In line with the International Health Regulations (IHR) Monitoring and Evaluation Framework and our organisational strategy plan, the Nigeria Centre for Disease Control (NCDC) has continued to play a critical role as the National Focal Point for the implementation of IHR in Nigeria. Since 2017, NCDC has also worked closely with the World Health Organization (WHO) and Public Health England (PHE) to strengthen Nigeria’s emergency preparedness, resilience and response (EPRR) through regular simulation exercises (SimeX). With this, we are gradually filling the gaps identified following the Joint External Evaluation (JEE) of IHR capacities conducted in 2017 and 2019 respectively.
The NCDC/PHE joint IHR strengthening programme provides a structured approach to strengthening NCDC’s EPRR capability at national level. In order to improve EPRR capacity, capabilities developed at national level are continuously being developed at sub-national level. With more involvement and active participation of the states in SimEX, we now have a more resilient sub-national public health structure as evident by improved epidemic intelligence and coordination of emergency responses at this level.
On March 9th, 2021, NCDC and PHE held the 3rd SimeX called Exercise “Keep Pushing 3”. This reflects the vision of agency in ensuring national health security through persistent, proactive and evidence-based implementation of public health EPRR measures at national and sub-national levels. The exercise was coordinated from NCDC’s National Incident Coordination Centre (ICC), Abuja. Given the ongoing COVID-19 pandemic, a hybrid model was adopted, combining both a workshop and a functional exercise. Using a ‘One Health’ approach and strategy, the objectives of the exercise were to:
1. Assess key stakeholders’ understanding of their national and state-level ‘One Health’ role and responsibilities in the coordination of an outbreak of rabies
2. Evaluate the coordination and interoperability between national and state-level plans. Specifically, the Infectious Disease Outbreak Response Plan, Incident Action Plan, Nigeria One Health Strategic Plan and state-level Public Health Emergency Operations Centre (PHEOC) Handbook
3. Assess the support and coordination for risk communications processes and arrangements to warn and inform the public during a public health incident
4. Evaluate the effectiveness of the SITAware event management system at a national level to enable NCDC to support coordination at state-level
5. Apply the feedback from the exercise to inform and support the operationalisation of ‘One Health’ in Nigeria.
Asides the facilitators from NCDC ICC, participants were selected from Public Health Emergency Operation Centres of five selected states - Niger, Imo, Oyo, Rivers and Gombe) and our One Health partners in the Animal Health and Environmental Health sector.
Following the exercise, the participants provided feedback which revealed strengths in the areas of coordination and efficient use of Emergency Operations Centres (EOCs). Some limitations were also identified, including incident management activation such as rapid communication. Importantly, the lessons learned are being reviewed to further inform capacity development processes particularly at the state-level.
Notes
1. Information for this disease was retrieved from the Technical Working Group and Situation Reports
2. Case Fatality Rate (CFR) for this disease is reported for confirmed cases only
3. Information for this disease was retrieved from IDSR 002 data
4. CFR for this disease is reported for total cases i.e. suspected + confirmed
5. Information for sentinel influenza was retrieved from the laboratory
Key points
• There were 140 suspected cases, 34 were laboratory confirmed and six deaths recorded from twenty-three LGAs in ten States
Actions
To date:
• Conducted 2021 Lassa fever high burden states preparedness/response engagement meeting
• Dissemination of reviewed case management and safe burial practices guidelines
• Risk communication and community engagement activities have been scaled up across states using television, radio, print, social media and other strategies
Planned:
• Finalise Lassa fever five-year strategic plan
Key points
• There were ten suspected cases of Cerebrospinal Meningitis (CSM) reported from eight LGAs in five states (Borno – 4, Ebonyi – 2, Katsina – 2, Oyo – 1 & Plateau – 1). Two cases were laboratory confirmed and no death was recorded
Actions
To date:
• National CSM TWG meets weekly to review reports from states and plan appropriately
• Enhanced surveillance in all states
Planned:
• Continue harmonisation of the national line list and SORMAS data
• Continue to ensure that states reporting cases send their line lists and collect CSM samples
Key points
• There were 28 suspected cases of Yellow Fever (YF) reported from 22 LGAs in 15 States and FCT. None was laboratory confirmed and no death was recorded
Actions
To date:
• National YF multi-partner Technical Working Group (TWG) continues to coordinate activities across states.
• Daily monitoring and analysis of surveillance data across the country to guide response activities
Planned:
• Continue to support affected states across all pillars of response
• Continue harmonisation of surveillance and laboratory data ongoing
Key points
• There were four suspected cases of cholera reported from two LGAs in two states (Bauchi – 1 & Delta – 3). None was laboratory confirmed and no death was recorded
Actions
To date
• National Cholera Multi-Sectoral Technical Working Group (TWG) is monitoring all states and supporting affected states
Planned:
• Continue follow up and monitoring of non-reporting states
• Continue harmonisation of the national line list and SORMAS data
Key points
• There were 272 suspected cases of Measles reported from 100 LGAs in 24 States and FCT. None was laboratory confirmed and one death was recorded
Actions
To date
• National Measles TWG is closely monitoring measles surveillance data and providing feedback to relevant agencies and development partners
• Weekly surveillance and laboratory data harmonisation ongoing
Planned:
• Intensify follow up with states to update and transmit line list
• Continue monthly measles surveillance data review
Key points
• There were two suspected case of monkeypox reported from Bonny LGA in Rivers State. None was laboratory confirmed and no death was recorded
Actions
To date
• National Monkeypox Technical Working Group (TWG) is monitoring activities in all States
Planned:
• Enhance surveillance for monkeypox in high burden states
• Continue harmonisation of the national line list and SORMAS data
Key points
• There were 50 suspected cases of AFP reported from 45 LGAs in 20 states. None was laboratory confirmed and no death was recorded
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