Health
How poverty fuels preventable childhood killer diseases despite available vaccines
As poverty and malnutrition deepen, many Nigerian children are battling preventable killer diseases because low-income families cannot afford basic healthcare and adequate nutrition. The 2025 Joint Health Sector Report by the Federal Ministry of Health and Social Welfare shows rising cases of malaria among children under five, diarrhoea, pneumonia, and other vaccine-preventable diseases despite the availability of free vaccines. DEBORAH TOLU-KOLAWOLE writes
When 20-month-old Batula stopped walking, her family believed something supernatural was happening.
The little girl from Nigeria’s conflict-ravaged North-East had become so weak she could barely move. Painful boils appeared on her cheeks, followed by diarrhoea and persistent fever. Convinced evil spirits were responsible, her mother, Aisha, invited a traditional healer who cut Batula’s cheeks with a razor blade and applied herbal remedies.
Still, the toddler’s health did not improve.
“I was convinced it was an evil spirit behind Batula’s illness, and I was so afraid of losing her. I had lost six infant children. Batula is my eleventh child,” Aisha recalled.
Eventually, the family took Batula to a UNICEF-supported outpatient nutrition clinic in Borno State, where health workers diagnosed her with severe acute malnutrition.
A nutritionist at the centre, Babagana Kolo, said the toddler had been ill for eight months before receiving appropriate treatment.
Batula’s story is one of the thousands unfolding across northern Nigeria, where poverty, conflict, disease and food insecurity leave children severely undernourished.
The Federal Ministry of Health and Social Welfare’s Joint Health Sector Report 2025 shows that although cases of severe acute malnutrition declined slightly from 947,001 in 2024 to 916,210 in 2025, the numbers remain among the highest recorded in recent years.
For paediatricians, Batula’s story illustrates how childhood illnesses rarely occur in isolation.
Malnutrition weakens a child’s immune system, making diseases such as malaria, diarrhoea and pneumonia far more likely to become fatal.
9.5 million malaria cases among children under-five
For Maryam Sherif, malaria is not simply another tropical disease.
It is the illness that claimed the life of her two-year-old son.
Sherif, who lives in the Muna displacement camp in Maiduguri after fleeing violence in Borno State, recalled how Ibrahim battled malaria before his demise due to lack of access to treatment.
Seeing her son’s state, the bereaved mother quickly carried him to the hospital, but as she went, she remembered that she had no money to pay for the treatment.
“Last year during the rainy season, my two-year-old son Ibrahim died of malaria. He fell ill all of a sudden, and there was very little I could do to save him. I did not have money to take him to the hospital,” she recounted in a testimony shared with journalists by MSF.
Still grieving, Sheriff added, “I can’t stand losing another child to malaria.”
Her experience mirrors that of countless internally displaced families where poverty, conflict and poor access to healthcare often turn a treatable illness into a death sentence.
Nigeria’s children remain trapped in a cycle of preventable illness, with malaria, diarrhoea, pneumonia and vaccine-preventable diseases continuing to dominate outpatient visits and child health outcomes, according to the Joint Health Sector Report 2025 published by the Federal Ministry of Health and Social Welfare.
The report paints a mixed picture. While some conditions such as diphtheria and circulating vaccine-derived poliovirus type 2 show improvement, the overall burden of childhood disease is still rising across several key indicators.
Malaria alone accounted for more than 9.5 million cases among children under five in 2025, up from 9.1 million in 2024. Diarrhoeal diseases, acute respiratory infections and measles also recorded increases, reinforcing concerns that progress in child health remains fragile and uneven.
Health experts warn that behind these numbers are children whose illnesses are not only preventable but often deadly if untreated.
Malaria: the leading killer disease
Malaria remains the single largest contributor to child illness in Nigeria.
With over 9.5 million under-five cases recorded in 2025, the disease continues to dominate outpatient visits and seasonal admissions. The Joint Health Sector Report attributes the increase to environmental conditions, climate variability and persistent gaps in mosquito net usage and vector control.
