Monday, December 12, 2016
President’s Malaria Initiative Country in Focus: Nigeria
PMI October 2016 E-Newsletter
Country in Focus – Nigeria
With a population of about 186 million, Nigeria is the most populous country in Africa, and 100% of the population is at risk of malaria infection. Two countries, Nigeria and the Democratic Republic of Congo, account for over 35% of total estimated malaria deaths. The public health system in Nigeria is weak, particularly at the primary care level; it is estimated that the government spends less than 5% of the national budget on health.
Nigeria is currently in its sixth year as a PMI focus country. With support from PMI and its partners, malaria control interventions are being scaled up, and vital commodities are being distributed to vulnerable populations. The most recent national population-based survey measuring malaria program progress in Nigeria shows impressive results. From 2010-2015, overall ownership of at least one insecticide treated net (ITN) increased, with usage rates among children and pregnant women also showing significant increases. Other PMI supported activities include: continued vector and insecticide resistance monitoring; indoor residual spraying (IRS) advocacy and support training; piloting community focused antenatal care (ANC) programs with intermittent preventative treatment for pregnant women (IPTp) where ANC attendance is low; procurement of antenatal drugs for focused antenatal care clinics; and expanded provision of rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACTs) to patent and proprietary medicine vendors to upgrade testing and treatment services in the private sector.
In July 2016, Mr. Nwachukwu, head of the zonal laboratory for the National Agency for Food and Drug Administration and Control (NAFDAC) in Agulu, received great news from his boss, the Director of Laboratory Services of the NAFDAC. The email message read: “The Agulu Zonal Laboratory has made NAFDAC proud today by emerging the best in round 57 scheme of Pharmassure‑Pharmaceutical Proficiency Testing.”
For Mr. Nwachukwu, this was one of the greatest achievements of his career. Prior to July 2016, the Agulu zonal laboratory played a small part in the overall quality control of medicines at NAFDAC. So, the fact that the little known village of Agulu would soon have a critical role in Nigeria was a dream come true for Mr. Nwachukwu. The laboratory scored 100 percent in all the areas assessed, a key step in the attainment of ISO 17025-laboratory accreditation.
In 2014, the U.S. President’s Malaria Initiative (PMI), through the Promoting the Quality of Medicine (PQM) program supported NAFDAC in receiving international accreditation, a major milestone in the fight against substandard and poor quality drugs. While this was a great achievement for NAFDAC and for Nigeria, the high volume of samples required to regulate medicines in the whole country was overwhelming for one laboratory. Therefore, in 2016, PMI supported two additional NAFDAC zonal laboratories — Kaduna laboratory in the north and Agulu laboratory in the east. PMI support included training, provision of basic equipment and consumables, and calibration of laboratory equipment.
PMI is currently helping to prepare Agulu zonal laboratory to receive a final accreditation audit from the American National Standards Institute ‒ American Society for Quality (ANSI‒ASQ) National Accreditation Board. If successful, the Agulu zonal laboratory will be one of few laboratories in the world to achieve accreditation in a record time of 6 months.
PMI’s investment in Agulu laboratory has had great impact on the operations of NAFDAC and other zonal laboratories. Furthermore, NAFDAC management is taking ownership of the accreditation process and funding a significant portion of it. Once accredited, the Agulu laboratory will play a critical role, not only in quality control of medicines in Nigeria and beyond, but also in developing the capacities of other NAFDAC zonal laboratories.