CDC in Nigeria

Emir of Shonga Dr. Haliru Yahya (left) speaks with Mary Beth Leonard, U.S. Ambassador to Nigeria, during a ceremony to mark Nigeria wild poliovirus free on August 29, 2020. Photo by Halilu Usman/CDC
The Centers for Disease Control and Prevention (CDC) established an office in Nigeria in 2001. CDC Nigeria works with the Federal Ministry of Health (FMOH), state ministries of health, government agencies, and partners to address HIV, tuberculosis (TB), malaria, and vaccine-preventable diseases. CDC Nigeria also supports strengthening laboratory, surveillance, and workforce capacity in response to disease outbreaks.
Global Health Security
Countries with strong and resilient public health systems can quickly prevent, detect, and respond to infectious disease threats. In 2019, Nigeria became a Global Health Security Agenda (GHSA) partner country committed to improving progress toward GHSA goals and International Health Regulations requirements. CDC works with the Government of Nigeria and partners to achieve these goals by strengthening workforce development, surveillance, emergency response, and laboratory capacity. Public health expertise in Nigeria has been strengthened throughout the control of HIV, TB, and malaria, the eradication of wild poliovirus, the response to mpox, and preparedness efforts for Ebola, influenza, and other pandemic diseases.
CDC Nigeria helps train epidemiologists in the basic, intermediate, and advanced Field Epidemiology and Laboratory Training Programs. These epidemiologists work in relevant sectors of Nigeria’s public health system, including the COVID-19 response. Graduates and current program residents include disease surveillance and notification officers, community health extension workers, state epidemiologists, physicians, lab scientists, and veterinarians.

All 774 local government areas in Nigeria now use an electronic case-based reporting system to detect and track emerging disease threats in real-time

CDC provided technical assistance for the five-year National Action Plan for Health Security that aims to strengthen core emergency management capacities by adopting strategies, setting priorities, and implementing activities to prevent, detect, and respond to public health threats

CDC helped develop a National Public Health Emergency Contingency Plan for border points of entry
National Public Health Institutes (NPHI)
CDC supported the creation of the Africa Centres for Disease Control and Prevention (Africa CDC). In addition, CDC provided technical support to establish five Africa CDC Regional Collaborating Centers. The West African Regional Collaborating Center is in Nigeria. With assistance from CDC, Africa CDC and the regional centers established the Surveillance and Response Unit and develop workforce capacity. CDC Nigeria also supports the NPHI, which integrates public health functions, coordinates across sectors, and accounts for public health resources. CDC helps strengthen the NPHI’s technical capacities that enable Nigeria to respond when disasters strike. Nigeria’s NPHI works to:
- Prevent and control communicable diseases
- Coordinate surveillance systems
- Support states with outbreak response
- Develop and maintain public health laboratories
- Conduct public health research to inform policy
- Coordinate compliance with International Health Regulations

Nigeria can activate its public health Emergency Operations Center (EOC) within two hours of receiving an early warning or notification of a public health event

CDC helped establish 36 sub-national public health EOCs across the six geo-political zones in Nigeria, all of which are linked to the National EOC

CDC developed a Public Health Emergency Management Professional Development Program

CDC established an NPHI Center of Excellence program for the Nigeria Center for Disease Control

CDC developed core laboratory diagnostic capacity to test for mpox, Yellow Fever, and cerebrospinal meningitis

CDC developed national guidelines and protocols for response to different disease outbreaks, including a national multi-hazard preparedness plan
COVID-19
Global health security investments and decades of global cooperation and support for outbreak response and routine immunization have built strong foundations and systems that are critical to the COVID-19 response. CDC Nigeria provided strategic direction to the Presidential Steering Committee on COVID-19 and continues to collaborate with national and state governments and partners to support ongoing response activities. CDC Nigeria supports COVID-19 surveillance and epidemiology, emergency response operations, case management, laboratory systems strengthening, risk communication, and vaccination. CDC also supported the establishment and operation of national and state-level EOCs.

CDC worked with the Nigeria Centre for Disease Control and partners to integrate COVID-19 testing into the laboratory network, enabling the country to conduct more than 5.5 million COVID-19 tests between 2020 and 2022

CDC supported the development of the Incidence Action Plan that guides COVID-19 operations in Nigeria

CDC supported serosurvey studies in 8 states and the Federal Capital Territory to provide accurate data on the COVID-19 burden in Nigeria

CDC helped create a state response coordination mechanism to enable weekly virtual meetings among the 52 national rapid response teams

CDC supported the design and implementation of a walk-in testing center and a COVID-19 response toolkit for national and state-level EOCs and emergency response teams

CDC supported the COVID-19 Community of Practice for Nigeria and the West Africa Region. These efforts benefited thousands of healthcare workers in COVID-19 case management

CDC developed digital user-friendly training materials to support COVID-19 infection prevention and control efforts among 1,000 frontline healthcare workers

CDC provided a platform to enable 108 treatment facilities to share weekly best practices on case treatment

CDC supported the development and implementation of the COVID-19 National Deployment and Vaccination Plan in Nigeria, providing data to guide decision making. As of October 26, 2022, almost 48 million people had completed a vaccine series

CDC provided COVID-19 vaccine deployment, oversight, and distribution plans across all 36 states and the federal capital territory

By 2021, CDC helped conduct risk communication and community awareness activities across all 36 states in Nigeria

Engaged religious leaders on risk communication and case reporting by funding the implementation of a “Messages of Hope” project

To increase COVID-19 preventive and protective behaviors in Nigeria, CDC supported the training of volunteers, community and religious leaders, media, and celebrities to disseminate COVID-19 messages
HIV and Tuberculosis (TB)
HIV and TB are the world’s two deadliest infectious diseases. Moreover, these epidemics are tragically interconnected, as TB is the leading cause of death for people living with HIV. As a key implementer of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), CDC works with the FMOH and partners to build sustainable and high-impact national HIV response programs. The objective is to achieve the Joint United Nations Program on HIV/AIDS (UNAIDS) 95-95-95 goals and accelerate HIV epidemic control.
CDC’s data-driven approach combined with HIV treatment and prevention strategies strengthen collaborative activities in Nigeria. Some activities include targeted HIV testing and counseling, HIV treatment, services to prevent mother-to-child transmission, and TB/HIV integrated service delivery. CDC also supports the expansion of diagnostic services for TB and COVID-19 testing and infection prevention and control for patients and healthcare workers.

