IMPROVING THE NATIONAL CAPABILITY FOR DISEASE SURVEILLANCE, DETECTION - - PowerPoint PPT Presentation

IMPROVING THE NATIONAL CAPABILITY FOR DISEASE SURVEILLANCE, DETECTION AND DIAGNOSIS IN PUBLIC HEALTH SYSTEMS IN NIGERIA

A paper presented to the Meeting of Experts of States Parties to the Biological Weapons Convention, Holding from 23th to 27th August, 2010, in Geneva, Switzerland.

Introduction

Biological agents are a threat to both developing and industrialized countries

A key to successful defence against threat to public health is: ‐ early detection ‐ identification ‐ monitoring progression in a community.

global disease surveillance is a basic public health necessity because ongoing interactions among humans, animals, and the environment will inevitably lead to disease emergence or re‐ emergence

Without these systems, the consequences of outbreaks of infectious disease and human exposures to agents would be great

The goal of disease surveillance is not merely to collect data for analysis, but to guide public health policy and action –

“information for action”

There is no way to predict when or where the next important new pathogen will emerge or what its ultimate importance might be.

Emergence of Pathogens

concerns over infectious diseases

• utbreaks include
• often novel diseases that society is medically

unprepared to handle

• Unpredictable and have variable impacts on

human and animal health

• diseases can emerge anywhere and spread

rapidly around the globe due to increasing international trade, travel, and movement of humans and animals

The most promising approach to sustainable global disease surveillance and response is to strengthen both national and regional capabilities of developing countries through international collaboration

Unfortunately most developing countries are facing a lot of challenges and obstacles due to insufficient resources, infrastructure or capacity to ensure effective health policy implementation

In addition, ‐ systems tend to be very disease‐ specific and limits the ability to detect diseases ‐ diseases of interest do not always match the interests of human health practitioners and public health authorities

‐ In 2000 WHO ranked the Nigerian health system in 187th place out of 191 countries ‐ life expectancy in Nigeria declined to 43 years (2006) from 47 in 1990 ‐ UNDP

Establishing IDRS in Nigeria

• Nigeria realized that routine disease

surveillance and reporting systems were not effective in the control of most diseases

• The need to address this problem led

to adoption in 1998 of the Integrated Disease Surveillance and Response System (IDSR)

IDRS OBJECTIVES

• provides a framework to

coordinate and improve the country’s ability to control priority communicable diseases

• strengthens the capacity to

conduct effective surveillance activities targeting priority diseases such as Avian Influenza and Swine Fever

• Integrate multiple surveillance

systems so that forms, personnel and resources can be used more efficiently and effectively,

• Improve the use of surveillance

data for decision making

IDRS OBJECTIVES CONTD.

• Improve communication of surveillance

information between and within levels of the health system,

• Improve laboratory capacity in identification of

pathogens and monitoring of drug sensitivity,

• Increase the involvement of clinicians in the

surveillance system and emphasize community participation in detection and response to priority diseases.

Since then;

‐ development of a National

Emergency preparedness plan against Avian Influenza in 2005 ‐ the appearance of the natural

• utbreak in 2006

‐ the control of the disease in 2007

analyzed 1,590 samples out of which 300 were positive for HPAI, as at 31st October, 2008

Other activities

• equipment procured and facilities

upgraded

• training of personnel in the public

health sector

• Institutions partnered with the WHO

and Centre for Disease Control (CDC) Kenya in training personnels from Veterinary Teaching hospitals and laboratories

• Training workshops in serological

techniques for the diagnosis of HPAI and Laboratory safety were also organized FAO and USAID

• Field Epidemiology Training programme
• Twinning programme initiated by the

OIE at the National Veterinary Laboratory

20

Foot & Mouth Disease and Avian Influenza Laboratories Complex

CENTRAL DIAGNOSTIC LABORATORY

Quality Control Laboratories Complex

Nigerian Academy of Science Workshop

• the surveillance infrastructure has improved

but still inadequate

• where capacity was available for diagnostic

techniques, facilities and equipment were lacking

• the need to enhanced and maintain

collaborations within and between the West African regions

• a disconnect between the human medical and

Veterinary public health activities

unanimous agreement that the current disease surveillance system in Nigeria needs to be strengthened in order to meet up with the challenges of the current threats of disease outbreaks.

