Diphtheria: MSF warns of treatment shortages as Nigeria records over 1,100 deaths

MSF photograph of a healthcare worker with patients at the ward

Médecins Sans Frontières (MSF) has warned that shortages of a lifesaving medicine are forcing medical teams to ration treatment for diphtheria patients in northern Nigeria, where more than 28,000 confirmed infections and 1,100 deaths have been reported this year.

The warning comes as figures attributed to the Nigeria Centre for Disease Control and Prevention (NCDC) show that the outbreak continues to spread, particularly among children who are unvaccinated or have not received all their recommended vaccine doses.

In a statement issued on Friday, MSF said supplies of diphtheria antitoxin (DAT), which neutralises the toxin responsible for potentially fatal complications, were dangerously low.

The organisation called on federal and state authorities, donors and international partners to urgently secure additional medicines and vaccines, ensure their timely clearance at ports and improve distribution to affected communities.

MSF’s Medical Coordinator in Nigeria, David Kizito, warned that the shortage could compromise the treatment of severely ill patients.

“Our stocks are dangerously low, and we risk being unable to treat children and save lives as the outbreak continues,” he said.

Diphtheria is a vaccine-preventable bacterial infection that can cause fever, sore throat and a thick membrane in the throat, sometimes obstructing breathing. Severe infections can damage the heart, nerves and kidneys.

According to the World Health Organisation (WHO), diphtheria antitoxin neutralises toxins circulating in the bloodstream, while antibiotics help eliminate the bacteria and reduce transmission.

Early administration of antitoxin is particularly important because it cannot reverse damage once the toxin has entered body cells.

MSF said limited global production and inconsistent availability had left treatment facilities struggling to obtain adequate supplies.

However, the organisation did not specify which facilities had exhausted their stocks, how many patients had been unable to obtain treatment or whether any deaths were directly attributable to the shortages.

The warning comes amid a prolonged outbreak that began in late 2022.

PREMIUM TIMES reports that a situation report issued on 11 November by the International Federation of Red Cross and Red Crescent Societies (IFRC) and the Nigerian Red Cross Society, citing NCDC data, indicates that Nigeria recorded 37,529 suspected diphtheria cases, 28,151 confirmed infections and 1,126 deaths in 2026 as of 7 November.

The report said the outbreak had affected 26 states and the Federal Capital Territory, covering 361 local government areas.

Kano accounted for 12,008 confirmed cases, approximately 43 per cent of the national total.

The figures are substantially higher than those in MSF’s latest statement, which relied on NCDC statistics from 9 August, when 406 deaths had been reported for 2026.

The difference reflects reporting from separate periods and may include subsequent updates to surveillance records.

In Katsina State, MSF reported managing 86 diphtheria cases between 26 October and 12 November, including 70 classified as severe and 16 as non-severe.

Severe infections accounted for approximately 81 per cent of the patients managed by its teams during the period, although the figures do not represent the severity of all diphtheria infections recorded across the state.

MSF said its teams also reached 1,315 contacts through surveillance and contact-tracing activities. Of these, 1,301 received vaccinations, while 1,311 were given preventive antibiotics.

The organisation did not provide the locations of the cases or a breakdown of recoveries and deaths.

The development follows earlier concerns about the capacity of health facilities to manage the outbreak.

On 31 August, PREMIUM TIMES reported that the Federal Teaching Hospital (FTH), Katsina, was struggling with an influx of suspected and confirmed diphtheria patients, leaving its children’s ward under considerable pressure.

The hospital attributed the overcrowding partly to referrals from other facilities across the state.

In response, the federal government announced an emergency multi-agency task force to strengthen surveillance, immunisation and access to treatment in Katsina and Kano.

The intervention included plans to supply additional antitoxin, antibiotics, medical personnel and protective equipment to FTH Katsina.

Authorities also announced plans to establish treatment annexes across Katsina’s three senatorial districts — Katsina, Daura and Funtua — to reduce pressure on the referral hospital.

MSF’s latest statement did not indicate whether those facilities had become operational or how much additional antitoxin had been delivered since the intervention was announced.

In neighbouring Zamfara State, MSF said its supported facilities in Gusau recorded more than 671 diphtheria admissions over approximately one month beginning on 6 October.

Most patients were children, while four out of every five had not been vaccinated.

The organisation also reported a substantial shortfall in vaccine supplies for an emergency immunisation campaign.

Of the 90,000 doses required, only 25,000 had been supplied, representing approximately 28 per cent of the stated requirement.

MSF said it was working with government health authorities to secure the outstanding doses and expand vaccination activities.

The shortfall highlights the continuing difficulties facing efforts to protect children against the disease.

In October, PREMIUM TIMES reported that the Executive Director of the National Primary Health Care Development Agency (NPHCDA), Muyi Aina, said about 93 per cent of children affected by recent diphtheria outbreaks had not received their full recommended vaccine doses.

Mr Aina said some had never been vaccinated, while others had received fewer than the three recommended doses. He identified misinformation and vaccine hesitancy among the challenges affecting immunisation uptake.

Despite the challenges, MSF said its teams had treated more than 9,000 diphtheria patients through facility-based and community interventions since the beginning of its 2026 response.

In Kano, the organisation supported vaccination campaigns in April and June, administering more than 835,000 doses to children in partnership with the state Ministry of Health.

It also supported two vaccination rounds in Sokoto between February and April, reaching 49,018 children under 15.

The organisation said it was supporting treatment, surveillance, infection prevention and vaccination efforts in several northern states, alongside government health authorities.

MSF called for increased global production of diphtheria antitoxin and sustained investment in routine childhood immunisation to prevent further outbreaks.

The latest warning also draws renewed attention to the emergency measures announced by the federal government in August, particularly the delivery of antitoxin supplies and the proposed expansion of treatment facilities in Katsina.

The extent to which those interventions have improved access to treatment remains to be established.