💉Cholera, Malaria, and Vaccines: Unpacking Nigeria's Public Health Crisis

Nigeria is at a critical juncture in its public health journey. In 2025, as the world moves closer to eliminating diseases like malaria and cholera, Nigeria continues to battle deadly outbreaks. The recent cholera outbreak in Bauchi State, one of the country's northern regions, has once again exposed the gaps in health infrastructure and access to basic services like clean water.

At the same time, malaria — a disease that is now largely a memory in many parts of the world — continues to claim lives in Nigeria. Why are these preventable diseases still thriving in a country with enormous potential? And what role can vaccines play in changing this narrative?

Let’s unpack the issue.

🚨 Cholera Outbreak in Bauchi: A Symptom of Systemic Failure

Cholera is a waterborne disease that spreads through contaminated water and food. The bacteria Vibrio cholerae can cause severe diarrhea and dehydration, often leading to death if not treated promptly. The outbreak in Bauchi is not the first, and sadly, it may not be the last. Cholera is a disease of poverty, and its persistence is an indictment of the failure to provide:

• Clean and safe drinking water

• Functional sanitation systems

• Health education and emergency response

💉Can Vaccines Help?

Yes, there is a cholera vaccine. The oral cholera vaccine (OCV), such as Dukoral, Shanchol, and Euvichol, provides short-to-medium-term protection and is especially useful in outbreak settings.

But here's the challenge:

A vaccine is not a substitute for clean water.

While vaccines can reduce the risk and control outbreaks temporarily, they do not replace the need for water infrastructure. For Nigeria, especially in rural and marginalized communities, vaccines should be deployed alongside efforts to improve WASH (Water, Sanitation, and Hygiene).

📉 The Tragedy of Zero-Dose Populations

A zero-dose child is a child who has not received even a single routine vaccine. In northern Nigeria, particularly in remote or conflict-affected areas, thousands of children fall into this category. These children are not just at risk of cholera — they are also vulnerable to:

• Polio

• Measles

• Diphtheria

• Tetanus

Zero-dose populations signal deeper issues:

• Healthcare inaccessibility

• Mistrust in government and medical systems

• Conflict and displacement

Reaching these populations with routine immunization is critical. It's not just about preventing disease — it's about integrating them into the national health safety net.

🦟 Malaria: Why Is It Still Killing Nigerians?

Globally, malaria is declining. But in Nigeria, it remains a top killer — especially of children under 5 and pregnant women. The reasons are clear:

• Poor drainage and environmental sanitation

• Widespread mosquito breeding grounds

• Limited use of insecticide-treated nets (ITNs)

• Drug resistance and gaps in treatment access

🧬 Is Malaria a Vaccine-Preventable Disease?

Until recently, no. But now, the answer is increasingly yes.

The RTS,S (Mosquirix) and the newer R21/Matrix-M malaria vaccines are now being rolled out across parts of Africa — including Nigeria. These vaccines don’t eliminate malaria completely, but they can reduce severe disease and death by up to 75%.

This is a game-changer.

However, just like with cholera, the malaria vaccine is not a silver bullet. It must work alongside:

• Insecticide-treated nets

• Indoor residual spraying

• Environmental management

• Health education

🧬 Do Vaccines Alter Human DNA or RNA?

This is a common concern, especially in the age of misinformation.

❌ The short answer: No, vaccines do not alter your DNA or RNA.

Let’s break it down:

• Traditional vaccines (like cholera or measles) introduce inactivated or weakened parts of the pathogen to teach the immune system how to fight it.

• mRNA vaccines (like some COVID-19 vaccines) use messenger RNA to instruct cells to produce a harmless protein — which triggers an immune response. This mRNA never enters the nucleus of the cell, where DNA is stored.

Once the immune system learns to recognize the threat, the vaccine components break down and leave the body. Your DNA remains untouched.

Vaccines do not reprogram your body. They simply train it to respond faster and stronger when real infection occurs.

🔍 What’s the Way Forward for Nigeria?

To truly shift the health trajectory of Nigeria, we must stop treating vaccines as magic bullets and start seeing them as part of a comprehensive public health strategy.

1. Invest in Infrastructure

Clean water, sanitation, drainage, and waste management must be prioritized — especially in northern states.

2. Expand Access to Routine Immunization

Reaching zero-dose populations must be treated as a national emergency.

3. Strengthen Public Health Education

Communities need to understand disease transmission, hygiene, and vaccine safety in local languages and with trusted messengers.

4. Scale Up New Vaccine Technologies

Malaria and cholera vaccines should be scaled up in hotspots — but always hand-in-hand with other interventions.

✅ Final Thoughts

The tools to end diseases like cholera and malaria exist — both in the form of vaccines and public health infrastructure. The question is no longer “can we stop these diseases?” but rather, “do we have the political will, leadership, and community engagement to do it?”

Until clean water flows freely in Bauchi, and mosquito breeding sites are drained in Lagos, vaccines will continue to fight an uphill battle.

But with the right strategies, Nigeria can — and should — become a success story in public health transformation.