Four in 10 Nigerian adults live with hypertension

At least 40 per cent of Nigerian adults live with hypertension, highlighting the growing burden of non-communicable diseases in the country.

This is according to the 2025 State of Health of the Nation Report released by the Federal Ministry of Health and Social Welfare on Sunday.

The report, produced in line with the National Health Act 2014, highlights the persistent public health challenge posed by high blood pressure while noting some progress in awareness, screening and prevention efforts.

The report shows that while the prevalence of hypertension remains high, awareness of high blood pressure and other cardiovascular diseases improved in 2025 compared with 2024.

The report attributed the improvement partly to intensified public health campaigns led by the Federal Ministry of Health and Social Welfare and professional health bodies.

These campaigns focused on educating Nigerians about the risks associated with high blood pressure and encouraging routine health checks.

Hypertension burden in Nigeria

Hypertension, commonly called high blood pressure, is one of the world’s leading causes of heart disease, stroke, and kidney failure. It is dubbed a “silent killer” because it often presents no symptoms until serious complications set in.

It remains one of the most common non-communicable diseases in Nigeria and a leading risk factor for cardiovascular complications such as stroke, heart disease and kidney failure.

The World Health Organisation (WHO) estimates that about 1.28 billion adults, aged 30-79 live with hypertension globally, with only one in five having it under control either through medication or addressing modifiable health risks.

The global health body also estimates that two-thirds of hypertensive adults live in low- and middle-income countries, where preventive screening and treatment remain limited.

While national data shows that about one in three Nigerian adults lives with high blood pressure, detailed breakdown for younger adults (20-35) remain limited.

However, doctors report increasing cases of hypertension in younger adults, signalling a shift in the pattern.

The Nigeria Demographic and Health Survey, 2023-2024, also confirm that approximately 30 per cent to 40 per cent of adults are living with high blood pressure.

Non-communicable diseases, including hypertension, are responsible for a growing share of deaths in the country. Cardiovascular diseases alone account for a significant proportion of these fatalities.

Health researchers also note that stroke, one of the most severe complications of uncontrolled hypertension, is a leading cause of death and disability in Nigeria.

Studies reported that hypertension is responsible for up to 80 per cent of stroke cases in some Nigerian hospital studies, highlighting the strong link between high blood pressure and stroke mortality.

Despite the high burden, awareness and treatment levels remain relatively low.

Health experts attribute the rising prevalence of hypertension to several lifestyle and environmental factors, including high salt consumption, unhealthy diets, tobacco use, harmful alcohol intake, physical inactivity and increasing rates of obesity associated with urbanisation.

Expanded screening at primary healthcare level

The report noted that the inclusion of non-communicable disease screening in selected primary healthcare facilities and community outreach programmes contributed to modest gains in early detection of hypertension and diabetes.

According to the report, these efforts were particularly targeted at men aged between 15 and 59 years, a group health authorities say often underutilises preventive health services.

It added that the ministry’s Family Health Department began integrating men’s health more deliberately into national health programmes to address specific risks affecting the male population.

Mental health, substance abuse concerns

Beyond cardiovascular diseases, the report highlighted the growing burden of mental health and substance abuse disorders, particularly among men.

It estimated that about 14 million Nigerians live with a history of drug use, indicating a major public health challenge that requires coordinated interventions.

The report said prevention campaigns led by government agencies were intensified in 2025, with increased collaboration with the National Drug Law Enforcement Agency to strengthen public awareness and early intervention.

The report also recorded progress in efforts to integrate mental health services into primary healthcare.

According to the document, more than 3,000 primary healthcare workers across states were trained to identify common mental health conditions and strengthen referral systems.

The initiative aims to improve early detection and treatment of mental health disorders, especially in communities with limited access to specialised services.

Despite improvements in awareness and screening efforts, the report warned that significant gaps remain in early diagnosis, service utilisation and screening coverage, particularly for non-communicable diseases among men.

It emphasised the need for sustained investment in primary healthcare, health promotion and preventive services to reduce the growing burden of hypertension and other non-communicable diseases in Nigeria.

By Zainab Adewale, Premium Times

Uncertainty on the streets over Nigeria’s sachet alcohol ban

 

It’s a hot early afternoon on a tree-lined street in FESTAC town, a popular residential estate in Lagos. People take shelter in the shade beside a local restaurant. Cash vendors work the curb near a major hotel, and at a roadside kiosk, two Seaman’s Aromatic Schnapps sachets go for 200 Naira ($0.12, €0.11).

Philip, who buys sachets “almost every day,” says he prefers to “take it small, small” rather than buy a large bottle. “I plan it…I have a minimum and a maximum.” For him, sachets are about volume control, not price. “If there is no sachet, I can switch to a bigger one… It depends on my mood,” he told DW.

Nigeria’s food and drug regulator, NAFDAC, has long planned a phase-out of alcohol packaged in sachets and in plastic bottles of less than 200ml (0.05 gallons). It announced the ban would be enforced as planned from December last year, but disagreement between government agencies has created confusion and ambiguity about whether the ban is actually in force. The policy is intended to reduce alcohol abuse by minors and drivers.

Conflicting directives are causing confusion

At a Lagos press briefing in late January 2026, NAFDAC Director General Mojisola Christianah Adeyeye stated that enforcement had resumed, saying the agency had received a “matching order” from the Senate. But NAFDAC’s statement conflicts with a December 15, 2025, directive issued by the Office of the Secretary to the Government of the Federation (OSGF), ordering an immediate suspension of all enforcement actionspending consultations and a final directive. The statement also added that any action taken without OSGF clearance “should be disregarded.”

At the time of publication, there was no public OSGF notice lifting that suspension, leaving manufacturers, retailers and buyers guessing which order to obey.

Segun Ajayi-Kadir, director general of Nigeria’s Manufacturers Association (MAN), says that a “renewed ban” would hurt the economy, disrupt compliant producers, and encourage the sale of illicit, unregulated products. He added that operators are “confused as to which directive to follow.”


According to Ajayi-Kadir, alcohol packaged in sachets serves low-income adult consumers, and an outright ban would limit their choice.

On January 23, members of Nigeria’s labour unions, including the country’s Distillers and Blenders Association, held demonstrations outside NAFDAC’s Lagos office, holding placards that read: “Local manufacturers deserve protection, not frustration” and “5.5 million Nigerians cannot be pushed to the streets.” They argue that the ban risks jobs and investments.

