By Taibat Ummi Yakubu

Nigeria's fight against diphtheria is facing another serious challenge as shortages of essential medicines threaten the treatment of infected patients, with Katsina State among the areas reporting a worrying number of severe cases.

Médecins Sans Frontières (MSF), the international humanitarian medical organisation, says dwindling supplies of diphtheria antitoxin are putting its ability to treat critically ill patients under pressure, warning that more children could lose their lives if fresh supplies are not urgently secured.

The warning comes against the backdrop of a major outbreak that has spread across 26 states and the Federal Capital Territory, with 28,151 confirmed infections and 1,126 deaths recorded nationwide as of November 7.

Katsina has emerged as one of the areas of concern. MSF disclosed that its medical teams handled 86 patients between October 26 and November 12, with 70 suffering from severe infections. Only 16 cases were classified as non-severe.

The organisation also carried out preventive interventions among people who had come into contact with infected patients. It reached 1,315 contacts, vaccinated 1,301 of them and administered preventive antibiotics to 1,311.

The figures highlight the pressure facing health workers as they attempt to contain the disease while dealing with shortages of the medicine needed to prevent its most dangerous complications.

MSF's Medical Coordinator in Nigeria, David Kizito, said the organisation's available stocks of diphtheria antitoxin (DAT) had reached dangerously low levels.

He warned that without additional supplies, medical teams could struggle to provide lifesaving treatment to children and other severely affected patients.

The antitoxin plays a critical role in treating diphtheria because it neutralises the dangerous toxin released by the bacteria. When administered early, it helps prevent serious complications that can affect the heart, kidneys and nervous system.

Patients may initially experience fever and sore throat, but the infection can develop into a life-threatening condition when a thick membrane forms in the throat and obstructs breathing.

Antibiotics are also used to eliminate the bacteria and reduce transmission. However, they cannot replace the antitoxin's role in neutralising toxins already circulating in the bloodstream.

MSF attributed the difficulty in obtaining sufficient supplies partly to limited global production and irregular availability of the medicine. It urged the Federal Government, state authorities, international donors and humanitarian organisations to intervene before the shortage further undermines treatment efforts.

Kano accounts for 43 per cent of confirmed infections

The scale of Nigeria's outbreak is reflected in figures contained in a November 11 situation report by the International Federation of Red Cross and Red Crescent Societies and the Nigerian Red Cross Society, which cited NCDC data.

The report put suspected infections at 37,529, with 28,151 confirmed cases and 1,126 deaths as of November 7. The disease had reached 361 local government areas across 26 states and the FCT.

Kano alone accounted for 12,008 confirmed infections, representing about 43 per cent of the national figure.

The latest statistics also represent a substantial increase from the 406 deaths recorded for 2026 as of August 9 in the earlier NCDC figures referenced by MSF.

Hospitals in Katsina face continued pressure

The latest development brings renewed attention to the challenges facing Katsina's healthcare system, particularly the Federal Teaching Hospital, Katsina, which previously came under pressure from an influx of suspected and confirmed diphtheria patients.

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The situation prompted the Federal Government to announce an emergency multi-agency response involving additional medicines, healthcare personnel, protective equipment and efforts to strengthen disease surveillance and immunisation.

Authorities also proposed establishing treatment annexes in Katsina, Daura and Funtua to reduce the burden on the state's major referral hospital and improve access to care.

However, MSF's latest update did not establish whether the proposed centres were fully operational or confirm the quantity of additional antitoxin delivered to the state.

Zamfara struggles to meet vaccination target

The situation in Zamfara presents another challenge, particularly as health workers battle to protect children who have not received the recommended vaccines.

MSF said facilities it supports in Gusau recorded more than 671 diphtheria admissions over approximately one month beginning October 6. Most of the patients were children, while four out of every five had not been vaccinated.

The organisation also disclosed that an emergency vaccination campaign requiring 90,000 doses had received only 25,000, leaving a shortfall of 65,000 doses.

This means that less than one-third of the required vaccines had been supplied, raising concerns about the campaign's ability to reach its intended target.

The shortage comes amid warnings from Nigeria's primary healthcare authorities about gaps in childhood immunisation.

In October, the Executive Director of the National Primary Health Care Development Agency, Muyi Aina, said approximately 93 per cent of children affected by recent diphtheria outbreaks had not received all their recommended vaccine doses.

He attributed the poor coverage partly to misinformation and vaccine hesitancy, noting that some affected children had never been vaccinated, while others had failed to complete the recommended three-dose schedule.

Over 9,000 patients treated in 2026

Despite the difficulties, MSF said its interventions across Nigeria had reached more than 9,000 diphtheria patients through hospital treatment and community-based activities since the beginning of its 2026 response.

In Kano, its collaboration with the state Ministry of Health also supported vaccination exercises in April and June, during which more than 835,000 doses were administered to children.

The organisation is now calling for urgent action to address the shortage of antitoxin, increase vaccine supplies and improve the movement of essential medicines into affected communities.

For Katsina, Zamfara and other states battling the outbreak, the challenge is not only containing new infections but ensuring that patients who develop severe symptoms can access the right treatment without delay.

With more than a thousand deaths already recorded this year, the availability of lifesaving medicines and improved childhood vaccination remain critical to preventing further casualties.