Nigerians cry out as malaria treatment hits rooftop

• Spend between N3,000 & N30,000, others resort to herbs

• We ignore treatment to feed – Parents

• ‘Dollar scarcity responsible’

• Govt should encourage local drugs – Pharmacists

Many Nigerians are increasingly finding it difficult to treat malaria, Daily Trust Saturday reports.

Ojoma Akor (Abuja), Hope Abah Emmanuel (Makurdi), Mumini Abdulkareem (Ilorin), Zahraddeen Yakubu Shuaibu (Kano) & Usman A. Bello (Benin)

This is as over 90 per cent of the population is estimated to be at the risk of the disease.

Findings by our reporters revealed that there is an increase in the cost of drugs at pharmacies and patent medicine shops. There is also a rise in the cost of malaria tests and treatment in health facilities.

This situation, it was learnt, has put many at the mercy of the disease.

According to the 2022 World Health Organisation (WHO) World Malaria Report, over 66 million cases of malaria occur annually in Nigeria.

WHO said one out of three deaths from malaria globally occurred in Nigeria. This translates to 22 persons dying every hour due to malaria in Nigeria despite efforts over the years.

Many families who spoke with our correspondents said they spent an average of N3, 000 to treat one case.

“This is if you want to just treat the disease based on assumption,” said Hannatu Sani, a mother of four in Jos, Plateau State.

“If you say you will go to hospital and undergo tests, you will spend between N7, 000 and N10, 000 per case. And unfortunately, because of the nature of the environment we live in, if one of your children has malaria, you will end up treating all of them,” she added.

According to WHO, in Africa, what adds to the challenge of controlling malaria is that the continent is home to some of the most efficient malaria vectors. These include the anopheles gambiae and the anopheles funestus.

Also, the malaria parasite species, plasmodium falciparum, the dominant species in Africa, is the most lethal. It is responsible for most malaria cases and deaths, 80 per cent of which occur in children younger than five.

Only two African countries, Algeria and Morocco, have been certified malaria-free by WHO.

Experts say Malaria is both a cause and a consequence of poverty, hence that the disease will remain a significant problem in Africa if more is not done to improve the socio-economic status of affected communities.

It was learnt that an estimated sum of N2.04 trillion is being spent on treatments of Malaria in Nigeria yearly.

A national daily said the conservative estimate of malaria cost, which is a far-cry from the $1.1 billion (N825 billion) estimated by the World Health Organisation (WHO), still excludes out-of-pocket costs of self-medication, and preventive measures by Nigerian households.

On April 17, 2023, Nigeria approved a promising new malaria vaccine. It is called R21, and in early trials, up to 80 per cent of kids who were vaccinated did not develop malaria. This is seen as a glimmer of hope but access for the poor remains a big question.

Situation across states

In Kano, the majority of people in the old and informal settlements are the most affected by the prevalence of malaria.

Daily Trust Saturday gathered that the people are now battling with malaria treatment, with many resorting to traditional medicine.

Most of the people spoken to in the state lamented over lack of money to eat food, not to talk of paying for the rising cost of medication for malaria.

A patent medicine vendor in the Kurna area of Kano metropolis, Abdulshakur Abdullahi, said of the over 50 people he received daily in his chemist, only 10 went for proper treatment of malaria, while the rest opted for partial treatment.

Abdullahi explained that some people came with as low as N200 to ask for treatment of malaria at a time when they needed to undergo tests and receive injections and tablets, noting that many of them assumed that it was “just malaria” and asked for medicines without undergoing tests.

He said, “A standard treatment of malaria will cost between N3,000 and N5,000 nowadays. This includes the Rapid Diagnostic Test (RDT) and treatment with injections and medications. But most people cannot afford that at the moment. People hardly pay for one injection, paracetamol and malaria tablets. That is why they are always battling with the disease as the treatment they go for is not enough.

“Some people even come empty handed, and one has no option than to do the little one can to help them.” Halima Abdullahi said her 12-year-old son battled with malaria every year and that this time around they had no option than to go for partial treatment as they could not afford the proper one.

Halima said, “We all know how malaria should be treated properly, but that is only possible if you have the money. Apart from him, my two other kids are battling malaria, and getting what to eat is very difficult. That is why I give them N1,000 to give me any medicine they think will cure the disease.”

Zunnuru Musa who came to a pharmacy to buy drugs to treat malaria said, “I don’t have the means to treat the disease. I know that what I will buy is not enough. But at least it will reduce it. I gave them N700 to give me Fansidar and paracetamol.”

For Adamu Muhammad Umar, treating malaria with traditional medicine is his last hope. He said, “I know it will cost me a lot to buy tablets and pay for the injections. That is why I opt for the use of herbs. We were told that the leaves of trees here are used to produce malaria medicines. I have tried it and it ‘treated’ me. Some people even say it treats them more than injections and tablets. I paid just N100 for the herbs. Some are even getting it free as the trees are available here.”