Each sachet has its ‘own work’ in the body

For Amara Ruth, who has sold alcohol packaged in sachets at her roadside kiosk in FESTAC town since 2019, demand has not dipped. “People always buy,” she told DW. “At night sales are very high,” she said, adding that afternoons also bring in a steady flow of clients. Pricing is simple: 100 Naira for the smaller sachet, 200 Naira for the larger one.

Ruth believes buyers would still pay even if prices rose, because sachets are an inexpensive entry point. Her bestsellers range from gins used for libation to bitters and “manpower” brands popular for sexual enhancement. “Each sachet has its own work they do in the body,” she explained. Nigerian bitters drinks are herbal-based alcoholic and non-alcoholic drinks that are traditionally believed to provide the body with various health benefits.

“Nobody from NAFDAC has come here. Nobody at all,” she says, recalling only a temporary squeeze on one bitters brand last year. Ruth sometimes refuses sales to older men who get drunk quickly or to young buyers she does not trust, but admitted that children may buy for adults.

Philip’s experience is similar. He says availability has not tightened since talk of a ban began. “Nothing changed. It’s even multiplied. In Lagos, you can get it anywhere, within 20 meters, you have one.” On youth access, he adds: “If they want to get it, they will get it.”

A 2019 report published in African Health Sciences revealed 30% alcohol use among young Nigerians. The World Health Organization’s (WHO)Global Status Report on Alcohol and Health (2018) estimated heavy episodic drinking among Nigerians aged 15–19 at 22.5%, one of the highest rates in Africa.

Alcohol in sachets linked to road accidents, domestic violence

Civil society groups like CAPPA, a regional corporate accountability organisation, and NHED, a Nigerian Health Equity NGO, argue that sachets make high-strength alcohol easy for young people to obtain and conceal, linking widespread use to road crashes, school dropouts, domestic violence and early addiction.

Several African countries have restricted or banned sachet alcohol on health grounds. Kenya in 2004 andCote d’Ivoire in 2016, with additional actions in Malawi, Cameroon and Tanzania.

In Nigeria, the question is no longer about availability — sachets remain widely sold — but about who is responsible for enforcement, with NAFDAC announcing a crackdown while the OSGF’s suspension order remains in place.

Back in FESTAC town, very little appears to have shifted. At Amara’s kiosk, sachets continue to sell alongsidebeer and sodas, and demand remains steady through the day.

For consumers like Philip, the appeal is still convenience and control over how much they drink. But until the authorities resolve the conflicting directives and set out how enforcement should work at street level, drinkers can allay their confusion with an alcohol sachet of their choice.

By Okey Omeire, Inquirer

US withdrawal from WHO puts strain on Nigeria’s health budget

Nearly N400 billion, or 20 percent of Nigeria’s 2026 health budget, depends on the World Health Organization’s (WHO) technical support, funding, and disease-surveillance operations. This has raised concerns among experts who believe that the United States’ exit from the global organisation could affect the speed and efficiency of health policy interventions in Nigeria.

From disease surveillance to strategic partnerships in vaccine programmes, training, and medical research, WHO plays a critical role in Nigeria’s health sector. However, with the United States’ withdrawal from the organisation, experts warn that the country’s health budget could come under significant strain.

BusinessDay analysis shows that about 12 items in the 2026 health budget rely on WHO’s technical support, international donor funding, policy guidance, and adherence to global standards. These items together amount to nearly N400 billion, representing about one-fifth of the N2.1 trillion proposed health budget for 2026.

For instance, the allocation for the National Blood Bank Service Commission, item 142 of the 2026 proposed health budget,worth N42.8 billion, largely depends on WHO’s technical support. Blood screening, safety standards, and quality assurance are critical aspects of the commission’s operations and are guided by WHO protocols.

Similarly, the allocation for the National Centre for Disease Control,item 90 of the 2026 proposed health budget,worth N22.4 billion, is heavily dependent on WHO’s technical capacity. Disease surveillance, health-emergency coordination, and laboratory safety standards are largely WHO-led, and any weakening of this capacity could undermine Nigeria’s preparedness for disease outbreaks or pandemics.

Ebuta Agbor, vice president of the Medical Initiative for Africa, expressed similar concerns, warning that Nigeria may need to draw up a supplementary health budget to address potential funding and capacity gaps.

“The withdrawal of the United States from WHO could have significant and unprecedented impacts on sub-Saharan Africa, as over 50 percent of countries in the region allocate less than five percent of their annual budgets to the health sector,” he said.

On the contrary, some budget items, including allocations to Federal Medical Centres, teaching hospitals, and psychiatric and orthopaedic hospitals, are not directly dependent on WHO support, according to BusinessDay analysis.

Recall that U.S. President Donald Trump officially announced on January 22, 2026, that the United States had completed its withdrawal procedures from WHO. As the organisation’s largest donor,contributing between $500 million and $700 million annually, representing 15 to 18 percent of its funding,the U.S. exit has raised concerns among experts about increased health security risks for many African countries.

Winners, losers of US exit from WHO

While some experts have raised concerns about the impact of the United States’ withdrawal from WHO on Nigeria’s health system, others argue that it presents an opportunity for the country to become more self-reliant and exercise greater control by dealing directly with the U.S.

Oyebade Funmilade, a public health specialist and expert in HIV/AIDS prevention and control, highlighted an increased disease burden as one of the possible impacts of the U.S. withdrawal from WHO in Nigeria.

“The HIV disease burden could spike if the PEPFAR programme slows its operations due to a shortage of funds,” he noted.

“However, it also creates an opportunity for increased investment in pharmaceutical research and the promotion of local products, thereby reducing our dependence on external sources,” he added.

Neto Ikpeme, a health economist and analyst, pointed out that although the U.S. withdrawal from WHO might affect some ongoing health programmes, it also offers Nigeria an opportunity to deal directly with the United States. He referenced a $2.1 billion five-year health partnership deal between Nigeria and the U.S. signed in December 2025.

“Although the U.S. withdrawal from WHO could slow the progress of some ongoing health programmes, it also presents an opportunity for direct partnerships with foreign partners, giving the country more control, as seen in the recent $2.1 billion deal signed by both countries,” he added.