Conference Recommendations

• National Centre for Disease Control in

Nigeria to integrate and coordinate all surveillance activities involving outbreaks

• f diseases in humans and animals.
• National Research Commission to oversee

and coordinate all activities involving human, animal and plant research in Nigeria

• Enhance Efforts towards strengthening global

laboratory network with integrated components for zoonotic disease diagnosis and reporting.

• Develop new and improve existing

interdisciplinary educational and training programs

• establish a technical multi‐disciplinary panel

to review current scientific information on drivers of disease emergence.

‐ Provide incentives for disease

• utbreak notification and also

reduce the social and economic repercussions for such early reporting ‐ Convene routine meetings of representatives from the public, private, and civil sectors to help build trust towards useful information

CONCLUSION

• The possibilities of another

panzootic of HPAI or any other disease cannot be overruled.

• The pandemic influenza of

moderate severity could reduce global gross domestic product by 2.0 percent, while a severe flu pandemic would drop global GDP by nearly 5%, or more than $3 trillion – World Bank.

‐ Nigeria has recognized the

seriousness of this situation and is focused on providing prompt and qualitative diagnostic and surveillance services ‐ Nigeria’s surveillance and reporting systems have improved significantly and many lessons can be learnt from this

There is need to do a lot more not only for early detection of the disease but also to monitor the ecology and epidemiology of the disease in order to manage it effectively

As a Country we can with all certainty state that we rose to the challenge of the time especially in relation to the recent outbreak of the Avian Influenza disease in Nigeria.

“Of the 84 countries the World Bank has assisted in the control

• f the deadly H5N1 virus,

Nigeria is the only country with a success story.”

• Mr. Onno Ruhl ‐World Bank Country Director

for Nigeria

This did not come easy, it involved sacrifice and passion put together to achieving this feat. However, we acknowledge that the Public Health system in Nigeria is currently facing a lot of challenges

CHOLERA OUTBREAK IN NIGERIA

• According to WHO more than 3,000 cases of

cholera in northern Cameroun, Nigeria and Niger

• An official anti‐epidemic in Nigeria indicated

that the cholera epidemic has killed 231 people in 11 states in the northeast of the country this year and infected more than 4500 others.

• More than 163 people, including 111 children,

have died of lead poisoning in Nigeria over the past five months

The recent sectarian crisis in some parts of the country has also worsened the surveillance situation and increased the potential threat of intentional or accidental use of biological agents

Nigeria urgently requires support in the provision of laboratory facilities to reduce these threats and to increase the likelihood that the diagnosis of any disease

• utbreak is correct, and that

public health action will be efficient and appropriate.

Nigeria continues to reaffirm its commitment to ensure the full realizations of the objectives of the Biological Weapons Convention (BWC) and attaches particular importance to the implementation

• f article X of the BWC which

provides for assistance and technical cooperation to State Parties against biological weapons attack.

Nigeria requests for technical assistance

• Provision of a Bio‐Safety Level (BSL) 3

laboratory to strengthen the capacity to protect the repository in the country

• Equipping the laboratory for molecular

diagnosis of highly pathogenic organisms

• Building capacity through training

programmes, joint cooperation projects and workshopss

Nigeria looks forward to receiving support from our partners at this meeting

Thank you for listening

CONTACT:

• DR. NWANKPA NICK‐ NATIONAL VETERINARY RESEARCH INSTITUTE
• VOM. PLATEAU STATE, NIGERIA

nicknwankpa2004@yahoo.com

• DR. OJEMBE CHRIS – FEDERAL MINISTRY OF HEALTH, ABUJA, NIGERIA

akanemeze1@yahoo.com