Now to the hard work – Building a Disease Surveillance and Response Workforce for Nigeria

By Dr. Chikwe | December 07, 2016
Now that the handshakes and photographs are over, we at the NCDC have gotten down to the business of restructuring the country’s disease surveillance system. For me, the obvious place to start was the NCDC’s most important resource; our team, partners

Now that the handshakes and photographs are over, we at the NCDC have gotten down to the business of restructuring the country’s disease surveillance system. For me, the obvious place to start was the NCDC’s most important resource; our team, partners and collaborators – our people.

A lot of my time over the last few months has been spent visiting disease surveillance institutions and attending related activities, to meet the people behind the scenes of disease control in Nigeria, and learn how to support the work that they are doing to keep our country safe and healthy. It is also important to learn their challenges and opportunities.

One of our key partners is the Africa Field Epidemiology Network (AFENET). AFENET supports NCDC in training Disease Surveillance Notification Officers (DSNOs) and State Epidemiologists at local government and state levels. I was delighted to join colleagues during training sessions in Enugu and Anambra states as they progress towards developing DSNOs in all 774 LGAs in the 36 states of Nigeria.

During my visit, it was amazing to experience the enthusiasm and dedication from the local government health workers, many of whom are working with the barest minimum resources, not being adequately supported in terms of equipment and infrastructure. I had the opportunity to listen to these colleagues present reports on activities they had taken part in during their training, and it became clear to me that we have to start from the bottom of the disease surveillance chain and build up from there.

These colleagues are at the frontline of our surveillance and response activities. Our ability to prevent, detect and respond to disease outbreaks depend almost entirely on their ability to adequately collect, collate, analyze and interpret data. The colleagues were being trained on basic tools like the use of Microsoft Excel in analyzing data, which for some of them was a first time of using the software. They are the most important factor for disease surveillance in Nigeria and unfortunately their role as “boots on the ground” has not been sufficiently resourced and supported. If properly supported they can greatly improve the work we have to do, and one of my medium term priorities is to integrate them fully into the surveillance activities of the Nigeria Centre for Disease Control. We will certainly be back to learn more.

Another remarkable visit for me was to the “Central Public Health Laboratory” in Lagos. This was the first public health laboratory in Nigeria and should be at the heart of our public health diagnostic capacity. It was clear to see that this critical laboratory in Lagos had been neglected for many years and its potential was not being put to good use. Despite a highly motivated team, I found derelict infrastructure and equipment that appeared old and unused. At its inception it was the only national reference laboratory in Nigeria, but on my visit, it was sadly was a shadow of itself. This will change! My team is drawing up a plan to rehabilitate the facility, re-engage its staff and restore it to its rightful place in the national disease surveillance ecosystem.

While in Lagos, I also visited the Central Medical Stores in Oshodi. It was great to see the facility in an impressive state with a proper system in place for supply chain management. Although often undermined, ensuring an efficient supply chain is a key part of the work we do and we want to ensure that this is not left behind in our strategic plans. Over the past month, members of my team have delivered medicines and commodities to the State Epidemiology teams in every state capital in Nigeria from Yenagoa to Maiduguri, from Calabar to Sokoto, in order to be prepared to respond to outbreaks.

These recent visits have helped me gain a better understanding of where we are and meet some incredibly self-motivated people working hard to ensure that Nigerians are safe from the threat of infectious diseases. It was clear, however, that they had very little to work with, and are in dire need of support. I met Disease Surveillance and Notification Officers without laptops and Laboratory Technicians with no laboratories. Motivated and properly equipped health workers at the frontline of our surveillance work are critical to our disease control efforts. An effective public health laboratory is critical. Proper supply chain management for our medical supplies will ensure that we are always ready for any outbreak. This three-pronged emphasis will ensure that we have what we need in place to begin to properly restructure Nigeria’s disease control system.

My visits have not ended. Ours is a big country, and from all that I have seen, I am confident that our biggest resource is still our people. I found an organisation yearning for leadership and direction. I have taken this finding back to my Minister, Professor Isaac Adewole and he has given us his support to keep making strides forward. He recognises that the work we do is not just about health but also about national security. It cannot be business as usual at NCDC. By the end of the year, all of us at NCDC would have contributed to a new vision, mission and strategy for the organisation.

I have come away with one major and important take away from my travels: if we will succeed – it will be because of our people.