In addition, African countries with relatively higher health budget allocations, such as Rwanda (18.8 percent), Botswana (17.8 percent), and Niger (17.8 percent), are better positioned to experience minimal disruption from the United States’ exit, according to WHO. In contrast, countries with significantly lower health spending, including Nigeria (4.2 percent), South Sudan (2.1 percent), and Cameroon (2.8 percent), are likely to face greater adverse impacts.

Increased budget, reduced percentage allocation

Nigeria’s health budget increased by 157.4 percent, from N816 billion in 2022 to N2.1 trillion in 2026, BusinessDay analysis shows.

However, the percentage share of the health budget allocation remained relatively stable over the five-year period but declined by 1.3 percentage, from 5.5 percent in 2025 to 4.2 percent in 2026.

Stakeholders in the health sector have raised concerns, noting that the allocation does not meet the Maputo Declaration target of 15 percent annually.

Taiwo Obindo, President of the Association of Psychiatrists in Nigeria (APIN), highlighted the impact of low funding in the health sector.

“Nigeria’s health budget falls short of the Maputo Declaration target of 15 percent, further putting the country’s health system at risk of poor emergency response and threats to lives,” he noted.

By Faith Donatus, Business Day

Video - Nigeria signs major health cooperation deal with the US

The $2.1 billion in funding will support Nigeria's fight against HIV, tuberculosis, malaria, and polio, while boosting maternal and child healthcare.

CGTN Africa

More young people suffer from diabetes in Nigeria

Nigerian health experts warn rapid urbanization, sedentary lifestyles, fried foods, and sugary diets are driving a diabetessurge. Particularly sharp is the rise in Type 1 cases, while low awareness and limited screening means many young Nigerians remain undiagnosed.

"We are seeing diabetes in younger people now," said Mary Nkem Babalola, a public-health worker with the Funmilayo Florence Babalola Foundation (FFB), which combats the illness in underserved Nigerian communities.

"We need early screening, public education, and access to affordable test kits and insulin."

Watrahyel Mshelia, 21, from Abuja told DW she never understood the long-term risks.

"So, at 16, when I was diagnosed, I didn't really understand what was going on," she said.

"The doctors and nurses explained, but they didn't explain so much. They just told me to take my medications and I should not get injured."

When Watrahyel left home for university, she stopped taking her medication because she felt fine. A car accident four years later changed that.

"I broke my leg, and it has not healed for a year because of diabetes. I realized it is a very serious condition," she said.

'Epidemic levels'

Nigeria's health authorities warn the surge is fast becoming one of the country's most urgent public-health threats.

Nigeria now has 11.4 million people living with diabetes, according to the Nigeria Diabetes Association, one of the highest figures in Sub-Saharan Africa.

That figure of diagnosed cases alone exceeds the combined population of Namibia, Botswana and Lesotho, though it remains a fraction of Nigeria's around 220 million citizens.

The association urges the government to declare a state of emergency on diabetes care.

"It's now more than a crisis, it's an epidemic, it is catastrophic," Ejiofor Ugwu of the Nigeria Diabetes Association told DW.

"11.4 million people represents only patients who have been diagnosed and that is less than half of the people who are living with diabetes in Nigeria," he said, adding: "Diabetes is killing about 30,000 to 40,000 Nigerians every year. That is not a joke."

Global bodies have raised similar alarms. The World Health Organization (WHO) projects diabetes will become the seventh leading cause of death by 2030, while the International Diabetes Federation (IDF) estimates over 24 million Africans currently live with the condition.

Diabetes has flown under the radar while infectious diseases dominate Africa's health agenda. But experts warn of deep impacts on households, health systems, and economies.

What would an emergency declaration achieve?

The diabetes association says emergency status would compel the federal government to develop a national response plan and introduce targeted policies.

"We are advocating for the federal government to subsidize essential diabetes medications," Ugwu said.

"A tax waiver on imported diabetes drugs would reduce landing costs and make them more affordable," he adds.

Currently, Nigeria's National Health Insurance does not cover most diabetes drugs or basic consumables such as glucose meters and test strips, leaving many patients unable to manage the disease.

Awareness and affordability

Cost remains one of the biggest barriers to diagnosis and treatment.

"Access to screenings, affordability of drugs, these make people ignore diabetes until it becomes a crisis," DW's Nigeria correspondent, Olisa Chukwuma, says.

A pack of glucose-testing strips costs 15,000–17,000 naira (around €10). Even a single test now costs 1,000 naira (€0.60), up from 100 naira a few years ago.

The IDF recommends annual blood-glucose screening for adults over 40, and from 18 in families with a history of diabetes or obesity. But this remains out of reach for many Nigerians.

Why are cases rising?

Experts link the surge to rapid urbanization and lifestyle shifts, including heavy consumption of processed foods and falling levels of physical activity.

"We have embraced westernized diets. Most of our meals are unhealthy. Physical inactivity is a major risk factor," Ugwu said.

Left unmanaged, diabetes can damage the heart, eyes, kidneys and nerves. The WHO says diabetes is affecting people at all phases of life, from childhood to old age.

By Privilege Musvanhiri, DW

Nigeria, WHO and Partners Reaffirm Commitment to End All Forms of Polio by 2030

Abuja, Nigeria, in collaboration with WHO and other partners, is intensifying efforts to eradicate all forms of polio by 2030 through government leadership, community engagement, and targeted vaccination campaigns.

Renewed Commitment on World Polio Day
Every year on 24 October, the global community reaffirms its commitment to eradicating poliomyelitis—a disease that can cause paralysis and, in some cases, death.

Although Nigeria successfully eradicated wild poliovirus in 2020, the experiences of survivors like Hassana Mohammed Bunur from Borno State serve as a reminder of the remaining challenge: eliminating circulating variant poliovirus type 2 (cVPV2), which still exists in parts of the country.

For Hassana Mohammed Bunur and Bukar Modu—both polio survivors—the fight to end polio is deeply personal. Hassana, who contracted the disease as a toddler, now uses a wheelchair and champions vaccination in her community. Bukar, 45, reflects,

“Had I been vaccinated; my life would be very different. But I can use my voice to protect others.”
Their experiences highlight the importance of immunisation and the power of advocacy in building a polio-free future.

Government Leadership Sustaining Progress
The Government of Nigeria, through the Federal Ministry of Health and Social Welfare (FMOH) and the National Primary Health Care Development Agency (NPHCDA), continues to demonstrate strong leadership in sustaining polio eradication gains.

