TWO European countries, Azerbaijan and Tajikistan, have added to 39 other countries declared malaria-free by the World Health Organization (WHO).

The certification follows a sustained, century-long effort to stamp out the disease by the two countries, the health agency said on Wednesday, March 29.

Azerbaijan has a population of about 10 million people, while there are nearly 10 million in Tajikistan.

The two countries beat Nigeria, which parades over a quarter (27 per cent) of global malaria cases and deaths to becoming free of the disease.

Report shows how Nigeria loses over 200,000 people, including women and children, and more than half a trillion naira to the disease yearly.

There are over 220 million people in Nigeria.

“The people and governments of Azerbaijan and Tajikistan have worked long and hard to eliminate malaria,” WHO Director-General, Dr Tedros Adhanom Ghebreyesus, said while declaring the two countries free of the scourge in a statement on Wednesday.

He added that the countries’ accomplishment further proved that eliminating malaria is possible with the right resources and political commitment. 

WHO noted that certification of malaria elimination is its official recognition of a country’s malaria-free status. 

The certification is granted when a country has shown – with rigorous, credible evidence – that the chain of indigenous malaria transmission by Anopheles mosquitoes has been interrupted nationwide for at least the past three consecutive years. 

A country must also demonstrate the capacity to prevent the re-establishment of transmission. 

According to the WHO, malaria control efforts in Azerbaijan and Tajikistan were strengthened through a range of investments and public health policies that enabled the governments, over time, to eliminate the disease and maintain malaria-free status.

The agency explained that for more than six decades, both governments guaranteed universal primary health care and vigorously supported targeted malaria interventions – including prevention measures such as spraying the inside walls of homes with insecticides, promoting early detection and treatment of all cases, and maintaining the skills and capacities of all health workers engaged in malaria elimination.

“Both Azerbaijan and Tajikistan utilize national electronic malaria surveillance systems that provide nearly real-time detection of cases and allow for rapid investigations to determine if an infection is local or imported. Additional interventions include biological methods of larvae control, such as mosquito-eating fish, and water management measures to reduce malaria vectors.”

With the certification for both countries, the WHO European Region is now two steps closer to becoming the first region in the world to be fully malaria-free, said Dr Hans Henri P. Kluge, WHO Regional Director for Europe.

Azerbaijan detected its last case of locally transmitted Plasmodium vivax (P.vivax) malaria in 2012 and Tajikistan in 2014. 

With Wednesday’s announcement, the WHO said 41 countries and one territory have been certified malaria-free by WHO, including 21 countries in the European Region.

A lesson for Nigeria

WHO argued that since the 1920s, a sizeable portion of Tajikistan’s economy and, to a lesser extent, Azerbaijan’s, has depended on agricultural production, particularly valuable cotton and rice exports.

The agricultural irrigation systems in both countries have historically also posed a malaria risk to workers. Both countries have established systems to protect agricultural workers by providing free access to malaria diagnosis and treatment in the public health care system.

Malaria control staff can immediately test, diagnose and treat infected workers with appropriate antimalarial drugs and monitor and assess environmental, entomological and epidemiological risk factors. 

Additional programme activities include:

• Regularly assessing the judicious use of insecticides for vector control.
• Implementing water management systems.
• Educating the public on malaria prevention.

The ICIR reports that Nigerian farmers who are most susceptible to malaria, and most other citizens, bear the costs of their treatment, while the distribution of long-lasting insecticidal nets, donated mainly by donors, has been marred by sleaze. 

A 2016 report showed how the Global Fund accused the Nigerian government of misappropriating the malaria funds it gave the country and consequently suspended funding for the nation’s malaria programme.

Another 2021 report detailed how gross corruption impeded the country’s success in containing the scourge.

In February, The ICIR reported how Nigeria got additional one billion dollars for tackling malaria, HIV/AIDS and tuberculosis from the Global Fund, despite misappropriating its previous grants from the donor.

Marcus FATUNMOLE

Marcus bears the light, and he beams it everywhere. He's a good governance and decent society advocate. He's The ICIR Reporter of the Year 2022 and has been the organisation's News Editor since September 2023. Contact him via email @ mfatunmole@icirnigeria.org