Nigeria recorded some challenges, milestones and innovations that shaped its health sector in 2024. They ranged from government policies and reforms, disease outbreaks, interventions by stakeholders to improve the health system as well as breakthroughs in medicine and research.
Roll out of malaria vaccine in Nigeria
A major health event in 2024 was the roll out of malaria vaccine in the country. The rollout of the vaccine was a highly anticipated event, having been piloted in some other African countries.
Nigeria is a malaria endemic country, contributing 27 per cent of the global malaria burden and 31 per cent of global malaria deaths. Over 90 per cent of the population is estimated to be at risk of malaria.
There is currently a malaria vaccine for children alone, not adults. The malaria vaccine offers protection to millions of children and moves the country closer to a malaria-free future.
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The federal government in collaboration with other partners such as the World Health Organisation (WHO), UNICEF among others commenced the first phase of the roll out in Kebbi and Bayelsa states on 2 December 2024.
Earlier in October, the federal government received one million doses of the R21/Matrix-M malaria vaccine donated by Gavi, the Vaccine Alliance.
The National Primary Health Care Development Agency (NPHCDA) said the introduction will be expanded to other states and integrated into the country’s national routine immunisation schedule as it receives additional doses. “The second phase targets 19 states and the Federal Capital Territory (FCT), while the third phase will target the remaining 15 states. Both phases are scheduled for 2025,” the Executive Director of NPHCDA, Muyi Aina said.
President Tinubu’s executive order on pharmaceutical products
In June this year, President Bola Ahmed Tinubu signed an Executive Order on zero VAT for pharmaceutical manufacturers. It became operational in October. The order is geared towards increasing local production of pharmaceuticals, diagnostics and medical devices. It is also expected to address the skyrocketing cost of medicines, which is currently bedevilling the country.
The Federal Ministry of Health and Social Welfare had also in October announced the finalisation of the Executive Order’s Harmonised Implementation Framework, which has now been cleared for gazetting.
The ministry said gazetting it ensures that the Federal Inland Revenue Service (FIRS) and the Nigeria Customs Service can proceed with the implementation of zero VAT and excise duties on pharmaceutical products and medical devices.
Lassa fever, cholera, other infectious disease outbreaks
Like previous years, the country witnessed outbreaks of various infectious diseases in the year 2024. Cases and deaths were recorded from Lassa fever, cholera, diphtheria, meningitis and yellow fever among others.
For Lassa fever in particular, the Nigeria Centre for Disease Control and Prevention (NCDC) said the case fatality rate consistently remained high, with over 13%, and that there was a rise in the number of suspected cases compared to a similar timeline in 2023.
According to the NCDC Director General, Dr Jide Idris cumulatively this year, Nigeria recorded 9,492 suspected cases of Lassa fever, 1,154 confirmed cases with 190 deaths.
A total of 10,837 suspected cases of cholera and 359 deaths were reported in 21 states this year. Lagos, Jigawa, Kano, Oyo and four other states led the number of deaths from cholera in 2024.
An NCDC report stated that cumulative deaths recorded from cholera this year increased by 239 per cent compared to the ones recorded last year. The report also said suspected cases in the current year increased by 220 per cent compared to those reported as at week 39 of 2023.
The country also recorded diphtheria cases but not in the same magnitude as 2023.
Nigeria, first to receive new meningitis vaccine
Nigeria became the first country in the world to roll out a new meningitis vaccine recommended by the WHO, called Men Five (Men5CV) in March this year.
The country received the vaccine from the Gavi-funded global stockpile.
As at December, Cerebrospinal Meningitis had killed 361 people across 24 states and the Federal Capital Territory (FCT). The deaths were recorded across 174 Local Government Areas (LGAs) in the 24 states.
NCDC said a total of 2, 281, 750 doses of meningitis vaccines (Men5CV- ACWYX) have been administered in Bauchi, Gombe, Jigawa and covering 134 wards in 13 LGAs,
Industrial actions by health workers
Nigeria’s health sector is perennially bedevilled with industrial actions. This year witnessed warning strikes by the Nigerian Association of Resident Doctors (NARD), Medical and Dental Consultants’ Association of Nigeria (MDCAN) and the Joint Health Sector Unions (JOHESU).
