Mike Egboh is national programme manager for PATHS2 (Partnership for Transforming Health Systems 2) in Nigeria. The opinions expressed are his own.
Given the theme for this year’s World Malaria Day - “Sustain Gains, Save Lives: Invest in Malaria" - it is worth pausing to reflect on the need for integrated partnerships that are uniting efforts and amplifying resources to scale-up malaria prevention and treatment measures.
While Malaria afflicts nearly half a billion people a year, it is particularly deadly in Africa. The contribution of malaria to high mortality rates, particularly in women and children, is of grave global concern.
Malaria remains a major public health problem on the African continent, with about 80 percent of malaria deaths occurring in African children under five years of age.
In Nigeria, over 140 million people (97 percent of the population) are at risk from malaria. It is estimated that 70 percent of all disease incidence in Nigeria is related to malaria.
The World Malaria Report of 2008 recorded over 57.5 million cases of malaria across Nigeria, causing 225,424 fatalities.
Malaria costs the Nigerian economy roughly 132 billion Naira (that’s about $1 billion) every year and severely limits economic growth. (Federal Ministry of Health National Malaria Control Program Strategic Plan 2009 – 2013).
Scaling up access to appropriate malaria treatment remains one of the greatest challenges in Nigeria where 70 percent of the population live below the poverty line and the major impediment to accessing effective anti-malarial treatment is its high cost.
The first step towards ensuring access to more effective anti-malarial drugs by the poor is to reduce cost. There is need for partnership among the government, donors and private sector.
In order to provide new hope for millions of poor Nigerians to gain access to the most effective combination treatment for malaria, Britain's Department for International Development (DFID) funded PATHS2 is working in an innovative partnership with Clinton Health Access Initiative (CHAI) through the Affordable Medicines Facility for malaria (AMFm) initiative to provide life-saving anti-malaria treatments to health facilities based largely in rural communities in the five Nigerian states of Lagos, Kaduna, Jigawa, Enugu and Kano where the projecting is working.
AMFm is a financing mechanism to expand access to affordable ACTs—Artemisinin-based Combination Therapies. ACTs are the medicines recommended by the World Health Organisation (WHO) as the most effective malaria treatment. The AMFm is hosted and managed by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), with key financial support provided by UNITAID, DFID and the Bill & Melinda Gates Foundation, with exclusive rights given to CHAI to ensure availability of ACTs.
International manufacturers of ACTs receive a subsidy directly through the AMFm initiative almost to the tune of 95 percent which in turn is passed on by Nigerian pharmaceutical manufacturers, the First Line Buyers of ACTs.
PATHS2 brought together Nigeria’s Federal and the five project State Ministries of Health and key Pharmaceutical Manufacturing companies in Nigeria at a roundtable dialogue in Lagos where a partnership was formed with CHAI.
Acting as second line buyers, PATHS2 will distribute ACTs through primary health centres in the five Nigerian states in which it currently works, which have a total population of approximately 37 million, representing around 22 percent of the population of Nigeria as a whole. A course of treatment will be provided for as little as 60 Naira (less than $1), in comparison to previous costs of nearly 20 times as much, making the drugs affordable to even the poorest Nigerians.
Through this partnership, people in the rural communities in the five states will have access to quality and affordable ACTs drugs. It will have a significant long term positive impact on health care service delivery as it will strengthen the treatment of malaria and save tens of thousands of lives.
Ultimately, pooling resources through partnerships like this is one way of expanding access to quality and affordable ACTS in Nigeria to help drastically reduce malaria deaths and help to achieve the Millennium Development Goals, especially those relating to improving child survival and maternal health.