For twenty years, the battle against malaria in Nigeria was a race against a resilient parasite. What began as a straightforward scramble to distribute basic commodities has transformed into a sophisticated, data-driven campaign of precision medicine and layered defense.
This photo assignment captures that evolution on the ground in Kebbi State—a region at the literal forefront of Nigeria's newest healthcare frontier.
An aerial view shows the Gwandu General Hospital in Gwandu, Kebbi State, Nigeria, on Monday, May 11, 2026. (unitaid/Dawali David)
Sarah Bello, head of maternity care at Gwandu General Hospital, speaks to pregnant women about malaria prevention during an antenatal visit in Gwandu, Kebbi State, Nigeria, on Monday, May 11, 2026. (Unitaid/Dawali David)
Sarah Bello, head of maternity care at Gwandu General Hospital, educates pregnant women on the use of Malnet SP, a preventive malaria treatment, during an antenatal visit in Gwandu, Kebbi State, Nigeria, on Monday, May 11, 2026. The distribution of the medication is part of a broader initiative to protect expectant mothers from malaria-related complications. 'Actually, due to different interventions from NGOs, we have really had improvement in malaria cases. There is a reduction in admissions of patients—especially pregnant women—in the facility.' (Unitaid/Dawali David)
Sarah Bello, head of maternity care at Gwandu General Hospital, provides an insecticide-treated mosquito net to an expectant mother during an antenatal visit in Gwandu, Kebbi State, Nigeria, on Monday, May 11, 2026. The distribution is part of a public health initiative to prevent malaria transmission among pregnant women. (Unitaid/Dawali David)
Rilwanu Aliyu, Assistant State Cold Chain Officer for the Kebbi State Primary Health Care Development Agency, inspects malaria vaccines inside the state cold room before dispatching them to a primary healthcare center (PHC) in Birnin Kebbi, Nigeria, May 12, 2026. Aliyu oversees the "vaccine push," a distribution system that maintains the cold chain from state storage to local government areas and frontline facilities. The program follows strict standard operating procedures and utilizes specialized cold boxes to ensure the vaccines remain effective for children and pregnant women, who are the populations most vulnerable to the disease.( Untaid/Dawali David)
Rilwanu Aliyu, Assistant State Cold Chain Officer for the Kebbi State Primary Health Care Development Agency, carries a box of R21 malaria vaccines inside the state cold room in Birnin Kebbi, Nigeria, May 12, 2026. Aliyu is preparing the shipment for dispatch to a nearby primary healthcare center as part of the "vaccine push". This logistical process is designed to maintain the cold chain from state storage to the end user to ensure the vaccine's effectiveness in reducing malaria cases among vulnerable populations, particularly children.
( Unitaid/ Dawali David)
Nusaiba Musa holds her child as they receive a malaria vaccine at Gwandu General Hospital in Gwandu, Kebbi State, Nigeria, on Monday, May 11, 2026. The vaccination program is part of an ongoing effort to scale up preventive healthcare for children in high-burden malaria regions. (Unitaid/Dawali David)
Bashir Malami places his daughter inside a small, portable mosquito-netted bed outside his home in Gwandu, Kebbi State, Nigeria, on Monday, May 11, 2026. Malami, who formerly spent significant portions of his income on malaria treatments, now uses consistent netting and immunizations to protect his children. "Keeping the sleeping area clean and using nets are the things we prioritize," Malami said. "As soon as the sun sets, we make sure everyone is protected". (Unitaid/Dawali David )
Bashir Malami assists his daughter, Hussaina, with her schoolwork outside their home in Gwandu, Kebbi State, Nigeria, on Monday, May 11, 2026. Malami notes that the consistent health of his children, maintained through malaria vaccinations and regular net use, has allowed them to focus more effectively on their education. “Since we started focusing on immunizations and using nets, my daughter hasn't needed even a dose of paracetamol,” Malami said, emphasizing the stability these health measures have brought to their daily lives. (Unitaid/Dawali David)
Nafisat Malami and her eldest daughter, Memuna, work together to sew clothing on a manual sewing machine outside their home in Gwandu, Kebbi State, Nigeria, on Monday, May 11, 2026. The Malami family has reported a significant decrease in medical expenses and lost work time since adopting a routine of malaria prevention treatments and childhood immunizations. “Since we started focusing on immunizations and using nets, my daughter hasn't needed even a dose of paracetamol,” said Bashir Malami of the family's improved health. (Unitaid/Dawali David)
Nafisat Malami sets up an insecticide-treated mosquito net outside her home in Gwandu, Kebbi State, Nigeria, on Monday, May 11, 2026. Due to the heat, the family often sleeps outdoors, and Nafisat ensures that the sleeping area is properly secured to protect her five children from malaria-carrying mosquitoes throughout the night. (Unitaid/Dawali David)
Twin siblings Hussaina and Hassan Malami pose for a portrait inside a mosquito net outside their home in Gwandu, Kebbi State, Nigeria, on Monday, May 11, 2026. Due to the high evening temperatures, the Malami family often sleeps outdoors on mats, using insecticide-treated nets to maintain protection against malaria-carrying mosquitoes throughout the night. (Unitaid/Dawali David)
Sanusi Umar sets up an insecticide-treated mosquito net outside his home in Gwandu, Kebbi State, Nigeria, on Monday, May 11, 2026. Due to the high evening temperatures and lack of electricity, the family often sleeps outdoors, making consistent use of the net a mechanical necessity for protection against malaria. “As soon as the sun sets, we are already inside the net,” Umar said, describing his family's nightly routine to prevent the disease. (Unitaid/Dawali David)
Sanusi Umar poses for a portrait with his wife and their young daughter outside their home in Gwandu, Kebbi State, Nigeria, on Monday, May 11, 2026. Umar, who previously experienced severe medical and financial crises during his wife's earlier pregnancies, now implements a strict household routine of consistent mosquito net use and supervised medication. “In previous pregnancies, my wife would hide her medicine because it tasted bitter,” Umar said, noting that the resulting anemia required the purchase of three pints of blood. “This time, we ensured she took every dose, and the child was born healthy". (Unitaid/Dawali David)
A laboratory scientist performs a malaria diagnostic test at a hospital laboratory in Birnin Kebbi, Nigeria, May 12, 2026.
( Unitaid /Dawali David)