Nigeria Has Built the Climate-Health System It Needs – It Just Has Not Connected It Yet

By the Climate-Health Desk, Sydani Group

In 2010, children began dying in Zamfara State. Artisanal gold mining had contaminated the soil with lead dust, and without an environmental health surveillance system, the exposure went undetected for months. By the time investigators identified the source, over 400 children were dead, and thousands more had sustained permanent neurological damage. The response, coordinated by the Federal Government, WHO, MSF, and the US Centers for Disease Control, was effective. But it was not prevention.

That system now exists. Nigeria built it. The defining unanswered question in Nigerian public health is who will resource it to national scale.

For several years, Sydani Group has been embedded in Nigeria’s Public Health Care (PHC) system, building workforce strategies, deploying cold chain equipment, and reconstructing community trust networks. That work has revealed something most policy conversations have not named: the infrastructure built to deliver vaccines must also absorb the next wave of climate-driven illness. It is not ready.

What We Built

From 2019, Sydani has worked with the Federal Ministry of Health and Social Welfare and USAID on Nigeria’s Strategy for Immunisation and PHC System Strengthening, NSIPSS. Under the Cold Chain Equipment Optimization Project, CCEOP, backed by GAVI and the Federal Government, we led coordination that took ward-level cold chain saturation from 39.5 to 96 per cent across 9,344 deployed units. Research documents that brief temperature excursions can reduce vaccine potency by up to 40 per cent; every point of that improvement represents children reached by vaccines still viable on arrival.

Through the Rebuilding Immunisation Support and Engagement (RISE) project in Kano, we are confronting the subtler frontier: public trust. Nigeria’s 2023–24 DHS found full vaccination coverage in the North at 12.2 per cent against 36.4 per cent in the South. Climate shocks that disrupt immunisation schedules will widen that gap faster than advocacy can close it, which is why surveillance and immunisation must be linked.

Three programmes. A cold chain rebuilt from collapse. Community trust reconstructed in difficult terrain. Here is what none of it includes, and why that absence is about to cost us dearly.

The Dimension We Did Not Design For

NSIPSS is a rigorous strategy, but it contains no climate-sensitive disease component, and almost no national PHC strategy produced before 2022 did. That design gap is now a vulnerability.

The WHO’s 2024 Global Health Estimates attribute 29 per cent of Nigeria’s total disease burden to environmental risk factors: air pollution, contaminated water, hazardous chemical exposure, and inadequate sanitation. These are active drivers of illness in the same LGAs where Sydani’s CHEWs work, where our cold chain units run, where our RISE champions rebuild vaccine confidence. Climate variability intensifies for everyone: heat corrupts cold chains, flooding brings cholera and typhoid, extended harmattan seasons drive respiratory surges to facilities staffed for immunisation, not environmental emergency response.

Nigeria’s 2022-23 diphtheria resurgence made this concrete. Flooding disrupted immunisation across Northern states, collapsing coverage in fragile communities. A vaccine-preventable disease re-emerged at epidemic scale,not because the vaccine failed, but because climate disruption destroyed the coverage that kept it suppressed. For RISE in Kano, we added diphtheria burden as a new LGA selection indicator. The disease map changed and we adjusted. The map will keep changing. The surveillance systems have not.

The System Already Built and Waiting

Nigeria has not merely a PHC infrastructure; it has a surveillance system built to detect the exposures that precede these events.

INEHSS,the Integrated National Environmental Health Surveillance System, was developed by the Federal Ministry of Environment and validated with WHO, the World Bank, the UK Health Security Agency, IFRC, and FAO. It is grounded in five pieces of enacted federal legislation, its 2025 National Guidelines are published, and it is running in 12 states today.

The CHEW observing a post-harmattan respiratory surge sits at the base of a five-tier reporting structure,community informants, ward focal persons, LGA officers, state desks, national secretariat,designed precisely for moments like hers. What she lacks is not the system. She lacks the integration: the threshold that tells her when to escalate, the protocol routing her observation upward, the feedback loop converting what she sees into a response.

Closing that gap is what Sydani’s climate-health desk exists to do,working with the Federal Ministry of Environment to scale INEHSS to all 36 states. Not to build new infrastructure. To complete the connection between two systems built for the same purpose that have never been linked.

The Zamfara children died because no detection system existed. That system now exists. The question is whether it reaches every state before the next emergency answers that question for us.

The Investment Case

For every development partner with a health security mandate in Nigeria, this is a portfolio question. Every PHC investment,immunisation coverage, cold chain, pandemic preparedness, community health workers,is exposed to climate risk not currently being measured. When a single 2022 flooding event collapsed coverage and reintroduced epidemic diphtheria to the North, that is not a weather story. That is evidence of what unmonitored climate-health risk costs: in lives, in coverage reversals, in years of wasted investment.

The solution exists. A USD 2.1 million, 12-month pilot would produce Nigeria’s first population-level environmental health intelligence system,protecting what decades of PHC investment have built.

Nigeria does not need to build the system. It needs the investment to finish it.

If you work in health systems, climate finance, or development in Nigeria, we’d welcome your perspective in the comments. And if this framing is useful, share it with someone who should see it.