ABSTRACT:
Introduction Nigeria bears the highest global malaria burden, accounting for approximately 31% of cases and deaths worldwide. Reliance on imported rapid diagnostic tests (RDTs), insecticide-treated nets (ITNs), and artemisinin-based combination therapies (ACTs) exposes supply chains to vulnerabilities and high costs. This study evaluates Nigeria's initiatives in local production as a pathway to health equity and self-reliance. Methods A secondary analysis was conducted using open-source data from the World Health Organization World Malaria Report 2025 and national progress updates from the Presidential Initiative on Healthcare Value Chain. We evaluated trends in local manufacturing capacity and regulatory milestones from 2017 to 2025. Results National initiatives have increased local manufacturing capacity for essential health commodities from 30% to 40% between 2017 and 2025. Key advancements include the establishment of domestic RDT production lines and the commissioning of dual-active ingredient ITN facilities to address insecticide resistance. Therapeutic efficacy studies integrated with genomic surveillance at the African Centre of Excellence for Genomics of Infectious Diseases confirmed that while artemisinin resistance markers remain absent in Nigeria, first-line ACTs maintain an efficacy rate of 95% to 98%. Domestic production has effectively reduced lead times and mitigated the impact of currency volatility on the procurement of over 24000000 ACT treatments annually. Conclusions Scaling local production positions Nigeria as a leader in African health sovereignty. By domesticating the malaria value chain, Nigeria builds resilient systems against supply shocks and ensures equitable access to life-saving tools. This model provides a scalable framework for other high-burden nations to achieve universal health coverage and malaria elimination.