Can Nigeria’s fragile Health System tackle the recent Anthrax emergence? A narrative review




Zoonoses, Disease Outbreaks, One Health, Nigeria, Anthrax


Background: Nigeria’s healthcare system grapples with systemic inadequacies which potentiate the inadequate management of infectious disease outbreaks. This is concerning as Anthrax, a neglected zoonotic disease emerged in 2023.

Objectives: This paper aims to review the weaknesses in the country’s healthcare system and propose solution for Anthrax mitigation, drawing lessons from past polio, COVID-19, Ebola outbreaks.

Methodology: A preliminary search was conducted on Ovid Medline and public databases with combination of Medical Subject Headings (MeSH) keywords, resulting in 173 articles. Five authors screened the articles based on selection criteria (including language, year of publication, relevance, and peer-review). Using a nonsystematic approach, a narrative synthesis was used to analyse and discuss the results from 29 selected studies.

Result: Nigeria’s health system is grappling a myriad of challenges significantly impacting the nation’s healthcare landscape. These challenges include accessibility to care, inequitable distribution of health services and health workers, catastrophic spending for healthcare, physician emigration, frequent industrial disputes, insecurity, and underfunding. Additionally, there are issues with inadequate disease surveillance infrastructure, while limited veterinary services and poor animal husbandry practices increase the potential for zoonotic disease outbreaks.

Conclusion: The review underscores the potential for Nigeria to effectively address the challenges of Anthrax and mitigate its impact on human and animal populations. Strengthening disease surveillance, increasing research funding, and raising public awareness are crucial. Targeted vaccinations, isolation facilities, treatment protocols, and collaboration among healthcare professionals, government, and international organizations are essential. The study recommends practical strategies and legislation to ensure human and animal safety.

Author Biographies

Emeruwa VE, First On-Call Initiative

Community and Clinical Research Division, Research Associate.

Essien EA, Federal Neuro-Psychiatric Hospital, Calabar.

Head of Research and Training Unit.

Ukoaka BM , First On-Call Initiative

Community and Clinical Research Division, Research Associate.

Gbuchie MA, First On-Call Initiative

Community and Clinical Research Division, Research Associate. 

Essiet RN, First On-Call Initiative

Community and Clinical Research Division, Research Associate. 

Josiah-Orisa PT, First On-Call Initiative

Community and Clinical Research Division, Research Associate. 

Nwilegbara S, First On-Call Initiative

Community and Clinical Research Division, Research Associate. 


Doganay M, Dinc G, Kutmanova A, Baillie L. Human anthrax: Update of the diagnosis and treatment. Diagnostics. 2023;13(6):1056.

Elelu N, Aiyedun JO, Mohammed IG, et al. Neglected zoonotic diseases in Nigeria: Role of the public health veterinarian. Pan Afr Med J. 2019;32(1).

Nigeria Centre for Disease Control and Prevention (NCDC) Confirmation of Anthrax Outbreak in Nigeria. Published online July 17, 2023:6232. Accesssed Septemeber 25, 2023,.

Ehizibolo DO, Ehizibolo PO, Ehizibolo EE, Sugun M V, Idachaba SE. The control of neglected zoonotic diseases in Nigeria through animal intervention. African J Biomed Res. 2011;14(2):81-88.

World Health Organization(WHO). Monitoring the Building Blocks of Health Systems: A Handbook of Indicators and Their Measurement Strategies. World Health Organization; 2010.

Federal Ministry of Health, Federal Ministry of Agriculture and Rural Development, Federal Ministry of Environment. One Health Strategic Plan, 2019 - 2023. Vol 1.; 2019. Accessed September 24, 2023.

Opinion Nigeria. Anthrax is here, Eat ‘ponmo’ and die, Adetifa, NCDC DG, insists – Opinion Nigeria.pdf. Opinion Nigeria Breaking News. Published July. Accessed September 21, 2023.

Federal Ministry of Agriculture and Rural Development(fmard). Anthrax: fmard donates free 50,000 doses of vaccines to lasg. Anthrax: fmard donates free 50,000 doses of vaccines to lasg. Published Online 2023. Accessed September 29, 2023.

Adeloye D, David RA, Olaogun AA, et al. Health workforce and governance: the crisis in Nigeria. Hum Resour Health. 2017;15(1):1-8.

Obansa SAJ, Orimisan A. Health care financing in Nigeria: prospects and challenges. Mediterr J Soc Sci. 2013;4(1):221-236.

