Analysis: Cape Verde shows Nigeria can be malaria-free

Cape Verde has achieved a remarkable milestone by becoming the first sub-Saharan African nation to be declared malaria-free in over 50 years.

The World Health Organization (WHO) granted the status to Cape Verde, acknowledging its three-year absence of local transmission. Malaria was once detected on all of Cape Verde’s nine inhabited islands, but in recent years could only be found on one, Sáo Tiago – where the final efforts were concentrated, according to the BBC.

This accomplishment serves as a powerful lesson for Nigeria, a nation grappling with the highest malaria burden globally and facing challenges in making significant progress against the disease.

In 2022, malaria claimed the lives of 580,000 people in Africa, constituting a staggering 95% of global fatalities. Nigeria, in particular, has struggled with the malaria scourge, highlighting the urgent need for effective strategies.

Despite advancements in malaria prevention, including vaccine usage and mosquito control, Cape Verde’s success emphasizes the importance of strengthening health systems, improving diagnosis and treatment access, and early case detection.

The last country in sub-Saharan Africa to be declared malaria-free was the island nation of Mauritius in 1973. Algeria, in North Africa, achieved this status in 2019.

Years of work

Cape Verde, an island nation off West Africa, achieved malaria-free status after years of fortifying its health systems, enhancing diagnostic and treatment accessibility.

Early case detection and mosquito control efforts by surveillance officers contributed to this success. Cape Verde’s comprehensive malaria control plan includes providing free care and diagnostics for international travellers and migrants, aiming to curb cases imported from mainland Africa.

Health Minister Filomena Gonçalves attributes this achievement to the tireless efforts of health professionals, collaborators, communities, and international partners, highlighting the impact of collective commitment to public health.

The WHO sees Cape Verde’s achievement as a beacon of hope, demonstrating that containment and elimination policies can work – especially in sub-Saharan Africa.

Cape Verde’s success “gives us hope that with existing tools, as well as new ones including vaccines, we can dare to dream of a malaria-free world”, WHO Director General Tedros Adhanom Ghebreyesus said.

Lesson for Nigeria

With existing tools and emerging solutions, including vaccines, the dream of a malaria-free world becomes more attainable. Cape Verde’s success serves as a call to action for nations like Nigeria, urging them to learn from effective strategies and prioritize collective commitment to public health.

Cape Verde’s declaration as malaria-free nation casts a stark light on Nigeria’s struggles to control the deadly disease and offers invaluable lessons for Nigeria. Its journey to zero local transmission in three years hinged on several key factors absent in Nigeria’s approach:

• Strengthened healthcare systems: Cape Verde prioritized expanding access to diagnosis and treatment across all levels, addressing vulnerabilities in primary care that remain a critical gap in Nigeria.
• Enhanced surveillance: Early case detection and targeted mosquito control interventions in Cape Verde stand in contrast to Nigeria’s often reactive approach and lagging surveillance infrastructure.
• Financial commitment: Free healthcare for all, including international travelers and migrants, curbed the inflow of cases in Cape Verde. Nigeria’s fragmented healthcare system, with uneven access and financial barriers, hinders effective control.
• Island advantage: Cape Verde’s geographic isolation facilitated targeted interventions and control of mosquito movement, a challenge amplified by Nigeria’s vast land borders and mobile population. Dorothy Achu Fosah, from the WHO Africa office, said the fact that the country is an archipelago is also an important factor in its success. On an island, it is easier to map out the areas most affected by the disease and see how it is being transferred from one island to another, compared to a continuous land mass.

Nigeria’s malaria fight has been plagued by inadequate funding, weak infrastructure, logistical challenges, and inconsistency in interventions. While the country has implemented national control programs, their effectiveness falters due to insufficient resources, corruption, and inconsistent political will.

For Nigeria, the path forward demands a frank assessment of existing shortcomings, a renewed commitment to strengthening healthcare systems, and decisive action to close funding gaps and implement effective control measures. Cape Verde’s achievement is not just a distant success story; it’s a stark reminder that a malaria-free Nigeria is not just a possibility, but a necessary endeavour.