Addressing Lassa Fever in Nigeria: The Case for Vaccines and Civil Society Engagement
Zubaida Baba Ibrahim and Ibukun Oguntola (Lead Writers)
“When a pandemic strikes, saving lives hinges on rapid vaccine development and equitable access” — David Agunlofi, Programme and Communications Associate at Options Consultancy
Lassa fever, a viral haemorrhagic disease endemic in West Africa, poses a recurring health challenge, particularly in Nigeria, where cases peak during the dry season from December to April. Nigeria has consistently had to grapple with a surge in Lassa fever infections during this period. Latest data from the Nigeria Centre for Disease Control and Prevention (NCDC) reveal that in 2025 (1st Jan to 12th Jan) alone, there have been 484 suspected cases, 143 confirmed infections and 18 confirmed fatalities across 7 states in the country.
Currently, there is no approved vaccine for Lassa fever. The Coalition for Epidemic Preparedness Innovations (CEPI) recognise that Lassa fever is a priority pathogen with pandemic potential (as defined by the World Health Organization) and have allocated up to $250 million in funding in the development of Lassa vaccine candidates.
One of these vaccine candidates developed by IAVI is currently undergoing the first-ever Phase 2A trials in Nigeria, Liberia, and Ghana. There are ongoing plans for late-stage clinical trials in Nigeria, Liberia, and Sierra Leone, offering hope for a much-needed breakthrough in the search for a safe and effective Lassa fever vaccine.
Civil Society Engagement in Lassa Vaccine Development — Perspectives from Nigeria
Recognising the importance of collaboration in tackling these challenges, CEPI and Nigeria Health Watch hosted a Civil Society Organisation (CSO) roundtable discussion titled “Civil Society Engagement in Lassa Vaccine Development — Perspectives from Nigeria” on January 15, 2025. The event brought together civil society organisations and key stakeholders to explore how they can play a role in advancing Lassa vaccine development and vaccine deployment.
In attendance were Dr Richard Hatchett, CEO of CEPI; Dr Fatimah Saleh, Director of Surveillance and Epidemiology at the Nigeria Centre for Disease Control (NCDC); Dr Abdu Mukhtar, National Coordinator of the Presidential Initiative for Unlocking the Healthcare Value Chain (PVAC); as well as representatives from various CSOs focusing on infectious disease control, vaccine access and strengthening immunisation. The event aimed to convene stakeholders to discuss perspectives on vaccine research and development in Nigeria, with a specific focus on the Lassa vaccine.
Dr Saleh, representing Dr. Jide Idris, the Director-General of NCDC, highlighted NCDC’s ongoing efforts since 2019 to support the Lassa fever vaccine development process. This involves participating in the Enable study, a multi-country epidemiology project to better understand the rate, location, and spread of Lassa virus across the region.
She added that, in September 2023, Professor Muhammed Ali Pate, Nigeria’s Coordinating Minister of Health and Social Welfare, launched the Lassa Vaccine Task Force to accelerate the development and deployment of a Lassa fever vaccine in Nigeria. This high-level task force brings together government agencies, researchers, and regulatory bodies to ensure a unified national response, foster collaboration, and to ensure that national interests and priorities are addressed in current international efforts to develop and advance Lassa fever vaccine candidates.
Dr Mukhtar made a case for vaccine production in Nigeria through PVAC. He highlighted its economic benefits and potential for significant returns on investment. He stressed the importance of developing a stronger health ecosystem, including research and development capabilities, infrastructure, market access and regulations which would not only create jobs but also drive technological advancements.
He also added that Nigeria is currently on a mission to create 437 clinical trial centres before 2030 as part of strengthening the health ecosystem in partnership with Purpose Africa through the Activate Africa initiative.
Additionally, Mrs. Moji Makanjuola, Executive Director of the International Society of Media in Public Health, noted the crucial role of strategic communications and media engagement in promoting vaccine acceptance, particularly in an era where vaccine scepticism and misinformation are prevalent. She added that limited awareness about the risks of Lassa fever persist in many communities across Nigeria. Simplifying information about the dangers of the disease could therefore increase the vaccine’s acceptance.
Speaking on CEPI’s 100 days mission, Dr Hatchett recalled the Ebola outbreak in 2014, recounting that a vaccine for the virus had been in development for over a decade prior to the crisis but was not ready for real-world trials nor use. It took an additional 15 months from the outbreak for the vaccine to reach the clinical trial phase in Guinea, where it was tested on contacts of confirmed Ebola cases in 2015. The results of the trial had a 100% success rate in protecting those who were in direct contact with infected individuals, and this served as a powerful reminder of the importance of preparedness and timely response in tackling infectious diseases.
