The recent alarm raised by the Nigeria Medical Research (NIMR) over the discovery that many states in the country are on the verge of witnessing large scale deaths as a consequence of mosquitoes developing resistance to Long Lasting Insecticide Treated Nets ordinarily should call for concern among authorities in government. NIMR had on June 21, 2017, released a report which indicated that 18 out of the 36 states in the country may have been affected by this latest development.
The states where the incidence has been confirmed include Lagos, Ogun and Niger States; these have the highest incidence of resistance cases. Others are Jigawa, Katsina, Kebbi, Sokoto, Zamfara, Benue, Kwara, Nasarawa, Plateau, Anambra, Enugu, Rivers, Ondo, Osun and Oyo – with the status of the remaining states on the matter yet to be established. Statistics from the National Malaria Elimination Programme shows that Nigeria accounts for 29 per cent of global burden of malaria, and the highest number of cases by any single country.
According to official records, malaria is responsible for deaths of an estimated 300, 000 children per year and contributes to over 4, 000 maternal deaths annually. It is also the number one cause of absenteeism in Nigeria, resulting in huge losses in productivity at work and school. It also accounts for 60 per cent out-patient visits and 30 per cent hospitalisation in the country. It is therefore a huge health burden requiring urgent attention by authorities in government at all levels.
We believe that government has a responsibility to design policies that will help protect the health of Nigerians. It is embarrassing for the country to occupy its current position among nations of the world regarding malaria infestation. It is even more disconcerting that after over 182 million LLINs have been distributed across the 36 states of the country, only 16 per cent reduction rate was recorded between 2008 and 2011. We strongly doubt if the treated nets actually get to end users, because on a daily basis and almost on major highways of most cities in Nigeria, street traders make brisk business with the same nets.
Moreover, recent reports from the World Health Organisation indicate that it has recorded appreciable reduction rate in the cases of malaria infestation in member countries. Therefore, giving the urgency of the latest development and the rising incidence of malaria cases in the country, the Federal Government should begin to work closely with the Federal Ministry of Health to develop appropriate responses to the imminent danger that may be looming across the country. There is the need for government to empower relevant agencies in the health sector to seek alternatives to the current major tools being adopted in Nigeria for vector control which are already showing signs of failure.
There are different alternative methods which can be adapted here now or in the future; they can be used to complement the existing methods. We support the idea being canvassed by the authorities in NIMR in this regard. And before insecticide resistance over-power the current portfolio of vector control tools especially the LLINs, the country will need to do away with such out-dated methods and embrace multiple vector interventions.
There is the need to explore alternative non-chemical based control measures. Therefore, government should commission NIMR without delay as a hub for vector surveillance and insecticide mapping in the country. NIMR should be adequately funded to explore the use of mosquito control measures such as Sterile Insect Techniques, Genetically Modified Mosquitoes, as well as other Biological and Physical options. In fact, the biological alternative in vector control strategies has been tested around the world especially in agricultural pest control. According to experts, this option is essentially for exploitation of organisms that are natural enemies of vectors to regulate vector population growth.
They are non-toxic, leaving no residues to contaminate food chains; they produce no secondary outbreaks, do not harm target organisms, and rarely lead to the development of resistance. In addition, health and environment officials should keep our surroundings clear of stagnant waters where mosquitoes breed, while creating same awareness on the part of the public. And finally, government owes Nigerians the commitment to fight against malaria, and adequately check the upsurge of a control-resisting deadly parasite.