Nets for Life Initiative, Antidote to Malaria Epidemic

from All Africa

This Day (Lagos)

By Godwin Haruna
Lagos

The drama presentation aptly captured the unsavoury predicament of most communities in Nigeria. A family goes to bed with neither the protection of window nets nor insecticide treated bed nets and becomes vulnerable to mosquito bites in the night. Few days later, the pregnant wife comes down with severe malaria. The poor husband had to reach for his entire savings, which he had intended to purchase a radio to get his wife treated at a health facility. He was even a bit lucky as others, who could not raise money got severe consequences because they did not take seriously the advice of using insecticide treated nets.

Although the audience was thrown into hilarious laughter by the theatrics of the actors and the actresses, it presented the sad reality in most Nigerian families. The drama presentation was staged last Thursday at the Suleja Gardens behind the International Conference Centre, Abuja to draw attention to the necessity of using insecticide treated nets to curb the rising incidence of the malaria burden on Nigerians. It was the official launch of the 'Nets for Life' project being undertaken by ExxonMobil Foundation, Coca-Cola Foundation and Standard Chartered Bank to advance preventive measures in a bid to reduce the malaria epidemic. The collaborators intend to work closely with other stakeholders to distribute 82,500 long-lasting insecticide treated nets to communities with a high prevalence of reported malaria cases. A pilot programme was already running in Plateau and Benue states before the formal launch.

Speaking at the event, Minister of Health, Professor Adenike Grange, who was represented by Dr. Yemi Sofola, coordinator of the Roll Back Malaria programme of the ministry, said malaria posed one of the most difficult challenges to public health in Nigeria. She said the scourge has underdeveloped people economically and also contributed to high mortality of infants. Government, she said, was in the forefront of both curative and preventive measures to checkmate malaria in the country.

"We have been able to put in place a policy for effective treatment of malaria using efficacious drugs. We have been able to distribute substantial preventive commodities. However, this is still not enough when you consider the huge population we are dealing with in the country. So, we still require enormous resources to be able to effectively ensure that every pregnant woman and every child under-five sleep an insecticide treated net, every pregnant woman is given preventive treatment after six weeks of pregnancy and that all those who have malaria will have access to this life-saving drugs.

"Apart from that, we also encourage people to keep their surroundings clean. This is why it is important that the private sector is now collaborating with us because government cannot do it alone. We need resources from both public and the private sector internally and externally so that we can provide enough of these commodities to put malaria in check", Sofola said in an interview with THISDAY.

She said the ministry was using multiple strategies to bring malaria under control in the country. She said she expects other tiers of government in the country to complement the federal government's efforts on malaria control. She said the initiative being launched was beyond the cliché of a drop in the ocean since little drops of water makes a mighty ocean, so it was a commendable effort.

"This is just the beginning, before now, a lot of the private-public collaboration have been in the area of HIV/AIDS. We are now happy that this is shift to malaria control because people have recognized that it is a very important public health problem that we must all collectively tackle. We are happy and encouraged by the effort of all stakeholders in this venture", Sofola said.

She said the future of bed nets in the control of malaria was bright through reinforcement and behaviourial change communication. According to her, experiences from other countries from the large scale use of insecticide treated nets have shown that malaria could be checkmated through them; adding, "We believe we can do the same here. Initially, our focus was the vulnerable groups, but for us to actually reduce the malaria burden by half in 2010, we must ensure that the population at risk, at least 80 per cent of them, sleep under insecticide treated nets. So, that's quite a challenge, how we mobilise the resources to enable us distribute these nets across the country. We are encouraging our local manufacturers to produce these nets locally by getting transfer of technology because when there are produced locally, there become more accessible, affordable and we can have rapid expansion of these interventions".

In her keynote address, Director General of the National Agency for Food and Drug Administration and Control (NAFDAC), Prof. Dora Akunyili, said malaria represented one of the major causes of ill health and death throughout Nigeria.

"In Nigeria, malaria is the cause of one in four deaths recorded in infants and young children and worse still, for every 10 women that die around childbirth, one is caused by malaria. About half of Nigerian adults have at least one episode of malaria each year while malaria occurs in younger children up to 3-4 times a year. It is also the reason for hospital attendance in 7 out of every 10 patients seen in Nigerian hospitals", Akunyili said.

She said the disease contributes to both poverty and underdevelopment because people spend a large part of their income on its prevention and treatment. She added that malaria also reduces economic productivity due to absenteeism from school and place of work during attacks.

According to the NAFDAC DG, resistance to antimalarial drugs was proving to be a challenging problem in malaria control in Nigeria and in most parts of the world where malaria is endemic. She said the incidence of resistance in Nigeria was essentially caused by fake drugs. She said this problem has necessitated the change in treatment policies over time in order to get around it. She said fake drug dealers operated in Nigeria unchallenged for over three decades until NAFDAC started its aggressive war against drug counterfeiting.

"Counterfeit drugs have caused treatment failures, development of drug resistance and death of many people. Drug resistance occurs mainly in the areas of infectious diseases and malaria. Before the 70s, malaria was regarded like flu in Nigeria because of the efficacy of chloroquine and quinine", she said.

While commending the initiative of Nets for Life as laudable and a good case of giving back to the society, she enjoined all stakeholders to focus more on the preventive measures. "In the face of the changing pattern of malaria, there is a need to supplement and strengthen control activities with preventive efforts. A vital component of the country strategic document is the improvement of multiple prevention through the promotion of effective interventions such as: intermittent preventive treatment of malaria in pregnancy; integrated vector management including environmental management; promotion of the use of insecticide treated nets and community sensitisation and mobilisation", she said.

