1.1     Background of the Study

Despite various declarations by African governments in the 1990s and complementary effort promised in the main content of the Roll back Malaria Declaration in Abuja in 2000, malaria remains a major health challenge. About 107 countries and territories involving about 3.2 billion people are still at risk of malaria attack as at 2004 (World Health Organisation [WHO], 2005). Present estimates suggest that around 350–500 million clinical disease episodes occur annually (Bawah and Binka, 2005). Around 60% of clinical cases and over 80% of the deaths due to malaria occur in Africa south of the Sahara (Alaba, 2005). The above has serious implication for economic growth and welfare. Malaria is responsible for an estimated average annual reduction of 1.3% in economic growth for those countries with the highest burden, Nigeria inclusive. The seemingly intractable trend of this ancient scourge has compounded the national and household poverty due to intensive loss of productive time to attack and death. A cause for worry at the moment is the growing resistance of the disease to cheap first line drugs and the need for the more expensive ACT combination therapy. Given that malaria is endemic throughout Nigeria, and that more than half the country’s population are living below poverty line. Malaria incidence may increase significantly in Nigeria because many may not be able to afford the newly introduced drugs due to poverty.