NCDC AND THE LEGAL MANDATE

Chikwe Ihekweazu writes that the NCDC Act will boost the job of protecting the health of Nigerians

When I accepted the responsibility to lead Nigeria’s national public health institute (NPHI) just over two years ago, I was acutely aware of our public health challenges. In countries that have NPHIs, they serve as focal points to protect and improve health. Having worked in similar institutes in other countries for most of my career, I felt I was well prepared technically for this role and accompanying leadership responsibilities. However, the one aspect that challenged me was that the agency I had been appointed to lead was yet to get a full legal mandate for its operations.

Without a legal mandate, we were limited in terms of access to the human and financial resources required to protect a country of over 180 million people from public health threats. For my team and I, we immediately set out some clear goals to work towards, one of which was getting a legal mandate for the agency. About 27 months after, one of our major goals was met. On the 12th of November 2018, the President of the Federal Republic of Nigeria provided final assent for the Bill for an Act to establish the Nigeria Centre for Disease Control (NCDC).

I attended a meeting with African Health Ministers convened by the African Field Epidemiology Network during its biennial conference in Maputo, representing the Nigerian Minister of Health. I shared with the ministers present a vision of what strong NPHIs with legal mandates mean for the African continent. I took examples from Ethiopia that has a long established NPHI, Liberia whose NPHI was built out of the urgency created by the 2014 Ebola outbreak, and the National Institute for Health in Mozambique, our host country. My reflection was that while we are building a strong NPHI in Nigeria, a strong legal mandate would provide us the clarity of mission to improve the roles we had performed over the last seven years.

It was great joy to step out of that meeting to the excellent news. Mr. President had just announced that the bill had been signed. From Nigeria and the global community, there was a lot of joy and excitement. For my team at NCDC, their messages were filled with pride and confidence- this bill is a boost to the excellent work they have been doing for the last seven years; the job of protecting the health of Nigerians from public health threats.

A lot of the questions that I have received since the signing of the bill centre around what it means to NCDC. The work that we do at NCDC requires dedicated financial, human, and technological resources. The signing of the bill provides an opportunity for improved access to these resources including the recruitment of more members of staff with specialised skills in line with our mandate. Since the establishment of the agency, we have led the implementation of the International Health Regulations (IHR) functions in Nigeria. The NCDC Act gives us the full legal mandate to continue this function, contributing effectively to global health security. Among other things, the NCDC Act also spells out our responsibility in surveillance, outbreak response, developing a network of public health laboratories and coordinating the training of field epidemiologists.

The journey to the passing of the NCDC Bill has taught my team and I valuable lessons. Notably, we cannot afford to protect the health of Nigerians without understanding the art of political engagement, advocacy and diplomacy. The political commitment from President Muhammadu Buhari in forwarding the bill as an Executive Bill to the National Assembly, gave it the much needed priority attention. The Senate Committee on Primary Healthcare and Communicable Diseases led by Senator Mao Ohuabunwa also ensured that the bill received expedited hearing, on the floor of the Senate. This journey which began with my predecessor Professor Abdulsalami Nasidi, also received great support from Professor Isaac Adewole, the Minister of Health.

The value of NCDC to Nigeria has become more obvious, given the many public health threats that we have faced and the ones that are yet to be discovered. We have an improved relationship with other national parastatals, as well as local and global partners. We recognise that we cannot change the world on our own and must build strong collaborations and coalitions with all those working to improve the health of Nigerians.

These relationships are crucial, as the determinants of health are often not in the health sector. The next outbreak will not be detected in Abuja. It will be detected by the frontline health worker or community member who recognises that there is an unusual occurrence of disease and can ensure that sick patients are tested and treated. NCDC will play an important role in providing technical resources, building capacities, and coordinating communities, states, parastatals, and the private sector. However, the parent at home, neighbours, hospitals, and state governments all have to work to improve health.

With the increased political commitment, funding and partnerships, NCDC will work relentlessly to prevent and prepare for outbreaks of infectious diseases, as well as manage surveillance and the reference laboratory architecture for Nigeria. We will continue working with other government agencies and sub-national levels of government, to provide science-based leadership and public health services.

We are all excited about the opportunity the new NCDC Act presents to us but recognise our increased responsibility to Nigerians. Our promise remains to continue protecting the health of all Nigerians, from the threat and occurrence of infectious diseases, 24/7. We cannot do this on our own, and need the support of every Nigerian, as we chart this new path together.

With the increased political commitment, funding and partnerships, NCDC will work relentlessly to prevent and prepare for outbreaks of infectious diseases, as well as manage surveillance and the reference laboratory architecture for Nigeria