Nigeria remains committed to halting all poliovirus transmission by 2030, investing in surveillance, routine immunisation, and supplementary immunisation activities (SIAs). Polio vaccination has been integrated with broader health initiatives through campaigns and community outreach to reach all eligible children.

The 2025 Measles–Rubella and Polio Vaccination Campaign aims to immunise over 106 million children, making it one of Africa’s largest immunisation efforts.

Eradicating All Forms of the Virus
While Nigeria remains free of wild poliovirus, cVPV2 cases persist. According to national surveillance data: As of 20 October 2024, 112 cases were recorded across 15 states.
In the same period in 2025, 66 cVPV2 cases were reported from 44 LGAs in 12 states—a 41% reduction, indicating progress in interrupting transmission.

Collective Commitment and Partner Support
WHO, in collaboration with national and international partners under the Global Polio Eradication Initiative (GPEI), supports Nigeria’s eradication efforts through:
• Technical assistance for planning and executing immunisation campaigns
• Logistical coordination to deliver vaccines to hard-to-reach areas
• Capacity-building for health workers in surveillance and outbreak response
• Data review mechanisms to identify gaps and guide corrective actions, including redeploying vaccination teams to missed settlements, strengthening social mobilisation, adjusting supply chains, and conducting targeted mop-ups to ensure no child is left behind

These efforts are complemented by partners including Rotary International, the Gates Foundation, Chigari Foundation, UNICEF, and others, who contribute to microplanning, social mobilisation, surveillance, and evidence-based decision-making.

Community Engagement Across States
Across Nigeria, WHO state offices joined government agencies, partners, and communities in commemorating World Polio Day, renewing advocacy for vaccination and stronger surveillance.
In Taraba State, the Commissioner of Health, Dr. Buma Bordiya, emphasized the state’s commitment during a press briefing in Jalingo:

“On World Polio Day 2025, we renew our collective commitment to reach every child, with every vaccine, everywhere—until polio is gone for good.”
• In Taraba State, over 2.3 million children received at least one dose of the polio vaccine during April and June SIAs.
• In Gombe, a 3 km awareness walk was held in collaboration with NYSC, Rotary, and others.
• In Ebonyi, the Commissioner of Health expressed gratitude to the Government of Nigeria, WHO, and partners for supporting child vaccination.
• In Kano, over 500 participants—including health officials, traditional leaders, and polio survivors—attended a commemorative event. The Chairman of the Polio Survivors Association urged continued advocacy and inclusion of survivors in outreach efforts.

Other states including Kwara, Kebbi, Kaduna, and Zamfara held similar events to reaffirm their commitment to reaching every child.

A Future Without Polio
For Hassana and other polio survivors, the fight against polio is deeply personal.
“If I had been vaccinated, my life would be very different,” reflects Bukar Modu, a 45-year-old polio survivor. “But I can use my voice to make sure no other child suffers as I did. Polio is still a threat, but vaccines save lives.”

Reaffirming WHO’s continued support, Dr. Kofi Boateng, Polio Eradication Programme Cluster Lead, emphasized:

“The only reason the poliovirus continues to circulate is because some children remain unvaccinated. The vaccine is safe and effective, and every child must be protected.”

Staying the Course and Taking Action
Nigeria’s strong government leadership, community resilience, and sustained partner collaboration are ensuring the country remains firmly on course toward a polio-free future by 2030—one where every child, everywhere, is protected.

To achieve this goal, continued community participation, timely vaccination, and coordinated efforts from all stakeholders are essential. Every caregiver, health worker, and partner has a role to play in ending polio for good.

WHO

Nigeria’s life expectancy ranked lowest globally

Nigeria now stands as the world’s lowest life expectancy, according to a new United Nations data for 2025, which confirms a national average of just 54.9 years. This statistic, highlighted in the latest UN global health report, places Nigeria behind every other country in the world.

The numbers show men in Nigeria live an average of 54.3 years, while women reach 54.9, each figure far below Africa’s continental average and less than three-quarters of the global benchmark of 73.7 years. For comparison, Chad and the Central African Republic barely surpass Nigeria, with life expectancies of 55.2 and 57.7 years, respectively.

Why is this the case

Experts link Nigeria’s dismal ranking to persistent health system challenges, including a high burden of infectious diseases, poor access to quality care, and frequent health worker strikes. Widespread insecurity, poverty, and environmental pollution compound the crisis, reflecting the broader structural struggles impacting millions of Nigerians daily.

These statistics come at a time of increased focus on global health inequalities, with calls rising for urgent government and international interventions. Public health advocates warn that unless Nigeria addresses critical shortages in medical infrastructure and tackles the underlying socio-economic issues, its population will remain among the world’s most vulnerable.

The UN report underscores that Nigeria’s situation is not simply a health challenge but a warning signal for social and economic progress. As world leaders prepare for upcoming global summits, Nigeria’s record-low life expectancy demands action and stands as a stark reminder of the urgent need for reform.

Africa News

Video - Doctors in Nigeria concerned over surge in sudden deaths amid low awareness

Doctors in Nigeria warn that sudden unexplained deaths now account for about 14 percent of all fatalities, driven by poor healthcare access, limited preventive checks, unhealthy lifestyles, and low health awareness. With low insurance coverage and many, especially men, delaying or avoiding care, experts say stronger hospitals, broader insurance, and nationwide health education are urgently needed.

CGTN Africa

Local women lead the fight against polio in Nigeria

 

In the neighbourhood of Kado Lifecamp on the outskirts of Nigeria’s capital, 29-year-old Eucharia Joseph grips a cooler box and sets out for her day. Inside are oral polio vaccines packed in ice.

Joseph’s route takes her through dusty lanes, past tin-roofed homes, mosques and churches. By nightfall, she and her team of six women will have vaccinated hundreds of children. Their mission: To ensure no child is left unprotected from the disease that once crippled thousands across the country.

In 2020, Nigeria was declared free of wild poliovirus by the World Health Organization (WHO) – a landmark achievement for a country once at the centre of global transmission. But the virus hasn’t vanished entirely.

A related strain, known as circulating vaccine-derived poliovirus (cVDPV), still threatens under-immunised communities. Unlike the wild virus, cVDPV emerges when the weakened virus from oral vaccines mutates and spreads via contaminated food or water, for instance, in areas where too few children are vaccinated.