“If that vaccine had been available at the beginning of the epidemic, most of the 28,000 cases, most of the 11,000 deaths and probably all of the [over] 50 billion dollars of economic losses that [outbreak’s] impact produced would have been preventable,” Hatchett said.
While the development of a vaccine for Lassa fever is a significant step forward in combating the disease, Hatchett emphasised that endemic countries also require a robust public health infrastructure to effectively distribute the vaccine and ensure its successful implementation, “vaccines don’t save people, vaccinations save people,” he said.
Key Takeaways: The Role of CSOs in the Lassa Vaccine Value Chain
The discussion highlighted the crucial roles that CSOs in Nigeria play in infectious disease prevention, detection, and response. Leveraging their grassroots reach, CSOs can lead communities in advocating for sustained investments in vaccine research, development, and manufacturing and offered the following areas.
1. Building Trust: Trust is vital for successful vaccine development especially during clinical trials and deployment, especially for this disease that has affected West African countries for over 50 years. CSO representatives emphasised tackling vaccine hesitancy through transparent communication and active community engagement. CSOs bridge the trust gap between healthcare systems and the public, using their local knowledge to combat misinformation and promote informed vaccination decisions and are willing to contribute this to Lassa vaccine development and access.
2. Promoting Accountability: CSOs hold the government accountable for Lassa fever prevention, detection, and response, and this could be expanded to include the government’s contribution to vaccine development and access. They advocate for adequate and sustained funding for vaccine R&D and facilitate consistent dialogues between the government and communities to ensure vaccine programmes align with national priorities and public health needs.
3. Addressing Logistical Challenges: The dialogue emphasised the importance of overcoming logistical challenges that hinder vaccine distribution. Strategic planning and investment in robust infrastructure and supply chain are critical to ensuring that vaccines reach underserved areas including remote and conflict-affected regions. This approach would ensure timely and equitable delivery, including for Lassa vaccines when licensed and introduced in future.
4. Promoting Equity in Access: The dialogue underscored the importance of ensuring Lassa vaccines are affordable for both the target populations and governments, while addressing any potential intellectual property (IP) barriers. Prioritising vulnerable and marginalised populations requires targeted interventions and equitable pricing strategies to overcome socioeconomic disparities. This approach ensures that when licensed, these life-saving vaccines can reach those who need them most, leaving no community behind.
5. Strategic Communication and Media Engagement: Strategic communication was highlighted as a powerful tool for advocacy and fostering public trust. Effective communication strategies are essential for countering misinformation and building confidence in vaccine safety and efficacy. The COVID-19 campaigns. Tailored messaging, leveraging both traditional and digital media platforms, is crucial to engage diverse audiences and address specific concerns, thereby enhancing public acceptance of vaccines.
6. Ensuring Sustainability: Long-term sustainability was a critical focus, with discussions on securing stable funding streams and questions were asked about embedding new vaccines within routine immunisation programmes. This approach ensures continuity and strengthens the health system’s resilience against future public health threats.
As Nigeria continues to combat the annual surge in Lassa fever cases, this engagement underscores the need for a multi-sectoral approach to address the disease. Vaccines, once available, will be a game-changer in protecting communities, but their success will depend on inclusive efforts which would involve CSOs helping to overcome potential hurdles and contribute to equitable access. Sustained advocacy, robust surveillance, and continued investment in vaccine research remains as urgent as ever.
Other Coordination Mechanisms for Lassa Fever Vaccine Development
To align countries and incorporate lessons from previous public health vaccine partnerships, Lassa requires a collaborative model focused on local ownership. Vaccine development and policies should be driven by regional and national efforts, with early and consistent community engagement. This approach ensures that vaccine use cases, vaccination strategies, clinical trial design and execution, demand evaluation, policy advocacy, and sustainable local supply and manufacturing are all locally supported.
Recognising this need, CEPI and the West African Health Organisation (WAHO) formalised their partnership in February 2024 through an MOU. This agreement aims to establish a Lassa coalition led by WAHO with support from CEPI. The primary goal of the coalition is to ensure that countries affected by Lassa fever have access to a safe, effective, and high-quality vaccine, enabling them to protect their populations adequately and equitably when needed.
Following the CSO roundtable, Professor Muhammed Ali Pate and the West African Health Organisation (WAHO), hosted the inaugural Lassa fever Governing Entity (LGE) meeting on Thursday, January 16. The meeting aimed to accelerate the licensure process for the Lassa fever vaccine in West Africa and ensure fair distribution of doses in the future.
Major outcomes from the meeting included the development of a 2025 roadmap, prioritising vaccine access, & fostering regional collaboration.
“The fight against Lassa fever reflects our shared commitment to health security and equitable access to life-saving solutions. Nigeria is proud to contribute to vaccine research through epidemiological studies, clinical trials, and other activities hosted by our institutions,” Prof. Pate noted.
