Prof. Akin Abayomi, the Lagos state commissioner for health, has revealed that most fever cases recorded in Lagos are no longer linked to malaria, a development he described as a major shift in the state’s disease landscape.
Speaking at the Mid-Term Review of the Pathway to Malaria Pre-Elimination in Lagos, Abayomi said recent data showed that only about 5.6 percent of fevers tested in informal healthcare outlets were malaria-positive.
This, he noted, confirms that Lagos is firmly in the malaria pre-elimination phase, with prevalence now hovering around one percent.
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“This new reality means that most fevers in Lagos are malaria-negative fevers. It requires accurate diagnosis and alternative treatments to ensure patients receive proper care. Continued reliance on presumptive treatment of fever as malaria carries serious risks,” the commissioner said.
Abayomi explained that with malaria cases declining sharply, misdiagnosis and drug misuse have emerged as new challenges. He warned that patients with non-malaria fevers risk delayed recovery and complications if treated with antimalarials without proper testing. To address this, he emphasized adherence to the “test-before-treatment” protocol, calling it essential to sustaining progress in malaria control and safeguarding overall public health.
The commissioner outlined new policies aimed at strengthening diagnostic capacity across public and private health facilities, alongside expanded environmental health interventions and intensified public awareness campaigns. He added that the next phase of the malaria elimination effort would demand a higher level of sophistication, surveillance, and behavioral change.
Governor Babajide Sanwo-Olu, in his keynote address, declared that Lagos had reached a decisive phase in its ambition to shift from high malaria burden to pre-elimination status, stressing the importance of accountability, data transparency, and community ownership in the ongoing campaign.
“When we kicked off this initiative on March 4, we had a clear vision: to transform hope into measurable results and shift Lagos from a high-burden malaria zone to one on the brink of elimination. Today’s review is more than a formality, it is a critical checkpoint in our journey to a malaria-free Lagos,” Sanwo-Olu said.
The governor highlighted the significance of the digital reporting system now operational in public and private health facilities, which has bridged information gaps and improved diagnostic accuracy. He said the innovation was not only strengthening surveillance but also integrating community pharmacies and patent medicine vendors into the state’s malaria control efforts.
“Every Lagosian must have access to rapid testing and the right treatment, when and where necessary,” Sanwo-Olu said, noting that scaling up interventions would not be allowed to compromise quality. He added that continuous training, supervision, and alignment with the ILERA EKO health insurance platform were central to sustaining progress.
Sanwo-Olu further called on residents to take ownership of malaria prevention by eliminating mosquito breeding sites, testing before treatment, and trusting the health system. He maintained that community participation, alongside government and private sector collaboration, would ensure that malaria ceases to be a major public health problem in Lagos.
The governor also acknowledged support from development partners including the World Bank, Islamic Development Bank, Bill and Melinda Gates Foundation, WHO, and the National Malaria Elimination Programme. He stressed that Lagos must remain a “shining example” of effective malaria control in Nigeria and West Africa.
Prof. Muhammad Ali Pate, the coordinating minister of Health and Social Welfare, praised Lagos state for pioneering malaria pre-elimination strategies that are already yielding tangible results. He described the digital integration of community pharmacies and medicine vendors into malaria service delivery as a “game-changer” in bridging gaps in Nigeria’s primary healthcare ecosystem.
Pate lauded the deployment of technology to enhance real-time reporting and analysis, which he said was vital to identifying service delivery gaps, tracking progress, and informing policy adjustments in Nigeria’s broader malaria elimination campaign.
Dr. Maya Ngon, WHO team lead for health promotion, disease prevention, and control, described Lagos as a model of strong leadership, innovation, and partnership in malaria control. She said the integration of private providers into a digital surveillance system was a major step forward in strengthening Nigeria’s health system.
Ngon assured that WHO would continue to provide technical guidance, global best practices, and strategic options tailored to Lagos, urging stakeholders to convert innovations into measurable outcomes that save lives. She reaffirmed the organization’s commitment to work with Lagos “until the vision of malaria elimination is achieved.”
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Dr. Onoriode Ezire, senior health specialist with the World Bank, in his presentation, highlighted that Lagos has made remarkable progress in reducing malaria prevalence, moving from about 15 percent in 2010 to just over 3 percent by 2022. He described Lagos as now being at the “pre-malaria elimination stage,” but warned that sustaining this progress would require a strong focus on intensified surveillance systems. According to him, “Every single case must be reported, investigated, and documented swiftly,” stressing the need for zero reporting, where health facilities provide updates even when no cases are detected, to ensure no data gaps.
Ezire further outlined strategies for the state’s malaria response beyond 2026, emphasizing data-driven interventions and vector control measures targeted at hotspots.
Ezire recommended scaling up new tools such as malaria vaccines, strengthening diagnostic services, and introducing proactive case detection methods in high-risk communities. He noted that Lagos could leverage the ongoing World Bank-supported IMPACT Project, which is expected to run until December 2026, to build capacity, strengthen surveillance systems, and advocate for stronger political and financial commitments towards malaria elimination.
