Lagos Is Rewriting Nigeria’s Malaria Story

 
Malaria remains one of Nigeria’s most persistent public health challenges. The World Malaria Report 2024 paints a worrying picture — in 2023 alone, Nigeria recorded over 68 million clinical cases and 184,000 deaths, the highest malaria burden globally.
 
Yet, amid these sobering statistics, there is an inspiring story emerging from Lagos State. Over the past decade, Lagos has steadily driven down malaria prevalence among children under five to below 5%, compared to a national average of 22%. This makes Lagos one of Nigeria’s few states now classified as a low transmission area — placing it firmly on the path toward malaria elimination.
 
This progress is not accidental. It reflects years of focused leadership, effective partnerships, and consistent investments in public health. Under the guidance of Governor Babajide Sanwo-Olu and the Commissioner for Health, Prof. Akin Abayomi, Lagos is deliberately positioning itself for malaria pre-elimination — a critical phase where malaria becomes rare and accurate diagnosis and treatment are essential to sustain gains.
 
Through the Lagos State Malaria Impact Project, the state Ministry of Health is working closely with the World Health Organization (WHO), the Pharmacy Council of Nigeria (PCN), the Society for Family Health (SFH), Maisha Meds, and the ANDI Centre of Excellence for Malaria Diagnosis at the College of Medicine, University of Lagos. Together, these partners are strengthening malaria surveillance, improving data quality, and promoting evidence-based case management.
 
However, even as malaria cases decline, a new challenge has emerged — overdiagnosis. In many health facilities, patients with fever are still being treated for malaria even when test results prove otherwise. This practice wastes valuable medicines, delays the correct diagnosis of other illnesses, and distorts official malaria data.
 
A recent study found that only 7 per cent of patients who presented with fever and were suspected to have malaria actually tested positive. Yet, many of those with negative results still received malaria treatment. Such practices can no longer be justified in a state on the verge of elimination.
 
To address this, Lagos State has introduced structured training, supervision, and provider-focused behaviour change communication. Doctors, nurses, pharmacists, and laboratory staff are being equipped to trust diagnostic results and manage cases appropriately. The Society for Family Health (SFH) and the ANDI Centre of Excellence are providing technical support to ensure that best practices are sustained across both public and private health facilities.
 
For malaria case management to be effective, every suspected case must first be confirmed using either microscopy or Rapid Diagnostic Tests (RDTs) — quick, reliable, and affordable tools that have revolutionized malaria testing worldwide. Treating patients without testing not only undermines these tools but also risks masking other serious conditions such as typhoid, dengue, or viral infections.
 
The public has an equally vital role to play. Lagosians must recognize that malaria is not as common as it once was. A fever does not automatically mean malaria. Every resident should request a test before treatment. By doing so, patients help themselves and contribute to a culture of accurate diagnosis and responsible healthcare.
 
When malaria tests return negative, health workers are being trained to explain results clearly and guide patients toward identifying the true cause of illness. This approach improves trust, ensures appropriate treatment, and prevents unnecessary out-of-pocket expenses.
 
The Lagos example proves that malaria elimination is achievable in Nigeria. The state’s journey shows what is possible when leadership, science, and community action align. The collaboration between government, academic institutions, and health development partners is transforming the malaria landscape — not through luck, but through deliberate policy and accountability.
 
Still, sustaining this progress requires vigilance. As malaria cases decline, complacency must not set in. Continued investment in surveillance, data quality, and community engagement will be crucial. Lagos must also continue to share lessons with other states so that Nigeria’s fight against malaria becomes a shared success story.
 
Malaria is both preventable and treatable. The difference lies in our collective discipline — from government to health workers to citizens. Lagos has shown that when data drives action and leadership stays committed, transformation is possible.

If Lagos maintains this course, it will not only achieve malaria pre-elimination but also lead Nigeria — and indeed Africa — into a future where malaria deaths are history.

By Prof. Wellington Oyibo and Dr. Jennifer Anyanti