Thought Leadership Series

Malaria…too common?

I remember growing up in Nigeria, through primary and secondary school…the several bouts of malaria, the painful chloroquine shots and a few days on incapacity. A small inconvenience at most. It was one of my most enlightening moments in medical school when I realised that malaria was the single largest cause of death in children in Nigeria. My initial surprise turned into shock during my first job as a house officer in paediatrics as a I watched children die in my hands. The link to poverty and ignorance became clear to me as women brought their children into hospital after they had been treated with paracetamol for days with a fever, often paper white with pallor…

Memories of those deaths linger….I remember them always….but especially today…

The World Malaria Day 2009

This is the impact on the health of Nigerians…

  • Malaria accounts for about 60% of outpatient cases in health facilities
  • For approximately 300,000 annual deaths.
  • It is also responsible for 25% of all infant related mortality.
  • 30% of child related mortality.
  • 11% of maternal mortality.

Insignificant…it is not!

Today, for the first time in 50 years, the international community is poised to win the fight against malaria worldwide. Effective, low-cost tools exist to prevent and treat the disease and new and improved tools are currently being developed and tested. A consensus global action plan has been put forth to guide a coordinated international effort to control, eliminate and eventually eradicate malaria. A robust Partnership, uniting all key actors and stakeholders in malaria control, is in place to respond to challenges that no organization or government can face alone.

But …will our country do its bit? Or will we be “the last country standing” like it has been for Polio, Guinea worm etc….Do we have the public health infrastructure to deliver bed nets to the people that need it most.

It will be even more embarrassing …as the name of our capital will always be associated with the renewal of efforts …the “ABUJA DECLARATION” at the African Summit on Roll Back Malaria at Abuja, Nigeria, 25 April 2000. They committed themselves to, among others,

  • “halve malaria mortality of Africa’s people by 2010”, and
  • resolved to “initiate appropriate and sustainable action to strengthen the health systems so that by 2005, 60% of populations at risk (especially pregnant women and children) have access to preventive measures, while 60% of those suffering from Malaria have access to prompt treatment”.

How far have we gone with this….well….you know the answer. The truth is that there is NO concerted action against malaria in Nigeria. None…..

That is our reality…

Find a list of statements relating to the World Malaria Day HERE

Find an excellent blog on malaria matters by a colleague passionate about Nigeria: Malaria Matters

To find out why things are stagnating despite the huge cost to your children, brothers, sisters…write:

Dr T.O. Sofola, National Malaria Control Programme Manager – email

Ask him….

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

By Chikwe Ihekweazu

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (, which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.

1 reply on “Malaria…too common?”

The WMD 2009 is celebrated with pomp and pageantry in many African countries by only those who survived malaria in their childhoods!

I grew up in Nigeria, had similar experiences to that in the blog ..several bouts of fever. It was so bad for some of my siblings that our mother had to keep a big jar of Chloroquine so she could do what is christened “Home Management of Malaria”.

My training in the medical school enable me realize that 600mg of Chloroquine delivered intra-muscularly by semi-trained personnel using metal syringes and needles which were sterilized by “boiling” was a dying “magic bullet”.

My early clinical practice saw me staying awake to keep children alive who should have been playing with their friends due to severe malaria.
One memory I remember so well is that of a wealthy lawyer whose child was admitted for acute malaria at the Children Emergency Room in a Teaching Hospital. He realized that even the Health facility didn’t have window netting and thus was invaded by mosquitoes at night. Mothers who brought their babies for malaria treatment many times went home with “another malaria”.
This lawyer decided to provide funds for netting all the windows in the Children Emergency Room (That was during the pre-ITN era)
Later in my clinical practice as a Resident in Obstetrics /Gynaecology, i realized that most of the women in ANC had anaemia from high malaria parasitaemia and at this time Chloroquine was no longer the “darling medicine”

I moved into Public Health at Federal Ministry of Health still battling with malaria (being one of the lucky survivors)and now into International Public health, i realize how much i need to do to give “life” to those who should live.

I have just returned from the WMD 2009 in celebration in Rwanda (one of the few African countries with a evidence of success in malaria control: the cases and deaths from malaria are “down and almost out”!. The Rwanda theme is ‘COUNTING OUT CHILD DEATH IN RWANDA BY FIGHTING AGAINST MALARIA AND VACCINATING AGAINST PNEUMONIA’.
The event was well attended (evidence of a successful community mobilization)
Between 2005 and 2007, more than 60% reduction in cases and deaths from malaria is a reason to celebrate. And due to reduction in malaria deaths, the deaths from pneumonia relatively increased and the government of Rwanda with support of GAVI, WHO, Wyeth and other partners decided to use the WMD 2009 to introduce the pnuemococcal vaccine.
This means total attack at all child killers.
Lessons for my country is that, increased ITNs avilability and use can lead to success. Also that the Community Health Workers when trained and are committed can add a great impact on malaria control at the community level.
Let the WMD 2009 be a period for all hands to be on deck to drive down these avoidable deaths.

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