APPMG World Malaria Day Event, 2013
Invest in The Future: Defeat Malaria
Kolawole Maxwell, Malaria Consortium Nigeria Country
Director
Presentation outline
• Our context - Nigeria
• Malaria Consortium
• Our approach
• Key achievements
• Results
• Conclusion
Our context - Nigeria
• Over 160 million people
• Malaria is endemic (up to 97% of total population at risk of
the disease)
• 42% of children under five were reported to have malaria –
MIS 2010
• 30% of children under five mortality attributable to malaria
• A quarter of global deaths due to malaria happens in
Nigeria
Malaria Consortium
• Works across Africa and Asia; in Africa we are
operational in Nigeria, Ethiopia, South Sudan, Uganda,
Mozambique, Zambia and Ghana
• Works in 3 out of the 5 countries that record the highest
burden of malaria
• Implements 37 projects in Africa and Asia
• Projects in Africa cover all aspects of malaria, including
prevention, diagnostics, treatment, demand creation,
systems strengthening, governance.
Malaria Consortium
Lead managing partner in Nigeria of the DFID UKaid funded
Support to National Malaria Control Programme (SuNMaP)
Other programmes in Nigeria:
• Malaria Action Programmes for States (MAPS) - USAID
/ Presidential Malaria Initiative (PMI)
• NetWorks – Global mechanism to research effectiveness
of treated mosquito nets and support coverage scale up
– USAID / PMI
• Seasonal Malaria Chemoprevention – Bill & Melinda
Gates Foundation
• Increasing access to diagnosis in private sector UNITAID
Malaria Consortium in Nigeria
17 states and
over 80 million
people
SuNMaP (DFID)
Katsina
Kano
MAPS (PMI) Niger
Ogun
Zamfara
Lagos
Nasarawa
Cross River Anambra
Kaduna
Oyo
Jigawa
NetWorks (PMI) Benue
Yobe
Ebonyi
Zamfara
Enugu
Kogi
Nasarawa
Cross River
Our approach
• To support the government and people of
Nigeria in improving access to both prevention
and treatment of malaria, while strengthening the
systems to deliver malaria services
• To lead the process of rallying donors to join
resources and use standard tools to roll-out
malaria interventions to increase coverage
• To work with the private and commercial sector
to increase access to malaria control services
and commodities
Key achievements
Delivery
Long lasting
insecticidal nets
(LLINs) – Mass
distribution campaigns
LLIN – Routine
distribution channels
Period
Results
4 years 2.54m –procured by
programme
22m in programme states
53m nationally
2 years 4.3 million
(antenatal care visits,
immunisation visits,
schools, community
distribution)
LLIN – Commercial sector 2 years
1 million
distribution
Sulphadoxine /
Pyrimethamine
2 years
4.6 million doses
Key achievements
Delivery
Artemisinin-based
combination therapy
(ACTs)
Rapid diagnostic tests
(RDTs)
Malaria treatment Training
Malaria in pregnancy Training
Malaria diagnosis Training
Period
Results
1 year
2.4 million doses
1 year
860,000 kits
2 years
24,800 health workers
8,500 health facilities
1 year
1,700 health workers
1 year
2,600 health workers
Key achievements
• Health Systems:
• Comprehensive malaria control capacity building
package developed and, with support of Malaria
Consortium, has been adopted as national tools
• Lead among the Roll Back Malaria partners in
country on the donor harmonisation agenda
• Recently led the National Malaria Programme
Review, which will inform the development of the
next National Malaria Strategic Plan: 2014 - 2020
• Monitoring, evaluation and surveillance
• Monitoring areas
Results – LLIN coverage
•
•
•
Dramatic increases from pre-campaign levels
Three states reach Abuja Target of 60% with any ITN
Coverage with at least 2 LLINs 34% to 57%
100
90
% o f H H o w n in g a n y IT N b e fo re c a m p a ig n (c h e c k e re d )
a n d a t le a s t o n e (s o lid ) o r a t le a s t tw o (h a tc h e d ) L L IN a t tim e o f s u rv e y
80
6 9 .3
P ro p o rtio n in %
70
6 4 .3
6 3 .8
60
5 7 .3
5 4 .7
5 2 .5
5 1 .5
50
4 2 .4
4 1 .1
40
3 4 .1
30
20
1 1 .5
10
3 .7
2 .0
1 .3
0 .5
0
S o k o to
Kano
N ig e r
O gun
A n a m b ra
Results - equity of LLIN distribution
Highly equitable in all states with a significant “pro-poor” result in Anambra
Concentration curve
100
80
a m o n g h h th a t g o t c a m p a ig n n e ts
C u m u la tiv e p e rc e n ta g e o f w e a lth q u in tile s
90
Concentration index
70
0.1000
60
0.0800
0.0600
50
0.0400
S o k o to
40
0.0200
K ano
0.0000
N ig e r
30
Ogun
-0.0200
A n a m b ra
-0.0400
Sokoto
e q u ity lin e
20
-0.0600
-0.0800
10
-0.1000
0
0
10
20
30
40
50
60
70
80
C u m u la tive p e rc e n ta g e o f w e a lth q u in tile s in s a m p le
90
100
Kano
Niger
Ogun
Anambra
Results – Strategic Plan Indicator
Performance
INTERVENTION COVERAGE
NDHS
2003
NDHS
2008
MIS 2010
NMSP target
(2013)
% of households with at least
one ITN
2.2%
16.3%
41.5%
80%
% of Children < 5 who slept
under ITN night before the
survey
1.2%
5.5%
30.5%
80%
% of pregnant women who
received IPT during ANC visits
1%
8%
13.2%
80%
% of Children< 5 with fever
treated with antimalarials the
same or following day
24.6%
15.2%
26%
80%
% that took recommended first
line drug
97%
2.4%
3.2%
80%
Pƒ PR
Binned Predicted Mean PfPR2-10
2-10
< 5%
2000
2005
≥ 5% - < 10%
≥ 10% - < 50%
2010
> 50%
Conclusion
• Some signs of real progress are beginning to show
• We need evidence more than ever before
• We need to maintain funding to keep the progress
made and achieve high coverage
• Remember, the story is all about life and death
Invest in The Future: Defeat Malaria
…especially in Nigeria
www.malariaconsortium.org
Thank you