In a significant step toward reducing under-five mortality in Nigeria, Malaria Consortium, in collaboration with Kebbi and Kaduna State governments, has flagged off the Mass Drug Administration of Azithromycin (MDA-AZM), a landmark public health effort aimed at safeguarding the lives of millions of children aged one to 59 months.
Funded by the Gates Foundation, the initiative is part of the broader Safety and Antimicrobial Resistance of Mass Administration of Azithromycin among U-5 children in Nigeria (SARMAAN II) project. This programme builds on proven approaches to cut child deaths from preventable diseases such as pneumonia, sepsis, malaria and diarrhoea.
In Kaduna State, the campaign targets 2.8 million eligible children, while Kebbi State aims to reach over two million children across all local government areas. Trained Community Drug Distributors (CDDs), health workers and town announcers are deployed to ensure a smooth house-to-house rollout of the biannual administration.
The strategy aligns with the World Health Organisation’s recommendation of Azithromycin as a promising intervention to lower child mortality in high-burden countries like Nigeria. Building on earlier evidence from the SARMAAN I and AVENIR studies, SARMAAN II expands both the age range and the geographic scope, now operating in eleven states across Northern Nigeria with high under-five mortality.
At the official flag-off ceremony in Kaduna, stakeholders from public health and development sectors reiterated their support. Deputy governor, Dr. Hadiza Balarabe, who represented the state government, reaffirmed Kaduna’s dedication to tackling child deaths, saying, “Diseases like pneumonia, sepsis, and diarrhoea continue to take thousands of young lives every year. This programme demonstrates our commitment to ending these preventable deaths and protecting our children’s future.”
Programme director for West and Central Africa at Malaria Consortium, Dr. Maxwell Kolawole highlighted the significance of the intervention. “This is more than distributing medicine; it is a bold, strategic step that demonstrates our resolve to save lives, gather crucial data on antimicrobial resistance and sustainably strengthen health systems.”
Over 16,000 personnel have been trained across both states to guarantee high-quality and equitable delivery. Alongside drug distribution, comprehensive awareness campaigns involving town criers, radio jingles, community dialogues, and advocacy visits are underway to secure community buy-in and encourage caregivers to participate fully.
In Kebbi State, the atmosphere was equally spirited as community leaders, traditional rulers, caregivers, and local health workers gathered to witness the launch. Many pledged their support to ensure that no eligible child is left out, especially in remote and hard-to-reach areas. The Kebbi State Government, working closely with Malaria Consortium, is deploying trained CDDs to visit every household with eligible children. Local mobilisation efforts are conducted in Hausa and other local languages to ensure the message resonates widely.
A crucial component of the SARMAAN II initiative is monitoring antimicrobial resistance (AMR) and ensuring safety. In both states, rectal and nasal swabs are collected from selected children before and after drug administration to detect any emerging resistance patterns. This scientific evidence will help shape national child survival strategies and guide decisions on potentially integrating MDA-AZM into Nigeria’s routine child health services.
As implementation progresses, SARMAAN II is expected to make a substantial contribution to reducing under-five deaths and closing the health equity gap in Nigeria. Kebbi and Kaduna States are setting the pace for what is achievable when government commitment, community involvement and global partnerships come together with a clear goal.
Malaria Consortium remains dedicated to supporting this life-saving intervention and working alongside partners to generate evidence that will inform future policies and sustain gains in child health in Nigeria and beyond.
Abantlehe is the country advocacy, communications and engagement manager, Malaria Consortium