That threat remains. Despite steady progress, Nigeria still reports sporadic outbreaks of cVDPV. As of March this year, the country had reported 10 cases of the mutated strain. Last year, 98 cVDPV2 cases were reported.

With ongoing insecurity in northern Nigeria and pockets of resistance elsewhere, the job of eradicating polio now rests heavily on the shoulders of women like Joseph, who are often the only ones granted access to households due to a confluence of cultural, religious and safety reasons.

“It’s my gift,” Joseph said of her work, as she adjusted her headscarf under the sun. “I go to different localities. I talk to mothers. I sit with them. I know how to convince them. That’s what makes this work possible.”


Women on the front lines

Female health workers like Joseph are the backbone of Nigeria’s polio response.

In rural or conservative communities, male health workers are often not allowed to interact with women and children. While in conflict-affected areas, strange men moving between households may be viewed with suspicion, as many of these areas are battling rebels.

In Borno State – the epicentre of Nigeria’s long-running Boko Haram rebellion and one of the regions hardest hit by polio outbreaks – the stakes are especially high. Male health workers have sometimes been suspected by the community of working with government forces or intelligence services.

In some neighbourhoods, the mistrust and resistance extend to female vaccinators as well.

“Most people in Maiduguri [the state capital] don’t always like the vaccine. They think it prevents them from giving birth,” said Aishatu, who chose not to reveal her last name. The community health worker leads immunisation rounds across several wards in the area.

Such rumours about the effects of vaccines have circulated for years, often fanned by misinformation circulating among community networks, some religious leaders, and occasionally by armed groups such as Boko Haram, which has attacked vaccinators and portrayed immunisation as part of a foreign agenda.

In some cases, religious teachings have been misrepresented, for example, claims that vaccines are forbidden during certain religious festivals or that immunisation interferes with divine will. There have also been conspiracy theories saying vaccines are a Western plot to sterilise children.

Combined with longstanding mistrust of government programmes in some areas, belief in these rumours has made vaccine acceptance a persistent challenge in parts of northern Nigeria, health workers say.

For front-liners like Aishatu, confronting the beliefs has become part of the job. Her strategy is persistence and patience.

“We handle it by trying to increase sensitisation,” she said, referring to the repeated community visits, one-on-one conversations, and informal group talks that female health workers use to counter vaccine myths and build trust among hesitant parents. “We keep talking to the mothers, telling them the truth. Some accept it slowly, some after seeing others take it.”

Aishatu has to balance this work with managing her household responsibilities. But she sees the job as something beyond a paycheck. “The work is a professional one,” she said. “But it also adds so much to life. I know I am helping people and I love it.”

But she also believes more needs to be done to expand the programme’s reach. “More female vaccinators are needed,” she said. “That’s the best approach for the government to use for creating more awareness about [the need and effectiveness of] polio vaccines.”

In areas or situations where male vaccinators face access constraints and restrictions, women doing the work have been more effective. And for some, their demeanour and approach to patients is what also makes a difference.

“Women are very social,” said Esu Danlami Audu, village head of Kado who has seen his village stamp out new polio cases because of efforts by women vaccinators.

“They are able to talk to parents, gain trust, and explain the importance of vaccines in ways men cannot. That is why they have played such an important role in our progress against eradication of poliovirus.”

This access has proven more critical in regions like Borno. According to the WHO, female vaccinators and community health promoters have been instrumental in reaching children in hard-to-access areas, sometimes even risking their lives to do so.

“All over Africa, despite facing life threats at many places, their [women vaccinators’] presence and persistence have helped overcome barriers of trust, cultural norms, and insecurity. This is especially true for conflict-affected areas of northern Nigeria where women are often the only ones allowed into households – especially those with young children – making their role irreplaceable,” said Dr Ndoutabe Modjirom, coordinator of WHO-led polio outbreaks rapid response team for the African region.

Innovation, persistence and economic ripple effect

To further counter these challenges, health workers have also adopted a mix of innovation and local knowledge.

Geographic Information System (GIS) mapping now helps identify missed settlements. Community mobilisers, often local women, monitor newborns and report missed vaccinations. Mobile health units and door-to-door outreach campaigns are routine.

“We go to schools, churches, mosques and markets,” said Aminat Oketi, a vaccinator in Nasarawa State and a mother of six. “Sometimes we vaccinate 150, even 300 children a day. The work is tough. But when I see a child protected, it is worth it.”

Although Oketi earns some money from her work, the job is not well paid. Most vaccinators receive just 12,000 naira (about $8) from the government for a five-day campaign. Transport often eats into their earnings, forcing them to supplement this income with petty trade or hawking goods.

Aishatu supplements her income by running a small beans trading business in Maiduguri to earn an income. “I buy and sell beans,” she said. “I manage it by separating my time to work [as a health worker] and do business.”

While the campaigns has improved public health outcomes, it has also unintentionally created a foundation for economic empowerment among women, many say. Empowered by training and purpose, many of these women have become micro-entrepreneurs and informal community leaders.

Vaccinators like Oketi, who joined the programme four years ago, are not only safeguarding children but also building personal livelihoods.

She runs a small poultry business alongside her health work. “I have a shop where I sell chicken feed and I rear birds too,” she said. Her modest vaccine stipend barely covers transport, but the exposure to community networks and the sense of mission have translated into entrepreneurial confidence.

“When people trust you with their children, they also trust you to provide them with other services,” she said. “My customers come because they know me from the vaccination rounds. It is all connected.”

This is a common trajectory. While some female vaccinators have leveraged their community credibility to start small businesses, others, like Joseph, have set up informal health outreach networks, advising new mothers and coordinating care for sick children.

According to Cristian Munduate, UNICEF’s country representative, this dual role of healthcare provider and entrepreneur reflects a deeper shift. “They are not just women with jobs; they are agents of change,” she said. “Vaccination campaigns have opened a pathway for leadership, agency, and financial independence.”

Helen Bulus, a government health officer in charge of vaccinations in Mararaba town in Nasarawa, reflects on the sense of commitment female health workers share.

“We are mothers too. Women take care of children, not just their own. That’s why they don’t give up [even when there is hardship],” she said.

