By Abdallah K. Gwarzo
1. NCDC IS LESS THAN A DECADE OLD
The Nigeria Centre for Disease Control first came to limelight in 2014, following the Ebola outbreak in West Africa. Since then, the young agency has focused on strengthening health security in Nigeria.
The first official step to establish NCDC as Nigeria’s national public health institute, was in 2011. Some departments and programmes in the Federal Ministry of Health, including the Epidemiology Division; Avian Influenza Project and its laboratories; and the Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP) were brought together to form the nucleus of the agency.
However, the NCDC implemented its functions without a legal mandate until November 2018, when the NCDC Act was signed into law by President Muhammadu Buhari.
Dr. Chikwe Ihekweazu is the first Director-General of NCDC.
2.NCDC’S MANDATE IS ANCHORED ON SIX PILLARS
The NCDC has the mandate to protect the health of Nigerians, through infectious disease prevention and control. The responsibilities of the agency as articulated in the NCDC Act include to prevent, detect, and control diseases of public health importance; coordinate surveillance systems to collect, analyse and interpret data on diseases of public health importance; support states in responding to small outbreaks and lead the response to large disease outbreaks; develop and maintain a network of reference and specialised laboratories; conduct, collate, synthesise and disseminate public health research to inform policy.
The agency is also responsible for Nigeria’s engagement with the international community on diseases of public health relevance.
3. NCDC HAS JUST 300 STAFF
Although NCDC has been in the limelight since the first confirmed COVID-19 case in Nigeria, the agency’s responsibilities are primarily carried out by less than 300 full-time staff.
They are spread across three campuses including its Headquarters and the National Reference Laboratory in Abuja, as well as the Central Public Health Laboratory in Lagos State which is a campus of the National Reference Laboratory.
The members of staff work across six Departments and Disease Technical Working Groups (TWGs). To ensure preparedness for diseases, NCDC established Disease TWGs for all epidemic-prone diseases. Each group focuses on the specific disease area to develop guidelines, monitor trends, support states in developing outbreak preparedness and response plans.
The Departments are responsible for the implementation of routine activities of the agency including the public health diagnosis of infectious diseases, implementation of health promotion and disease prevention activities, preparedness for and response to disease outbreaks, as well as collation and analysis of data on priority diseases from across the country, which is used for response activities and decision making.
4. AN AGENCY ALWAYS ON THE MOVE
In response to the COVID-19 outbreak, NCDC has deployed over 100 personnel as rapid response teams (RRT) to support all 36 states and the Federal Capital Territory. These RRTs have supported training of state personnel, strengthening of coordination, surveillance and response activities. Some of these RRTs have been in states for as long as four months.
In 2018 alone, NCDC deployed 51 RRTs to 21 states in response to outbreaks of Lassa fever, cholera, monkeypox, meningitis, yellow fever and other infectious diseases that are endemic in Nigeria. As stated in the NCDC Act, the agency leads the training of field epidemiologists through the Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP). The Residents and graduates of this programme are part of NCDC’s RRTs to states.
5. BUILDING ON NCDC’S FOUNDATION FOR HEALTH SECURITY IN RESPONSE TO COVID-19
The immediate response to COVID-19 in Nigeria was based on the resources built by NCDC in the last four years. One of these is the National Incident Coordination Centre (ICC) established in 2017, which is now serving as the National COVID-19 Emergency Operations Centre (EOC).
Before the first COVID-19 case was confirmed in Nigeria, the EOC was activated at preparedness mode to monitor the trend in other countries, develop scientific guidelines and protocols, train health workers and other preparedness activities.
In addition, the first four laboratories which were activated to test for COVID-19 were laboratories within NCDC’s molecular laboratory network. These laboratories had already built their molecular testing capacity by carrying out public health diagnosis of diseases such as Lassa fever. The structures and frameworks in NCDC’s five-year strategy (2017-2021) such as its mode of operations and partnerships have proven very useful in the response to this pandemic.
