WHO: Nigeria, Four Others Led Concentration of Malaria Cases in 2022

•Agrees with FG to intensify health emergency programmes in north-east

Ndubuisi Francis and Onyebuchi Ezigbo in Abuja

The World Health Organisation (WHO) has revealed that the global cases of malaria increased by five million compared to 249 million in 2021, noting that the  increase was mainly concentrated in five countries – Pakistan, Nigeria, Ethiopia, Uganda and Papua New Guinea.

In its 2023 World Malaria Report, WHO attributed the development to a combination of factors, including catastrophic weather events, population growth and conflict/forced migration.

Meanwhile, the federal government and the WHO have restated their commitment to continue health emergency interventions in Nigeria’s North East zone.

WHO said it will step up the provision of leadership and coordination to support the government in reaching the underserved and vulnerable populations in northeast Nigeria with essential health services. Both parties expressed their commitments after the 13th End-Term Joint Operational Review meeting held in Yola, Adamawa State, from 27 to 29 November 2023.

Although the global health agency noted the estimated 249 million cases reported last year exceeded the 2019 total by 16 million cases, the number of lives lost to malaria saw a marginal decline when compared to 2021 at 608,000 deaths, but still significantly higher than 2019, where deaths were 576,000. It added that some 95 per cent of the deaths were in the WHO African region.

Explaining that progress was currently too slow to meet 2030 goals on malaria, the report stated that the global health community urgently needs to accelerate the pace of progress to meet the 2030 malaria elimination goals.

Progress, it added, had stalled since COVID-19 and as a result, the effort to reduce the annual global malaria incidence and mortality rate had fallen significantly short of 2022 targets.

For instance, insecticide-treated net (ITN) use remains generally unchanged, with only 50 people of people sleeping under a net, while a 42 per cent Intermittent Preventive Treatment in pregnancy (IPTp) coverage indicates that too many pregnant women are still missing out on malaria prevention treatment.

However, while the World Malaria Report said that ITN use remains unchanged, the latest statistics by Alliance for Malaria Prevention (AMP) indicated that a significant milestone had been reached with the shipping of three billion insecticide treated nets (ITNs) since 2004 to prevent malaria, most of them to countries in sub-Saharan Africa.

AMP data showed that in 2022 alone, more than 190 million ITNs were distributed globally by National Malaria Programmes in malaria endemic countries. Of these 180 million were distributed in sub-Saharan Africa.

But continuing with its findings, the World Malaria Report further revealed that even the 217 million courses of Artemisinin Combination Therapy antimalarial treatment delivered last year were fewer than in 2021.

It stressed that malaria funding needed to almost double to accelerate progress towards the elimination goals, adding that $4.1 billion was invested in malaria globally in 2022 compared to a target of $7.8 billion.

The report explained that as the growing number of malaria cases demonstrates, the world is in the throes of accumulated threats, adding that climate change can both directly and indirectly affect malaria transmission.

 “Mosquito breeding grounds are changing (e.g., slight warming in cooler, malaria-free zones could lead to new malaria cases), requiring countries to make better use of data to predict malaria seasons and geographies and plan seasonal malaria chemoprevention (SMC) campaigns. 

“Indirectly, climate change can weaken healthcare systems, disrupt medical supply chains and increase migration, exposing new populations.

“The impact of climate change and extreme weather events on malaria transmission was dramatically demonstrated in the 2022 floods in Pakistan, where collections of stagnant water resulted in a five-fold increase in malaria cases, contributing to the increase in global malaria cases last year,” the report said.

On its interventions in Nigeria’s North East zone, a statement by WHO said the Country Representative to Nigeria, Dr Walter Kazadi Mulombo, gave the assurance in his welcome remark at the Joint Operational Review (JOR) meeting.

Speaking on the sideline of event, Mulombo said that the review sought to identify opportunities and assess the impact of WHO’s work in Borno, Adamawa and Yobe (BAY) states.

The statement said that contrary to reports quoting Mulombo as decrying the increasing rate of Tuberculosis cases in Borno State, he had advocated strengthening of Tuberculosis case detection, reporting and treatment to improve the low TB detection and treatment rate in the state.

It quoted Mulombo as having said that: “Everyone is entitled to have access to basic health services, and the WHO is committed to providing, promoting, and protecting health, including to the underserved affected by humanitarian crises.

“WHO will be working closely with the Borno State Government to enhance the detection and treatment rate of tuberculosis in the state.

“In the intervening time, the primary objective of the JOR is to identify and document the best practices, gaps, challenges and lessons learned during the 2023 response to humanitarian emergencies in the BAY states to further prioritize efforts and resources of WHO and partners to deliver results and align with up-to-date, evidence-based plans.

“Additionally, the JOR aims to support the BAY states in developing operational strategies for 2024, in line with the health challenges in the region.”

In her remarks, the Director of Public Health, Federal Ministry of Health, Dr.  Chukwuma Anyaike, represented by Mrs. Anthonia Chukwuemeka, commended WHO for championing health for all agenda and pushing for Nigeria to attain Universal Health Coverage (UHC).

Mrs. Chukwuemeka said “that the JOR will enhance the humanitarian response in the BAY states to reach the underserved populations with essential health services.”

WHO has been supporting the BAY states to respond to the protracted humanitarian crisis which has negatively impacted public health, putting intense pressure on healthcare services in the affected communities. 

“At the end of the meeting, some recommendations made included a call for continued implementation of lifesaving interventions including utilizing local structures to reach underserved populations, the development of a multi-hazard plan with a focus on preparedness, strengthening program integration to improve case detection and treatment of tuberculosis, building resilience, and ensuring the reliability of data emanating from the BAY states.

“Likewise, concerns were raised about the dwindling humanitarian funds from national and international fronts. This, they agree is interfering with the provision of extensive health emergency response in the affected states,” it said.

The meeting brought together key stakeholders from the Federal and concerned State Ministries of Health, health agencies, UN agencies, public health experts and partners working in the BAY states.

According to the 2023 humanitarian response plan, approximately 5,757,483 people in the region are requiring health interventions. The health sector is targeting 4,285,848 persons with 621,939 persons in IDP camps, 837,285 out of camps, 1,485,066 returnees, and 1,341,558 persons living in host communities, with life-saving health services.

The JOR is part of WHO’s core internal strategy to assess its health emergency programmes to improve current standards and develop a roadmap for 2024 interventions.