Health system readiness and barriers to effective deployment of the R21 malaria vaccine in Nigeria

Malaria is a major public health concern in Nigeria and has accounted for the highest percentage of the global malaria burden compared to any other country in the world. Over the past decades, Nigeria has implemented a broad range of interventions to reduce malaria cases and deaths. Some of these efforts include the distribution of long-lasting insecticide-treated nets and seasonal malaria chemoprevention. Other governance mechanisms for malaria control include the establishment of the National Malaria Elimination Programme (NMEP), National Malaria Strategic Plan (NMSP), and the Nigeria End Malaria Council (NEMC) aimed at eliminating malaria. While these interventions and strategic plans have been beneficial in achieving success in reducing malaria prevalence, Nigeria has yet to achieve nationwide elimination. The recent introduction of the R21 malaria vaccine is one of the most promising developments in achieving malaria control strategy. Several challenges hinder the widespread deployment of the R21 malaria vaccine in Nigeria. In this commentary, we address challenges including logistical hurdles and supply chain challenges, inadequate financing, vaccine inaccessibility, and vaccine hesitancy. We further provided recommendations such as ensuring adequate vaccine supply and efficient access and distribution, strict data collection and monitoring, comprehensive vaccine health education programs, and strengthening healthcare infrastructure for effective vaccine deployment. The introduction of the R21 vaccine, if effectively deployed, represents a critical tool in Nigeria’s malaria control strategy, which has the potential to significantly reduce malaria-related deaths, and contribute immensely to Nigeria’s long-term malaria elimination efforts.