Nigeria’s child survival drive reaches 15.8m as sustainability questions loom

A large-scale child health intervention in northern Nigeria has reached 15.76 million children in just over two years, underscoring both the potential of mass public health campaigns and the challenge of sustaining them without long-term domestic funding.

The Safety and Antimicrobial Resistance of Mass Administration of Azithromycin in Nigeria (SARMAAN) Project, an evidence-based programme targeting child survival, said it has administered more than 26 million doses of azithromycin to children aged one to 59 months across ten states between 2024 and early 2026, delivering targeted interventions designed to reduce preventable childhood illnesses and deaths.

The milestone comes as stakeholders mark World Health Day, a platform often used to highlight gaps in healthcare access in developing economies.

The scale of the intervention reflects a growing reliance on Mass Drug Administration (MDA) campaigns to tackle preventable childhood illnesses in high-burden regions. In the first quarter of 2026 alone, more than 7.2 million children were treated across Kano, Bauchi, Jigawa and Kaduna states, pointing to an acceleration in outreach efforts.

While the numbers signal progress, they also highlight a familiar structural issue in Nigeria’s health sector: dependence on donor-backed programmes. The SARMAAN initiative is part of the REACH network, a regional effort focused on reducing under-five mortality, but its long-term impact will depend on whether the government can absorb and scale the model within its own systems.

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“Reaching over 15 million children shows what is possible when global priorities meet local action,” said Oliver Ezechi, the project’s principal investigator and a director at the Nigerian Institute of Medical Research.

Ezechi added that beyond drug distribution, the programme is designed to build trust and community ownership, factors often cited as critical to sustaining public health gains.

Health experts say such community-driven approaches are increasingly important in Nigeria, where weak primary healthcare systems and uneven access continue to drive high child mortality rates. By combining drug delivery with local engagement and communication strategies, SARMAAN is attempting to address both medical and behavioural barriers to care.

Even so, questions remain about funding continuity. Project leaders are already pushing for a transition from donor dependency to government ownership, warning that gains could reverse without institutional backing.

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“True impact is what can be sustained tomorrow,” said Ikechukwu Ofuani, who leads the project’s advocacy efforts. Ofuani called for the integration of the initiative into national health budgets and policies, arguing that locally driven implementation is key to long-term success.

Nigeria accounts for one of the highest burdens of under-five mortality globally, according to international health agencies, making scalable interventions like SARMAAN critical. However, analysts note that without stronger fiscal commitment and health system reforms, such programmes risk remaining isolated successes rather than systemic solutions.

As policymakers and global health actors renew commitments on World Health Day, SARMAAN’s results offer both a proof of concept and a test case: whether Nigeria can convert donor-supported gains into a durable, government-led child survival strategy.