The Challenge of Infectious Diseases in Nigeria
Nigeria continues to face a significant burden of infectious diseases, including Lassa fever, malaria, and tuberculosis. Despite the high prevalence of these diseases, the country’s capacity for conducting clinical trials of therapeutics and vaccines remains limited. This lack of infrastructure and technical expertise highlights the urgent need to strengthen local trial capabilities and ensure equitable access to vaccines targeting global health threats. Developing this expertise also involves improving regulatory readiness to meet international standards.
This challenge is not unique to Nigeria but reflects a broader issue across the African continent. Africa accounts for 25% of the global disease burden, yet it has only hosted 845 out of 76,331 clinical trials conducted worldwide in 2023, which represents just 1.1%. Additionally, only 43% of all clinical trials analyzed in the 2024 Index were conducted in low- and middle-income countries (LMICs), despite these countries being home to nearly 80% of the global population. According to the World Health Organization’s International Clinical Trials Registry Platform (WHO-ICTRP), only 1,185 clinical trials were registered in Nigeria over the past 25 years.
This underrepresentation limits Africa’s ability to generate context-specific data for its populations, constraining progress in vaccine development, manufacturing readiness, and policy translation needed to ensure timely and equitable access to innovations.
Building Africa’s End-to-End Vaccine Ecosystem
A joint assessment by the Africa Centre for Disease Control and Prevention (Africa CDC) highlights how this gap has contributed to the continent’s continued reliance on external sources for life-saving vaccines. Only about 1% of vaccines used in Africa are produced locally, while 99% are imported. Such an imbalance perpetuates inequitable access to essential vaccines and widens health disparities between Africa and the rest of the world.
Building end-to-end capabilities from research and development to production and delivery has become critical to reducing dependency and ensuring sustainable access. To address this, the Coalition for Epidemic Preparedness Innovations (CEPI) has taken an integrated approach to strengthening the broader vaccine ecosystem. CEPI aims to accelerate the development of vaccines against emerging infectious diseases by building a connected and resilient ecosystem that links clinical evidence and manufacturing readiness.
In collaboration with the Nigeria Lassa Fever Vaccine Task Force, the West African Health Organization (WAHO), and with support from CEPI, a Lassa Fever Vaccine End-to-End (E2E) Access Deep Dive Workshop was convened. The task force, led by the Nigeria Centre for Disease Control and Prevention (NCDC) and the National Agency for Food and Drug Administration and Control (NAFDAC), brought together a broad coalition of national stakeholders to align on Nigeria’s needs, risks, and priority actions.
The End-to-End Model in Action
Deepening the commitment to vaccine equity, CEPI is currently funding the Phase 2a Lassa fever vaccine trial alongside the end-to-end (E2E) workshop in Nigeria. By linking research to policy, regulation, production, financing, and access, CEPI’s model provides a practical example for how collaborative investment can transform Africa from a passive recipient of innovation into an active contributor to global health security.
Unlike conventional donor-funded trials that focus narrowly on product evaluation, accelerating vaccine development and delivery readiness will ensure comprehensive support across the entire vaccine value chain. This integrated model represents an important change toward sustainable scientific autonomy for the region.
Advancing Vaccine Development in Nigeria
As the epicentre of Lassa fever, hosting clinical trials alone will not be enough. Nigeria has a strategic opportunity to lead vaccine innovation and distribution across West Africa. With Lassa fever cases in over 20 states, the country’s proximity to the burden of infection provides an opportunity to strengthen leadership and clinical trials capacity for regional vaccine research and delivery.
A next step for Nigeria lies in using its participation in clinical trials as a foundation to build in-country capabilities and strengthen the supporting systems, from research governance to regulatory oversight. Aligning CEPI’s catalytic investments with existing national frameworks such as the Nigeria Vaccine Policy and the Biovaccines Nigeria Limited (BVNL) partnership would help translate this potential into sustained institutional capacity and public health impact.
Why Now?
The convergence of factors, including the recently concluded 2nd ECOWAS Lassa Fever International Conference, the pledge by West African leaders to advance the Lassa vaccine, and the encouraging results from IAVI’s Phase 1 clinical trials of their Lassa vaccine candidate, has created increased momentum around Lassa vaccine development.
With Nigeria’s expanding regulatory maturity and demonstrated coordination among national health institutions, the Lassa vaccine trial provides a blueprint for building comprehensive clinical trial ecosystems that strengthen national health security.
To ensure this vital momentum is not lost, Nigeria must implement several key structural changes:
- Institutionalise the E2E Model: The multi-stakeholder End-to-End model must be formally adopted as the standard operating procedure for all large-scale, public health research projects.
- Develop Long-Term Funding Mechanisms: Creative and sustainable long-term funding mechanisms for domestic health research must be secured, reducing reliance on short-term grants.
Seizing this moment requires investment in research infrastructure and skilled professionals, that link individual vaccine trial to broader national and regional goals. Nigeria must transition from being merely a host for global trials to becoming a regional leader in innovation, manufacturing, and equitable access.
Conclusion
Nigeria’s participation in Lassa vaccine development creates an opportunity to strengthen local innovation and regulatory systems, ensuring that this translates into access for the country and the wider West African region. By embedding these efforts within long-term national strategies, Nigeria can help build the foundation for scientific self-reliance and sustainable health security. To support regional preparedness, the end-to-end workshops will take place in other Lassa-endemic West African countries to encourage shared learnings.
