Nigeria's malaria crisis demands urgent ITN adoption as rainy season peaks

The rains have returned to Nigeria, and with them comes the season when mosquitoes thrive. Across northern cities and towns, stagnant water collects in forgotten containers, puddles pool in streets, and blocked drains create breeding grounds by the thousands. For the insects that carry malaria, this is their moment—the female mosquitoes lay eggs in these still waters, and within days, the cycle begins again. By evening, stepping outside in Borno or Yobe state becomes a calculated risk. The mosquitoes come in waves, and each bite carries the possibility of plasmodium, the parasite that causes one of Africa's most persistent killers.

Hafsat Musa knows this risk intimately. Three years ago, her son Ali developed a fever on a rainy day in Damaturu, the capital of Yobe State. She thought it was the cold—a natural reaction to the weather. She gave him warm herbal remedies, rubbed his small body with herbal balm, and waited. For three days she waited. When someone finally urged her to take him to the hospital, it was already too late. At the public hospital, the doctors and nurses worked through the night, but Ali's body was too weak. He died shortly after dawn prayers. Hafsat still remembers his heat, his vomiting, his crying. She remembers the moment she lost him.

Ali's death is not an outlier in Nigeria. According to the World Health Organization's 2025 report, Nigeria records approximately 194,000 malaria deaths each year and 68.4 million cases. These figures represent between 30 and 31 percent of all malaria deaths globally—the highest burden of any nation on earth. Among children, the toll is even steeper: Nigeria accounts for 38 percent of malaria deaths in children worldwide. The disease drains families financially, exhausts the health system, and takes lives that should have been lived.

Public health experts have a clear prescription: sleep under insecticide-treated nets, install screens on windows, keep homes clean, and eliminate standing water. These are not new ideas. They have been part of prevention campaigns for decades. Yet malaria persists, and frustration is mounting. Dr. Michael Adekunle Charles, who leads the RBM Partnership to End Malaria—a global coalition of over 500 organizations—speaks of the disease with a weariness born of long struggle. "Malaria has been with us for decades," he said in a recent interview. "This is why we are saying 'enough is enough.'" The partnership has launched the Zero Malaria campaign, which includes an unusual tactic: a football advocacy team featuring former international players like Jay Jay Okocha, using the sport's global reach to spread the message of prevention.

But there is a complication that has emerged in recent years. Mosquitoes are developing resistance to the very insecticides that have long been the backbone of malaria control. Dr. Abubakar Abiso, a family physician and public health expert at the University of Maiduguri Teaching Hospital, points to WHO data showing that nearly 80 countries have reported mosquito resistance to commonly used insecticides. In about 28 countries, mosquitoes have developed resistance to all available insecticide classes. This means that indoor spraying—a strategy many Nigerians have relied on—is becoming less reliable. "People should be careful," Dr. Abiso warned. "Reports have shown there is resistance to many of the insecticides."

The geography of the crisis compounds the problem. Eighty percent of Nigerians live in areas where malaria transmission is high, while only 20 percent live in low-transmission zones. This means contact with infected mosquitoes is nearly unavoidable for most of the population. The solution, experts agree, lies not in any single intervention but in a sustained, multi-layered approach: nets that work, homes that are sealed and clean, drainages that are cleared, and a population that understands the threat and acts on it. The Zero Malaria campaign is pushing this message through sports, through media, through advocacy. But the real work happens in homes like Hafsat's, where families must decide, night after night, whether to sleep under a net, whether to clear the water from the yard, whether to take the fever seriously enough to seek help immediately. For Ali Musa, that decision came too late. For the millions of Nigerians living in high-transmission areas, the question remains urgent: will they act before the rains return?