mosquito (the vector for malaria) in most homes and, consequently, Nigeria’s unrelenting malaria crisis. Yet conflicts and natural disasters may have exacerbated the burden in recent years.
Nigeria ranks among the ten countries with the highest number of Internally Displaced Persons, or IDPs, in the world. The country had around 3.3 million people reportedly living in internal displacement as of December 2023, ostensibly owing to a spate of conflicts and natural disasters in the country’s northern region.
The surging population of displaced people puts a strain on public sanitation systems, creating more breeding sites for the mosquito and accelerating the spread of malaria.
Nnabiget Oke, a microbiologist with the federal ministry of health, highlights the limited knowledge of malaria among the populace. Some Nigerians continue to downplay the symptoms of malaria as though it were a common cold. “We have this attitude of not actually knowing the cause of the diagnosis,” explained Oke. “And malaria is one of the diseases that people play down.”
Self-medication is rampant. “We also find people showing apathy to orthodox medicines and instead preferring herbal solutions, especially with regard to malaria,” he added.
Over the years, the Nigerian government has launched a variety of interventions, including insecticide-treated nets, in an ambitious stride to become malaria-free.
For a country to be certified malaria-free, the WHO requires that the country must report zero indigenous malaria cases for three consecutive years. Preparing a scheme to prevent future transmission of the virus is an additional requirement. To date 44 countries, including one territory, in the world have been certified malaria-free. On October 20, Egypt became the latest country to join the list.
Similarly, in October, Nigeria launched the R21 vaccine in Bayelsa and Kebbi, with plans to roll out 1 million doses across the states of the country.
But stamping out malaria, Oke emphasises, requires more than just administering vaccines. “You can’t achieve malaria-free clearance from the World Health Organisation if you continue to show a poor attitude towards town planning,” he said.
Sanitation remains a critical challenge for many Nigerian cities, including Lagos, where less than half its residents have access to water supply. In addition to clogged drainage systems, millions of Nigerians still defecate in the open, thereby creating suitable breeding grounds for mosquitoes. “Urban planning is very, very important way to reduce the burden,” Oke said. “We need to become deliberate… about where wastes and certain industries should be sited.”
Egypt’s successful elimination of malaria provides a valuable blueprint. Early inventions included banning the cultivation of rice and agricultural crops near homes. By 2001, the country had eradicated malaria through a robust health system and improved surveillance.
Nigeria’s successful ousting of poliomyelitis illustrates how engaging with religious and traditional rulers can dispel popular myths and deepen public awareness of health initiatives.
These measures will not immediately achieve a malaria-free status. Yet they underscore an urgent need for a coordinated and sustained effort to combat a disease that remains a leading cause of illness and deaths in children aged under five.
Nigeria's National Malaria Elimination Programme aimed to reduce malaria deaths and achieve low parasite levels by 2025, but recent data suggests these goals may be unattainable. As of 2023, Nigeria had the highest burden of malaria, accounting for 26% of global cases and 31% of deaths. Despite the launch of the Nigeria End Malaria Council in 2022, progress remains stagnant due to factors like inadequate healthcare and poor sanitation that encourage mosquito breeding. Additionally, the country's high population of internally displaced persons exacerbates the issue.
Public knowledge about malaria is limited in Nigeria, leading to self-medication and preference for herbal remedies over orthodox medicine. Government interventions, including insecticide-treated nets and the recent rollout of the R21 malaria vaccine, aim to combat the disease. However, achieving malaria-free status requires improved urban planning and sanitation. Learning from Egypt's success story, Nigeria must engage religious and traditional leaders to increase awareness and dispel myths about health initiatives.
To address the challenge effectively, Nigeria would need a coordinated and sustained effort, focusing on urban planning, sanitation, and public education. This approach is critical for reducing a disease that is a leading cause of illness and mortality among children under five.