Public health experts note that malaria is no longer just a clinical issue but a development challenge tied to housing, drainage systems, and poverty.
According to UNICEF, malaria transmission in Nigeria is strongly influenced by climate conditions and environmental exposure, making under-five children particularly vulnerable due to their weaker immune systems and dependence on caregivers for protection.
For many families, malaria is a recurring burden rather than an isolated illness.
A mother of three in Nasarawa State, who lost her youngest child to severe malaria complications, previously told health workers during a community outreach programme that she initially treated the illness at home because she “did not think fever could kill a child within days.”
By the time she reached a health facility, the child had already developed severe anaemia.
Such stories are common in rural and peri-urban communities where access to prompt healthcare remains limited.
Nigeria: Where preventable diseases remain leading killers
Nigeria continues to carry one of the world’s heaviest burdens of under-five mortality linked to preventable diseases.
Globally, UNICEF has identified pneumonia as one of the leading infectious killers of young children, particularly in countries with low vaccination coverage and high exposure to indoor smoke from cooking fuels.
According to UNICEF’s Nigeria child survival analysis, pneumonia alone is responsible for a significant proportion of child deaths globally, with Nigeria consistently contributing a high share due to low immunisation coverage and environmental risks such as indoor air pollution and malnutrition.
A 2019 UNICEF analysis noted that Nigeria accounted for the highest number of pneumonia-related child deaths globally, with 162,000 deaths among under-5-year-olds annually.
Also, the Coordinating Minister of Health and Social Welfare, Prof Muhammad Pate, in November 2025, reiterated that the country records 162,000 childhood pneumonia-related deaths annually.
According to the JAR report, acute respiratory infections, including pneumonia, also increased from the rate of 0.81 to 0.90 in 2025.
Pneumonia is especially dangerous for children under five, and experts say it often goes undiagnosed in its early stages because symptoms resemble a common cold.
Child experts who spoke with PUNCH Healthwise stressed that these deaths rarely happen in isolation.
They mentioned poor nutrition, lack of vaccination, unsafe water, and delayed access to care as factors making children vulnerable to illnesses.
They also stated that overcrowding, air pollution, and delayed treatment contribute significantly to mortality.
A senior paediatric consultant at the University College Hospital, Ibadan, Dr Olufemi Agboola, described childhood illness in Nigeria as “a predictable tragedy of inequity,” where survival often depends on geography and income rather than medical possibility.
Diarrhoea and the WASH crisis
Diarrhoeal diseases remain closely linked to Nigeria’s water, sanitation and hygiene (WASH) deficits.
The report shows a steady rise in the rate from 3.03 in 2024 to 3.11 in 2025, indicating persistent transmission.
Public health experts consistently link diarrhoea-related child deaths to unsafe drinking water, open defecation and seasonal flooding.
UNICEF has repeatedly warned that poor sanitation infrastructure remains one of the most underestimated drivers of child mortality in Nigeria, particularly in informal settlements and rural communities where clean water access is inconsistent.
Health workers note that diarrhoea becomes deadly not because it is difficult to treat, but because families often arrive at hospitals too late or rely on home remedies that fail to prevent dehydration.
Measles resurgence and vaccine gaps
The report also showed that measles cases rose from 0.15 in 2024 to 0.23 in 2025, reflecting ongoing immunisation gaps.
Health officials attribute the resurgence to declining herd immunity, misinformation, and uneven vaccine distribution across local government areas.
A UNICEF consultant, Dr Pita Obam, warned that measles outbreaks in Nigeria are often driven by “waning immunity and gaps in vaccination coverage,” urging stronger community engagement and routine immunisation drives.
Measles, though preventable, remains a major killer of children in low-income settings when vaccination coverage falls below required thresholds.
Meanwhile, to combat vaccine-preventable childhood killer diseases, the World Health Organisation recommends routine immunisation for all children and appropriate vaccination through the life course.
Immunisation is one of the most cost-effective proven tools for controlling and eliminating life-threatening infectious diseases and is estimated to avert about three million deaths every year.
