New data presented by the Lagos State Commissioner for Health, Prof. Akin Abayomi, reveals that an astounding 95 out of every 100 fevers experienced in Lagos are not caused by malaria, challenging a long-held assumption that fever is synonymous with malaria infection.
Prof. Abayomi disclosed this finding during the three-day Study Kick-Off of the Pathway to Pre-Elimination and Digitisation Project in Lagos, which focuses on Malaria Rapid Diagnostic Test (RDT) and Microscopy Comparative Study and the assessment of Private-Public Mix for Malaria and Febrile Illnesses (PPMVS) capacity to manage malaria and other febrile illnesses.
He emphasized the urgent need for a paradigm shift among healthcare providers, stating, “We need to get malaria out of the region. It is very, very important that we do that once and for all, perform the mind shift in our healthcare providers that on average, 95 out of every 100 fevers that you may see are not caused by malaria.”
For decades, the default response to fever in Lagos and across Nigeria has been the empirical administration of antimalarial drugs without proper diagnostic confirmation. Prof. Abayomi warned that this practice is not only wasteful but also dangerous, as it accelerates antimicrobial resistance (AMR)—a global health threat where common infections become untreatable due to overuse and misuse of antimicrobials.
“We are really sitting on a very major problem of microbial resistance. And we have to be careful how we dispense antimicrobials and how we dispense antibiotics,” he cautioned, noting that recent research indicates that 60 percent of human infections related to AMR originate from animals, highlighting the interconnectedness of the problem.
Under the new “test, treat, and track” strategy, Lagos residents presenting with fever will first undergo a Rapid Diagnostic Test for malaria. If the test result is negative, which is expected for the vast majority, healthcare providers will conduct thorough examinations to identify the true cause of the fever, whether pneumonia, gastroenteritis, or other infections.
The Lagos State Ministry of Health is also tightening regulations on pharmacies, making it illegal for customers to purchase antimalarial drugs or antibiotics without a prescription from an accredited healthcare practitioner. Prof. Abayomi urged the Pharmacy Council of Nigeria to enforce these regulations strictly to prevent inappropriate dispensing of these drugs.
“If we don’t stop that practice, we are going to be the capital of antimicrobial resistance,” he warned.
This announcement aligns with Lagos’s broader malaria control efforts. Recent data show that Lagos has drastically reduced malaria prevalence from 15 percent in 2010 to just 1.3 percent as of early 2025, putting the state on track to achieve malaria pre-elimination status as defined by the World Health Organization.
Despite this progress, Prof. Abayomi noted that over 50 percent of patients with fever are still being treated for malaria without confirmation, underscoring the need for intensified public education and responsible prescribing practices.
Vulnerable groups such as pregnant women and children under five remain a key focus, as their compromised or underdeveloped immune systems make accurate diagnosis and treatment especially critical.
The Lagos State Ministry of Health continues to collaborate with the World Health Organization, the Federal Ministry of Health, and the Pharmacy Council of Nigeria under the IMPACT Project to sustain momentum toward malaria elimination.
The commissioner’s call to action highlights the importance of accurate diagnosis, responsible drug use, and multi-sectoral collaboration to safeguard public health and curb the growing threat of antimicrobial resistance in Lagos and beyond.