The Nigerian Association of Resident Doctors (NARD) went on a seven- day nationwide warning strike in August this year over the continued detention of its abducted member, Dr. Ganiyat Popoola-Olawale.
There were also industrial actions by some branches of the Association of Resident Doctors (ARD) across hospitals in the country.
The Medical and Dental Consultants’ Association of Nigeria (MDCAN), South-East Caucus, also embarked on a five-day solidarity and warning strike for universities in the South-East and South-South regions in support of the staff of the Nnamdi Azikiwe University Awka, who were protesting the exclusion of clinical lecturers from the eligibility criteria for the vice-chancellor position.
Also, the JOHESU and Assembly of Healthcare Professional Associations (AHPA) embarked on a seven – day warning strike on Oct 26, 2024 over the federal government’s inability to meet its demands such as the adjustment of the Consolidated Health Salary Structure as was done with the Consolidated Medical Salary Structure since January 2, 2014, and the review of retirement age from 60 to 65 years for health workers and 70 years for consultants, among others.
Soaring cost of medicines, services
The exit of some pharmaceutical companies from Nigeria in 2023 such as GlaxoSmithKline (GSK) and Sanofi led to skyrocketing cost of drugs and health services this year. Many Nigerians found it hard to afford even basic services thereby affecting the goal of reducing out of pocket expenditure and attaining Universal Health Coverage (UHC) in the country.
Mpox outbreak, vaccine
There was an outbreak of Mpox in the Democratic Republic of the Congo (DRC) and some other countries on the continent this year.
The World Health Organisation (WHO) and the Africa Centres for Disease Control and Prevention (ACDC) both declared Mpox a Public Health Emergency of International and Continental Concern (PHEIC/PHECC).
The alarming increase was linked to a new strain of the Mpox virus, which emerged in eastern Congo and later detected in Kenya, Rwanda, and Uganda.
Nigeria recorded some cases of Mpox during the course of the year, and some states were put on high alert in August.
Following the outbreak, Nigeria also became the first African country this year to receive Mpox vaccines.
The 10,000 U.S.-donated doses of the vaccine were rolled out in five states to protect those most at risk.
The National Agency for Food and Drug Administration and Control (NAFDAC) had earlier given Emergency use authorization of the Mpox vaccine.
Malnutrition
There were widespread cases of malnutrition among children this year especially in the Northeast and Northwest zones of the country. According to Médecins Sans Frontières (MSF), an international charity, severe malnutrition rose by 51% in the Northern states.
An annual survey conducted by the organization showed extremely high levels in parts of the North- West.
MSF’s International President, Dr Christos Christou, said the organisation treated 52,725 children with severe malnutrition, a life-threatening condition, across the whole of northern Nigeria over the first eight months of this year.
Brain drain
Nigeria continued to witness mass emigration of doctors and other health workers out of the country for greener pastures in 2024.
President Bola Ahmed Tinubu approved a new national policy aimed at curbing the migration of healthcare workers from Nigeria, commonly referred to as the “japa” syndrome this year.
Prof Pate said the policy seeks to improve working conditions and retain health professionals across the country.
African-led HIV vaccine from Nigeria
Despite the burden of HIV globally, there is currently no vaccine for the disease. This year, the Institute of Human Virology, Nigeria (IHVN) commenced research to develop an effective vaccine for HIV. This makes Nigeria the first in West Africa to participate in a research for a HIV vaccine in the sub-region.
The Executive Director, International Research Centre of Excellence of IHVN, Prof. Alash’le Abimiku said the research is significant because before now countries in Eastern and Southern Africa have been participating in HIV vaccine research but that the strain of the virus causing HIV there is not the same with the one causing it in Nigeria and the rest of West Africa.
The National Agency for the Control of AIDS (NACA) said the research is being done under the Bringing Innovation to clinical and laboratory research to end HIV in Africa through New vaccine Technology (Brilliant) project.