Uzochukwu BSC, Ughasoro MD, Etiaba E, Okwuosa C, Envuladu E, Onwujekwe OE. Health care financing in Nigeria: Implications for achieving universal health coverage. Niger J Clin Pract. 2015;18(4):437-444.

Onah CK, Azuogu BN, Ochie CN, et al. Physician emigration from Nigeria and the associated factors: the implications to safeguarding the Nigeria health system. Hum Resour Health. 2022;20(1):85.

Daniel FM, Essien EA, Gbuchie MA, Ukoaka BM, Emeruwa VE. Mitigating Physician Emigration in Nigeria by Improving the Internship Experience. Int J Med Stud [Internet]. 2023 Nov. 21 [cited 2023 Nov. 28];. Available from:

Yenet A, Nibret G, Tegegne BA. Challenges to the Availability and Affordability of Essential Medicines in African Countries: A Scoping Review. Clin Outcomes Res. Published online 2023:443-458.

Bamidele JO, Adebimpe WO, Oladele EA. Knowledge, attitude and use of alternative medical therapy amongst urban residents of Osun State, southwestern Nigeria. African J Tradit Complement Altern Med. 2009;6(3).

Otu A, Ameh S, Osifo-Dawodu E, Alade E, Ekuri S, Idris J. An account of the Ebola virus disease outbreak in Nigeria: implications and lessons learnt. BMC Public Health. 2018;18(1):1-8.

Isere EE, Fatiregun AA, Ajayi IO. An overview of disease surveillance and notification system in Nigeria and the roles of clinicians in disease outbreak prevention and control. Niger Med J J Niger Med Assoc. 2015;56(3):161.

Naidoo D, Ihekweazu C. Nigeria’s efforts to strengthen laboratory diagnostics-why access to reliable and affordable diagnostics is key to building resilient laboratory systems. Afr J Lab Med. 2020;9(2):1-5.

Oyeranti O, Sokeye B. The evolution and spread of Covid-19 in Nigeria. Cent Pet Energy Econ Law. Published online 2020:1-18.

Worldometer. Nigeria’s population August 2023-224,418,261. Published 2023. Accessed September 28, 2023. 2023 population is estimated,636 people per mi2).

Daniel FM, Gbuchie MA, Emeruwa VE, Ike WI, Udam GN, Torubiri AO Nigeria’s Flood Disaster Unpreparedness : Impacts on Health and the Society. CRJMED. 2023;(August). Available at:

FMARD, FAO. Cadre Harmonize for Identification of Food and Nutrition Insecurity Risk Areas and Vulnerable Populations in 26 States and Federal Capital Territory (FCT) of Nigeria.; 2023. Accesssed September 23, 2023.

Fallah MP, Skrip LA, Gertler S, Yamin D, Galvani AP. Quantifying poverty as a driver of Ebola transmission. PLoS Negl Trop Dis. 2015;9(12):e0004260.

Durrheim DN, Freeman P, Roth I, Hornitzky M. Epidemiologic questions from anthrax outbreak, Hunter Valley, Australia. Emerg Infect Dis. 2009;15(5):840.

Makhija S, Sumit K, Hossain S. Risk factor associated with anthrax transmission among the Tribal Communities of Odisha. Indian J Public Heal Res Dev. 2020;11(1):603-608.

Musa E, Nasidi A, Shuaib F, Nguku PM, Vaz RG. Nigeria’s Ebola outbreak response: lessons for future epidemic preparedness. Arch Med. 2016;8(6).

Centre for Disease Control and Prevention(CDC). Anthrax Vaccination : What Everyone Should Know. CDC Vaccines and Preventable Diseases. Published 2016. Accessed September 12, 2023.

Ihekweazu C. Lessons from Nigeria’s adaptation of global health initiatives during the COVID-19 pandemic. Emerg Infect Dis. 2022;28(Suppl 1):S299.

Amadi SC, Daniel FM, Ikiroma S, Oboro IL. Antimicrobial Stewardship in Resource-Limited Settings. IntechOpen 2024.

Baethge C, Goldbeck-Wood S, Mertens S. SANRA—a scale for the quality assessment of narrative review articles. Res Integr Peer Rev 4, 5 (2019).




How to Cite

Daniel, F., Emeruwa, V. . E., Essien, E. A., Ukoaka, B. M., Gbuchie , M. A., Essiet, R. N., … Nwilegbara, S. (2024). Can Nigeria’s fragile Health System tackle the recent Anthrax emergence? A narrative review. The Nigerian Health Journal, 24(1), 1001–1009.

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