“Médecins Sans Frontières” (MSF) is calling on donors and governments not to lose focus on diphtheria, even as the peak of infections passes in Nigeria. A forgotten childhood illness due to its eradication through vaccination in many parts of the world, this deadly form of sore throat resurfaced in May 2022 on the African continent, particularly in Nigeria, where the epidemic is still ongoing.
At the height of the epidemic in northern Nigeria last year, healthcare workers faced a shortage of vaccines and the diphtheria antitoxin. This made it impossible to immunize all vulnerable individuals and effectively treat all severe cases in the territories most affected by the resurgence of diphtheria, a disease characterized by severe sore throat, fever, fatigue, and the formation of a grayish membrane in the throat and tonsils.
For instance, in Nigeria, as of November 2023, only 7.8 million out of 14 million children were vaccinated, according to UNICEF. Since the peak in July last year in Nigeria, 98.9% of the 35,324 suspected cases and 923 deaths recorded since 2023 have occurred in the states of Kano, Yobe, Bauchi, Katsina, and Borno. While the monthly number of infections is decreasing, it remains high.
“Active Epidemic Outbreaks”
Niger, Guinea, Mauritania, and South Africa are also affected by “active epidemic outbreaks,” according to the WHO. In Niger and Guinea, the situation of this disease, which can lead to respiratory problems and death in severe cases, remains stagnant.
For Niger, where sporadic cases were recorded as early as 2021 before an epidemic outbreak in 2022, 3,398 suspected cases, including 229 deaths, were recorded in 2023. Last year, the Zinder region accounted for 76% of cases. Since the beginning of 2024, it now accounts for “only” 50% of cases, with the rest mainly distributed between the Agadez (23%) and Tahoua (18%) regions.
For Guinea, where the outbreak was recorded in August 2023, 78 deaths (2,240 suspected cases) were recorded in 2023, with 16 deaths since the beginning of January (2,709 cases). The vast majority of cases (98%) are reported in the Siguiri health district, in northeastern Guinea, near the border with Mali.
Low Vaccine Coverage
According to MSF, 65% of patients with diphtheria are not fully vaccinated. Due to irregular demand and uncertain return on investment, private laboratories producing vaccines and treatments are reluctant to significantly increase their production. MSF calls on the World Health Organization and governments to establish emergency stockpiles as is the case for yellow fever and cholera, to invest more in catching up on vaccination gaps, and to develop treatments that are easier to deploy in the field.