The Lagos State Commissioner for Health, Professor Akin Abayomi, has stated that the state is on the brink of making history as it moves to become the first geopolitical zone in West Africa to eliminate malaria.
According to Abayomi, the state’s ambitious drive is not reliant on vaccines or genetically modified mosquitoes, but rather on “simple common sense” medical practices and a robust public health strategy.
The initiative is being spearheaded by the Lagos State Ministry of Health, in partnership with Professor Wellington Oyibo, Director of the Centre for Transdisciplinary Research for Malaria and Neglected Tropical Diseases.
Speaking at the kick-off of the “Pathway to Pre-Elimination and Digitisation Project” in Lagos, the Commissioner emphasised the urgency of ending the malaria burden.
“It is very, very important that we do that once and for all,” Abayomi said.
The project focuses on a comparative study between Rapid Diagnostic Tests (RDTs) and microscopy, as well as assessing the capacity of Private Patent Medicine Vendors (PPMVs) to manage malaria and febrile illnesses.
Abayomi noted that Lagos has sustained a 20-year “war against malaria”, resulting in a dramatic drop in malaria prevalence among fever patients from 15–20 per cent down to just 1–2 per cent.
“Where malaria used to be 20 per cent to 15 per cent of people with fever, it is now down to between one per cent and two per cent, meaning that our strategy is working,” he explained.
This sharp decline prompted Governor Babajide Sanwo-Olu to endorse the elimination strategy.
“When we got this data, we took it straight to His Excellency, Mr Governor. ‘Commissioner for Health, do it,’” Abayomi recounted, underscoring the strong political backing.
The cornerstone of the state’s approach is the “test, treat, and track” strategy. Rather than treating every fever as malaria, the focus is now on accurately diagnosing the cause.
While microscopy has long been considered the gold standard for malaria diagnosis, Abayomi pointed out its limitations in low-resource settings, including the need for reliable equipment, trained personnel, and electricity.
Instead, Lagos is embracing Rapid Diagnostic Tests, which he described as cheaper, faster, more accurate, and more practical for broad application across community pharmacies and primary health centres.
He added that Professor Oyibo’s comparative study would further validate the effectiveness of RDTs.
The “track” component of the strategy involves environmental control rather than fumigation.
“The emphasis is on good environmental sanitation,” said Abayomi, including the removal of stagnant water, clearing blocked drains, and covering water containers to prevent mosquito breeding.
When a malaria case is detected, health officials investigate the surrounding environment to eliminate potential sources of infection.
Professor Oyibo described the initiative as a strategic shift in managing fever and emphasised the importance of accurate diagnosis.
“Whenever you talk about Africa, the thing that comes to mind is malaria and poverty and famine,” he said.
“But the evidence we are seeing right now shows that Lagos State has come to a place where, from all indications, if you say you have fever, it’s not likely going to be malaria in over 90 per cent of the cases.”
He warned that treating fevers presumptively as malaria without testing can have fatal consequences, especially for children.
“If it is a child that has pneumonia… and you now give anti-malaria medicine without doing a test, what will happen to that child? That child will die quickly of pneumonia,” he warned.
Oyibo stressed that testing before treatment ensures better care, and noted that traditional microscopy is being phased out in favour of more scalable methods like RDTs.
He praised the political will demonstrated by the Lagos State Government, describing it as unmatched in Africa.
“This is one of the greatest commitments we have from Lagos State, which we are still looking for in Africa,” he said.
According to him, with the support of stakeholders including the World Health Organization (WHO) and the National Malaria Elimination Programme, Lagos could lead the way on the continent.
“Lagos State can drive that now. They are the only state in Nigeria that has reached that,” Oyibo added.
He concluded that Lagos aims to set an example for Africa by leveraging accurate data, promoting evidence-based medicine, and applying disciplined public health practices to eliminate malaria for good.