She said government efforts through the roll back malaria programme and the implementation of the national antimalarial treatment policy must be complemented by the private sector. Therefore, she lauded the private sector collaboration by the three outfits and described it as a practical commitment of the private sector towards improving the wellbeing of the people.

'In NAFDAC, our ultimate goal is to eradicate fake drugs and other substandard regulated products within the shortest possible time and become a model regulatory agency in Africa that will be comparable to food and drug regulatory agencies in developed countries. In the delivery of healthcare services, quality of products and services cannot be compromised because people's lives are involved", Akunyili stated.

Earlier, representatives of the three partners on the project delivered welcome addresses in which expressed their desire to reduce the malaria burden. Mr. Cyril Odu, executive director and chief financial officer, who represented ExxonMobil, said in more than a century of the company's operation in Africa, it has witnessed first-hand the devastating health and economic impacts that malaria has wrought on the company's workforce, their families and the communities.

"It is for their sake - and the sake of all affected by this disease - that ExxonMobil decided to join the fight in defeating malaria by launching the Africa Health Initiative in 2000. We became a part of this important effort because we believe that improving health is fundamental to improving economic opportunity in Africa and that economic opportunity lays the foundation for development and prosperity", Odu said.

He said through the end of 2007, ExxonMobil had invested about $40m in malaria projects all over Africa and continues to work with local partners and collaborators to save lives. Since 2000, he said the company has contributed over $120m to African community projects and an additional $10m this year to fight against malaria. He said by investing in effective tools such as bed nets, insecticides and rapid diagnosis and treatment, the needless deaths could be prevented and allow for greater economic development.

"Science tells us that the malaria parasite thrives on disorganized human systems. But it can be defeated through collaboration. Nets for Life are exactly the type of collaborative effort that can have real impact in combating malaria", he said.

In her own address, Mrs. Irene Ubah, director of public affairs and communications, Coca-Cola Nigeria Limited, said enormous value could be created when the private sector collaborates effectively with governments and NGOs to tackle a social problem. "Our commitment to this cause further derives from our belief that people are the most valuable asset of any organization and that a healthy community is a necessary condition for development. Malaria poses a substantial threat to the wellbeing and development of Africa. It remains the continent's number one killer disease" Ubah said.

She said despite the grim statistics of malaria in Africa, the good news is that is both preventable and curable. The challenge, she added, was to make the treatment and prevention techniques available to those who need it most.

According to her, with approximately 60,000 employees across Africa, the company and its bottling partners are major stakeholders and understand the impact of productivity in the workplace. She said since 2006, the company has been a major funding partner for Nets for Life programme, which focuses on prevention. She added that the long-lasting treated nets have been distributed in 16 African countries.

Also speaking, Mr. Christopher Knight, chief executive officer, Standard Chartered Bank said two years ago, the bank set an ambitious objective of distributing one million long lasting insecticide-treated nets among the vulnerable people. Knight said the initiative was launched in 2006 in Zambia and has now been rolled in 12 African countries.

He said the distribution of the nets would be complemented by parallel educational programmes, which would raise awareness on the long-term sustainable use of the nets. The main target, he said, include children under-5, pregnant women, the chronically ill and the elderly.

"We have already distributed over 11,000 insecticide-treated nets to different target groups in Nigeria. In addition, malaria education is also currently taking place in 20 communities in Plateau and Benue states and with 17 support groups in the six north central states and the Federal capital Territory. A total of 60 community agents have been trained and these agents are currently calling house-to-house and using local community gatherings to carry out educational programmes", he said on the operation of the initiative.

He said the deaths from malaria were staggering enough and managing the problem costs Africa in excess of $12b a year through lost GDP. Nigeria, he added, shared a huge part of this loss. "It is a major constraint to sustainable economic development. Annual economic growth in countries with high incidences of malaria is considerably lower than in countries that do not suffer its effects and the prosperity gap between these countries is becoming wider every year", Knight said.

Dr. Benjamin Kwashie, Anglican Bishop of Jos, which is one of the implementing partners, lauded the initiative of the companies. The clergy man said life was very important and families are happier when the children are healthy. He said every success of the project would have saved him one funeral service.

The bishop said the initiative would save many children, who are the future leaders of any nation. "The funds invested in this project might not be enough, but God works in miraculous ways for more people to be touched. In caring and in doing good, you might not know who is being touched, but God returns the goodness in many more ways", he stated.

Also speaking, Mr. David Pain, Africa Head, Christian Aid, an implementing partner, said the NGO was committed to reducing poverty, where it was working in over 50 countries. Pain said they work directly with the poor because the best people to determine how to end poverty are poor people themselves. Pain stated that more attention was being diverted to HIV/AIDS at the expense of other diseases.

Nets for Life, which started in Nigeria on May 1, 2007 is a partnership between Christian Aid and Episcopal Relief and Development and is funded by Standard Chartered Bank, Coca Cola and ExxonMobil.

According to Olusola Onifade, Christian Aid are the managers of Nets for Life in Nigeria where a programme has been developed that seeks to utilise faith-based organisations and support groups of People Living with HIV / AIDS (PLWHA) to reach groups vulnerable to malaria. He said the greatest challenge encountered so far is the importation of nets. This has proved to be a prolonged and costly process, such that so far only one consignment has been released. This has slowed down net distribution to target communities considerably. Christian Aid is now in the process of changing the clearing agent in an effort to resolve this situation.