Nigeria: An Exemplar in Malaria Subnational Tailoring

Nigeria has the highest malaria burden in the world: in 2025, it accounted for approximately 24.3% of global malaria cases and 30.3% of malaria deaths. Although malaria is endemic and widespread across the country, rates of malaria transmission and prevalence still vary considerably. For instance, according to the 2025 Malaria Indicator Survey, parasite prevalence ranged from 2.6% in Lagos to 31.2% in Ebonyi. Consequently, the country has moved away from a “one-size-fits-all” malaria response and toward an approach known as subnational tailoring (SNT), which uses granular local data to target malaria interventions to specific geographic, entomological, socioeconomic, and climate conditions.

With the support of technical partners, local leaders, and stakeholders at all levels of the health system, Nigeria has deployed key promising practices that enable SNT implementation nationwide. These include:

• Embedding SNT within national planning, financing, and decision-making frameworks such as National Malaria Strategic Plans and donor investment processes.

• Strong national leadership and coordination via the National Malaria Elimination Program, aligning government and partners in the use of evidence to inform national strategy, make financing decisions, and shape subnational implementation.

• Improved data collection, dissemination, analysis, and quality through the National Malaria Data Repository.

• Forecasting the projected impact of interventions on prevalence and mortality, strengthening granular subnational evidence for both real-time adaptation and future planning.

Decisions informed by SNT have enabled Nigeria to make meaningful progress, and national parasite prevalence declined from 27% in 2015 to 15% in 2025. This work exemplifies the country as a model for evidence-driven decision-making in similar settings.