Experts brainstorm on lessons from COVID-19 pandemic, disease outbreaks

Medical experts have warned that Nigeria is at risk of yearly, multiple, and concurrent disease outbreaks due to tropical climate, population density and poor socio-economic factors. They, however, said the country is yet to see the worst of the COVID-19 pandemic.

The medical experts brainstormed on lessons from the COVID-19 pandemic and other disease outbreaks at the maiden edition of the Nigerian Conference of Applied and Field Epidemiology (NiCAFE). The conference, which was held virtually, was organised by the Nigeria Centre for Disease Control (NCDC) in collaboration with partners from July 26 to 28, 2021.

The theme of this year’s NiCAFE conference was “Building back better: COVID-19 and other disease outbreaks”.

Minister of Health, Dr. Osagie Ehanire, in his opening remarks, said despite the pandemic, the country has not stopped recording other infectious disease outbreaks. Ehanire said, in the last one month, Nigeria has been responding to an outbreak of cholera across states, an increasing number of Lassa fever cases, a recent monkeypox case reported in the United States (U.S.) with travel history from Nigeria, as well as weekly reports of yellow fever and measles cases.

He said Nigeria is at risk of these infectious disease outbreaks because of its tropical climate, population density, and other factors such as the high number of international travels and local movements.

Ehanire said, in the last five years, Nigeria has prioritised measures to strengthen her health security. “From the establishment of the NCDC National Reference Laboratory in 2017, NCDC led the establishment of at least one molecular laboratory in every state in 2020. From the establishment of the National Public Health Emergency Operations Centre (EOC) in 2017, the NCDC has led the establishment of State Public Health EOCs across the country,” he said.

Ehanire said the FMoH has also continued to strengthen government ownership of Nigeria Field Epidemiology Training Programme (NFETP), with coordination by NCDC on behalf of the FMoH and collaboration with the Federal Ministries of Agriculture and Environment.

Ehanire said NFETP residents and graduates have proven to be extremely valuable resources for public health in Nigeria, Africa, and globally. He said they have played a key role in the response to the COVID-19 pandemic and outbreaks of other infectious diseases and public health challenges.

“Given the success of our frontline and advanced NFETP, we have now begun the rollout of the intermediate programme to train more mid-career public health professionals in Nigeria who can contribute to our public health workforce,” he said.

Director General (DG)/Chief Executive Officer (CEO), Dr. Chikwe Ihekweazu, said: “The last time we met for a scientific conference was in 2019 when we hosted the NCDC/NFELTP Annual Scientific Conference. At the time, we discussed preparing for future pandemics but none of us had the inkling that less than one year after our conference, we will be faced with a pandemic.

“The COVID-19 pandemic has turned our lives upside down. It has infected over 190 million people and sadly, we have lost 4.15 million people. In Nigeria, we have had over 170,000 infections and more than 2,000 deaths. It pains me to say that there is a possibility that we are yet to see the worst of this pandemic. But, this is part of the reason we are here today.

“We are not only faced with a pandemic in Nigeria but multiple concurrent disease outbreaks. In the last month alone, we have been responding to an increasing number of COVID-19 cases, outbreaks of cholera in several states and the panic associated with the detection of a monkeypox case in the US with travel history from Nigeria. Every week, we detect cases of yellow fever, Lassa fever, measles, and other infectious diseases that are endemic in Nigeria.”

Ihekweazu added: “That is our reality – our tropical climate, population density, poor socio-economic factors leave us at risk of annual, multiple, concurrent disease outbreaks in Nigeria. Therefore, we must be one step ahead of these pathogens.

“We must also think of the other public heath challenges that lie ahead of us – our population is growing at a rapid phase and this will have an incredible impact on our health system.”

The epidemiologist warned that there is a rise in antimicrobial resistance, and this will affect the prevention and management of infectious disease cases and humans are also faced with increasing risks and prevalence of non-communicable diseases.

Ihekweazu said the last one year spent responding to the COVID-19 pandemic has presented NCDC with lessons – from leadership and governance to building laboratory systems and risk communications. “It has also given us a wake-up call. In the next few days, we will hear from eight exceptional plenary speakers who work at global, regional, and country levels on various aspects of global health and health system strengthening,” he said.

Ihekweazu added: “We will also hear from the staff of NCDC, our field epidemiologists, public health professionals from across Nigeria and African countries on the work they do in contributing to national, regional, and global health security.”

The NCDC DG recognised that this is a difficult period where several colleagues are working extremely hard in response to an increasing number of COVID-19 cases. “But, it is also important that we reflect on lessons learned so far, and think together on how we can strengthen our response to COVID-19 and other disease outbreaks,” he said.

In the last 17 months, countries across the world have been affected by the impact of the COVID-19 pandemic. In Nigeria, there have been other disease outbreaks in addition to the COVID-19 pandemic, including Lassa fever and cholera. The NiCAFE conference sought to bring together public health professionals, laboratory scientists, field epidemiologists, researchers, health care professionals and other members of the public to reflect on the response to these outbreaks, review gaps in epidemic preparedness and response and brainstorm innovative solutions to strengthen health security.

The 2021 NiCAFE conference began as Nigeria reinvigorated the ongoing COVID-19 response given an increasing number of new cases. The conference, which was held virtually, featured eight keynote/plenary speakers, over 170 oral and poster presentations across various themes. These include governance and leadership, epidemiology, surveillance and transmission dynamics, case management of infectious diseases. Other conference sub-themes include social sciences and community engagement, the role of agriculture and environment in disease transmission as well as health system strengthening for future pandemics.

The conference keynote lecture was given by the Chief Scientist of the World Health Organisation, Dr. Soumya Swaminathan, on Day 1, and the Director of the Africa Centers for Disease Control, Dr. John Nkengasong on Day 2.

Plenary speakers at the conference include: Prof. Babatunde Salako, Director General of the Nigerian Institute of Medical Research (NIMR) Yaba; Prof. Akin Abayomi, Commissioner for Health, Lagos State; Dr. Akindele Adebiyi, Public Health Physician and Clinical Epidemiologist; Prof. Folasade Ogunsola, Consultant
Clinical Microbiology and Infection Control, and Chair of the Infection Control Africa Network (ICAN); Dr. Richard Hatchett, Chief Executive Officer of Coalition for Epidemic Preparedness Innovations (CEPI); and Ms. Zouera Youssoufou, Managing Director and Chief Executive Officer of the Aliko Dangote Foundation.

The NiCAFE conference provided an opportunity for learning, connecting, and collaborating among public health professionals and enthusiasts in Nigeria. Ahead of the conference, nine pre-conference workshops focused on skill-building and experience sharing were organised.

Since 2008, the Federal Ministry of Health through the NCDC and the Federal Ministry of Agriculture and Rural Development has closely worked together to establish and strengthen NFELTP. The NFELTP, which has been supported by the US Centers for Disease Control (US-CDC), African Field Epidemiology Network (AFENET), and more recently, the World Bank, has significantly contributed to an increased number of field epidemiologists contributing to national health security.

The NCDC expressed gratitude to the 2021 NiCAFE supporting partners including WHO, United Nations Children Fund (UNICEF), the World Bank-funded Regional Disease Surveillance Systems Enhancement Project, US-CDC, AFENET, Public Health England, Resolve to Save Lives, Tony Blair Institute, and the Bill and Melinda Gates Foundation.

The NiCAFE conference is an evolution of the previous NCDC/NFELTP conference. This year’s conference focused on how Nigeria can build back better from the COVID-19 response to strengthen the country’s capacity to prevent, detect and respond to disease outbreaks.