By ALO360 Editorial Board
Every April 25, the entire world reflects and dialogues on the challenges and health implications of malaria. This year’s theme, “Driven to End Malaria: Now We Can. Now We Must.” is not just aspirational. It is a direct challenge to countries like Nigeria, where the disease remains a daily killer despite decades of interventions.
Malaria remains one of the deadliest diseases globally. It kills over 600,000 people annually, with more than 95 percent of these deaths occurring in Africa. Nigeria bears the heaviest burden. The country accounts for about 31 percent of global malaria deaths, with estimates ranging from 190,000 to over 300,000 deaths yearly. Most of these victims are children under five.
Nigeria also records the highest number of malaria cases in the world, contributing about 27 percent of the global total. Across Africa, about 75 percent of malaria deaths occur among young children. These are not just statistics. They represent families broken, futures cut short, and a healthcare system that continues to struggle.
Over the years, the Nigerian government has rolled out several initiatives to combat malaria. These include the National Malaria Elimination Programme (NMEP), the distribution of insecticide-treated nets (ITNs), seasonal malaria chemoprevention for children, and partnerships with global bodies such as the Global Fund and the World Health Organization. More recently, Nigeria has also begun limited deployment of malaria vaccines. On paper, these efforts appear robust. In practice, the results tell a different story.
Primary healthcare remains the weakest link. Nigeria has an estimated 30,000 primary healthcare centres (PHCs), yet a significant number are either under-equipped, understaffed or completely non-functional. In rural communities, where malaria hits hardest, access to basic healthcare is still a luxury. Many residents travel long distances to reach facilities that may not even have essential drugs. The gap between policy and reality is glaring.
While political campaigns dominate public spaces with branded buses and loud messaging, ambulances are scarce in many local governments. Preventable deaths continue because patients cannot reach care in time. Sanitation, a critical factor in malaria prevention, is poor in many states. Open drains, stagnant water and unregulated waste disposal create ideal breeding grounds for mosquitoes. These are not complex problems. They are failures of priority.
Malaria thrives where systems fail — where there is poor drainage, weak health infrastructure and limited public awareness. Yet these are areas where targeted action can yield immediate results.
Other African countries have shown that progress is possible. Rwanda, for instance, has significantly reduced malaria deaths through sustained investment in community health workers, widespread use of mosquito nets, indoor residual spraying, and strong data-driven interventions. Cabo Verde has gone even further, achieving malaria-free status certified by the World Health Organization. These successes were not accidental. They were the result of deliberate planning, funding, and accountability. Nigeria must take note.
First, the government must fix primary healthcare. Functional PHCs in every ward are not optional. They are the frontline of malaria prevention and treatment. Facilities must be staffed, equipped and monitored.
Second, prevention must be taken seriously. Distribution of mosquito nets should be consistent and targeted, not seasonal or politicised. Environmental sanitation laws must be enforced. Local governments must take responsibility for waste management and drainage.
Third, funding must be transparent and sustained. Malaria programmes cannot depend heavily on donor funding while domestic investment remains weak. If Nigeria carries the highest burden, it must also commit the highest level of seriousness.
Fourth, data must guide action. Real-time tracking of malaria cases can help identify hotspots and deploy resources effectively. Technology should not be an afterthought.
Finally, there must be accountability. Every death from a preventable disease like malaria should raise questions. Who failed? Where did the system break down? Without accountability, policies will remain documents, not solutions.
World Malaria Day should not end with speeches and social media campaigns. It should force a national reckoning.
Nigeria cannot continue to lead the world in malaria deaths. Not when solutions are known. Not when other countries with fewer resources are doing better.
The choice is clear: act with urgency or continue to count avoidable deaths year after year.