Africa: Malaria Elimination

The recent certification of Cabo Verde by the World Health Organisation, WHO, as the third malaria-free country in Africa after Mauritius (1973) and Algeria (2019) offers valuable lessons for Nigeria in its fight against the disease.

Cabo Verde’s success came from sustained commitment from the government. High-level political leadership ensured consistent funding, effective policy implementation, and strong coordination across different sectors.

Nigeria can learn to replicate this commitment by prioritising malaria control in national development plans and mobilising resources effectively. Currently, malaria in Nigeria is a major public health concern. Despite impressive progress, Nigeria still faces several hurdles on its path to achieving malaria elimination status.

Among hurdles, Nigeria must overcome the persistent threats posed by the resistance of malaria parasites and mosquitoes to drugs and insecticides, and must also address the challenge of environmental factors. The gaps in access and equity gaps to healthcare access, especially in rural areas, continuously increase the risk of malaria transmission and delay diagnosis.

Then the impact of socio-economic inequalities, such as poverty, inadequate housing, and education that contribute to malaria risk, necessitates urgent attention to address these disparities for effective malaria control.

Government initiatives such as the National Malaria Elimination Programme, NMEP, and the 2021-2025 National Malaria Strategic Plan, have made an appreciable impact. However, challenges remain.

Those challenges include drug and insecticide resistance, limited healthcare access, environmental factors, and socio-economic inequalities. So despite progress, Nigeria still needs to improve access to prevention and treatment, address drug resistance, and strengthen healthcare systems to combat the disease.

The good news is that there are takeaways and lessons from the Cabo Verde experience. Adoption of a multi-pronged approach of combining vector control measures like indoor residual spraying and insecticide-treated nets with case management, surveillance, and community engagement, helped Cabo Verde to target different stages of the malaria parasite’s life cycle and address social and behavioural factors contributing to transmission. Nigeria can adopt this model by tailoring interventions to specific needs of different regions and populations.

In the same way Cabo Verde relied on robust data to track progress, identify gaps in coverage, and adjust programmes accordingly, this data-driven approach can also ensure efficient resource allocation and targeted interventions where they are most needed in Nigeria. Just as Cabo Verde actively engaged communities in malaria prevention and control efforts, so can Nigeria invest in strengthening its health information systems and use of data to guide decision-making for malaria control.

Cabo Verde diversified its funding sources, with a mix of domestic resources, international support, and private-sector partnerships. This ensured the long-term sustainability of its malaria control programme. Nigeria can explore similar strategies to secure sustainable financing for its malaria elimination efforts.

Nigeria can also learn from the approach of recognising the importance of investing in research and development of new tools and strategies, such as exploring alternative vector control methods, developing new diagnostic tools, and researching potential vaccines, to address emerging challenges like drug resistance and explore innovative solutions for malaria control.

Cabo Verde worked closely with international partners like the WHO and NGOs, leveraging their expertise and resources to strengthen its malaria programme. Nigeria can benefit from similar partnerships to share best practices, access technical expertise, and mobilise additional resources for its malaria fight.