Health workers are working to prevent the further spread of the disease through vaccination and community awareness.
MSF team member Diaka Kaba administers a diphtheria vaccine to a child in Siguiri. | Guinea 2026 © Mohamed Mara/MSF
Diphtheria had not been reported for more than 30 years in Guinea, but in 2023, cases reappeared in the border district of Siguiri, in the northeast of the country.
In response, Doctors Without Borders/Médecins Sans Frontières (MSF), in coordination with the Ministry of Health and Public Hygiene, opened a project combining patient care, vaccination, and community awareness.
This resurgence of diphtheria cases has also been seen in several other countries in West Africa and the Sahel, including Niger, Nigeria, Mali, Chad, and Mauritania. The disease circulates particularly in cross-border transit areas, where there is also inadequate vaccination coverage.
"Diphtheria is an acute bacterial infection that mainly affects the respiratory tract and is transmitted by droplets," says Nicoletta Bellio, MSF project medical manager in Siguiri. "It can cause a thick membrane to form in the throat, leading to severe breathing difficulties if the disease is not treated quickly."
"My daughter was the first to fall ill, in Mandiana, where I work in a gold panning mine," says Hawa Fofana. "For several days, she had a very high fever and we were told that it was malaria and bronchitis. We were evacuated to the regional hospital and my daughter died there. As her younger brother also started to have the same symptoms, relatives advised me to hurry and take him to the epidemic treatment center. My son had trouble breathing and his neck was swollen. At the center, we were told that it was diphtheria. He was hospitalized and treated. Today he is much better."
As of March 28, our teams have treated 213 patients at the MSF-supported epidemic treatment centre in Siguiri. Patients with respiratory complications or signs of neurological damage, such as paralysis, difficulty swallowing, blurred vision, or even heart problems, receive specific treatment including diphtheria antitoxin, an essential drug used to neutralize the toxin of the disease.
"Diphtheria can progress very quickly,” explains Nicoletta Bellio, medical manager of the MSF project in Siguiri. “Without receiving antitoxin in time, the consequences can be dramatic. The patient may die.”
The diphtheria antitoxin is the most effective treatment for the disease, but this essential medicine is expensive and only produced by a limited number of manufacturers. It can take up to six months to become available in a country.
MSF is advocating for Guinea to be included among the priority countries in the provision of diphtheria antitoxin in order to guarantee patients have rapid and free access to this lifesaving treatment. We call for the urgent mobilization of international partners to ensure rapid and equitable access to the diphtheria antitoxin and vaccines.
"My sister was hospitalized for diphtheria and recovered," says Gnalén Konaté. "Soon after, I started to have the same symptoms, such as a sore throat, body aches, and a fever. The staff at the treatment center took good care of me and gave me medicine and food. They even came to see us at night. Today, I can finally go home and continue my treatment there thanks to the doctors."
In addition to medical care, MSF teams support the Expanded Program on Immunization with vaccination activities for children aged six weeks to 9 years old in the most affected areas. As of March 28, MSF has vaccinated 85,000 children through its 20 fixed and mobile vaccination teams covering the districts of Siguiri and the surrounding area.
Teams are planning to visit more distant villages in the future. In total, more than 180,000 children are expected to receive two doses of vaccines by May. Unfortunately, some children had never been vaccinated against diphtheria, which has contributed to the rapid spread of the disease.
"Diphtheria remains a vaccine-preventable disease,” says Bellio, “The vaccine is essential for preventing severe disease, interrupting transmission, and preventing new outbreaks of cases.”
In addition to medical care and vaccination, MSF's health promotion teams also coordinate awareness-raising activities in communities.
Community health workers disseminate information on prevention and quickly identify suspected cases. The aim of awareness campaigns is to increase people’s understanding of the disease, enabling early recognition and prompting referrals to for treatment. Awareness-raising messages are also shared through local media.
At the same time, the involvement of traditional practitioners is essential, because in some areas, people see them first when they fall ill. MSF organizes awareness-raising sessions at health centers and with community leaders and traditional healers to help people recognize the warning signs of diphtheria and quickly refer patients to health facilities.
"Access to vaccines and antitoxin remains a challenge globally, with lead times of up to several months,” says Adélard Shyaka, MSF's medical coordinator in Guinea. “To maintain free care and strengthen the response in these cross-border areas, more medical organizations and humanitarian partners need to get involved. “
