The World Health Organization (WHO) is to spend about =N= 2.7 million this year to support State Epidemiology teams to implement Integrated Disease Surveillance and Response (IDSR) activities in the country. This was disclosed by the WHO Representative for Nigeria, Dr. Abdou Moudi at a recent meeting of State Epidemiologists and WHO Surveillance Officers, held in Kaduna.

In a related development, the Federal Ministry of Health is to strengthen its capacity to implement Integrated Disease Surveillance and Response (IDSR) in the country. It will initially build on the structures and resources that are in place for Acute Flaccid Paralysis (AFP) surveillance.

The AFP surveillance system, put in place as one of the strategies for polio eradication in the country, is not only functional but has been adjudged successful.

Participants at the Kaduna meeting noted that the current status of the disease surveillance system in the country is deplorable, characterized by lack of intra and inter-sectoral collaboration. This leads to verticalization of programmes and multiplicity of disease reporting formats, thus compromising efficiency and quality of data.

Inadequate financial and material support for disease surveillance; lack of basic infrastructure (e.g. communication equipment, transport and data management tools); and dearth of skilled manpower for case detection, data collection analysis and interpretation were some other problems identified by the participants, which they said militate against effective disease surveillance.

Non-existence of functional public health laboratories in most states of the federation and deficient capacity at all levels to forecast and respond in a timely and appropriate manner to epidemics and disasters were also blamed for inaccurate ascertainment of cases and poor response to epidemics and disasters.

To address these and other issues, the meeting recommended top level advocacy to the three tiers of government (federal, state and local government) - to raise awareness about IDSR and secure political commitment, so that adequate budgetary provision for IDSR is made and funds released promptly for activities.

In a communique issued at the end of the meeting, participants noted the need for the development of a National Policy on IDSR. They also urged the National Programme on Immunization (NPI) Agency, National Primary Health Care Development Agency (NPHCDA), the Epidemiology Division and other relevant programmes of the Federal Ministry of Health, to as a matter of urgency, forge a collaboration so as to be able to successfully address the burden of disease in the country.

Participants called for enhancement of surveillance skills through the recruitment of competent Epidemiologists and retraining of existing ones as well as other relevant categories of health workers in IDSR. They also advocated the strengthening of IDSR units at all levels with the provision of data management tools, logistic support, transport facilities and communication equipment.

On vaccine preventable epidemics, the meeting called for strengthening of routine immunization with the use of existing primary health care structures through NPHCDA, with proper epidemic forecasting and pre-positioning of vaccines, drugs and relevant equipment.

As a first step towards improving integrated disease surveillance and response in the country, the Federal Ministry of Health in collaboration with State Epidemiologists has developed a five-year (2002 - 2006) National IDSR Strategic Plan. The 5-year Plan was based on the findings of a scientifically driven analysis. The Plan addresses such major domains as sensitization/advocacy, training, data management, epidemic preparedness/response and evaluation/research.

With the new focus, a total of twenty priority diseases have been approved for integrated disease surveillance and reporting. These are cholera, CSM, Lassa Fever, measles and Yellow Fever grouped under epidemic prone diseases; Guinea Worm, Poliomyelitis, leprosy, Neonatal Tetanus and Lymphatic Filariasis, which are diseases for eradication/elimination. Others, grouped under diseases of public health importance include acute watery diarrhoea, blood diarrhoea (>5 years), pneumonia, Tuberculosis and Onchocerciasis. Others are STIs, Hepatitis, malaria, Pertussis and HIV/AIDS.

For further information, please contact Mr. Austine Oghide, 
NPO/HIP, WHO, 443, Herbert Macaulay Road, Yaba, Lagos. 
Tel: (234 1) 5453662/3 Fax: (234 1) 5452179 
E-mail: oghidea [at] who-nigeria.org (oghidea[at]who-nigeria[dot]org)