WASHINGTON, May 13, 2009—With Africa’s largest population (estimated at 160 million), Nigeria bears a greater malaria burden than any other country in the world. Over 300,000 Nigerians die each year of the disease.
On May 8, the country’s National Malaria Control Program (NMCP) and the Kano State Government launched the first wave of a national bed net distribution campaign designed to reduce by half the number of malaria deaths in the country over the next few years. If successful, the campaign could have significant impact on Africa’s overall malaria burden.
“By the end of 2010, over 60 million treated bed nets will blanket the country,” announced Nigeria’s Minister of Health, Babatunde Osotimehin, at a recent malaria summit in Washington, DC.
Sleeping under insecticide-treated bed nets is one important part of the solution. The Roll Back Malaria Partnership, a global partnership of malaria donors, recommends a comprehensive strategy that includes improving diagnosis, getting highly effective anti-malarial drugs quickly to all who need them, spraying interior walls of houses with long-lasting insecticide so mosquitoes die when they land there to rest, and giving pregnant women two doses of an anti-malarial to prevent them from getting malaria. Nigeria’s program has begun implementing this recommendation.
World Malaria Day goals
Though preventable and treatable, malaria kills nearly one million people every year. In addition to the hundreds of thousand of Nigerians that die each year, malaria also makes millions of Nigerians sick. This single disease accounts for about 60 percent of outpatient visits and 30 percent of hospitalizations; 25 percent of deaths in children under one year old; and 11 percent of maternal deaths —a heavy burden on Nigeria’s families, communities, health system, and workforce.
“The financial loss due to malaria annually is estimated to be about 132 billion Naira [USD 906 million] in [the] form of treatment costs, prevention, loss of man-hours, etc.,” according to the NMCP. “This chips away at Nigeria’s prospects for development.”
On April 25, 2009, the global malaria community commemorated the second annual World Malaria Day, which focused on the countdown to the ambitious goal set forth by United Nations Secretary-General Ban Ki-Moon: universal coverage by the end of 2010 with proven malaria control interventions for all people at risk. The new Nigeria bed net distribution program is the first to aim at this target. As part of the program, campaigns will be launched in each of Nigeria’s 36 states over the next two years. The goal is for every household to have at least two bed nets—and to use them correctly.
Encouraging Results: Progress on the Ground
The World Bank has contributed to some of the biggest successes at country level:
In Zambia, 62 percent of households now have at least one insecticide-treated net (ITN – up from less than 5% in 2004), 66% of pregnant women receive preventive treatment (tripling coverage since 2004), and 87% of eligible households in targeted districts have received IRS.
In Ethiopia, 68% of households in malarious areas are protected by at least one ITN or IRS (up from less than 5% in 2003), and recent data suggest a sharp decline in malaria cases.
In Benin, the World Bank supported the purchase and distribution of 1.4 million LLINs during a national child health campaign in October 2007 the first LLIN distribution to cover Benin’s entire under-five population. Children also received vitamin A and deworming medicine.
What the World Bank and partners are doing
Nigeria’s partners in the Kano campaign, as the program is being called in the country, include, in addition to the World Bank, DfID, USAID, and UNICEF. The Global Fund and many other funding agencies, NGOs, and the private sector will join the national campaign. These same partners are supporting scale up of the other aspects of malaria control as well:
- Officially launched in December 2008, Phase II of the World Bank’s Booster Program for Malaria Control in Africais making available up to $1.125 billion for malaria control and elimination, depending on country demand. This amount is in addition to the $463.7 million committed under Booster Phase I.
- Phase II represents the Bank’s commitment to the Roll Back Malaria Partnershipglobal effort and complements the work of Bank partners including the Global Fund, the United States President’s Malaria Initiative, and key bilateral donors. With Phase II, the Bank seeks to better finance malaria efforts in Africa and help Booster countries carry out a full, nationwide scale-up of their key malaria control activities. The Bank is focusing attention on Nigeria and DR Congo, which together account for up to 40 percent of the malaria burden in Africa. Phase II also will support a major regional project to address surveillance, drug and insecticide resistance, cross-border vector control, and other issues essential to malaria’s elimination from the African continent.
“Malaria is not just a health burden; it is a tax on the productivity and potential of a nation,” said the World Bank’s Africa Region Vice President Obiageli Ezekwesili. “Unhealthy, less-productive populations are less able to generate the growth needed to lift themselves out of poverty. So we need to keep our children healthy so they can learn in school and become highly productive members of society.”
“We need to keep adults healthy so they can work, provide for their families, and contribute to Africa’s economic growth,” Ezekwesili added.
In addition to Nigeria, the Bank has provided funds to fill finance gaps in Ethiopia and Tanzania.
Malaria and the financial crisis
With Africa’s economic growth slowing, reducing the growth penalty imposed by malaria is more important than ever. New estimates for 2009 suggest that lower economic growth rates will trap 46 million more people in extreme poverty than was expected prior to the crisis. In addition, new research shows that lower growth rates will sharply slow progress in reducing infant mortality.
In these difficult times, reliable financing and aid flows are crucial to ensuring that countries can massively scale up efforts to reach the 2010 targets. Estimates show that it would cost only around $3 billion per year to end malaria deaths and greatly reduce malaria’s burden on families and health systems.