And as they persevere, their work creates other positive ripples, like contributing to higher school enrolment among girls in some regions, she added. “As mothers become more economically stable, they invest more in their daughters’ futures.”


A global model – with challenges

While wild polio now remains endemic only in Pakistan and Afghanistan, Nigeria’s experience offers vital lessons. Its fight against polio, led by women, supported by community trust, and bolstered by innovative strategies, has reshaped how public health can be delivered in fragile settings.

The next step, experts say, is sustaining this momentum.

“Routine immunisation must be strengthened,” said Munduate. “And communities must be supported, not just during outbreaks but all year round.”

The polio infrastructure has also transformed Nigeria’s broader healthcare system. Cold chains, data systems, and human networks developed for polio now support routine immunisations, maternal health, and even responses to outbreaks like cholera and COVID-19.

“We have built a legacy platform. Female vaccinators trained for polio are now part of nutrition drives, health education, and emergency response. They have become health champions,” WHO’s Modjirom explained.

Still, hurdles persist. Insecurity continues to hinder access in parts of northern Nigeria. In conservative areas, misinformation remains rife, fed by rumours that vaccines cause infertility or are part of foreign agendas.

Despite gains, health workers say there is little scope for complacency. Experts warn that until every child is reached, the virus remains a threat not just to Nigeria, but to global eradication efforts.


“For each paralytic case, thousands more may be infected,” said Munduate. “That’s why we can’t stop and efforts have to continue.”

The reporting for this story was supported by UN Foundation Polio Press Fellowship

Al Jazeera

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Video - Aid cuts deepen malnutrition crisis in northeast Nigeria

Foreign aid reductions are severely impacting humanitarian operations in northeastern Nigeria. Key NGOs, including Mercy Corps, shut down nutrition programs, leaving mothers without critical support for malnourished children.

CGTN

Children die as USAID aid cuts snap a lifeline for the world’s most malnourished

Under the dappled light of a thatched shelter, Yagana Bulama cradles her surviving infant. The other twin is gone, a casualty of malnutrition and the international funding cuts that are snapping the lifeline for displaced communities in Nigeria’s insurgency-ravaged Borno state.

“Feeding is severely difficult,” said Bulama, 40, who was a farmer before Boko Haram militants swept through her village, forcing her to flee. She and about 400,000 other people at the humanitarian hub of Dikwa — virtually the entire population — rely on assistance. The military restricts their movements to a designated “safe zone,” which severely limits farming.

For years, the United States Agency for International Development had been the backbone of the humanitarian response in northeastern Nigeria, helping non-government organizations provide food, shelter and healthcare to millions of people. But this year, the Trump administration cut more than 90% of USAID’s foreign aid contracts and $60 billion in overall assistance around the world.

Programs serving children were hit hard.

Bulama previously lost young triplets to hunger before reaching therapeutic feeding centers in Dikwa. When she gave birth to twins last August, both were severely underweight. Workers from Mercy Corps enrolled them in a program to receive a calorie-dense paste used to treat severe acute malnutrition.

But in February, Mercy Corps abruptly ended the program that was entirely financed by USAID. Two weeks later, one of the twins died, Bulama said.

She has no more tears, only dread for what may come next.

“I don’t want to bury another child,” she said.

‘Very traumatic’

Globally, 50% of the therapeutic foods for treating malnutrition in children were funded by USAID, and 40% of the supplies were produced in the U.S., according to Shawn Baker, chief program officer at Helen Keller Intl and former chief nutritionist at USAID.

He said the consequence could be 1 million children not receiving treatment for severe malnutrition, resulting in 163,500 additional deaths per year. For Helen Keller Intl, its programs in Bangladesh, Nepal and Nigeria have been terminated.

“It is very traumatic,” said Trond Jensen, the head of the United Nations humanitarian office in Maiduguri, Borno’s capital, of the funding cuts, noting that other donors, including the European Union, have taken similar steps this year. “One of the things is the threat to the lives of children.”

UNICEF still runs a therapeutic feeding center nearby, which now supports Bulama’s surviving baby, but its capacity is stretched. It is turning away many people previously served by other aid groups that have pulled out due to funding cuts.

Intersos, an Italian humanitarian organization, has the only remaining facility providing in-patient services for malnutrition in Dikwa, treating the most perilous cases. Its workers say they are overwhelmed, with at least 10 new admissions of seriously malnourished children daily.

“Before the USAID cut, we made a lot of progress,” said Ayuba Kauji, a health and nutrition supervisor. “Now my biggest worry is high mortality. We don’t have enough resources to keep up.”


Intersos was forced to reduce its staff from 30 to 11 in Dikwa after the USAID freeze. Its nutrition and health facilities now operate solely on support from the Nigerian Humanitarian Fund, a smaller pot of money contributed by a few European countries. That funding will be finished in June.

The crisis is equally acute in Maiduguri, where the economy is reeling from massive terminations of aid workers. At another Intersos-run facility, 10 of the 12 doctors have left and four nurses remain, with 50 new admissions of malnourished children per week.

“It used to be far less,” said Emmanuel Ali, one of the remaining doctors.

Beyond nutrition

The effects of the funding cuts extend far beyond nutrition. At the International Organization for Migration’s reception center in Dikwa, thousands of displaced families and those escaping Boko Haram captivity are stranded. There are no new shelters being built and no support for relocation.

“Before, organizations like Mercy Corps built mud-brick homes and rehabilitated damaged shelters to absorb people from the IOM reception center,” said one official at the center, speaking on condition of anonymity because he was not authorized to speak publicly on the situation. “Now, that has stopped.”

Jensen, the U.N. humanitarian head in Maiduguri, said, “sadly, we are not seeing additional funding to make up for the U.S. cuts.” He warned that vulnerable people could turn to risky ways of coping, including joining violent groups.

A global problem

The crisis in Nigeria is part of a larger reckoning. According to Kate Phillips-Barrasso, Mercy Corps’ vice president for policy and advocacy, 40 of its 62 U.S.-funded programs with the potential to reach 3.5 million people in Nigeria, Central African Republic, Ethiopia, Somalia, Iraq, Sudan, Afghanistan, Kenya, Lebanon and Gaza have been terminated.

In Mozambique, where jihadist violence in the north has displaced over a million people since 2017, humanitarian organizations face steep shortfalls with “devastating” effects on the needy, said Frederico João, chairman of the forum of NGOs in the region.

