Statement by the Minister of Health, Professor Onyebuchi Chukwu on the Strategies of Government to Prevent Spread of Ebola Virus Disease (EVD) at the Emergency National Council on Health Meeting on Ebola Virus Disease Outbreak Held on Au
I welcome all members of the National Council on Health to this
Emergency meeting on Ebola Virus Disease (EVD), which has become more
pertinent now that the disease has been declared a National Health
Emergency by Mr. President. This shows how serious Nigeria is taking the
case of EVD. WHO has also declared the disease a global health
emergency.
You will recall that in March this year we had sent out an alert on the Ebola Virus Disease calling on all State Governments and the Federal Capital Territory Administration to put in place several measures to prevent the spread of the virus. Though it was an advice, we had hoped that it would not come to Nigeria, as the contiguous states that had announced the presence of the virus do not share borders with Nigeria.
I am sad to inform that this optimism was punctured with the coming to Nigeria of the index case through a commercial airline to Lagos. The patient who is a Liberian-American died but left behind a National Health Emergency.
STRATEGIES/ACTION
At the first Notification of the Outbreak of Ebola Virus Disease (EVD) in Guinea on the 24th March 2014, the Federal Ministry of Health, through the Nigeria Centre for Disease Control and Prevention (NCDC), took necessary steps to sensitize Nigerians and put in place necessary machinery to halt and or contain it in the eventuality of the outbreak coming into the country. All the 36 States and the FCT were alerted on the outbreak in Guinea and advised to maintain vigilance and to strengthen disease surveillance mechanism for haemorrhagic fevers and promptly report suspected cases. The following actions were also taken:
a. Training of Health care personnel on EVD surveillance and Medical procedures was carried out on Zonal basis across the country;
b. Port Health Officers and Disease Surveillance Units across the country were placed on Red Alert;
c. A far reaching Action Plan produced jointly with multi-sectoral stakeholder input was developed;
d. Public Awareness measures were carried out including the airing of Jingles in English, pidgin and three (3) Nigerian languages, distribution of posters and fliers and engagement in media talk programmes on electronic media outlets on the subject;
e. All federal tertiary hospitals were alerted and directed to prepare isolation wards in case of an outbreak in Nigeria;
f. Proposed strengthening of the existing NCDC reference Virology Laboratories (Institute of Human Virology Centre, Asokoro Abuja, UCH Ibadan, LUTH, Institute of Lassa Fever, Specialist Hospital Irrua and Central Public Health Laboratory in Lagos);
g. Strengthening of Emergency Operation Centres at Asokoro and Lagos;
h. Developed operational multi-sectoral national work plan in July 2014;
i. Pandemic preparedness plan has been activated.
INDEX CASE IN NIGERIA
On the 22nd of July, 2014 the Federal Ministry of Health was alerted on a suspected case of EBOLA VIRUS DISEASE (EVD) in Lagos involving a 40 year old male (an American Liberian, Mr Patrick Sawyer), travelling from Monrovia, Liberia to Calabar, Nigeria on Asky Airline via Lome to Lagos.
Despite the urgent specialized barrier nursing care provided for the patient in a Lagos Hospital, the patient unfortunately passed away in the early hours of 24th July, 2014.
RESPONSE MEASURES
Upon confirmation of a suspected case of EVD in Nigeria on the 22nd of July 2014, the FMOH immediately dispatched a Rapid Response Team (RRT) headed by the Project Director, NCDC to Lagos. The team was mandated to work with the Lagos State health team to contain and control the outbreak.
