Nigeria: Effective malaria treatment still out of reach

The neglect of the Nigerian health care system has left the population vulnerable to medical crises and epidemics. MSF focuses its work on treating malaria, the main killer of children under five in Nigeria, and expects to launch an HIV/AIDS program in the near future. MSF's malaria program continues in Bayelsa state in the Niger Delta. Accurate diagnosis and effective treatment are the goals of this project, but successful treatment is increasingly hampered by high levels of parasite resistance to the most commonly used medicines, chloroquine and sulfadoxine-pyrimethamine (SP). In Southern Ijaw, in Bayelsa, MSF resistance studies involving these front-line malaria treatments have shown 40% resistance to chloroquine and 45% resistance to SP; an amodiaquine resistance study was ongoing in mid-2002. Other effective options exist, including treatment with combination therapy using artemisinin derivatives; however, as of July 2002, the Bayelsa state Ministry of Health had not yet granted MSF permission to introduce the therapy. MSF is campaigning for the introduction of the most appropriate treatments for malaria, the number-one killer of children on the continent (see page 10). Attempts to reach female sex workers in Lagos state with a new HIV/AIDS project were unsuccessful in late 2001, leading to a reevaluation of HIV-related needs. Plans are underway for a project focusing on HIV-positive patients who are also suffering from tuberculosis. MSF has been working in Nigeria since 1999. International staff: 16 National staff: 80