` THE MALARIA STORY
Femi Olugbile
Malaria is an illness that is characterised by fever, chills, and a general debilitation of the whole person. It occurs up to two weeks after one is bitten by the female of certain strains of mosquito, during which process the infective organism, Plasmodium in one of its varieties is injected into the blood stream.
From that point on the hapless individual is at the mercy of the organism, which goes through different stages of its lifecycle, replicating itself and sending a virtual invading army of parasites to do havoc to the internal organs of the afflicted. Sometimes, even now, despite the availability of effective treatments, the result is death.
The sheer familiarity of Malaria fever in these parts creates the dangerous illusion in the minds of many that it is a ‘normal’ experience.
Nigeria has one of the highest infant mortality rates in the world. One out of every four of those Nigerian infants who die – mostly from avoidable causes, dies from Malaria. Three out of every ten children who die do so as a result of Malaria.
It is a desperate, pathetic picture. Malaria is the commonest cause of absenteeism from school or work. The loss in productivity that the nation and the continent of Africa suffer as a result of the plasmodium is very difficult to quantify. In a historical sense, the tiny plasmodium has probably played a very great part in the underdevelopment of sub-Saharan Africa. Because it thrives most in a dirty, deprived environment, it is both a result of Africa’s poverty, and a major cause of it.
In 1998, under the aegis of the World Health Organisation, the ‘Roll Back Malaria’ initiative was launched with great fanfare. One of the avowed aims of the project was to cut Malaria deaths by half by 2010, and by half again by 2015. There was a heavy focus of eliminating areas of mosquito breeding in the environment, promoting the wide-spread use of insecticide-treated nets, and mass spraying of residential areas.
Four years beyond the happy target date by which Malaria should have been ‘rolled back’, Malaria bestrides the homes and hallways of Nigeria, and Africa, majestically, with the impunity of an out-of-control Mafia boss.
Every two minutes, a child somewhere in the world dies of malaria.
Among the eleven countries with the highest burden of malaria in the world, Nigeria stands at number one, followed by Democratic Republic of Congo, followed by Mozambique. India lurks somewhere in the mix.
It is clear that new thinking is required in the fight against Malaria.
Since 2016, the Global Technical Strategy for Malaria, with a ‘High Burden, High Impact’ focus, has been in operation. The policies are supposed to be aligned with national health goals and Sustainable Development Goals (SDGs), with a strong foundation in primary health care. The target this time is to reduce malaria cases and deaths by at least 40% by 2020, 75% by 2025, and 90% by 2030.
The cynical would say the politicians, international civil servants and donor organisations have merely kicked the can down the road.
Not a lot of impact from these high-sounding clichés is yet in evidence.
The philosophy at play, really, is much the same as that underpinning the familiar ‘Roll Back Malaria’ campaign.
It is not that ‘Rolling Back’ malaria is inherently faulty as a strategy. Afterall, such measures, have been responsible for the elimination of Malaria from places such as Southern Europe. But the intensity of the mosquito threat, as well as the density of population under threat, was low in Europe. The same elements, by comparison, in highly endangered areas of Africa, especially Nigeria, are humongous. In Nigeria, and other members of the ‘group of eleven’ highly at-risk countries, government’s reaction to date, has oscillated between those who apply token measures and those who ‘don’t do jack’.
Malaria needs to be seen as an existential threat to get into the appropriate mind-set to deal with it. Malaria, the plasmodium and its mosquito vector, are the African’s enemies, and are not to ‘Rolled Back’. They are to be KILLED, ‘by any means necessary’.
Finally, help is on the way to do just that, it would seem. There is a race to develop an effective vaccine that would prevent people from ‘catching’ Malaria. Most of the scientific research, as usual, took place outside the shores of Africa. A few weeks ago, a pilot vaccination program was commenced in Malawi. It is not yet the finished product. The vaccine has a low effectiveness and requires four doses to be given. Nobody has even yet looked at cost, or how to get it to millions of people in Nigeria, if it proves successful.
There is another route of attack – genetic engineering. Some years ago, Bill and Melinda Gates gave money to help ongoing research to alter the genetics of the female Anopheles mosquito, the principal enemy in spreading malaria in Africa. The attack is meant to reduce the mosquito’s ability to breed, to reduce the population of active females, and to push the ‘damage’ into the mainstream population of mosquitoes. Sadly, as usual, the efforts sterilize the mosquito into species extinction has been dogged by a bizarre disinformation campaign on social media that seeks to portray it as an effort to ‘sterilize’ Africans.
Research is expensive. Nigeria’s contribution to date to the new knowledge that would win the battle against Malaria has been miniscule.
But at least the battle to ‘kill’ Malaria is now well and truly joined.
People of means who profess love for Nigeria, the most malaria-ravaged country on earth, are welcome put their money where their mouths are, for a change.