Maiden Joint Annual Health Review (JAR)
The Federal Ministry of Health held the first-ever sector-wide Joint Annual Health Review (JAR) in November this year. It brought health sector stakeholders together to assess program performance, evaluate resource distribution and review outcomes or issues that need to be addressed to improve performance.
The Coordinating Minister of health and social welfare, Prof. Muhammad Ali Pate- led other heads of agencies under the ministry and major stakeholders ( representatives from 36 States including FCT ) and development partners to jointly brainstorm on solutions to identified challenges and set clear priorities for the upcoming year.
Maternal health
The federal government launched some policies and initiatives geared towards boosting maternal and child health during the year.
The Federal Ministry of Health launched an initiative called 𝐌𝐚𝐭𝐞𝐫𝐧𝐚𝐥 𝐌𝐨𝐫𝐭𝐚𝐥𝐢𝐭𝐲 𝐑𝐞𝐝𝐮𝐜𝐭𝐢𝐨𝐧 𝐈𝐧𝐧𝐨𝐯𝐚𝐭𝐢𝐨𝐧 𝐈𝐧𝐢𝐭𝐢𝐚𝐭𝐢𝐯𝐞 (𝐌𝐀𝐌𝐈𝐈).
A key component of the initiative is the provision of free cesarean sections for poor and vulnerable women who meet eligibility criteria, covering services provided through both public and private facilities and empanelled by the National Health Insurance Authority (NHIA).
Also, the NHIA in June launched an obstetric fistula free programme to enhance financial access to care for women suffering from obstetric fistula in the country. The Director General of the NHIA, Dr Kelechi Ohiri, said 22 hospitals are carrying out the fistula program,and that so far over 1, 000 women have been treated.
Launch of National Action Plan on Antimicrobial Resistance (AMR) 2.0
The federal government launched the National Action Plan on Antimicrobial Resistance (AMR) 2.0, and the national genomic surveillance strategy in October this year. The launch was done at a time when the global community, through platforms like the 2024 United Nations General Assembly (UNGA), committed to renewed and urgent action against AMR.
In 2019, over 64,000 deaths were attributable to antimicrobial resistance in Nigeria, while only 42.7% of the population had access to healthcare services in 2019.
Nigeria had launched its first National Action Plan on AMR in 2017.
Health insurance: NHIA reviews tariffs
The National Health Insurance Authority (NHIA) reviewed tariffs and the basic minimum benefit package for health insurance this year.
The agency said it increased capitation by 60%, the fee for service by 40% and also instituted actuarial studies based on industry best practices following deliberation with stakeholders.
Non-communicable diseases
Nigeria faces a growing burden of non- communicable diseases particularly cancer, diabetes and cardiovascular diseases. There were cases, deaths and intervention to respond to them this year.
This year, experts at a health summit said Nigeria records over 684,000 deaths from non communicable diseases annually. NCD-related deaths in Nigeria were estimated to have increased from 24% in 2010 to 29% today.
Over 55, 000 people are estimated to have lost their lives to diabetes alone this year, a diabetologist and consultant endocrinologist, Prof. Olufemi Fasanmade said.
As part of efforts against NCDs, the government entered into agreement for six new cancer treatment facilities.
Second phase of HPV vaccine roll out
The federal government commenced the second phase of the human papillomavirus (HPV) vaccination rollout to fight cervical cancer this year. The first phase commenced in October last year. The NPHCDA said so far over 12,345,572 girls have been vaccinated across the 36 states and FCT, thereby protecting them against cervical cancer for life.
NCDC commenced investigations into ‘mysterious illness, deaths in Kaduna, Sokoto and Zamfara.
In April, the Nigeria Centre for Disease Control and Prevention, NCDC launched an investigation into a ‘strange’ illness that has continued to trigger in Kaduna, Sokoto and Zamfara states.
Further investigations into incidents in Sokoto and Zamfara the following months raised a suspicion of metal poisoning.
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