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30-Jan-2025

New malaria vaccine brings hope in Nigeria

In December 2024, the new malaria vaccine was used in Nigeria for the first time. Kebbi state, where MSF supports the Nigerian Ministry of Health in tackling increasingly high levels of malnutrition, is receiving over 500,000 doses of the vaccine. MSF teams have been assisting Kebbi state's Ministry of Health as they vaccinate children under three years old.

The search for a malaria vaccine began in the 1960s, but it wasn’t until 2021 that a vaccine was approved by the World Health Organization (WHO). As of April 2023, 1.5 million children have received at least one injection in Malawi, Ghana and Kenya. Following the initial pilot, Cameroon, Burkina Faso, Benin, Sierra Leone, Liberia, Côte d'Ivoire, South Sudan, and Mozambique also introduced the malaria vaccine into their immunisation plans - but not Nigeria.

Nigeria approved the second-ever malaria vaccine, the R21 vaccine, in April 2023 and it has now incorporated it into the country’s regular immunisation plan. Vaccination with R21 may be in the early stages, but it offers hope that the thousands of children in Nigeria who get malaria annually can be protected.

We’ve all heard of malaria, that it’s spread by mosquitoes, and we even probably know just how widespread it is across the globe. But here are four additional facts that you should know about the disease.

1. Nigeria carries the highest burden of malaria worldwide - 26 per cent

This is the highest burden of malaria worldwide according to the WHO Malaria Report 2024: almost one in four of all malaria cases occur in Nigeria. During the rainy season (June to November), when we generally see the most cases of malaria, our teams consistently have high levels of children reporting to our facilities with the disease. In October 2024, in Maiduguri alone, MSF teams supported the treatment of 24,620 confirmed cases of malaria. Not only are the rates very high, but year after year we are seeing an increase in the number of patients who seek medical assistance for malaria in MSF-supported facilities. Across the whole of Nigeria, in the clinics and hospitals where we work, MSF saw 27 per cent more confirmed cases of malaria between January – October 2024, compared to the same period in 2023.

2. In 2023, 39 per cent of all malaria deaths worldwide happened in Nigeria

As well as the high prevalence, malaria also has a high mortality rate and in the latest WHO malaria report, published in December 2024, more than one third of all these occurred in Nigeria in 2023. Overwhelmingly, these deaths occur in children under five years old. Malaria can cause seizures, anaemia, dehydration, and kidney failure, because of this our teams often see children in severe conditions.

3. Malaria can contribute to malnutrition and other health issues

According to the Lancet, malaria and malnutrition are related. Recurrent malaria can lead to malnutrition, while malnutrition also increases the risk of severe malaria. Malnutrition rates reached terrifying highs in Nigeria in 2024 and are projected to continue to worsen this year. One of the drivers of this malnutrition crisis is the susceptibility of children to the number of diseases that are recurrent in Nigeria, diseases that significantly increase the likelihood of malnutrition – like malaria.

Malaria is also dangerous during pregnancy and can have substantial risks for both the pregnant woman and their baby. In Nigeria, maternal mortality is very high - for many reasons. The latest UN estimates (from 2020) show a maternal mortality rate of 1,047 deaths per 100,000 live births. This puts Nigeria in the ‘extremely high’ maternal mortality category, with the third highest level in the world. In Maiduguri, MSF works in collaboration with the Borno state Ministry of Health to support a referral hospital for complicated deliveries and new-born babies. Our midwives there have seen high numbers of mothers admitted with malaria, which has led to severe anaemia or pre-term labour.

4. We could see more malaria because of the climate crisis

The link between the changing climate and malaria is still a new aspect of the disease, the most recent WHO global malaria report states that “environmental and climatic factors play a significant role in hindering progress towards a malaria free world”. We are currently seeing both rapid increases in global temperatures and an increase in natural disasters, like flooding. Both of these offer prime conditions for malaria. The severe flooding in Pakistan in 2022 led to a major malaria epidemic and a fivefold increase in malaria cases that year. Several parts of Nigeria experienced severe flooding in August and September 2024. During our response activities, as teams supported communities who had lost their homes and were staying in temporary shelters, one of the most common things we treated was malaria.

Having a vaccine in Nigeria for the first time means hope for communities for whom malaria is a constant threat. In addition to this vaccine, effective prevention methods for malaria already exist. Both in Nigeria and globally, this disease is still affecting millions of people despite being so easily preventable.

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Last Updated: 30-Jan-2025