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Despite carrying the highest malaria burden in the world, Nigeria’s malaria treatment policies remain effective, according to a senior researcher at the Nigerian Institute of Medical Research (NIMR).
However, she warned that emerging threats — including drug resistance, insecticide failure and the spread of invasive mosquito species — could undermine both national control efforts and the global push to eradicate malaria.
Speaking at NIMR’s December Media Chat in Lagos, Dr Adeola Olukosi, Director of Research at the institute, said Nigeria’s size and disease burden make it central to global malaria elimination.
“Malaria remains the most widespread public health problem in Nigeria,” she said. “Because Nigeria accounts for the largest number of malaria cases and deaths worldwide, especially among children under five, global eradication will not succeed unless malaria is effectively controlled here.”
Dr Olukosi disclosed that surveillance data from NIMR’s collaboration with the National Malaria Elimination Programme (NMEP) shows that Nigeria’s first-line malaria medicines — Artemisinin-based Combination Therapies (ACTs) — are still working.
She explained that NIMR supports national malaria policy through sentinel surveillance and therapeutic efficacy studies, which track how antimalarial drugs perform across selected sites nationwide.
According to her, results from surveillance coordinated by NIMR and NMEP in 2018 led to the inclusion of dihydroartemisinin-piperaquine as an additional first-line treatment for uncomplicated malaria, alongside artemether-lumefantrine and artesunate-amodiaquine.
“There are very few effective malaria drugs available globally,” she said. “Once a drug’s effectiveness drops below acceptable levels, treatment policies must change. That is why continuous monitoring is essential.”
Although Nigeria has not recorded widespread resistance to ACTs, Dr Olukosi cautioned that experiences elsewhere point to future risks. Artemisinin resistance has already been documented in parts of Southeast Asia, while molecular surveys suggest emerging resistance-related mutations in East Africa.
“Historically, resistance often starts in South-East Asia and gradually spreads towards Africa. Nigeria must remain vigilant,” she warned.
She added that molecular surveillance — recently assigned to NIMR by NMEP — enables scientists to detect resistance patterns before treatment failure becomes widespread.
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On malaria prevention, Dr Olukosi said research conducted with partners such as the Malaria Consortium and the London School of Hygiene and Tropical Medicine found low levels of resistance markers to sulfadoxine-pyrimethamine, the drug used for Seasonal Malaria Chemoprevention (SMC) in northern Nigeria.
“The findings confirm that SMC remains suitable and effective in the states studied,” she said, noting that malaria transmission is seasonal in the north but occurs year-round in southern Nigeria.
She also raised concern over growing insecticide resistance in malaria-transmitting mosquitoes, explaining that resistance to pyrethroids — commonly used in insecticide-treated nets — is now widespread nationwide.
“As a result, Nigeria has transitioned to deploying nets treated with combinations of insecticides, rather than pyrethroids alone,” she said.
One of the most serious emerging threats, according to Dr Olukosi, is the detection of Anopheles stephensi, an invasive mosquito species originally from South-East Asia that thrives in urban environments.
She confirmed that NIMR was the first institution in Nigeria to molecularly confirm the presence of the species, following samples collected in Gombe State.
Dr Olukosi stressed that Nigeria cannot be side-lined in global malaria strategies, noting that NIMR participates in international collaborations, including the West African Network for TB, AIDS and Malaria (WANATEM).
In his remarks, NIMR Director-General, Prof Oladapo Obafunwa, said Nigeria’s malaria statistics must be viewed in the context of its population size.\ “Nigeria represents a quarter or more of Africa’s population, so higher absolute numbers are expected,” he said, adding that malaria prevalence varies widely even within the same state. Citing a recent study in Epe, Lagos State, Prof Obafunwa said malaria prevalence of between six and eight per cent was recorded in some primary health centres.
While acknowledging progress in some urban areas, he stressed that population movement across state boundaries continues to influence malaria transmission.
“There are no watertight borders. Malaria control requires sustained, coordinated effort,” he said, reaffirming NIMR’s commitment to evidence-based malaria interventions nationwide.