6. NCDC’S FOCUS ON STRENGTHENING HEALTH SECURITY IN STATES
In 2017, NCDC embarked on a project to support states in the establishment of Public Health Emergency Operations Centres (PHEOCs) and supported the training of health workers to manage these PHEOCs in every state. The State PHEOCs are connected to the National ICC for public health coordination in Nigeria. As at January 2020, NCDC has established PHEOCs in 20 states and the Federal Capital Territory.
The states include Lagos, Ondo, Nasarawa, Kogi, Kebbi, Rivers, Zamfara, Cross-River, Edo, Plateau, Anambra, Niger, Benue, Osun, Kwara, Abia, Enugu, Ebonyi, Bayelsa and Benue States.
Since the beginning of the COVID-19 outbreak, these PHEOCs have been used for coordination of response activities by states. Prior to the COVID-19 outbreak, most states had used their PHEOCs in response to other infectious disease outbreaks, strengthening their preparedness and capacity for emergency response.
In addition to these PHEOCs, NCDC has supported the training of human resource at state-level, provision of vehicles and resources for outbreak response, deployment of standardised surveillance tools across all states and other disease control activities.
7. NCDC’S MANDATE IS BEYOND COVID-19
NCDC’s responsibilities go far beyond COVID-19. The agency was set up to respond to the challenges of public health emergencies and to enhance Nigeria’s preparedness and response to epidemics through prevention, detection and control of communicable diseases. Such diseases include cholera, meningitis, yellow fever and Lassa fever.
Even as it battles the country’s number one health challenge at this time – COVID-19 – the agency is not ignoring its responsibilities to manage other diseases that fall under its purview. A good example of this focus is the significant progress recorded in the fight against Lassa Fever.
A Lassa fever outbreak was active in many states in Nigeria when the first COVID-19 case was confirmed in February. It had killed over 160 people since the start of 2020 alone, prompting calls for the declaration of a national health emergency. It is a credit to the work done by the NCDC that the emergency phase of the outbreak has been declared over.
The number of people who died from Lassa fever in 2020 reduced, when compared to the last two years. This may be related to NCDC’s training of additional health workers in all states in Nigeria. The NCDC continues to publish a weekly epidemiological report, showing that Nigeria has not stopped recording cases of Lassa fever, cholera, measles, yellow fever and monkeypox.
8. NCDC’S ROLE IN REGIONAL HEALTH SECURITY
In addition to its role in Nigeria, NCDC plays a key role as Nigeria hosts the ECOWAS Regional Centre for Disease Control and West African hub of the African Union’s Africa Centres for Disease Control. In this role, NCDC staff are part of regional health response activities.
In 2019, NCDC staff were part of a Rapid Response Team deployed by ECOWAS West African Health Organisation (WAHO) to support a Lassa fever outbreak in Liberia. As Nigeria is responding to COVID-19, NCDC has also supported training and response activities in other African countries, organised by Africa CDC.
9. NCDC’S ROBUST PUBLIC COMMUNICATIONS STRATEGY
Although many Nigerians only began to follow NCDC on social media for COVID-19, the agency has maintained a strong public communications strategy for the last four years.
NCDC has an active and up to date website and has published an annual report on its activities since 2017. The NCDC has also supported the training of journalists and engages with them strategically.
On social media, NCDC has maintained an active response even before COVID-19. NCDC has always maintained that communicating actively with Nigerians is core to its mandate and an important part of its responsibilities.
10. NCDC’S CONTRIBUTION TO SCIENCE
The NCDC is a public health institution and although it is relatively new, has contributed to the development of scientific evidence for Nigeria.
The NCDC has documented and published lessons from its response to all epidemic-prone diseases in Nigeria including Lassa fever, meningitis, yellow fever, cholera and measles in the last three years, in peer-reviewed journals.
The agency’s National Reference Laboratory (NRL) served as the central laboratory for the National AIDS Indicator Impact Survey (NAIIS) in 2019, which is the largest population-based HIV/AIDS survey in the world.
The agency also contributes to global public health research through platforms such as the Global Antimicrobial Resistance Surveillance System, Global Influenza Surveillance and Response System etc.
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