Written by: Dr Adam Abdullahi

In early 2020, as SARS-CoV-2 spread across continents, overwhelming even well-resourced health systems in Europe and North America, Nigeria faced a defining question: could it build the capacity to detect and respond to a major global health security threat in real time?

For many observers, the answer seemed uncertain. Despite prior experience with Ebola, COVID-19 presented a different scale of challenge: simultaneous national spread, prolonged disruption, and the need for sustained coordination across institutions and levels of government. The response that followed demonstrated something important and often underappreciated.

Within weeks, Nigeria began scaling the core components of epidemic response. Diagnostic laboratories expanded across geopolitical zones. Surveillance systems were activated nationwide. Data reporting improved. Scientists, clinicians, and public health officials worked with a level of coordination rarely seen before. Under the leadership of the Nigeria Centre for Disease Control (NCDC) and the Federal Ministry of Health, the country assembled a team in its emergency operations centre, including key units focused on challenges ranging from risk communications to diagnostic capacity.

By mid-2021, the laboratory network had expanded from fewer than five testing centres to over 140 across all six geopolitical zones, millions of COVID-19 tests had been conducted, and sequencing capacity, an advanced capability that remains beyond reach for many countries with comparable resource constraints, was developed, representing a functional epidemic response architecture spanning testing, reporting, emergency coordination, and genomic sequencing to track viral evolution. This response positioned Nigeria among Africa’s leaders in pandemic management and demonstrated that Nigeria possessed scientific talent, institutional leadership when aligned and empowered, and the ability to mobilise rapidly in moments of crisis.

But this is only part of the story. Much of this capacity was built under emergency conditions, driven by urgency, supported by external funding, and sustained by political attention that is difficult to maintain outside a crisis. As case numbers declined, a familiar pattern began to re-emerge. Systems slowed, and momentum weakened, as a system built for crisis was not fully converted into one built for prevention. That tension between what Nigeria can build during a crisis and what it can sustain afterwards defines the country’s epidemic preparedness challenge.

Precedence and Diagnoses

Recent outbreaks illustrate this with clarity. Recurrent Lassa fever outbreaks continue to expose uneven response capacity across states, including in places like Bauchi, where early detection remains limited. Similarly, emerging research on mpox transmission in urban Nigeria suggests that silent circulation may be occurring more widely than formal case reports indicate, with exposure in individuals never formally diagnosed.

These are not failures of science, but of detection systems. Epidemics do not always announce themselves. Some spread quietly through gaps in detection, surveillance, and trust. Yet between outbreaks, prevention consistently loses to short-term priorities that carry greater political appeal but limited long-term value. As a result, Nigeria remains caught in a reactive cycle: respond, recover, and reset without fully building a system that endures. The question is no longer whether Nigeria can respond to epidemics; it has shown that it can, but whether it can build systems that function before crises begin.

Doing this requires recognising epidemic preparedness work not only as a technical problem, but also as a political and governance problem. Epidemic preparedness depends on whether prevention is treated as a core government function, equivalent in importance to maintaining roads, providing electricity or education. It is not a single-institution function; it is a system, and over the past decade, it has developed credible technical capabilities.

Identifying Stress Points

State ministries of health carry much of the operational burden. Primary health care centres (PHCs), often under-resourced, serve as frontline detection points. Community health workers, embedded and trusted, are frequently the first to recognise unusual patterns of illness. Research institutions and laboratories provide critical scientific capacity, as demonstrated during COVID-19 through genomic surveillance. Beyond formal institutions, epidemic response depends on trust. Faith-based organisations, civil society, and the media influence how health information is understood and acted upon. During outbreaks, trust in these actors can determine whether public health measures are followed or resisted.

The challenge is not the absence of capacity, but fragmentation. Coordination across federal, state, and local levels remains uneven. While international partners have helped strengthen these systems, they have also created dependencies where key components of preparedness rely on external funding cycles rather than domestic investment. As a result, preparedness exists in pockets, not as a cohesive system.

Nigeria’s epidemic risk is increasing, shaped by structural changes already underway. Rapid population growth, urbanisation, and the expansion of informal settlements create environments where infectious diseases spread quickly. Climate variability is altering patterns of disease emergence, increasing risks of outbreaks such as cholera and vector-borne infections. At the same time, closer human–animal interaction raises the likelihood of zoonotic spillover. These dynamics suggest that Nigeria is entering a period where outbreaks may become more frequent, more complex, and more difficult to contain.

Recent work on mpox highlights both risk and opportunity. Serological evidence suggests exposure to orthopoxviruses may be more widespread than reported case numbers indicate, pointing to ongoing low-level transmission that remains undetected. Similarly, Lassa fever response efforts demonstrate that early detection dramatically improves outcomes. Cases identified quickly are more manageable, with shorter transmission chains and reduced mortality.

