Malaria kills one million people each year, including 300,000 Nigerians
A new program will provide 60 million treated bed nets to households across Nigeria’s 36 states
It would cost an estimated $3 billion per year to end malaria deaths worldwide
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. Â
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.
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.
“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.”Â
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.Â
What the World Bank and partners are doing Â
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:Â
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.Â
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. Â
“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.” Â
“We need to keep adults healthy so they can work, provide for their families, and contribute to Africa’s economic growth,” Ezekwesili added.Â
In addition to Nigeria, the Bank has provided funds to fill finance gaps in Ethiopia and Tanzania.Â
Malaria and the financial crisis  Â
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. Â
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.Â
Arne Hoel, USA Kano, Nigeria, 2008 Digital Pigment Print World Malaria Day 2009 marks a critical milestone. With less than two years left to reach the target of universal coverage with existing malaria interventions, we as a global community must accelerate action now. Several countries are proving what is possible. Harmonizing efforts across partners and countries, we can do this!
Arne Hoel, USA Juba, Southern Sudan, 2006 Digital Pigment Print Malaria is preventable and treatable, yet nearly one million people die from it every year. 90% of these deaths happen in Africa. Every day, close to 3,000 children die from malaria. They don’t have to. We can do something about it.
Arne Hoel, USA Accra, Ghana, 2006 Digital Pigment Print Countries are working to massively scale up the use of long-lasting insecticidal nets, effective drugs, indoor residual spraying, accurate diagnosis, and other malaria control measures to end deaths from malaria.
Anna Wang, USA Kenya, 2008 Digital Pigment Print This widowed mother of four is a subsistence farmer living on the edge of Lake Victoria. She set off for the clinic just after dawn with her feverish 2-year old, leaving her four-year old alone at home. The baby was diagnosed with malaria, her third episode this year. She was also given an HIV test since her father died of AIDS and her mother is HIV-positive. Part of scaling up for impact (SUFI) means bringing malaria prevention and treatment into all affected communities.
Julian Chraibi, France Lao PDR, 2008 Digital Pigment Print Malaria remains a serious health problem in Southeast Asia, particularly in border regions. This baby in Lao People’s Democratic Republic is well-protected.
Arne Hoel, USA Dakar, Senegal, 2007 Digital Pigment Print The economic case for solving malaria has never been stronger. With Africa’s growth slowing, reducing the 1.3% growth penalty imposed by malaria can help keep the continent from falling even further into poverty.
Yosef Hadar, World Bank Brazil, 1984 Digital Pigment Print In Latin America and the Caribbean, 37% of the population (308 million people) in 21 countries lives in areas with malaria. Countries in this region are concerned that global warming will increase the mosquito population and thereby increase mosquito-borne diseases such as malaria and dengue fever.
Arne Hoel, USA Freetown, Sierra Leone, 2006 Digital Pigment Print Keeping Africa’s children healthy is an investment in Africa’s future. Mass campaigns get information and millions of insecticidal nets to millions of families quickly.
Ron Haviv/VII, USA Zambezi Expedition, 2008 Digital Pigment Print Zambians come to get tested for malaria, learn about disease, and receive mosquito nets near the source of the Zambezi River as part of Roll Back Malaria’s Zambezi Expedition in April 2008. Because of strong partnership in Zambia, malaria is no longer the first cause of death in the country.
Courtney Dudley, USA India, 2008 Digital Pigment Print Where appropriate, World Bank financing supports the spraying of interior walls of homes with insecticide—indoor residual spraying, or IRS. Mosquitoes rest on nearby walls after feeding. When they do this in homes treated with IRS, most will die before they can further transmit the disease.
Courtney Dudley, USA India, 2008 Digital Pigment Print Early treatment with effective drugs such as ACTs (artemisinin-based combination therapies) is a critical part of the solution and will prevent the progression to severe disease, which may require hospitalization and the use of higher-risk interventions such as intravenous quinine, and blood transfusions, to save the patient.
Bonnie Gillespie, USA Ethiopia, 2008 Digital Pigment Print As malaria control gains strength, accurate diagnosis through microscopy and widespread use of rapid diagnostic tests becomes even more important.
Arne Hoel, USA Freetown, Sierra Leone, 2006 Digital Pigment Print If by the end of 2010, malaria-endemic countries and their partners can get at least 2 insecticidal nets into every household at risk of malaria, 500,000 lives can be saved annually. A 2007 campaign in Benin reached nearly every household.
Arne Hoel, USA Jinja, Uganda, 2003 Digital Pigment Print Pregnant women and children under five years old are the most vulnerable. Malaria is a major contributor to maternal mortality.
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