As Diphtheria Returns to Our Doorsteps

In the last three weeks, Plateau State has recorded no fewer than 23 deaths and 143 suspected cases of diphtheria in Jos North alone. In Kano, the toll is over 32,000 confirmed infections and more than 1,800 deaths since December 2022. And Katsina has now joined the emergency list, with treatment annexes being set up across its three senatorial districts.

This is another crisis that demands an urgent response.

Diphtheria is vaccine-preventable. It spreads through coughs, sneezes, and close contact. It starts like a sore throat, then turns deadly when the toxin attacks the heart and nerves. The difference between life and death is often hours, and a single dose of antitoxin.

Yet our health system is fighting with one hand tied. The Plateau Commissioner for Health has said the biggest challenges are shortage of diphtheria antitoxin and late presentation at hospitals. We are also short of the special containers needed to move samples for confirmation. In Kano, officials report that more than 16,000 of the confirmed cases involved children who had never received a single vaccine dose.

That statistic is embarrassing especially in an era that the subnational governments are believed to be swimming in humongous revenues.

The Federal Government has moved. A task force has been activated, co-led by NCDC and the Ministry of Health. The NPHCDA has deployed 500,000 doses of diphtheria-containing vaccines to Kano and Katsina for intensified immunization. Treatment annexes are also said to be coming to Katsina, Daura and Funtua. The Federal Teaching Hospital in Katsina will get emergency supplies of antitoxin, antibiotics, personnel and Personal Protective Equipment, PPE.

These are welcome steps. But emergency vaccination cannot substitute for routine immunization. We cannot chase an outbreak forever.

The resurgence points to three hard truths we must confront in the North.

Vaccine hesitancy and misinformation are still killing us. For years, rumours and fear have kept parents away from health centres. We must stop outsourcing health education to Abuja. We must take the message directly using our local languages in the market, at the worship places, and from the people communities trust. This is where the role of traditional rulers, religious leaders, teachers, and women’s leaders become imperative. As infectious disease experts have said, go directly to local communities to build real understanding.

It is also common knowledge that our primary health centres are not ready. Most deaths happen because families arrive too late to facilities that are distant. We need functional Primary Health Centres in every ward with trained staff who can recognize diphtheria, isolate cases, and refer quickly. We also need the basic tools: antitoxin, antibiotics, and sample containers. We must admit that stockouts at this stage are a policy failure, not an accident.

And surveillance must be real-time. Diphtheria thrives in silence. Weekly reporting is good, but community health workers should be empowered to flag clusters immediately. Parents should know the signs and where to go. This is tied to the need for sustained enlightenment.

Accordingly, we urge parents not to wait whenever their child has fever, sore throat, swollen neck, or trouble breathing. Vigilance is key because isolation and early treatment can save lives.

We also urge governments in the affected states-Plateau, Katsina, Kano-to release emergency funds now. But they should not stop at that. They should also audit their cold chains and vaccine records. Further, the zero-dose children in the communities should be located and vaccinated in this mop-up, while health workers should be protected with PPE.

In finding immediate solutions to this crisis, religious and traditional leaders cannot be ignored. Their voices carry more weight than any publicity instruments. As trusted people, they can urge vaccination, debunk myths and accompany health teams into homes. That is the state we are now.

The good news, however, is that this outbreak is preventable because the vaccines and the knowledge exist. What we lack is urgency and coordination. We can step them up.

It is disturbing that the North has carried too much grief in the last decade — from insurgency to banditry to hunger. We cannot now add a vaccine-preventable disease to that list.