Marking One Year at NCDC

By Dr. Chikwe | November 07, 2017
One year and three major outbreaks later, I have taken some time to reflect on our activities during the year under review, and to provide some feedback to Nigerians whom we serve. Over the last one year, we have made steady progress across all sections o

About a year ago, precisely on the 15th of August 2016, I started as the Chief Executive Officer of the Nigeria Centre for Disease Control (NCDC), following an appointment by His Excellency, President Muhammadu Buhari. While the appointment came as a surprise, I accepted it with a huge sense of responsibility. It is this sense of service that has primarily kept me going, even during some very difficult moments. For our country to make progress, we have to leave the armchair and get engaged. With the amazing Team at NCDC, supportive leadership at the Federal Ministry of Health (FMoH) and some excellent partners, I am beginning to see the light at the end of the tunnel. I recall my first days in office, meeting with the NCDC Team, deciding on our top priorities and designing a plan for the next few years. I shared some of this in my first blog post. What a year it has been since!

One year and three major outbreaks later, I have taken some time to reflect on our activities during the year under review, and to provide some feedback to Nigerians whom we serve. Over the last one year, we have made steady progress across all sections of our mandate summarised into; disease prevention, detection, and response. Our administrative and other supportive roles have also not been neglected.I acknowledge that we may not have performed as well as I wished for in some areas, but these have been noted as areas for improvement. It is important to note that we have worked in a context of constrained financial resources and a historical skepticism of the potential of a public parastatal. But nonetheless, we have made progress. (Figure 1: November 2016- Developing the NCDC 2017-2021 Strategy Plan)

Epidemic prone diseases seem to be on the rise in Nigeria. In the last one year, we have recorded an increase in cases of Lassa fever and Cholera, as well as a large outbreak of Meningitis C. While further research is required to completely understand this trend, it may be linked to the intensification of our surveillance, diagnostic and communication activities. We have strengthened our surveillance system, supported states with training sessions and other resources, to ensure timely and complete reporting of priority diseases. With this, we are now finding more cases. In addition to this, the operationalisation of the NCDC National Reference Laboratory as well as strengthening of our public health laboratory networks means that we are now able to carry out more tests for these diseases. Our revamped communications network - both on mainstream and social media – has increased awareness among Primary Health Care workers on the need to report, and among Nigerians on their responsibility to visit a health facility when they feel ill and to avoid self medication. (Figure 2: Activities at the NCDC National Reference Laboratory)

In June 2017, Nigeria became one of 52 countries globally and number 15 in Africa to carry out a Joint External Evaluation (JEE) of our capacity to implement the International Health Regulations (IHR). The JEE process is led by the World Health Organisation and other external partners, using a peer-review mechanism. (Figure 3: Leadership of the Federal Ministries of Health and Agriculture, WHO Nigeria, US CDC at the Joint External Evaluation closing meeting)

Following lessons from the 2016/2017 Meningitis outbreak, and our subsequent response to concurrent outbreaks, we developed an Incident Coordination Centre (ICC) at our Jabi Head office, converting a cafeteria that was not being used. The ICC works through the different departments and structures in NCDC to implement daily intelligence gathering and risk analysis of public health events, for identification of potential threats aimed at informing adequate counter-actions to forestall negative health consequences. This keeps us on our toes daily, ready to respond to outbreaks as and when required. (Figure 4: NCDC Incident Coordination Centre (ICC))

We have prioritised the development of guidelines to support our areas of work and the areas of work where support is expected of us. We have completed new public health guidelines for the response to viral haemorrhagic fevers, acute watery diarrhoea and meningitis. Others will follow. The guidelines which were developed with contribution from colleagues across various sectors including academia can be found on the NCDC website (http://www.ncdc.gov.ng/diseases/guidelines) and are being disemminated to States.

The next big threat we face in public health is resistance to antibiotics that help us fight off infections. In the last year, we convened the Antimicrobial Resistance (AMR) Technical Working Group with membership from different government agencies and partners to develop a National Situation Analysis Report and National AMR Action Plan. We are now in the process of implementation, ensuring Nigeria is not left behind in the control of AMR globally. I am particularly grateful to Estelle Mbadiwe and Global Antibiotic Resistance Partnership (GARP) for supporting us and the indefatigable colleagues; Professors Iruka Okeke and Dipo Aboderin who have selflessly supported and pushed us along on this journey.

Our vision is to build the confidence of Nigerians and the global community in NCDC as a responsible organisation working 24/7 to protect the health of Nigerians through information, and a timely response to health concerns. Despite the general pessimism at the ability of public institutions to deliver on their mandate, we are ready to take on the task ahead. We will give it all it takes to strengthen our contribution to improving public health in Nigeria. I am very grateful to all our partners, the media and the general public whose growing confidence in NCDC, motivates us greatly.

Our “Top Ten” priorities for the next year are:

1. Legislative approval for the bill establishing the NCDC

2. Strengthen our National Reference Laboratory

3. Strengthen our Surveillance architecture

4. Digitise our disease surveillance eIDSR implementation

5. Enhance the capacity of our Emergency Operations Centre (EOC)

6. Develop and implement an all hazard risk communication plan

7. Strengthen inter-sectoral collaboration between human and animal health, the environmental sectors and security agencies- Establish ONE Health Platform

8. Support the take-off of activities of the Regional Centre for Disease Control (RCDC) / Africa Centre for Disease Control (ACDC) Regional Collaborating Centre

9. Play a stronger role in International Public Health

10. Continue to build the confidence of Nigerians in NCDC as a responsible & responsive government agency

Finally, I am grateful to the team at NCDC, from the drivers to the directors. This is an incredible team, that I am priveleged to work with. It has been an exciting journey which has been made easier by the expertise each person brings. I acknowledge that it would have been impossible to attain this level of progress without the team spirit and support. Thank you for all the work you do. We are as always, #strongertogether!