Issues Trends - Malaria -- Nigeria

April 24 - 25, 2000

In a broad bold initiative to tackle the scourge of malaria epidemic in Africa, which experts warned is more devastating than the dreaded Acquired Immune Deficiency Syndrome (AIDS), Nigeria organized an African Head of State Summit on Roll Back Malaria on April 24 and 25, 2000 at Abuja.

To underscore their seriousness to tackle the scourge of malaria epidemic, the Summit was attended by 21 African Heads of States, Ministers from the Group of 8 countries and the leaders of Organisation of Economic Cooperation and Development countries (OECD).

Malaria has indeed been the major cause of death in Africa more than anything else (war or famine). The statistics are horrifying. About 255 million of the 300 million cases in the world are found in Africa. This is 85 percent of the global total. In Nigeria alone, 60 million experience malaria attack at least twice in a year, with no less than 80 percent of the population exposed to the disease. 225 children in Africa die every two and a half hours, while about 2173 children under the age of five die daily in the continent from malaria.

Nigeria's President Olusegun Obasanjo put it more clearly in his opening address at the Summit when he noted that Africa loses between $7 billion and $12 billion yearly to the deadly scourge. Professor Jeffrey Sachs, Director of the Harvard Institute of International Development, and a participant at the Summit argued that the prevalence of malaria has continued to be a major cause of the underdevelopment of the continent. According to him, until malaria is effectively brought under control, other macro-economic and related policies will continue to fail in addressing the African Development crisis. The link between malaria and development is very clear. Malaria reduces productivity of labour and increases the already high mortality rate of the African population. It also aggravates the incidence of poverty by reducing the capacity of the poor to earn sustainable livelihood. The poor are more likely to die from malaria attack than the rich because of inability to meet the cost of treatment.

With all these in mind, the Summit set out to review strategies for reducing by half within 10 years the number of malaria related death. Several experts offered suggestions as to how this goal can be achieved within the time frame.

Director-General, United Nation Education, Scientific and Cultural Organisation (UNESCO), Mr. Koichiro Matsuura, canvassed debt swaps for science as a way of reducing the heavy indebtedness of Africa thereby making it possible for her to make progress. UNESCO, Matsuura explained, has produced a guide to the scourge. He pledged commitment to raising African and global awareness about the devastating effects of malaria in Africa, especially among women and children.

World Health Organisation (WHO) on its own said that it would spend about $10 billion on the Roll-Back-Malaria in Africa programme in the next 10 years. According to WHO Director of Roll-Back-Malaria (RBM) in Geneva, Dr. David Nabarro: "an estimated cost ranging between $300 million and $1 billion would be needed to fight the malaria scourge yearly for a decade in Africa." Nabarro stated that at the moment, $500 million would readily be available through donor agencies as their contribution toward combating the devastation caused in the social economic frontiers on the African continent.

At the end of the two-day Summit, African leaders resolved to substantially increase funds allocated by their countries for combating the dreaded disease in a working document titled "Abuja Declaration on RBM in Africa." Participants agreed to reduce or waive taxes and tariffs on mosquito nets, insecticides, and anti-malaria drugs. They urged international donors to donate $1 billion yearly towards the fight against malaria in Africa.

African leaders present at the Summit also called for appropriate and sustainable action to be initiated to strengthen health systems in the region, and to ensure that by the year 2005 at least 60 percent of malaria sufferers would have prompt access to correct, affordable and appropriate treatment within 24 hours of the onset of symptom. The Abuja Declaration on RBM in Africa document calls for the promo-tion of community participation in the ownership and control of RBM schemes to enhance their sustainability, and in order for diagnosis and treatment of the disease to be available and easily accessible to the poorest groups in the community. The Declaration urged creditor nations to consider canceling African countries' debt in order to re-lease more funds for Poverty Alleviation Programmes, including Roll-Back-Malaria Initiatives.

For example, we cannot fathom how much relief malaria victims will get from the resolve by the leaders to initiate appropriate and sustainable action to strengthen the health system to ensure that by the year 2005 at least 60 percent of affected persons have prompt access to use current affordable and appropriate treatment within 24 hours. But the Summit Declaration does not indicate by how much the health budgets of the member states should be raised to achieve these set-targets."

The Guardian further queried "the bulk of the preventive and prophylactic drug to be administered is imported from foreign countries which do not harbour the malaria parasite. There is an obvious economic trap in advising African governments to reduce or waive taxes and tariffs for mosquito nets and materials, insecticides, anti-malaria drugs and other critical areas of development in Africa, the malaria programme is already being designed to guarantee an emergency commodity market for industrialized nations."

Nigerian Tribune in its own editorial titled "Winning the Anti-Malaria War" said: "The battle against malaria must not be limited to the Summit Declaration alone. African government must allocate a fixed proportion of their budgets towards prevention and control of malaria. African countries must also fund research in our universities and health institutes and even traditional curative medicine in the spirit of total war against the parasite."

The Punch in an editorial on the Summit also advised: "We suggest, finally, that conscious efforts be made to integrate traditional medicine into malaria eradication programmes, as one measure of ensuring active and sustained communal participation in the roll-back project. African parliaments should also take a practical interest in providing the executive arm of government in their countries with the fiscal muscle to implement the laudable objectives of the Roll-Back-Malaria Programme."

All in all, it is expected that African-governments would pay more attention to preventive measures than curative ones in their attempt to stem out malaria. Malaria parasite is spread by mosquitoes and most African communities are breeding nest for these agents of death. In view of the fact that most African nations are still grappling with problematic sewage/waste disposal systems, open drainage, grown bushes around living areas and general poor sanitation in both urban and rural dwelling, strategies to roll back malaria are unlikely to achieve much if they do not also address basic developmental problems. No matter how much African governments pump into rolling back malaria, these would largely achieve little if adequate attention is not paid to integrating developmental solutions into the various non-developmental strategies proposed at the summit. There is no better way to roll back malaria than keeping a very clean environment.

The decision to hold the African Roll Back Malaria Summit has, no doubt, demonstrated African leaders anxiety to find an enduring solution to the problem. Several of the far-reaching decisions taken at the Summit is capable of helping to reduce the high mortality rate associated with the Malaria scourge in Africa.

The Guardian in an editorial titled " To the Malaria Summiteers" says: "But there are problems with the remedial approach adopted. We do not think this is a matter for a Summit of Heads of States and Governments; there are enough African specialists on the subject to do what the Summiteers gathered for in Abuja. A galaxy of 21 Heads of States does give a sense of immediacy and political impact to the project, but this is, at best, only in symbolic sense. For a lower cost, a more purposeful workshop of African Medical Scientists and Ministers could have produced a more detailed programme oriented plan of action.

If about N1.1 billion (approx. US $ 11.0 million) spent in organizing the Summit is not to be considered a waste, the gains of the Summit must be fully and urgently implemented through preventive remedies rather than curative. It is also hoped that African leaders will put their purses where there mouth is.

Source:

The Guardian, February 17, 2000. Pg.3 No by line.

The Punch, April 26, 2000. Pg.3 No by line.

The Guardian April 26, 2000. Pg.12 By Seth Akintoye.

The Guardian April 26, 2000. Pg.20 Editorial.

The Punch, May 2, 2000. Pg. 8 Editorial.

Nigerian Tribune May 1, 2000. Pg.10 Editorial.

Source

DATELINE HEALTH NIGERIA: Supplement on Roll Back Malaria Summit, 4 June 2000.

Contact: A Odutola of Dateline Health Nigeria. E-mail: chpss_abo@yahoo.com