More widely, the USAID funding cut compromises Mozambique’s health sector, especially in HIV/AIDS care, said Inocêncio Impissa, cabinet spokesman. The government now seeks alternative funding to prevent total collapse of health systems.

Charles Mangwiro in Maputo, Mozambique, contributed to this story.

By Taiwo Adebayo, AP

Related story: Nigeria has a food security problem as water for crops is harder to find

Nigeria still carries world’s highest malaria burden

Nigeria continues to lead the world in malaria cases and deaths, despite decades of global and domestic investments, according to the latest World Malaria Report 2024 released by the World Health Organization (WHO).

The report draws on 2023 data from 83 malaria-endemic countries, including the territory of French Guiana, while also presenting trends in malaria morbidity and mortality globally and by region.

The report, which highlighted the 2023 global malaria incidence, shows that Nigeria accounted for 26 per cent of global malaria cases, again making it the most malaria-affected nation worldwide.

Out of the estimated 263 million malaria cases recorded globally in 2023, Nigeria accounted for 68 million (68,136,000). DRC Congo followed suit with 33 million cases. Uganda had over 12 million people affected by the disease in 2023, while Ethiopia logged 9.5 million of the global reported cases of the disease.

This shows that the four countries are among the 11 ‘High Burden to High Impact (HBHI)’ countries, a group responsible for 66 per cent of global malaria cases and 68 per cent of deaths in 2023.

Others are Mozambique (9.2 million), United Republic of Tanzania (8.5 million), Angola (8.2 million), Mali (8.2 million), Burkina Faso (8.1 million), Niger (7.9 million), and Côte dʼIvoire (7.8 million).

Nigeria also ranked highest in malaria-related deaths, contributing significantly to the 597,000 global fatalities. The WHO African Region, which includes Nigeria, accounted for 94 per cent of the total global malaria burden and 95 per cent of deaths.

Four African countries accounted for just over half of all malaria deaths globally, with Nigeria having 30.9 per cent, and the Democratic Republic of the Congo having 11.3 per cent. Niger (5.9 per cent) and the United Republic of Tanzania (4.3 per cent) are the two other nations that accounted for 10 per cent of the cases.

While mortality from malaria has declined slightly over the past three years globally, from 622,000 in 2020 to 597,000 in 2023, according to the latest WHO report, Nigeria’s data remain high, especially among children under five and pregnant women.

According to WHO estimates, the country also recorded the largest number of under-five malaria deaths.

By Mustapha Usman, ICIR

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CGTN

Nigeria's Malaria Hot-Spot Identified

The Federal Republic of Nigeria is reported to have the highest malaria burden in the world, accounting for 39.3% of global malaria deaths in children under five years in 2023.

According to recent reporting by GAVI, while the country’s annual malaria death toll has declined over the past five years, the case count has risen, with 1.4 million more malaria infections reported in 2023 than in 2022.

Bordering both Benin and Niger in Nigeria’s northwest, the Kebbi state has the highest malaria prevalence in the country at 49% of young children and the highest mortality rate.

The state’s high malaria prevalence has been linked to several factors, including rice cultivation.

Since rice farming requires stagnant water, it is a perfect breeding ground for virus-carrying mosquitoes.

Ahmad Muhammad Sani, a public health expert in Kebbi State, told GAVI on April 7, 2025, that he believes the malaria vaccine will help significantly lower malaria morbidity and mortality, especially when combined with existing preventive measures like the use of insecticide-treated mosquito nets and indoor insecticide spraying.

Sani also encouraged parents to complete the four vaccine doses to protect children against malaria outbreaks.

“Some possible challenges relating to the vaccine effectiveness in this region include factors like high malaria transmission rates. Hence, full vaccination coverage is crucial. Parents should be aware that incomplete vaccine doses offer partial protection,” he said.

As of April 14, 2025, most malaria cases in the United States are travel-related. Two malaria vaccines are offered in Africa but are unavailable in the U.S.

Vax Before Travel

Nigeria struggles to rein in a widespread meningitis outbreak that has killed at least 150

Nigerian health authorities are struggling to contain a rapidly spreading meningitis outbreak that has so far killed 151 people across the west African nation, mostly in remote parts of the northern region with children affected the most.

While cases first recorded in October have spread to 23 of Nigeria’s 36 states, nearly half of the deaths, 74, were reported this year, the Nigeria Center for Disease Control said this week, with local partners describing the recent rise in fatalities as “alarming.”

Most deaths from the disease have been mainly due to infected people not going to health facilities or arriving there late with severe complications, NCDC spokesperson Sani Datti told The Associated Press, a common problem in past outbreaks in the country.

The current outbreak has hit Africa’s most populous country as its health sector reels from U.S. aid cuts ordered by the Trump administration in February that have affected multiple countries. Nigeria relied heavily on such aid over the years to help fight similar outbreaks and support its underfunded healthcare systems.

Seasonal meningitis outbreaks are common during the dry season, especially in northern Nigeria. Almost all the worst-hit states are in the north, where health providers have warned the outbreak is rapidly spreading in hard-to-reach areas.

Meningitis, more common during the hot season in Nigeria, affects the protective membranes surrounding the brain and spinal cord. It’s a major public health challenge for a country already grappling with “the world’s highest burden of malaria,” according to the World Health Organization.

Last week, Nigeria received the first batch of more than 1 million vaccine doses from the global vaccine alliance Gavi, described by local officials as a crucial milestone in disease response.

The Nigeria CDC also said it is working with state authorities to scale up disease surveillance with a focus on tracking new cases, laboratory testing, and public sensitization campaigns to curb the outbreak.

Campaigns are also being rolled out, urging residents to take precautionary measures and seek immediate medical attention if they are experiencing symptoms such as high fever, stiff neck and severe headaches.

However, access to hospitals remains a huge problem, local partners say.

“We have seen hundreds of admissions and scores of deaths in just a few weeks. The high fatality rate is due to access (to) care, there are challenges with that and low vaccination coverage,” said Simba Tirima, Nigeria’s country representative for French medical charity Doctors Without Borders, or MSF.

Tirima told the AP that the most vulnerable are residents in remote areas who often arrive late to MSF facilities.

“We know that meningitis progresses rapidly, and patients' (conditions) can deteriorate in 24 hours,” he said, calling for mass vaccination campaigns.

