Philip Njemanze, a medical doctor and Chairman, Global Pro-life Alliance, GPA, has proposed to the Senate, ‘for the establishment of four malarial days of three months intervals throughout the year”

He said this became necessary, despite the report of the World Health Organization, which revealed that malaria incidence has reduced to 26 percent since 2000 in Nigeria

In a letter to the Senate President, Senator Godswill Akpabio, made available to this newspaper, the GPA, noted that “during these designated days, highly effective anti malarial artemisinin combination therapy (ACT), will be distributed to all residents of the comstituency for a three day full dose regimen

According to him,” the proposed Malarial Days could occur on January 1st, April 1st, and October 1st”

“The result of this intervention, is that, at any given time there is no malaria parasite or very low parasite load in every treated individual in Nigeria, so that, if bitten by mosquitoes, there would be no parasite to transmit in blood”

Njemanze added that ‘as pro life advocates and Catholic doctors, our objective is to draw the Nigerian Senate attention to the alarming issue of Malaria Eradication in Nigeria for which there is urgent need for legislation.

“Malaria poses a significant public health challenge in Nigeria, with an estimated 68 million cases and 194,000 deaths attributed to the disease in 2021 alone”

The full letter to the Senate President titled “10th NASS Legislative Agenda On Expanded Roll Back Malaria Programme: Two Year Campaign With Four Malaria Days In Nigeria and Africa”, reads:

Executive Summary

We propose the establishment of Four Malarial Days at three-month intervals throughout the year. During these designated days, highly effective anti-malarial artemisinin combination therapy (ACT) will be distributed to all residents of the constituency for a three-day full dose regimen. The proposed Malarial Days could occur on January 1st, April 1st, July 1st, and October 1st. The result of this intervention is that, at any given time there is no malaria parasite or very low parasite load in every treated individual in Nigeria, so that, if bitten by mosquitoes there would be no parasite to transmit in blood. Repeated ACT doses throughout the year will eradicate the malaria parasite in human host.


As pro-life advocates and Catholic doctors, our objective is to draw the Nigerian Senate’s attention to the alarming issue of Malaria Eradication in Nigeria for which there is urgent need for legislation. Malaria poses a significant public health challenge in Nigeria, with an estimated 68 million cases and 194,000 deaths attributed to the disease in 2021 alone. In Nigeria, malaria is responsible for 30% of childhood mortality and 11% of maternal mortality. Globally, Nigeria bears the highest burden of malaria, accounting for nearly 27% of the world’s malaria cases. The risk of malaria transmission persists throughout the country, year-round, but the incidence is particularly pronounced in the northern and northeastern regions.


The WHO’s 2023 report reveals that in Nigeria, despite the significant burden and the challenges posed by the COVID-19 pandemic, malaria incidence has decreased by 26% since 2000. Specifically, it has dropped from 413 cases per 1000 population in 2000 to 306 cases per 1000 in 2021. In 2019, prior to the pandemic, the malaria incidence stood at 302 cases per 1000 population.


During the same timeframe, the malaria mortality rate, which indicates the number of deaths per 1000 population at risk, has decreased by 55%. It has fallen from 2.1 per 1000 population in 2000 to 0.9 per 1000 population in 2021, with a rate of 1.2 per 1000 population in 2019.


The rapid decline in malaria cases and mortality can be attributed to several factors, including the use of prophylactic measures and effective treatment with Artemisinin Combination Therapy (ACT). However, there is a concerning trend indicating that the effectiveness of current treatment drugs may diminish in the near future.


As a result, it is imperative that the expanded Roll-back Malaria (eRBM) program be carefully designed to work towards the complete eradication of malaria in the near future, employing new research-based approaches.
We initiated a multi-center research program to demonstrate the spatial and temporal correlation between local water conservation methods for rainwater harvesting and the risk of malaria. This research made use of Satellite Remote Sensing and Geographic Information System (RS/GIS) technologies. The study was led by the Institute of Space Medicine and Terrestrial Sciences, International Institutes of Advanced Research and Training, Chidicon Medical Center, Owerri, Imo State, Nigeria, in collaboration with the National Space Research & Development Agency (NASRDA) Federal Ministry of Science and Technology, Abuja
.

Additionally, investigators from the Department of Environmental Technology, Federal University of Technology (FUTO), Owerri, Imo State, and the Department of Animal and Environmental Biology, Imo State University, Owerri, Imo State, Nigeria, were involved. Copy of the published work is hereby attached.


The analysis encompassed 216,527 cases of malaria across all groups. Groups A and B, totaling 80,511 malaria cases, represented the population with widespread potable water supply supplemented by rainwater harvesting from rooftop catchment systems. In contrast, Group C, with 136,016 malaria cases, represented the population exposed to land streams and limited access to potable water. RS/GIS data revealed seasonal vegetation cover that correlated with water availability.


In Group C, the incidence of malaria significantly decreased from 1996 to 2007 due to the implementation of new rural water projects equipped with mechanical hand pumps. Conversely, in Groups A and B, malaria incidence increased during the same period due to the absence of electricity to power motorized water pumps. We recommend that the expanded Roll-Back Malaria (eRBM) initiative should encompass the provision of potable water, sanitation, drainage, nutrition, and the administration of artemisinin combination therapy (ACT) four times a year to all individuals residing in Nigeria to eliminate the malaria parasite in the human host. Our experience with the eRBM should extended across other African countries.


Our proposal to the members of the National Assembly is to declare 2024-2025 as Malaria Eradication Years. During these two years, all budget allocations for Constituency projects should be directed toward Malaria Eradication Programs. These projects should include the provision of portable water sources with hand-pumps and solar-powered pumps equipped with filtration purification systems. Additionally, sanitation improvements in schools and public areas within each constituency should be prioritized, alongside drainage system maintenance to eliminate mosquito breeding sites. To prevent malnutrition, we suggest implementing a program that provides balanced nutrition to school children through at least two balanced meals per day.


We propose the establishment of Four Malarial Days at three-month intervals throughout the year. During these designated days, highly effective anti-malarial artemisinin combination therapy (ACT) will be distributed to all residents of the constituency for a three-day full dose regimen. The proposed Malarial Days could occur on January 1st, April 1st, July 1st, and October 1st. This means that from January 1st to 3rd, 2024, ACT would be distributed for a full three-day dosage, and the same would occur on all other Malarial Days throughout the year. The Ministries of Health, Culture and Information, Agriculture and Rural Development, in collaboration with their State and Local Government Area counterparts, will coordinate this program.


The result of this intervention is that, at any given time there is no malaria parasite or very low parasite load in every treated individual in Nigeria, so that, if bitten by mosquitoes there would be no parasite to transmit in blood. Repeated ACT doses throughout the year will eradicate the malaria parasite in human host.

We solicit your cooperation in this historic project. We thank you in anticipation.

Yours Truly,
PCnjemanze

Academician Prince Dr Philip C. Njemanze MD (Hons)
Chairman, Global Prolife Alliance (GPA), for the Council on National Policies; BOT member, Association of Catholic Medical Practitioners of Nigeria, Owerri, Archdiocese, for Ethics Committee.

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