Lessons from Nigeria’s Adaptation of Global Health Initiatives during the COVID-19 Pandemic

Ihekweazu, Chikwe

doi:10.3201/eid2813.221175

Cited by 7 publications

(5 citation statements)

References 11 publications

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“…Historical evidence has demonstrated that nearly all resurgence events can be attributed, at least in part, to the weakening of malaria control programs for a variety of reasons, of which resource constraints are the most common [ 33 ]. Several reports have shown that countries with higher investments in health security were better prepared to respond to the COVID-19 pandemic [ 34 ]. The gains experienced in the past decade can be attributed, in part, to the increased financing available to scale up effective interventions.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Malaria Control in Africa: A Preliminary Analysis

et al. 2023

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Malaria remains a significant public health concern in Africa, and the emerging coronavirus disease 2019 (COVID-19) pandemic may have negatively impacted malaria control. Here, we conducted a descriptive epidemiological analysis of malaria globally, and preliminarily explored the impact of COVID-19 on the malaria elimination program in regions of Africa (AFR). The present analysis found that there was a vast heterogeneity of incidence of deaths caused by malaria globally in different continents, and the highest malaria burden was observed in AFR. In 2020, there was an obviously increasing trend in the malaria epidemic in AFR, while the other four continents exhibited stable and declining patterns. Historically, malaria has been largely concentrated in high-malaria-burden regions, such as West Africa, and there has been an obvious increasing trend in Nigeria. These data suggest that dynamic changes in the malaria epidemic situation worldwide have primarily originated from AFR, and West Africa has played an important role in the global malaria increase in recent years. Under the coercion of COVID-19, multiple factors have co-driven the increase in malaria in AFR, including insufficient financial investments, a high native malaria burden, weak surveillance systems, limited medical resources, and low socioeconomic development levels. In addition, the shift of medical resources (e.g., health workers and personal protective equipment (PPE), the manufacturing of diagnostic reagents, and drugs) from malaria control to emergency COVID-19 response in the pandemic’s early stage caused disruptions, reductions, and delays in pillar malaria control measures, leading to a significant negative impact on malaria control. In particular, a funding shortfall at both the international and domestic levels led to a “significant threat,” resulting in vast gaps in access to proven malaria control tools. Although there has been a declining trend in malaria control over time due to COVID-19, the effect still cannot be ignored. Hence, we recommend the implementation of medical and technical resource assistance as a priority strategy to support Africa (West Africa) in order to curb further transmission.

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Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Malaria Control in Africa: A Preliminary Analysis

et al. 2023

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“…4 The experiences during the COVID-19 pandemic in Nigeria demonstrated that the resources of various donors should be grouped and unified to reduce fragmentation and increase collective responses. 24 Malaria studies had greatly aided by global funding. However, the funding gap between invested funds and the resources needed has recently increased dramatically.…”

Section: Discussionmentioning

confidence: 99%

Trends of the Global, Regional and National Incidence, Mortality, and Disability-Adjusted Life Years of Malaria, 1990–2019: An Analysis of the Global Burden of Disease Study 2019

Shi¹,

Li²,

Liang³

et al. 2023

RMHP

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Background: Malaria remains a substantial concern in the realm of public health on a worldwide level. Using information from the global burden of disease (GBD) 2019 for 204 countries and territories between 1990 and 2019, we assessed the burden of malaria. Methods: Data on malaria were derived from the GBD 2019 study between 1990 and 2019. We evaluated the number of incidence, deaths, disability-adjusted life years (DALYs), age-standardized incidence rates (ASIR), age-standardized mortality rates (ASMR), and age-standardized DALY rates (ASDR), examining them across variables such as age, year, gender, country, region, and sociodemographic index (SDI). Results: The burden of malaria decreased globally between 1990 and 2019. There were 2313.57×10 5 incident cases and 6.43×10 5 deaths in 2019, contributing to 464.38×10 5 DALYs. Largest incident cases were observed in Western Sub-Saharan Africa [1151.72 (95% UI: 890.01-1527.17)] ×10 5 in 2019. The only region where deaths increased between 1990 and 2019 was Western Sub-Saharan Africa. ASRs of malaria are distributed heterogeneously in different regions. The highest ASIR was observed in Central Sub-Saharan Africa [21,557.65 (95% UI: 16,491.48)] in 2019. From 1990 to 2019, the ASMR of malaria declined. Compared to other age cohorts, the ASIR, ASMR, and ASDR for children aged between 1 to 4 years were found to be higher. Worst-affected regions by malaria infection were the low-middle SDI region and low SDI region. Conclusion: Malaria threatens global public health, especially in Central Sub-Saharan Africa and Western Sub-Saharan Africa. Children 1-4 years old continue to bear the most significant burden of malaria. The study's results will guide efforts to reduce malaria's impact on the global population.

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“…12 First, it could focus national resources towards funding a core package of the most essential services, which could ensure that funding for the provision of key services is not affected by aid volatility. Second, fragmentation of health financing 29,30 (and resulting duplication) could be reduced by a clearer separation of funding responsibilities. Further, the application of separate cost-effectiveness thresholds can avoid displacement of domestic resources by aid.…”

Section: Why Does This Matter?mentioning

confidence: 99%

Why cost-effectiveness thresholds for global health donors should differ from thresholds for Ministries of Health (and why it matters)

Drake,

Chi,

Morton

et al. 2024

F1000Res

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Healthcare cost-effectiveness analysis is increasingly used to inform priority-setting in low- and middle-income countries and by global health donors. As part of such analyses, cost-effectiveness thresholds are commonly used to determine what is, or is not, cost-effective. Recent years have seen a shift in best practice from a rule-of-thumb 1x or 3x per capita GDP threshold towards using thresholds that, in theory, reflect the opportunity cost of new investments within a given country. In this paper, we observe that international donors face both different resource constraints and opportunity costs compared to national decision-makers. Hence, their perspective on cost-effectiveness thresholds must be different. We discuss the potential implications of distinguishing between national and donor thresholds and outline broad options for how to approach setting a donor-perspective threshold. Further work is needed to clarify healthcare cost-effectiveness threshold theory in the context of international aid and to develop practical policy frameworks for implementation.

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Lessons from Nigeria’s Adaptation of Global Health Initiatives during the COVID-19 Pandemic

Cited by 7 publications

References 11 publications

Impact of the COVID-19 Pandemic on Malaria Control in Africa: A Preliminary Analysis

Impact of the COVID-19 Pandemic on Malaria Control in Africa: A Preliminary Analysis

Trends of the Global, Regional and National Incidence, Mortality, and Disability-Adjusted Life Years of Malaria, 1990–2019: An Analysis of the Global Burden of Disease Study 2019

Why cost-effectiveness thresholds for global health donors should differ from thresholds for Ministries of Health (and why it matters)

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