MSF Raises Alarm Over Diphtheria Drug Shortage, Says Thousands of Nigerian Children at Risk
Médecins Sans Frontières (MSF), otherwise known as Doctors Without Borders, has warned that shortages of life-saving diphtheria antitoxin and poor vaccination coverage are worsening Nigeria’s diphtheria outbreak, leaving thousands of children vulnerable to severe illness and death.
The international medical humanitarian organisation said the global shortage of diphtheria antitoxin (DAT), the only specific treatment capable of neutralising the toxin produced by the disease, was undermining treatment efforts, particularly in northern Nigeria where infections and deaths remain high.
It urged the Federal Government, state authorities, donors and international health partners to urgently secure available supplies of antitoxin, vaccines and other essential medicines, while ensuring their prompt clearance at ports and distribution to affected communities.
MSF Medical Coordinator in Nigeria, Dr David Kizito, raised the alarm in a statement issued on Friday, warning that dwindling stocks could leave medical teams unable to treat critically ill children.
“The global shortage of diphtheria antitoxin is becoming a matter of life and death. Our stocks are dangerously low, and we risk being unable to treat children and save lives as the outbreak continues,” Kizito said.
He regretted that children continued to develop life-threatening complications from a preventable disease because of incomplete vaccination and delays in accessing medical care.
According to MSF, diphtheria antitoxin is most effective when administered within 48 hours of the onset of symptoms, making timely availability critical to preventing complications and deaths.
The organisation said inadequate supplies had repeatedly forced its medical teams to ration treatment or manage patients without sufficient quantities of the essential drug, thereby compromising treatment outcomes.
Nigeria has been battling a major diphtheria outbreak since late 2022, with cumulative figures exceeding 41,000 suspected cases, more than 24,000 confirmed infections and over 1,260 deaths nationwide.
The outbreak has particularly affected northern states, including Bauchi, Borno, Kaduna, Katsina, Kano, Plateau, Sokoto and Zamfara, where several communities have recorded fresh increases in infections.
In 2026 alone, Nigeria had recorded 12,977 suspected cases, 10,476 confirmed infections and 406 deaths as of August 9, according to the organisation.
The figures underscore the continuing pressure on healthcare facilities, particularly in communities where routine immunisation remains inadequate and access to specialised treatment is limited.
MSF said it had treated more than 9,000 diphtheria patients through facility and community-based interventions since the beginning of its response this year, while supporting state health authorities with surveillance, infection prevention, vaccination, health promotion, referrals and medical supplies.
Its teams are currently supporting treatment and isolation facilities in Kano, Sokoto and Zamfara, with additional interventions in Bauchi, Katsina and Kebbi states.
In Kano, the organisation supported a two-round vaccination campaign in April and June in partnership with the state Ministry of Health, administering more than 835,000 vaccine doses to children.
In Sokoto, it supported two vaccination rounds between February and April, reaching 49,018 children under the age of 15.
However, the situation in Zamfara illustrates the scale of the vaccination gap confronting efforts to contain the outbreak.
Following the state’s declaration of an outbreak in September, MSF-supported facilities in Gusau recorded more than 671 admissions within one month, beginning October 6.
The organisation said most of the patients were children, while four out of every five admitted had not received diphtheria vaccination.
It further disclosed that only 25,000 of the 90,000 vaccine doses required for a reactive vaccination campaign in Zamfara had been supplied, leaving approximately three-quarters of the targeted children unreached.
MSF said it was working with government health authorities to secure additional doses and implement a large-scale vaccination campaign to close the gap.
The organisation also highlighted the human consequences of the outbreak through the experience of Shafa’atu, a mother whose three children were treated for diphtheria at an MSF-supported hospital in Sokoto.
She said her family initially knew little about the disease and became frightened when their first child developed symptoms.
“My child struggled to eat, and whenever he ate, he vomited. Diphtheria is a dangerous disease,” she said.
Beyond the immediate shortage of treatment, MSF identified weak routine immunisation as a major factor sustaining transmission, particularly in rural communities across northern Nigeria.
It called for sustained investment in routine vaccination to build community immunity and prevent recurring outbreaks, while urging pharmaceutical manufacturers and global health partners to expand diphtheria antitoxin production and establish reliable supply arrangements.
The organisation noted that although DAT is included in the World Health Organisation’s Model List of Essential Medicines, its global availability remains inconsistent because manufacturers produce limited quantities amid unpredictable demand and low financial returns.
It said many countries, including Nigeria, lacked contingency stocks and depended on donations or procurement through United Nations agencies.
Diphtheria is a potentially fatal bacterial infection transmitted mainly through respiratory droplets and contact with infected wounds. It can cause fever, sore throat, swollen lymph nodes and the formation of a thick membrane in the throat that can obstruct breathing.
In severe cases, the toxin can damage the heart, nerves and kidneys, with between 30 and 40 per cent of infected persons at risk of dying without appropriate treatment, according to MSF.
The organisation said its interventions in Zamfara’s Gummi, Talata Mafara, Shinkafi and Zurmi local government areas had resulted in the treatment of 1,054 patients since January 2026.
In Bauchi State, MSF said it helped reduce the diphtheria case fatality rate from 8.7 per cent to one per cent after treating at least 1,890 suspected patients between August 2025 and May 2026.
It also reported that its teams managed 86 diphtheria cases in Katsina between October 26 and November 12, comprising 70 severe and 16 non-severe cases.
During the same period, 1,315 contacts were reached through facility-based interventions and contact tracing, with 1,301 vaccinated and 1,311 given antibiotic prophylaxis.
MSF stressed that addressing the outbreak required more than emergency treatment, insisting that uninterrupted access to antitoxin, expanded vaccination coverage and sustained investment in primary healthcare were essential to protecting children and preventing further deaths.
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