In an effort to institute a cohesive, all inclusive national response to the Ebola outbreak, His Excellency, President Goodluck Jonathan, GCFR established the “Presidential Inter-Ministerial Committee on Communication Strategy for Ebola Virus Disease prevention and Containment” to drive the national response. The Committee comprised Hon. Ministers of Information (Chairman), Health, Aviation, Interior, Science and Technology, Education, Environment, Agriculture and National Planning, with Federal Ministry of Health providing Secretariat support. Since its inaugural meeting on 24th July, 2014, all actions on the subject had been integrated under the coordination of the Presidential Committee. The Federal Ministry of Health is in charge of the Health Response. The following have been accomplished:
a. An incident Command and Control Centre has been established within the Nigeria Centre for Disease Control (NCDC) to coordinate field operations;
b. The Emergency Operations Centre in Lagos has been strengthened;
c. The Presidential Committee using its technical sub-Committees had been meeting regularly to address unfolding developments;
d. People believed to have come in contact with the Liberian in the plane, at the airport and hospital were placed under surveillance, with seven placed on quarantine
e. A national response intervention work-plan/budget which contains all inclusive actions and activities to prevent and contain the spread of EVD in the country had been produced and approved by Mr. President;
f. Several press briefings have been held to give Nigerians necessary information and updates on the outbreak in addition to the establishment of dedicated hot lines to report suspected cases. Ebola virus information desk at the FMOH Headquarters has also been created to give daily information and response to questions from the general public;
g. Platforms have been created for communication with the public. These include a Toll Free Line, Ebola Website, Face Book and Twitter accounts, Mobile phone applications using bulk SMS;
h. The Emergency Operations Centre (EOC) has been strengthened to collate and provide up to date data on the EVD;
i. Isolation wards are being prepositioned in our Tertiary hospitals
j. Most of the persons who had contacts with the index case both on and off the plane have been contacted and placed on observation while those who left the country before the outbreak was reported are being traced for further preventive actions;
k. Nigerian Centre for Disease Control (NCDC) Laboratories have been screening samples taken from suspected cases;
l. Personal Protective Equipment (PPE) and other supplies have been distributed to Lagos to aid the activities of the health personnel and ensure their safety;
m. Dissemination of information on EVD is being intensified through TV, radio jingles and distribution of IEC materials;
n. Mortuaries across the federation have been put on alert to take necessary steps in the event of receipt of corpses from outside the country, especially from countries where Ebola outbreak has been reported;
o. States have been advised to establish their multi-sectoral response to contain possible outbreak within their domain;
p. Presently, laboratory diagnosis of EVD can be made in LUTH, Redeemer’s University laboratory, UCH Ibadan and NCDC, Asokoro, Abuja.
q. A Treatment Research Group (TRG) has been inaugurated to carryout research into treatment of EVD including verifying claims, collating research findings around the world and advise government accordingly;
r. The Heads of mission and Envoys in Nigeria have been briefed on the country’s efforts to contain the EVD
s. There was a World Press Conference this morning on EVD outbreak with the Ministers of Interior, Information, Environment, Special Duties, HMSH, PSH and PS information present.
t. The Nigeria Association of Road Transport Owners and the National Union of Road Transport Workers are going to be addressed tomorrow,
SUMMARY of the EVD OUTBREAK
1. The first case of the EVD is an imported case by a Liberian- American;
2. Today marks 22 days since the index case which means all primary contacts who have not shown symptoms are unlikely to come from the first index case
3. This is a global health emergency and every individual and every nation is at risk;
4. Mr. President has formally declared the outbreak in Nigeria a National Health Emergency and approved the National Ebola Virus Disease Emergency Containment Plan;
5. Containment and the Elimination of the EVD outbreak in Nigeria depends on the following factors:
i. Contact tracing and surveillance of all contacts –primary, secondary and 3rd degree contacts
ii. Observance of personal hygiene and Infection Prevention and Control protocols by individuals, health professionals especially doctors and nurses who often have direct contact with the patients; and various hospital authorities.
6. Screening of inbound and outbound travelers at the ports of entry and ports of exit
7. Honest and full disclosure of medical history by travelers crossing Nigerian borders
8. Quarantine of suspected cases and isolation and barrier nursing of confirmed cases
9. Effective treatment of confirmed cases
10. Provision of laboratory and quarantine / isolation facilities
11. Close collaboration between the federal authorities, the states and local governments. There is hardly any way we can have an effective surveillance and containment strategy without the collaboration of state governments.
I want to thank Mr. President for the support he has given to us in this tiring period and we will do all it takes to ensure that the EVD is contained
I urge all members of Council to rise up to this National Public Health Emergency and replicate the actions at the Federal level to the state level. We should all endeavour to provide appropriate correct information to our people and urgently dispel rumours. While ensuring that our citizens are well sensitized on these prevention strategies, our health workers should be well protected and all states should be prepared to attend to any emergency that may arise.
