As Nigeria joins the rest of the world to mark the 2024 World Malaria Day, the progress in national malaria control is being threatened by the continued rising cost of anti-malaria drugs, which have gone beyond the reach of many Nigerians.
Nigeria accounts for nearly 27 per cent of the global malaria burden globally, and the country records 55 million cases of malaria and about 90,000 malaria-related deaths yearly. Malaria is a major public health concern in Nigeria, with an estimated 68 million cases and 194,000 deaths due to the disease in 2021.
The growing deaths and cases have been linked to the escalating cost of malaria drugs. The Guardian investigation showed that the prices of most malaria drugs have increased by about 150 per cent in the last two years. For instance, Coartem Tab 80/480, which sold for N1,300 in 2022 now sells for N5,000, Lonart DS 80mg/480mg tablet is now N3,000 against N1,200 in 2022, Amatem Soft gel 80/480 is now N2,600 against N1000 it was sold in 2022, Kalther Soft gel 80/480 which was N800 in 2002 now goes for N1500.
Other anti-malaria drugs prices include: Arthequick Tab N900 in 2022, now N1, 500, Lynsunate forte 80/480 N1,500 in 2022 and now sells at N2,200, Coaxin Tab N900 in 2022 now N2,100, Camosunate (Adult) N700 in 2022 and now N2,200, Camosunate (one-six years) N800 in 2022, N1,300 and Clartem DS 80/480 which was N500 in 2022, sells for N950.
Experts confirmed the development and blamed the trend on the worsening economic situation in the country. According to them, the high cost of malaria treatment has pushed Nigerians to unregulated traditional medicine.
A professor of Public Health Parasitology at the Nnamdi Azikiwe University, Awka, Anambra State; and Founder Malaria Eradication and Safe Health Initiative of Nigeria, Prof Dennis Aribodor told The Guardian that the rising cost of malaria drugs poses a threat to the nations malaria control and elimination efforts, saying that a situation where malaria treatment cost over N10,000 portends danger to the fight against malaria.
Aribodor warned that the exorbitant cost of antimalarial medicines will worsen the already terrible situation as most Nigerians live under the poverty line. What this means is that Nigerians are suffering more burdens associated with malaria. There will be more morbidity and mortality, as well as recycling of poverty among the majority of the population. The economy is already biting hard on most Nigerians, and the exorbitant cost of antimalarial medicines will worsen the situation, he said.
Aribodor said with many Nigerians resorting to herbal drugs (Agbo) for the treatment of malaria and other ailments; it means that there will be more health problems in the country. Many Nigerians including children are already coming down with kidney and liver problems associated with consumption of unregulated herbal medicines. These problems normally end in death. The federal and state governments should declare an emergency in the treatment of malaria. Most hospital visitations are still due to malaria or consequences associated with malaria, he said.
He disclosed that between 2009 to around 2015, Nigeria achieved success in reducing the malaria burden through the support of global partners including UKAID- SuNMaP (Support to National Malaria Programme), World Bank Malaria Assisted Programme, United States President Malaria Initiative, other development partners and organisations.
During that period, he said, antimalarial commodities including insecticidal-treated nets, artemisinin-based combination therapy for malaria treatment, intermittent preventive therapy for infants and pregnant women, as well as malaria diagnosis were given almost free to Nigerians.
He urged the federal and state governments to go back to that experience, to retain gains recorded in the battle against malaria. Aribodor also advocated the social marketing of antimalarial commodities.
More importantly, political leaders should summon the political will to address the malaria burden, which has become an embarrassment to the country. If countries like Algeria where Malaria was discovered in 1808, and Cape Verde were able to eliminate malaria from their territories in 2020 and 2023, respectively, then Nigeria has no business being the malaria capital of the world. It is an unenviable record that should be reversed, he said.
For Aribodor, Nigeria should set a deadline for malaria elimination, which can be achieved by the year 2030, if states and Federal Governments muster the political will, mobilise needed resources including funding, human resources and give free malaria services to citizens.
Also, a pharmacist at the Heeds Pharmacy and Stores Ltd, Lugbe, Abuja, Kosamot Kayode told The Guardian that the present cost of malaria drugs is alarming and unaffordable.
Rafiu, who called for urgent government intervention, stated that the high cost of drugs discourages many Nigerians from seeking care in health facilities and makes them resort to traditional medicines for their healthcare needs.
He said: The high exchange rate is affecting the prices of drugs because most of the drugs are imported. The most affected are the anti-hypertensive and anti-diabetic drugs, especially the branded drugs. The government needs to intervene so that people will not die. The high cost of drugs has made many people to patronise Agbo, I have never seen any traditional medicine that is effective in the cure of malaria. Most of these people come to the pharmacy after trying the Agbo. If the Agbo had worked, they wouldn’t come to the pharmacy.
Rafiu explained that since the Federal Government banned the use of oral artemisinin-based monotherapies (oAMTs) for malaria treatment due to recurring malaria incidents and resistance, they now use Artemisinin-based combination therapies (ACTs) for the treatment of malaria, except for injectables.
Currently, malaria is treated with a combination drug and the most common among them is artemether-lumefantrine because the combination enhances the curative treatment of malaria and low resistance and incidence of reoccurrence, he added.
But a journalist, Dele Anofi disagreed with Rafiu. He told The Guardian that he uses Agbo for the treatment of malaria because it is effective and affordable considering that the herbs can be acquired without spending on them.
Anofi, however, explained that the economic situation has nothing to do with his preference for Agbo because to him, orthodox treatment of malaria is equally inexpensive. I have no fears about any negative implications of Agbo for malaria because the herbs involved have been proven not to be harmful. Besides, theres never an overdose or abuse of Agbo in malaria treatment.
A traditional medicine vendor marketing Baba Aisha’s product told The Guardian that with N1,200, one can get three wraps of malaria medicine, adding that the herbal mixture can be taken with pap for a complete malaria cure.
According to the World Health Organization (WHO) 249 million new cases of malaria and 608, 000 malaria deaths were recorded globally in 2022. The global health body noted that the African Region shoulders the heaviest burden of the disease accounting for 94 per cent and 95 per cent of malaria cases and deaths.
WHO added that in recent years, progress in reducing malaria has ground to a standstill, stressing that not only does malaria continue to directly endanger health and cost lives, it also perpetuates a vicious cycle of inequity.
With equity in access to malaria services as the focus of the years World Malaria Day theme, WHO stressed the need to end discrimination and stigma, bring health care close to where people live and work through primary health care and address factors that increase malaria risk including malaria control interventions in universal health coverage.
”Not only does malaria continue to directly endanger health and cost lives, but it also perpetuates a vicious cycle of inequity. People living in the most vulnerable situations including pregnant women, infants, and children less than five years of age, refugees, migrants, internally displaced people, and indigenous peoples continue to be disproportionately impacted,” WHO said.
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