Key Takeaways: 4th NCDC/NFELTP Annual Scientific Conference 

The Annual Scientific Conference organised by the Nigeria Centre for Disease Control (NCDC) and Nigeria Field Epidemiology and Laboratory Training Program (NFELTP) has remained an avenue for building the capacity of public health professionals and leaders in the field of epidemiology. Sharing their work and experience with the global health community as they play a critical role in preventing, detecting and responding to epidemics and infectious disease outbreaks.

This year’s theme, “Applied Epidemiology: Providing Evidence for Public Health Action,’’ was an opportunity for participants to collaborate and explore ways of applying epidemiological skills and tools in the prevention and management of diseases of public health conference.

Here are the key takeaways from the 4^th NCDC/NFELTP Annual Scientific Conference:

The commendable growth of the NFELTP program

Started in 2008, the NFELTP program has now taken in its 11^th cohort, graduating over 300 professionals who are working in various areas of disease surveillance and response across many institutions nationally and internationally. Dr Patrick Nguku, Regional Technical Coordinator and Senior Resident Advisor for NFELTP at Africa Field Epidemiology Network (AFENET) noted that NFELTP is founded and implemented on the One World, One Health paradigm. This ensures that residents of the programme are trained in the three tracks that make up the One Health: medical, veterinary, and laboratory. The program also receives technical and financial support from the United States Centers for Disease Control (USCDC), with affiliation from two of Nigeria’s most prestigious education institutions; The Ahmadu Bello University (ABU) Zaria and the University of Ibadan.

Emerging threats from infectious diseases are real
Dr. Babatunde Olowokure in his talk mentioned that the World Health Organisation (WHO) was responding to 165 active public health events as of September 2019, out of which 49 were graded as emergencies and one public health emergency of international concern. Dr. Tom Frieden of Resolve to Save Lives noted that the Joint External Evaluation (JEE) carried out in more than 100 countries from 2016 identified more than 7000 life-threatening gaps in epidemics preparedness. This further confirms the global vulnerability to epidemics and the ticking dangers of infectious diseases.

Dr. Olurunnimbe Mamora, Honourable Minister of State for Health, noted that the constant change in Nigeria’s population and environment requires health systems to be continuously upgraded to detect and respond to infectious disease outbreaks. Building resilient systems will require viable public health institutions like the NCDC to be continuously supported to effectively respond to global health security threats.

Nigeria’s Health Security: A work in progress
Dr. Chikwe Ihekweazu, the Director-General of NCDC acknowledged that at the 3^rd NCDC/NFELTP conference, the bill for the establishment of the Nigeria Centre for Disease Control was yet to be passed. Today, the bill has been passed and signed into law by President Muhammadu Buhari, making the NCDC a fully-fledged institution under the Ministry of Health with the legal mandate to prevent, detect and respond to infectious disease outbreaks in Nigeria. The NCDC is also working with state governments across the country to establish public health Emergency Operations Centres (EOCs) at the state level to coordinate timely detection and response to outbreaks of infectious diseases. The establishment of the Incidence Coordination Centre at the NCDC headquarters is a driver for continuous coordination and data sharing between the NCDC and EOCs across the states, Ihekweazu said. The conference highlighted key issues around data sharing and its importance for applied epidemiology.

NFELTP graduates bring experience and expertise on the ground during epidemics

In his keynote address, Dr. Faisal Shuaib Executive Director of the National Primary Healthcare Development Agency (NPHCDA), recounted how Nigeria successfully fought Ebola in 2014. This was possible “due to the availability of the boots on the ground – NFELTP graduates,” he said. The NFELTP graduates have proven that one of the effective ways to manage outbreaks is to have a trained and skilled response team. Dr. Frieden acknowledged that the experience of NFELTP graduates, especially in data generation also played a vital role in the fight against polio.

A conference to share, learn and network
The 4^th NFELTP conference received 339 abstracts submissions and 104 presentations on various topics, especially on disease surveillance and response. Most of the NFELTP delegates were young and in the early stages of their careers and the presenters seized the opportunity to share findings on infectious disease outbreaks in the country.

Henry Uguru Ekechi presented findings on ‘’Factors Associated with a Confirmed Lassa Fever Outbreak in Eguare Community of Edo State’’. The findings, from the Lassa fever outbreak in Edo state between January and March 2019 showed that patients who had contact with Lassa fever patients were 32 times more likely to develop the disease and households with poor waste management were 15 times more likely to have a Lassa fever patient than others.

Nanpring Dawn Williams presented on the experience of her and colleagues at NCDC in managing one of the largest Cholera outbreaks in the country in 2018. The outbreak which affected more than 200 LGAs in 20 states across the country had 44,201 suspected cases and claimed 836 lives between January 2018 and November 2018.

It was also an opportunity for the NCDC Director of Surveillance Mrs. Olubunmi Ojo to gracefully bow out of public service after 35 years, capping the 4^th NFELTP conference with a delightful presentation specifically targeting young public health professionals on how to build a successful career in public service.

The 4^th NCDC/NFELTP conference did not only serve its purpose of celebrating the journey of applied epidemiology in the country but also provided an avenue for young professionals to meet, learn and connect with experts in the field. It was also an opportunity to acknowledge talent and hard work, as various awards were given to deserving NFELTP graduates.

The NCDC/NFELTP conference was also preceded by eight workshops simultaneously that were organised in partnership with international public health organisations on topics like leadership management, data management, specimen collection and referral, One Health, biosafety and biosecurity among others. There were breakouts sessions in between the various keynote addresses on the four key topics of outbreak investigation, surveillance and information management systems, emergency response and preparedness,  as well as vaccine-preventable diseases and immunization strategies.

The conference participants and speakers were unanimous in the fact that for One Health to be achieved, all stakeholders had to work together, from the environment to food safety, agriculture and health experts. There was also consensus that NFELTP graduates must be able to secure guaranteed, clear career paths so as to drive fulfillment in the work they do. In addition, it was felt that the field epidemiologists also should be acknowledged and appreciated at the highest level.

As advocated by Dr. Faisal Shuaib, of particular importance was the need by the Federal Government to formally honour the epidemiologists that battled the 2014 Ebola outbreak in Nigeria. Speakers also highlighted the need for determination and perseverance in the drive to prevent and manage infectious diseases. Mrs. Olubunmi Ojo particularly owed the successes recorded so far in the fight against polio in the country to the hard work and determination of public health workers in the country, many of whom were at the conference. For Dr. Patrick Nguku, perseverance is key, and he stated that it needed to be across the whole African continent in order to respond to challenges of infectious diseases. There was also the need for improved funding for field epidemiology as a key pillar of infectious disease prevention and management. Dr Tom Frieden highlighted that building systems that could effectively prevent infectious disease outbreaks was a smart buy that could be achieved through an effective budget of one dollar per person per year. Finally, the challenge was put to presenters at the conference to push to get their work published by peer-reviewed journals in order to sustain the momentum and also demonstrate the strong research capability of the country.