More than seven million people were tested for HIV between July 2021 and June 2022

As of September 2022, more than 1.2 million people are receiving comprehensive HIV treatment services in CDC-supported states

An average of 4,200 people per week were newly diagnosed with HIV and started treatment between July 2021 and June 2022

More than one million people living with HIV were screened for TB from July 2021 to June 2022. Nearly 6,000 people living with HIV were also confirmed to have TB and started treatment

All PEPFAR-supported facilities in Nigeria now use TB BASICS. This successful infection prevention and control program prevents healthcare-associated TB infection and other airborne infections

PEPFAR-supported TB prevention sites reported a 99% completion rate for TB preventive therapy as of September 2020

As of June 2022, nearly 25,000 orphans and children received one or more HIV/TB services through CDC-supported implementing partners

More than 1,000 health facilities use electronic medical record system as of June 2021

CDC Nigeria helped establish a national repository of de-identified patient records for over 1.9 million HIV patients. The system provides data for program decision-making

Assisted in the establishment of a health information exchange system between 500 facilities in 11 PEPFAR supported labs for automated and instant viral load result transmission

CDC supports 7 of the 16 PEPFAR/Global Fund supported laboratories in the PCR Laboratory Network, including the Mega PCR laboratory at the National Reference Laboratory. The PCR Laboratory Network provides viral load testing services to more than 1.9 million patients on antiretroviral therapy annually

CDC Nigeria helped establish and provides support to West Africa’s first National HIV Clinical Mentorship Program. Nigeria’s program has over 180 state clinical mentors that work towards ensuring a sustained, state-led HIV epidemic control response
Malaria
Malaria is endemic in Nigeria and is a leading cause of death and disease in many countries. Young children and pregnant women are the most affected groups. Under the U.S. President’s Malaria Initiative (PMI), CDC works with national and international partners to implement malaria prevention and control interventions. In Nigeria, PMI supports key intervention areas in the national malaria control strategy. PMI prioritizes the areas in Nigeria with the highest burden of malaria to achieve significant reduction in death and illness. CDC assigned a resident advisor to Nigeria to support malaria control efforts, including:
- Sourcing and distributing long-lasting insecticide-treated bed nets
- Preventing malaria in pregnancy
- Improving diagnostics and case management
- Monitoring and evaluating malaria-related activities
- Providing support for a routine health information system in select states and local government areas
- Strengthening entomological monitoring and insecticidal resistance monitoring capacity at federal and state levels

CDC helped provide 22 million doses of malaria prevention medicine to pregnant women, nine million doses to children, and 129 million treatment doses at health facilities and communities in 2020

CDC helped provide 62 million rapid test kits to diagnose and treat patients for malaria and other fevers in 2020

Since 2010, PMI has provided $712 million in investments. This includes the distribution of over 61 million insecticide-treated bed nets, which are now in 43% of all households, twice the rate before the intervention
Vaccine-Preventable Diseases
Every year, vaccines prevent two to three million global deaths among children younger than age 5. Still, one child dies every 20 seconds from a disease that a vaccine could have prevented. CDC provides technical and programmatic expertise to eradicate, eliminate or control vaccine-preventable diseases through immunizations. CDC works with international and local partners to strengthen immunization systems and provide evidence-based technical knowledge to expand routine vaccine delivery. This work helps prevent cases of infectious diseases like polio and measles.
Nigeria was certified as free of wild poliovirus by the Africa Regional Certification Commission in August 2020. CDC supported field activities to eliminate polio in Nigeria for the past 10 years, including:
- Vaccination campaign planning
- Program monitoring and supervision
- Acute flaccid paralysis surveillance
- Outbreak investigations of polio and other vaccine-preventable diseases
- Outreach to nomadic populations
- Research
- Data management

CDC’s support contributed to Nigeria being certified as free of wild poliovirus in 2020. Nigeria also experienced a 24% increase in routine immunization coverage between 2015 and 2019

CDC supported the introduction of the novel oral polio vaccine type 2 (nOPV2) to reduce vaccine-derived poliovirus type 2 cases

As of November 2022, more than 310 million doses of nOPV2 have been administered to children under age five through vaccination campaigns since March 2021

CDC supported the expansion of the National Stop Transmission of Polio Program to improve the delivery of routine immunization services across northern states to reach missed or under-vaccinated children

CDC led geospatial tracking to help get vaccines for polio and other diseases to children in rural areas

CDC established surveillance systems to monitor adverse events following immunization and adverse events of special interest

CDC helped implement a national software system for routine immunization and an SMS texting system for weekly reporting in 18 states. CDC also supported an electronic data management system for COVID-19 vaccination
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- 14 U.S. Assignees
- 94 Locally Employed
- Population: > 211.4 million
- Per capita income: $5,000
- Life expectancy: F 56 / M 54 years
- Infant mortality rate: 58/1,000 live births
Sources: World Bank 2021, Nigeria; Population Reference Bureau 2021, Nigeria