I want to appreciate the WHO staff, US CDC, the Lagos State Government, the NCDC and our Port Health Services for all their efforts to contain the EVD.
Let me end this address by stating that this is a global health emergency. Everybody is at risk and every nation is at risk.
I thank you.
You will recall that in March this year we had sent out an alert on the Ebola Virus Disease calling on all State Governments and the Federal Capital Territory Administration to put in place several measures to prevent the spread of the virus. Though it was an advice, we had hoped that it would not come to Nigeria, as the contiguous states that had announced the presence of the virus do not share borders with Nigeria.
I am sad to inform that this optimism was punctured with the coming to Nigeria of the index case through a commercial airline to Lagos. The patient who is a Liberian-American died but left behind a National Health Emergency.
STRATEGIES/ACTION
At the first Notification of the Outbreak of Ebola Virus Disease (EVD) in Guinea on the 24th March 2014, the Federal Ministry of Health, through the Nigeria Centre for Disease Control and Prevention (NCDC), took necessary steps to sensitize Nigerians and put in place necessary machinery to halt and or contain it in the eventuality of the outbreak coming into the country. All the 36 States and the FCT were alerted on the outbreak in Guinea and advised to maintain vigilance and to strengthen disease surveillance mechanism for haemorrhagic fevers and promptly report suspected cases. The following actions were also taken:
a. Training of Health care personnel on EVD surveillance and Medical procedures was carried out on Zonal basis across the country;
b. Port Health Officers and Disease Surveillance Units across the country were placed on Red Alert;
c. A far reaching Action Plan produced jointly with multi-sectoral stakeholder input was developed;
d. Public Awareness measures were carried out including the airing of Jingles in English, pidgin and three (3) Nigerian languages, distribution of posters and fliers and engagement in media talk programmes on electronic media outlets on the subject;
e. All federal tertiary hospitals were alerted and directed to prepare isolation wards in case of an outbreak in Nigeria;
f. Proposed strengthening of the existing NCDC reference Virology Laboratories (Institute of Human Virology Centre, Asokoro Abuja, UCH Ibadan, LUTH, Institute of Lassa Fever, Specialist Hospital Irrua and Central Public Health Laboratory in Lagos);
g. Strengthening of Emergency Operation Centres at Asokoro and Lagos;
h. Developed operational multi-sectoral national work plan in July 2014;
i. Pandemic preparedness plan has been activated.
INDEX CASE IN NIGERIA
On the 22nd of July, 2014 the Federal Ministry of Health was alerted on a suspected case of EBOLA VIRUS DISEASE (EVD) in Lagos involving a 40 year old male (an American Liberian, Mr Patrick Sawyer), travelling from Monrovia, Liberia to Calabar, Nigeria on Asky Airline via Lome to Lagos.
Despite the urgent specialized barrier nursing care provided for the patient in a Lagos Hospital, the patient unfortunately passed away in the early hours of 24th July, 2014.
RESPONSE MEASURES
Upon confirmation of a suspected case of EVD in Nigeria on the 22nd of July 2014, the FMOH immediately dispatched a Rapid Response Team (RRT) headed by the Project Director, NCDC to Lagos. The team was mandated to work with the Lagos State health team to contain and control the outbreak.
