A warning by the World Health Organization that the COVID-19 pandemic could harm efforts to eradicate malaria appears to be coming true in Nigeria. Nigerian officials say people are refusing to get treatment for fear of catching the virus at a clinic.
Fatima Mohammed is in her home at a camp for displaced people in Abuja, tending to her two sons who are currently down with malaria.
She says she's can't afford huge hospital bills and is afraid that taking them to the hospital could potentially expose them to COVID-19 or result in a misdiagnosis.
"I don't have money to take them to the hospital — and, again, at the hospital, they'll easily call it coronavirus,” she said. “I don't have money for that.”
Malaria and COVID-19 present similar symptoms, but fear and stigma attached to the pandemic are reasons many like Fatima are seeking alternatives to hospital treatment.
Health experts say in-hospital visits for malaria declined significantly in Nigeria since reporting the coronavirus in February 2020.
The World Health Organization's World malaria report 2020 suggested the pandemic is threatening years of progress made against malaria and warned that death rates from the mosquito-borne disease could double.
WHO malaria consultant Lynda Ozor says disruption of preventive measures is to blame.
"The use of long-lasting insecticidal nets, seasonal malaria chemo prevention and prevention of malaria in pregnancy were interrupted,” she said. “So, assuming all these preventive interventions were interrupted, then it was expected, and the model shows that there will be very negative effects."
Nigeria accounts for about a quarter of malaria cases worldwide, and about 23% of deaths globally.
Even before COVID-19 hit, many Nigerians took malaria less seriously, says Adeboyega Adeyogo, who heads pharmaceutical operations at WellaHealth, a Nigerian health company focusing on eliminating malaria.
"Due to advances in health and technology, many people resolve malaria within days,” Adeyogo said. “So, you see that many Nigerians now take it with a lot of levity because of the ease of treatment. But if they decide to avoid it, then it becomes a major issue and you now start seeing the serious complications associated with malaria."
Nigeria's National Malaria Elimination Program planned to provide 31 million people with free mosquito nets, anti-malaria drugs and malaria testing last year. But disruptions caused by COVID-19 meant they reached only half of their goal.
That has increased concern that malaria, along with COVID-19, will remain a threat to Nigerians for years to come.