A pharmacist, Salisu Zayya, said the majority of people visiting his pharmacy were for malaria cases.

He said, “Some of them come for their children. People often beg us as they cannot afford the medicines. They are really passing through a lot of difficulties treating malaria.”

In Edo State, Godspower Esosa said he was diagnosed with malaria last week and spent over N30,000 on treatment.

Esosa said, “The malaria test was N3,000. I was given three drips and several injections. At the end of the treatment my bill was N30,000. The drugs are expensive. I took injections for five days before taking tablets.”

Another Edo resident, Julius Idahosa, said, “I spent N3,500 for tests, and the malaria drugs cost over N12,000, because I took both injections and tablets. At the end of the treatment at the hospital I spent N60,000.”

Speaking on the development, Pharmacist Daniel Edegbe, owner of Gina Pharmacy, said malaria was common during the rainy season.

He explained that, “Malaria seems to be more resistant during the cold season than the dry season, hence there is the issue of treating and retreating to get better.

“During the rainy season, we have lots of things such as viral infections and colds that also come into play. Some people have to treat malaria twice or thrice depending on how their system is, and in this season, symptoms of cold and flu may also be mistaken for malaria.”

According to him, malaria drugs are on the high side because, “We don’t manufacture drugs, and even those anti-malaria therapy we are producing are not in large quantities while the raw materials are imported, and you know what is happening to the dollar now.

“Everything has gone up and malaria treatment is rampant. This has also increased the cost of malaria drugs. For instance, the Coartem brand of malaria drugs that was between N1,700 and N2,000 as of June,  is now between N2,700 and N2,800 in Benin. Amatem Forte Soft Gel that was between N1, 000 and N1,200 is now N1,700. Other drugs have also increased.”

In Kwara, a resident of Ilorin, Ishola Audu, said he was frustrated treating malaria. According to him, “I went to the chemist to get a malaria drug for my daughter and had to postpone her treatment because of the cost. I went to the chemist with N2,000 but was  given a bill of N5,000. I had to take her home and use paracetamol to reduce her temperature until the following morning to take her to the hospital.”

On his part, Pharmacist Adebayo Oni said sometimes customers who came for malaria drugs left disappointed because of the high cost of the drugs.

Oni said, “A situation where Coartem, one of the most common malaria drugs, which was sold for less than N2,000 is now around N5,000 is taking a toll on malaria treatment.

“Also, the economic situation in the country has not helped. I had an experience whereby a patient came with N100 to buy a malaria drug. That is just for paracetamol in most cases, and yet, he was sick. But you could see the genuineness of his predicament.”

On her part, a civil servant, Mrs Oladunni Abdullahi, told Daily Trust that she took her child who was down with malaria to the hospital and spent N5,000 on consultation, tests and medicines.

Mrs Abdullahi said, “We discovered that expensive malaria drugs are off hospitals’ shelves and the process of getting them outside extends the treatment time; which is another area of concern.”

In Benue, malaria remains one of the commonest ailments dealing with households. Some residents who spoke with our correspondent in Makurdi said the ailment came with financial implications that forced them to cough out at least N2,000 in accessing the cheapest treatment.

Abahi Onum, who treated malaria a week ago, said she decided to visit a government health centre after she came down with a fever and headache for more than three days after taking over-the-counter pain relievers which cost her a little over N500.

Onum said, “The caregivers at the facility asked me to do malaria tests. I was told that the malaria tests were free but that I would pay N300 for hand gloves. The result of the tests showed malaria positive. I was then told that their free anti-malaria drugs had been exhausted so I would have to go to a medicine outlet to buy. I proceeded to a pharmacy where I bought the drugs at the cost of N1,800.”

Similarly, Tersoo Charles, who was seen at a pharmacy with malaria drugs he purchased at the cost of N2,300, expressed worry over how expensive it took to treat malaria for a low-income earner like him.

He said, “I spend a minimum of N3,000 each time I need to treat malaria. And this is the least, if it were the private hospital I used to go to, I would have bought this same drug or gotten treated for at least between N5,000 and N8,000.”

The immediate past Publicity Secretary of the Association of Community Pharmacists of Nigeria (ACPN) in the FCT, Pharmacist Kenneth Ujah, said the high cost of malaria treatment was a fall out of the current economic situation in the country.

He said, “The scarcity of forex makes it difficult to import anti-malaria drugs. There is also the internal cost of running the companies. The cost of staffing, overhead costs and maintaining the companies are also part of the costs transferred to medications.”

Pharmacist Ujah, therefore, called on the government to create an enabling environment for the local manufacture of drugs, saying it would go a long way in driving down the cost of antimalarial drugs.

He added that, “Access to credit will encourage local production of quality anti-malaria medicines, noting that, “High costs of drugs also fuel availability of fake drugs.”

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