COUNTDOWN in Nigeria

By Russell Stothard, Liverpool School of Tropical Medicine

A first dialogue with future partners

COUNTDOWN has been in Nigeria for a busy round of meetings. These ranged from establishing first dialogue with international partners (UNICEF/WHO) and national agencies (Federal Ministry of Health), to NGOs (FHI360, Sightsavers, Helen Keller International etc.), with academia (Bingham University) and clinical medicine (Zankli Medical).

I found this series of consecutive meetings truly informative. Above all, they revealed the sincere politeness and etiquette to be found in Nigeria, especially by those whom have dedicated their professional lives to the study of tropical medicine and the control of Neglected Tropical Diseases (NTDs). This gentle hospitality often gets somewhat overlooked with pre-trip concerns about presidential elections or terrorist activity.

Why NTDs in Nigeria?

In our original DFID tender, we did not feature direct activity in Nigeria. This was primarily due to budget constraints. But this view has been revised through our discussions with DFID and other donors and we now believe it is important to develop supportive activities in Nigeria, and these are ear-marked to take place in the latter half of our programme.

It must be remembered, as I often heard on my visit, that Nigeria is a very big place, with a large population. Coordinating activities across the many States of Nigeria is really challenging, and what I saw was that they are each doing their level best with limited resources available. Clearly COUNTDOWN should help orchestrate additional support across the international donor landscape to ensure that Nigeria has the resources they deserve.

Towards an expanded partnership

Nigeria has fully functional National Plan for Control of NTDs, with supportive documentation, which has been honed with regular updates and amendments by research-led activities. I met the central team, headed by Ifeoma Anagbogu, and they are rich in knowledge and experiences on-the-ground. Talking with this team and hearing their insights into bottlenecks in the delivery and sustainability of control was a rare privilege. Potential solutions to these challenges ranged from addressing treatment coverage in schools where there local school enrolment is low, to identifying better ways to sustain, reward and further incentivize Community Drug Distributors (CDDs). Imagine the scale – Nigeria has 774 local government areas (LGAs) with several hundred CDDs typically on the books within each LGA alone – this adds up to about half a million volunteers!

Being based in FHI360 for the week meant I was also fortunate to have direct discussions, with several people including the Deputy Country Director Robert Chiegil, elaborating the connection between schistosomiasis and reproductive health/HIV. It is very easy for me to be passionate about this issue and stress the importance of female and male genital schistosomiasis in Nigeria. We quickly identified that there is a treatment gap in provision of care for mothers and their young children with schistosomiasis. Could FHI360 help with the distribution of praziquantel and albendazole as an additional level of care provided to their patients in high endemic areas? I hope so.

There is a real knowledge gap here and we need to better measure the clinical burden of disease as elaborated in the Female Genital Schistosomiasis conference last month, and ensure treatment for all infected. COUNTDOWN is in a really unique position to develop a West Africa research theme to reprioritise urogenital schistosomiasis. Hopefully this will have effects on gender, marginalisation and stigmatisation all in one go. Isn’t that something we should be excited about achieving?

Another busy month

This coming month of March is going to be busier than ever for COUNTDOWN. Rachael and Sally have now recruited two new staff for social science themes (who I hope to convince about FGS!), and from the 9th March we have our inception planning workshop for Cameroon, Ghana and Liberia. With Rachael, Susie has been busy securing travel and local arrangements to look after our guests and colleagues.

COUNTDOWN will launch on the 12th March within the LSTM. I am especially delighted that Ifeoma will join us by video-link that day as a further step to develop activities in Nigeria. To close, we have a lot to look forward to and thank colleagues, especially Pauline, for making the necessary arrangements for this trip to Abuja to happen.

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