In an effort to institute a cohesive, all inclusive national response to the Ebola outbreak, His Excellency, President Goodluck Jonathan, GCFR established the “Presidential Inter-Ministerial Committee on Communication Strategy for Ebola Virus Disease prevention and Containment” to drive the national response. The Committee comprised Hon. Ministers of Information (Chairman), Health, Aviation, Interior, Science and Technology, Education, Environment, Agriculture and National Planning, with Federal Ministry of Health providing Secretariat support. Since its inaugural meeting on 24th July, 2014, all actions on the subject had been integrated under the coordination of the Presidential Committee. The Federal Ministry of Health is in charge of the Health Response. The following have been accomplished:
a. An incident Command and Control Centre has been established within the Nigeria Centre for Disease Control (NCDC) to coordinate field operations;
b. The Emergency Operations Centre in Lagos has been strengthened;
c. The Presidential Committee using its technical sub-Committees had been meeting regularly to address unfolding developments;
d. People believed to have come in contact with the Liberian in the plane, at the airport and hospital were placed under surveillance, with seven placed on quarantine
e. A national response intervention work-plan/budget which contains all inclusive actions and activities to prevent and contain the spread of EVD in the country had been produced and approved by Mr. President;
f. Several press briefings have been held to give Nigerians necessary information and updates on the outbreak in addition to the establishment of dedicated hot lines to report suspected cases. Ebola virus information desk at the FMOH Headquarters has also been created to give daily information and response to questions from the general public;
g. Platforms have been created for communication with the public. These include a Toll Free Line, Ebola Website, Face Book and Twitter accounts, Mobile phone applications using bulk SMS;
h. The Emergency Operations Centre (EOC) has been strengthened to collate and provide up to date data on the EVD;
i. Isolation wards are being prepositioned in our Tertiary hospitals
j. Most of the persons who had contacts with the index case both on and off the plane have been contacted and placed on observation while those who left the country before the outbreak was reported are being traced for further preventive actions;
k. Nigerian Centre for Disease Control (NCDC) Laboratories have been screening samples taken from suspected cases;
l. Personal Protective Equipment (PPE) and other supplies have been distributed to Lagos to aid the activities of the health personnel and ensure their safety;
m. Dissemination of information on EVD is being intensified through TV, radio jingles and distribution of IEC materials;
n. Mortuaries across the federation have been put on alert to take necessary steps in the event of receipt of corpses from outside the country, especially from countries where Ebola outbreak has been reported;
o. States have been advised to establish their multi-sectoral response to contain possible outbreak within their domain;
p. Presently, laboratory diagnosis of EVD can be made in LUTH, Redeemer’s University laboratory, UCH Ibadan and NCDC, Asokoro, Abuja.
q. A Treatment Research Group (TRG) has been inaugurated to carryout research into treatment of EVD including verifying claims, collating research findings around the world and advise government accordingly;
r. The Heads of mission and Envoys in Nigeria have been briefed on the country’s efforts to contain the EVD
s. There was a World Press Conference this morning on EVD outbreak with the Ministers of Interior, Information, Environment, Special Duties, HMSH, PSH and PS information present.
t. The Nigeria Association of Road Transport Owners and the National Union of Road Transport Workers are going to be addressed tomorrow,
SUMMARY of the EVD OUTBREAK
1. The first case of the EVD is an imported case by a Liberian- American;
2. Today marks 22 days since the index case which means all primary contacts who have not shown symptoms are unlikely to come from the first index case
3. This is a global health emergency and every individual and every nation is at risk;
4. Mr. President has formally declared the outbreak in Nigeria a National Health Emergency and approved the National Ebola Virus Disease Emergency Containment Plan;
5. Containment and the Elimination of the EVD outbreak in Nigeria depends on the following factors:
i. Contact tracing and surveillance of all contacts –primary, secondary and 3rd degree contacts
ii. Observance of personal hygiene and Infection Prevention and Control protocols by individuals, health professionals especially doctors and nurses who often have direct contact with the patients; and various hospital authorities.
6. Screening of inbound and outbound travelers at the ports of entry and ports of exit
7. Honest and full disclosure of medical history by travelers crossing Nigerian borders
8. Quarantine of suspected cases and isolation and barrier nursing of confirmed cases
9. Effective treatment of confirmed cases
10. Provision of laboratory and quarantine / isolation facilities
11. Close collaboration between the federal authorities, the states and local governments. There is hardly any way we can have an effective surveillance and containment strategy without the collaboration of state governments.
I want to thank Mr. President for the support he has given to us in this tiring period and we will do all it takes to ensure that the EVD is contained
I urge all members of Council to rise up to this National Public Health Emergency and replicate the actions at the Federal level to the state level. We should all endeavour to provide appropriate correct information to our people and urgently dispel rumours. While ensuring that our citizens are well sensitized on these prevention strategies, our health workers should be well protected and all states should be prepared to attend to any emergency that may arise.
I want to appreciate the WHO staff, US CDC, the Lagos State Government, the NCDC and our Port Health Services for all their efforts to contain the EVD.
Let me end this address by stating that this is a global health emergency. Everybody is at risk and every nation is at risk.
I thank you.
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