Preparing for Next-Generation Antimalarials in Nigeria: A Pre-Introduction Readiness Assessment with Focus on Infant-Friendly Formulations and Emerging Therapies

Nigeria shoulders the world's highest national malaria burden, accounting for approximately 25.9% of global malaria cases and 30.9% of malaria deaths in 2023, with children under five years of age comprising the most vulnerable group. As the global antimalarial pipeline advances notably with GanLum (ganaplacide-lumefantrine), which completed successful Phase 3 trials in November 2025, and new infant-specific formulations for neonates under 5kg. Nigeria's health system readiness to absorb, deploy, and equitably distribute these innovations is critically under-examined. This paper conducts a secondary data review to assess Nigeria's preparedness across five domains: disease burden, regulatory infrastructure, supply chain capacity, health system readiness, and financing. Findings reveal a nation with enormous need but significant structural gaps in regulatory harmonization, last-mile supply chain reliability, healthcare worker training, and domestic financing. The paper concludes with actionable pre-introduction recommendations to position Nigeria to benefit immediately and equitably when next-generation antimalarials receive regulatory approval.