Nigeria has numerous endemic diseases, with prominent ones including malaria, Lassa fever, yellow fever, cholera, meningococcal disease (meningitis), and several neglected tropical diseases (NTDs) such as schistosomiasis, leprosy, and Buruli ulcer. Other endemic conditions like hepatitis A, HIV/AIDS, and diarrhoeal diseases are also significant public health challenges.
Currently, an overview of the Lassa fever outbreak in Nigeria, according to the latest report from the Nigeria Centre for Disease Control and Prevention (NCDC), between January 6 and 26, 2025, shows new confirmed cases, suspected cases, and fatalities due to Lassa fever were reported in Ondo, Edo, Taraba, Bauchi, Gombe, Kogi, and Ebonyi states, etc.
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Nigeria’s long-standing battle with endemic diseases and a host of NTDs continues to test the resilience of the country’s healthcare system. Yet, there is hope, and a model for success just across the West African subregion. Sierra Leone, a country of modest means and limited health infrastructure, recently made global headlines for its remarkable containment of mpox (formerly monkeypox), showing that public health wins are possible even in the most challenging circumstances.
In 2024, Sierra Leone stood out on the African continent for its rapid and effective response to a surge in mpox cases, even as neighbouring nations like the Democratic Republic of Congo and Uganda struggled to contain the disease. While these nations faced rising death tolls, especially among vulnerable populations such as people living with HIV, Sierra Leone’s caseload declined significantly within months of the outbreak. The reasons for this success are clear: proactive public-health messaging, community-based interventions, early containment, and a sense of national urgency.
This is precisely the kind of clarity and cohesion Nigeria urgently needs in confronting its own public-health crises.
“Training and deploying community health workers, like Sierra Leone did, should be a central part of Nigeria’s disease control strategy.”
Often, Nigerians only learn about an epidemic once it has reached a catastrophic stage. Take cholera, which continues to cause deadly outbreaks in underserved communities every rainy season. Or Lassa fever, which is endemic in several states, yet lacks the public attention necessary to drive preventive action. In contrast, Sierra Leone’s government bombarded citizens with daily text messages, posters, and jingles warning about mpox. The campaign included vivid images on social media that helped remove doubts about the disease’s reality. Even former sceptics became believers, and more importantly, participants in prevention.
Nigeria must do the same. Messaging about malaria or schistosomiasis should not be relegated to obscure Ministry of Health or National Orientation Agency bulletins. These diseases must be made visible in the media, in markets, in schools, and in motor parks, where real people live, work, and travel. The average citizen must know how diseases are transmitted and what steps to take to avoid them. Cultural taboos around diseases like leprosy or ulcers must be tackled head-on through education and compassion.
Another key lesson from Sierra Leone’s mpox case was its decentralised response. Public-health workers were deployed to remote communities to identify suspected mpox cases, initiate treatment, and deliver care (although it is a smaller nation than Nigeria). Nigeria, despite its size and greater resources, often concentrates its health interventions in urban centres. Rural areas are left with broken primary health facilities, poor diagnostic infrastructure, and almost no surveillance capacity.
If Nigeria is to beat back endemic diseases, the strategy must be community-led and decentralised. Primary Health Centres (PHCs) across the country must be equipped and empowered, not only to deliver routine care but also to detect and report unusual disease trends. Training and deploying community health workers, like Sierra Leone did, should be a central part of Nigeria’s disease control strategy.
Even without the scale of Ebola or COVID-19, Sierra Leone treated mpox with seriousness. Airports introduced hand sanitiser checkpoints. Offices conducted temperature screenings. Isolation centres were set up in military and police hospitals. Notably, mild cases were managed at home to avoid overwhelming the health system, a balance of urgency and pragmatism.
Nigeria, in contrast, has become numb to its endemic crises. Malaria kills more than 200,000 Nigerians yearly, yet barely triggers any emergency-level response. Yellow fever re-emerges periodically in avoidable outbreaks. By now, Nigeria should be treating endemic diseases as long-term emergencies, especially when the solutions are within reach: better sanitation, improved vector control, vaccination campaigns, and surveillance.
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To achieve this, Nigeria must overcome two familiar barriers: underfunding and political apathy. As Sierra Leone shows, even limited resources can go far with the right prioritisation. Despite budgetary constraints and cuts in foreign aid, Sierra Leone reallocated military and police facilities into care centres. Nigeria’s states, which often waste billions on white-elephant projects, have no excuse.
The time has come to treat Nigeria’s health crises not as background noise, but as national priorities. Funding for disease control must be ring-fenced. Partnerships with local NGOs, international health agencies, and research institutes must be deepened. Politicians must be made accountable for health outcomes, just as they are for elections.
Sierra Leone’s handling of the mpox outbreak underscores a simple truth: public health victories are not just about money; they are about urgency, clarity, and community engagement. Nigeria, with its vast population and diverse geography, has a tougher task but also a greater incentive. By adapting Sierra Leone’s strategy, clear messaging, decentralised response, and political will, Nigeria can begin to push back the diseases that have long held its people hostage.
Endemic diseases should no longer be seen as part of life in Nigeria. They should be seen as enemies of progress. The roadmap to defeating them is clear.