Current vaccines for routine childhood vaccination in Nigeria protect children against tuberculosis, hepatitis B, Polio, diphtheria, pertussis, tetanus, Haemophilus influenza type b, pneumococcal disease, rotavirus, measles, yellow fever and meningitis.
The Federal Government, in collaboration with WHO, with funding from GAVI, the Gates Foundation, and other partners, has been implementing free routine immunisation programmes across public health facilities in the country.
Malnutrition: the silent multiplier
Severe Acute Malnutrition remains one of the most critical underlying causes of child death in Nigeria.
The report recorded a slight improvement from 947,001 cases in 2024 to 916,210 in 2025, but health experts warn that the figures remain alarmingly high.
Malnutrition weakens the immune system, making children more vulnerable to infections such as malaria, diarrhoea and pneumonia.
UNICEF has consistently described malnutrition as a “silent driver” of child mortality, particularly in conflict-affected and economically stressed regions of northern Nigeria.
Improving detection, not necessarily incidence
One of the notable increases in the report is sickle cell disease, rising from 64,666 identified cases in 2024 to 74,424 in 2025.
However, the report clarifies that this reflects improved detection rather than increased incidence, driven by expanded newborn screening and better reporting systems.
Health officials say this improvement signals progress in surveillance capacity, even if the disease burden itself remains unchanged.
The human cost behind the data
Behind every statistic is a household shaped by illness, loss, and financial strain.
Childhood diseases in Nigeria do not only result in death. Survivors often experience long-term complications such as stunted growth, cognitive impairment, organ damage, and lifelong disability.
Health economists warn that repeated illness in early childhood also reduces school attendance and productivity later in life, reinforcing cycles of poverty.
Experts say the emotional toll on families is equally devastating, particularly for mothers who often bear the burden of caregiving and treatment costs.
Public health experts say the most urgent intervention is expanding and strengthening primary healthcare systems so that children can be reached early before illnesses become severe.
The WHO Regional Director for Africa, Dr Chikwe Ihekweazu, said many childhood deaths persist because health systems are not strong enough to prevent basic diseases.
“The reality is that too many children across our region are still dying from diseases that we already know how to prevent, diagnose, and treat. This is unacceptable in the 21st century. We must strengthen primary health care systems, expand routine immunisation, and ensure that every child—no matter where they are born—has access to life-saving vaccines and essential health services,” he said.
He stressed that repeated outbreaks of measles and diphtheria reflect deeper structural weaknesses.
“Outbreaks of measles, diphtheria, and other vaccine-preventable diseases are not just biological events; they are signals of system failure. When we see them, we must respond by fixing the health system, not just reacting to the disease,” Ihekweazu said.
Clinical experts say improving childhood survival also depends on how quickly caregivers recognise symptoms and seek medical care.
Nigerian paediatricians warn that many children arrive at hospitals too late because caregivers initially rely on home treatment or self-medication.
A senior paediatric consultant at the University of Benin Teaching Hospital, Dr Fidelis Eki-Udoko, said infections remain the most common causes of childhood emergencies seen in hospitals.
“These conditions range from infections like diarrhoea, respiratory infection, to non-infectious causes like children with asthma, convulsion, epilepsy, cancer… all these constitute emergencies,” Eki-Udoko said.
Another Nigerian paediatrician, Dr Atinuke Uwajeh, said incorrect assumptions about childhood illnesses continue to worsen outcomes, especially when fever is automatically treated as malaria.
She explained, “There are certain things we know are more common: cold and upper respiratory infections. A cold is a viral infection. It will run its course, and you don’t need antibiotics for it.”
Uwajeh warned that fever must not be assumed to be malaria without proper diagnosis.
“There are so many things that could cause a fever. A viral infection, a bacterial infection, parasites, which is where malaria falls… Malaria is an infection caused by a parasite called Plasmodium. It is not enough to say a child is warm or vomiting and conclude it is malaria. Malaria is a diagnosis, which means there must be tests done,” she said.
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