From an opportunity standpoint, a large, young population represents a potential public health workforce. Urban systems offer opportunities for scalable interventions. Expanding research capacity positions Nigeria to lead in understanding emerging infectious threats. The implication is straightforward: the problem is not simply the presence of pathogens, but the reach and sensitivity of detection systems. The solution is achievable; it requires investment in reach, not new science. Without sustained investment, the consequences are predictable. In the short term, delayed detection can accelerate transmission, increase emergency response costs, and fuel misinformation. In the long term, underinvestment risks eroding laboratory capacity, driving the loss of skilled personnel, and weakening the surveillance systems needed to identify and contain future threats.

These risks are not evenly distributed either. Rural communities face delayed detection and limited access to care. Urban populations face rapid transmission risks. Women, as primary caregivers and the majority of community health workers, bear disproportionate burdens during outbreaks, facing increased care responsibilities and disrupted access to maternal health services. Young people, who constitute over 60% of the population, face both direct health risks and broader socio-economic consequences, including school closures, disrupted livelihoods, and economic scarring. If current patterns persist, Nigeria will face not isolated epidemics but overlapping and recurring syndemics — multiple disease outbreaks within already strained systems.

The Architecture of Actors

Addressing these requires a shift from reactive response to sustained prevention. This shift is not abstract thinking. Consider early detection: a suspected Lassa fever case in rural Plateau State may currently take weeks to confirm. With investment, it could be diagnosed within days, limiting the spread, reducing mortality, and reducing economic costs. With geographic reach, diagnostics are currently concentrated in a few urban centres, but with expansion, every region could have reliable testing, eliminating blind spots. The same applies to the workforce, where trained experts leave due to limited opportunities. With structured career pathways and competitive systems, talent could be retained and strengthened. Data systems present a similar opportunity, as current surveillance systems are fragmented. With integrated digital reporting, real-time data could guide faster and more transparent responses. Finally, there is the question of permanence. Funding often surges during crises and recedes once the immediate threat passes. Sustained financing would transform preparedness from a temporary response into permanent infrastructure, where expertise is continuously strengthened and resilience is built into the system itself.

This transition requires deliberate action. At the federal level, epidemic preparedness must be financed as a core function, with predictable funding rather than emergency allocations. Surveillance systems must be integrated across primary care, laboratories, and national data platforms. Genomic surveillance should be embedded within routine public health systems, not dependent on research cycles. State governments, for their part, must strengthen primary health care systems as frontline detection platforms, expand laboratory networks, and retain trained personnel. At the local level, community health workers must be formally integrated into surveillance systems, supported with clear reporting pathways and linked to state and national systems.

Trust-building through community engagement must be prioritised. The Africa CDC estimates that annual per capita spending of US$1 to US$3 on preparedness could avert billions in outbreak response costs. Epidemic preparedness is not a government-only responsibility; it is a collective endeavour. Beyond government, private sector actors, civil society organisations, and development partners all have roles to play.

Private laboratories and healthcare providers should be integrated into national surveillance frameworks. Civil society and media organisations are essential for strengthening public health communication and countering misinformation. Development partners should transition toward co-financing models that prioritise sustainability and national ownership rather than parallel systems.

The question is political: Will our nation sustain preparedness when crises fade? COVID-19 showed that rapid mobilisation, scientific excellence, and institutional coordination are possible. The challenge is to institutionalise these gains before the next outbreak.

Citizens must demand accountability by asking fundamental questions: How is epidemic preparedness funded? How are rural communities protected? What systems are in place before outbreaks occur? Policymakers must embed preparedness into national planning and provide consistent funding. Scientists must lead from within. Communities must remain engaged. International partners must support systems that are locally owned and sustainably financed.

The next epidemic is not a question of if, but when. The real question is whether Nigeria will be ready. Will we continue responding to crises as they emerge, or build the systems needed to prevent them from becoming crises in the first place?

—

Dr Adam Abdullahi is an infectious disease scientist and global health researcher. He trained as a tropical disease scientist at the Liverpool School of Tropical Medicine and completed a PhD in Infectious Diseases and Global Health. He is a former Takemi Fellow at the Harvard T.H. Chan School of Public Health, where he currently serves as a Departmental Associate in the Department of Immunology and Infectious Diseases.

He was a 2025 Emerging Leaders in Biosecurity Fellow hosted by Johns Hopkins University. He has served as a Research Associate in Virology and Infectious Diseases at University of Cambridge and was selected as a World Health Organization–Charité – Universitätsmedizin Berlin Research Fellow in Public Health