By Dyepkazah Shibayan, AP

Related story: Meningitis outbreak kills 20 students in northern Nigeria

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A mother's mission to help Nigerians with cerebral palsy

Although Babatunde Fashola, affectionately known as Baba, is 22 years old, he is less than 70cm (2ft 4in) tall.

He has cerebral palsy and requires lifelong care. He can neither speak nor walk and is fed via a tube attached to his stomach.

As a baby, he was abandoned by his parents but 10 years ago, he found a home at the Cerebral Palsy Centre in the Nigerian city of Lagos.

"Baba weighs about 12kg [26lb]. He is doing well," the facility's founder, Nonye Nweke, tells me when I visit.

Ms Nweke and her staff work around the clock to support him and other youngsters living with permanent brain damage.

Although there is a lack of official data, cerebral palsy is believed to be one of the most common neurological disorders in Nigeria. In 2017, a medical professor from the University of Lagos said 700,000 people had the condition.

For many of those living with cerebral palsy in the country, their condition was caused by a common phenomenon among newborns - neonatal jaundice.

This is caused by a build-up of bilirubin, a yellow substance, in the blood, meaning the babies' skins have a yellow tinge.

Professor Chinyere Ezeaka, a paediatrician at the Lagos University Teaching Hospital, tells the BBC that more than 60% of all babies suffer from jaundice.

Most babies recover within days. More severe cases need further medical intervention - and even then the condition is easily treatable.

Children are basically exposed to ultra-violet light to dissolve the excess bilirubin in their red blood cells. The treatment lasts a few days depending on the severity.

However, in Nigeria this treatment is often not immediately available, which is why the country is among the five with the most neurological disorders caused by untreated jaundice in the world, according to data from the World Health Organization (WHO).

Any treatment for neonatal jaundice "must occur within the first 10 days of life, else [the condition] could cause permanent brain damage and severe cerebral palsy", says Prof Ezeaka.

To make matters worse, the West African country lacks facilities to care for those with neurological disorders. There are just three cerebral palsy centres, all privately run, in Nigeria, which has a population of more than 200 million.

Ms Nweke - a single mother - set up the Cerebral Palsy Centre after struggling to find support for her own daughter, Zimuzo.

"When I took her to a day-care [centre], they asked me to take her back because other mothers would withdraw their children. As a mum, I must say it was quite devastating," Ms Nweke tells the BBC.

Zimuzo is now 17, and Ms Nweke's Cerebral Palsy Centre provides full-time support for others with similar experiences.

On the day I visit, colourful playtime mats and toys are neatly arranged on the floor. Mickey Mouse and his friends converse on a wide-screen television in the lounge.

Twelve youngsters, some as young as five, gaze at the TV, their bright environment ignored for a moment. They are all immobile and non-speaking.

At lunchtime, caregivers help the youngsters eat. Some take in liquified food through tubes attached to their stomachs.

Carefully and slowly, the carers support their heads with pillows and push the contents of their syringes into the tubes.

The youngsters are fed every two hours and require regular muscular massages to prevent stiffness.

But they are the lucky 12 receiving free care from the Cerebral Palsy Centre, which is funded exclusively by donors.

The facility has a long waiting list - Ms Nweke has received more than 100 applications.

But taking on more youngsters would require extra financial support. The cost of caring for someone at the centre is at least $1,000 (£790) a month - a huge amount in a country where the national minimum wage is about $540 a year.

"As a mum, I must say it's quite overwhelming. You have moments of depression, it gives you heartaches and it is quite expensive - in fact it's the most expensive congenital disorder to manage," Ms Nweke says.

"And then of course, it keeps you away from people because you don't discuss the same things. They are talking of their babies, walking, enjoying those baby moments. You are not doing that. You are sad," she adds.

Ms Nweke explains that she adopted Zimuzo from an orphanage.

A few months after taking her new daughter home, Ms Nweke realised Zimuzo was not developing in the same way as the children around her were. She was assessed at a hospital and diagnosed with cerebral palsy.

Ms Nweke was told she could take Zimuzo, who was then just a few months old, back to the orphanage and adopt another baby instead, but she refused.

"I decided to keep her and I began researching what the disorder was about, the treatment and type of care my child would need - she's my life.

"I was also told by the doctors she won't live beyond two years. Well here we are - 17 years later," says a smiling Ms Nweke.

A lack of awareness and adequate medical support hinders the diagnosis and treatment of neonatal jaundice in Nigeria.

Ms Nweke also says the common local belief that children with congenital disorders are spiritually damaged or bewitched leads to stigmatisation.

Some children with neurological disorders - mostly in Nigeria's rural areas - are labelled witches. In some cases, they are abandoned in prayer houses or cast out of their families.

Ms Nweke is not alone in her mission to dispel myths and improve care.

The Oscar Project - a charity aimed at improving the diagnosis and treatment of neonatal jaundice - recently began operating in Lagos.

The project is named after Vietnamese-born British disability advocate, Oscar Anderson, whose untreated jaundice caused his cerebral palsy.

"We're equipping health facilities at the primary, secondary and tertiary levels with the equipment to treat jaundice, primarily light boxes, but also detection and screening equipment," Toyin Saraki, who oversaw the launch, tells the BBC.

Project Oscar, backed by consumer health firm Reckitt, is training 300 health workers in Lagos. The hope over the first year is to reach 10,000 mothers, screen 9,000 children and introduce new protocols to try and prevent babies with jaundice from developing cerebral palsy.

In a country where the public health system is overstretched, the government has little to say about the disorder, although it lauded the Oscar project's goals.

Treatment for neonatal jaundice is significantly cheaper than the cost of lifelong care, doctors say.

First launched in Vietnam in 2019, Project Oscar has helped about 150,000 children in the Asian country.

Mr Anderson, 22, says he wants to prevent other children experiencing what he has been through.

"People with disabilities are not to be underestimated," he tells the BBC.

He is working to ensure screening for every newborn infant for neonatal jaundice, and, with the support and courage of mums, midwives and medical professionals, ensure there is better understanding and quicker treatment.

However, achieving this is a hugely ambitious goal in Africa's most-populous country, where thousands of babies are born each year with neonatal jaundice.

Regardless, Mr Anderson is determined to defy the odds.

"The work doesn't stop until every baby is protected against neonatal jaundice," he says.

By Nkechi Ogbonna, BBC