Médecins Sans Frontières (MSF), also known as Doctors Without Borders, has raised the alarm over shortages of life-saving diphtheria antitoxin and inadequate vaccination coverage in Nigeria, warning that thousands of children remain vulnerable to severe complications and death from the disease.
The international medical humanitarian organisation said the global shortage of diphtheria antitoxin (DAT), the only specific treatment capable of neutralising the toxin produced by the bacteria, was undermining efforts to contain the outbreak, particularly in northern Nigeria, where infections and fatalities remain high.
MSF called on the Federal Government, state authorities, donors and international health partners to urgently secure available supplies of antitoxin, vaccines and other essential medicines. It also urged authorities to facilitate prompt clearance of medical supplies at ports and ensure their timely distribution to affected communities.
MSF Medical Coordinator in Nigeria, Dr David Kizito, raised the concern in a statement issued on Friday, warning that dwindling stocks could leave medical teams unable to provide life-saving treatment to critically ill children.
“The global shortage of diphtheria antitoxin is becoming a matter of life and death. Our stocks are dangerously low, and we risk being unable to treat children and save lives as the outbreak continues,” Kizito said.
He expressed concern that children continued to suffer life-threatening complications from a preventable disease because of incomplete vaccination and delays in accessing medical care.
According to MSF, diphtheria antitoxin is most effective when administered within 48 hours of the onset of symptoms, making uninterrupted availability essential to preventing complications and deaths.
The organisation disclosed that inadequate supplies had repeatedly forced its medical teams to ration treatment or manage patients without sufficient quantities of the essential drug, potentially compromising treatment outcomes.
Nigeria has been battling a major diphtheria outbreak since late 2022, with cumulative figures exceeding 41,000 suspected cases, more than 24,000 confirmed infections and over 1,260 deaths nationwide.
Northern states, including Bauchi, Borno, Kaduna, Katsina, Kano, Plateau, Sokoto and Zamfara, have been particularly affected, with several communities recording fresh increases in infections.
In 2026 alone, Nigeria had recorded 12,977 suspected cases, 10,476 confirmed infections and 406 deaths as of August 9, according to MSF.
The figures highlight the growing pressure on healthcare facilities, particularly in rural communities where routine immunisation remains inadequate and access to specialised medical treatment is limited.
MSF said it had treated more than 9,000 diphtheria patients through facility-based and community interventions since the beginning of its response this year, while supporting state health authorities with disease surveillance, infection prevention, vaccination, health education, referrals and medical supplies.
Its teams are currently supporting treatment and isolation facilities in Kano, Sokoto and Zamfara, alongside additional interventions in Bauchi, Katsina and Kebbi states.
In Kano, the organisation supported a two-round vaccination campaign in April and June in partnership with the state Ministry of Health, administering more than 835,000 vaccine doses to children.
Similarly, in Sokoto State, MSF supported two rounds of vaccination between February and April, reaching 49,018 children under the age of 15.
However, the situation in Zamfara State highlights the significant immunisation gaps confronting efforts to contain the outbreak.
Following the state government’s declaration of an outbreak in September, MSF-supported facilities in Gusau recorded more than 671 admissions within one month, beginning October 6.
The organisation said most of the patients were children, while four out of every five admitted had not received diphtheria vaccination.
It further disclosed that only 25,000 of the 90,000 vaccine doses required for a reactive vaccination campaign in Zamfara had been supplied, leaving approximately three-quarters of the targeted children unreached.
MSF said it was working with government health authorities to secure additional doses and implement a large-scale vaccination campaign to bridge the gap.
Highlighting the human impact of the outbreak, the organisation recounted the experience of Shafa’atu, a mother whose three children were treated for diphtheria at an MSF-supported hospital in Sokoto.
She said her family initially had little knowledge of the disease and became frightened when their first child developed symptoms.
“My child struggled to eat, and whenever he ate, he vomited. Diphtheria is a dangerous disease,” she said.
Beyond the immediate shortage of treatment, MSF identified weak routine immunisation as a major factor sustaining transmission, particularly in rural communities across northern Nigeria.
It called for sustained investment in routine vaccination to strengthen community immunity and prevent recurring outbreaks. The organisation also urged pharmaceutical manufacturers and international health partners to expand diphtheria antitoxin production and establish more reliable global supply arrangements.
MSF noted that although DAT is included in the World Health Organisation’s Model List of Essential Medicines, its global availability remains inconsistent because manufacturers produce limited quantities amid unpredictable demand and low financial returns.
It added that many countries, including Nigeria, lacked contingency stocks and relied heavily on donations or procurement through United Nations agencies.
Diphtheria is a potentially fatal bacterial infection transmitted mainly through respiratory droplets and contact with infected wounds. It can cause fever, sore throat, swollen lymph nodes and the formation of a thick membrane in the throat that can obstruct breathing.
In severe cases, the toxin can damage the heart, nerves and kidneys, with between 30 and 40 per cent of infected persons at risk of dying without appropriate treatment, according to MSF.
The organisation also highlighted the impact of its interventions across affected states. In Zamfara, its activities in Gummi, Talata Mafara, Shinkafi and Zurmi Local Government Areas resulted in the treatment of 1,054 patients since January 2026.
In Bauchi State, MSF said its interventions helped reduce the diphtheria case fatality rate from 8.7 per cent to one per cent after treating at least 1,890 suspected patients between August 2025 and May 2026.
In Katsina, its teams managed 86 diphtheria cases between October 26 and November 12, comprising 70 severe and 16 non-severe cases.
During the same period, 1,315 contacts were reached through facility-based interventions and contact tracing, with 1,301 vaccinated and 1,311 provided with antibiotic prophylaxis.
MSF stressed that containing the outbreak would require more than emergency medical interventions, insisting that uninterrupted access to diphtheria antitoxin, expanded vaccination coverage and sustained investment in primary healthcare were critical to protecting children and preventing further deaths.
