SARMAAN II azithromycin MDA, 2024-27
In Africa’s most populous country, and in states where childhood mortality rates remain a pressing concern, REACH teams are working hard to turn the tide.
The SARMAAN program, in collaboration with its many implementing and technical partners, is planning to deliver life-saving interventions to children in 11 states in northern Nigeria, and to treat some 18 million children aged 1-59 months by 2027.
Harnessing the proven power of mass drug administration, the REACH platform in Nigeria will seek to reduce all-cause mortality rates in children through the distribution of azithromycin, with field teams working tirelessly towards a future in which no child is left behind.
Facing up to the challenge
With an estimated population of 220,000,000 people and some 20% of inhabitants under the age of five, Nigeria has made significant progress in reducing the overall under-five mortality profile.
However, it has not been able to meet its Millennium Development Goal (MDG) targets and faces challenges in lowering under-five mortality rates to 25/1000 live births, in line with the 2030 Sustainable Development Goals.
With an average of 850,000 child deaths recorded annually in the country, the Federal Ministry of Health favours evidenced-based interventions aimed at reversing these trends.
With this in mind, the Ministry, in collaboration with the Gates Foundation, the REACH Network and the National Institute for Medical Research (NIMR), implemented the SARMAAN I project, which showed favorable results both in terms of under-five mortality and in terms of antimicrobial resistance.
REACH and ambition
Building on findings from the MORDOR and AVENIR studies, which demonstrated azithromycin’s effectiveness in reducing child mortality, and following the successful SARMAAN I pilot phase – implemented across six states and reaching more than 1.3 million children with a 95% treatment success rate – SARMAAN II is now significantly expanding its reach and ambition.
The goal is clear: to ensure that every vulnerable child receives the medical interventions they need to thrive and prosper.
Map showing the 11 Nigerian states slated for MDA coverage by SARMAAN II
Partnerships for efficiency
Needless to say, such a vast operation will not be accomplished without strong partnerships and committed collaboration. SARMAAN II is spearheading a multi-stakeholder approach to ensure the success of its program. Notably, the Nigerian Federal Ministry of Health and Social Welfare is working with the Task Force for Global Health to ensure a steady supply of azithromycin for MDA campaigns in Nigeria.
In 2025 alone, the Task Force will donate some 5.9 million bottles of azithromycin for distribution.
Alongside this, regular consortium meetings, data tracking dashboards, and coordinated efforts by local and global stakeholders will seek to drive efficiencies throughout the program so that its benefits can be felt in every participating village.
REACH Network
National focus, regional scope
SARMAAN II in Nigeria is a proud member of the REACH Network, which brings together azithromycin for child survival initiatives in countries throughout West Africa.
The REACH Network recently received a major boost with the signing of the Abuja Declaration by the Coordinating Minister of Health and Social Welfare of the Federal Republic of Nigeria, Professor Muhammad Ali Pate, and Professor Samba Sow, former Minister of Health of the Republic of Mali.
Honourable Minister Muhammad Ali Pate
REACH Network Co-chairs, Professor Samba Sow and Minister Muhammad Ali Pate, after signing the Abuja Declaration
Their joint declaration seeks to place a commitment to reducing child mortality at the heart of African health policy and discourse, grounding in concrete terms a “future where African children are healthy, resilient, and able to reach their full potential.”
Action with responsibility
As SARMAAN and the REACH Network scale up their efforts, the focus remains on delivering equitable access to healthcare in a responsible manner. This means scrupulously tracking trends in antimicrobial resistance so as to safeguard the efficacy of medicines and treatments for future generations too.
Fortunately, SARMAAN is able to count on the dedication of expert healthcare workers, researchers, and policymakers, all of whom are committed to bringing about real change on behalf of their communities.
Currently, SARMAAN teams are preparing to receive supplies of azithromycin so that MDAs can be conducted in the states of Kano, Kaduna, Kebbi, Bauchi, Katsina and Sokoto in the second quarter of 2025. Planning is also well underway for subsequent implementations during the second half of this year.
The fight against child mortality remains a monumental challenge, of course, but as SARMAAN / REACH teams build momentum, the tide is turning towards a future where child survival and good health are a fundamental right not a privilege.
