#PreventEpidemicsNaija: Advocating for domestic resource mobilisation to strengthen Nigeria’s health security

By Ibukun Oguntola  In October 2018, four years after the first case of Ebola Virus Disease (EVD) was reported in Nigeria, Nigeria Health Watch, supported by the Global Health Advocacy Incubator (GHAI), launched the #PreventEpidemicsNaija project. The overall goal of the project was to increase public awareness and support for epidemic preparedness and response (EPR), […]

By Ibukun Oguntola 

In October 2018, four years after the first case of Ebola Virus Disease (EVD) was reported in Nigeria, Nigeria Health Watch, supported by the Global Health Advocacy Incubator (GHAI), launched the #PreventEpidemicsNaija project.

The overall goal of the project was to increase public awareness and support for epidemic preparedness and response (EPR), as well as to advocate for increased funding to boost the efforts of the national public health institute, the Nigeria Centre for Disease Control (NCDC).

At the time, the Ebola outbreak was no longer foremost in mind of many Nigerians, therefore initial campaign efforts were likened to the story of the boy who cried wolf. There was also the argument that Nigeria had many pressing health needs which required urgent attention, so why should the country dedicate resources to prepare for an epidemic that might never happen? Well, the Ebola outbreak left a clear message that the COVID-19 pandemic reinforced, which is the vital need to build a strong health system that strengthened surveillance efforts and the country’s ability to detect, respond to and control future disease outbreaks. This is essential in order to prevent and minimise the health and socio-economic consequences of an infectious disease outbreak.

The project sought to engage with political decision-makers on the need to prioritise epidemic preparedness; build government, civil society and media capacity to advocate for funding for epidemic preparedness, making the case for investments in epidemic preparedness and tracking budget allocation and spending, to inform advocacy.

The campaign was flagged off with vox pops, media engagement, forums and policy dialogues. Notably, at the ‘Cost of Epidemics’ policy dialogue in May 2019, participants shared strategies on how Nigeria could prepare for infectious disease outbreaks, budget for epidemic prevention, and pool local resources towards epidemic prevention. It was agreed that achieving sustainable financing for epidemic prevention would require including a budget line item for epidemic prevention in national and state budgets.  

In addition, in February 2020, Senator Chukwuka Utazi, Chairman of the Senate Committee on Primary Healthcare & Communicable Diseases, and Senator Ibrahim Oloreigbe, Chairman, Senate Committee on Health, discussed the role of the legislature in funding epidemic preparedness at a breakfast meeting themed, ‘Legislating Epidemics’. 

These activities contributed to achieving the project’s objectives which were to increase awareness and funding for epidemic preparedness and implementation of the National Action Plan on Health Security (NAPHS) in Nigeria, but it soon became imperative to take the #PreventEpidemicsNaija advocacy to the sub-national level. Therefore, in 2020, the campaign expanded, as Nigeria Health Watch, the Legislative Institute for Sustainable Development (LISDEL) and BudgIT were part of a GHAI-led consortium to intensify budget advocacy toward epidemic preparedness at the federal and state level. It was especially important to take the campaign to the states, because despite Nigeria’s history of infectious disease outbreaks, there were gaps in the epidemic preparedness and response capacities at the sub-national level. 

LISDEL and Nigeria Health Watch also collaborated with the Health Sector Reform Coalition (HSRC), the Legislative Network for Universal Health Coverage and other organisations to create public demand for epidemic preparedness.

The media is an important stakeholder for the Prevent Epidemics programme and it was therefore important to equip journalists who report on health and those interested in health reportage with the professional and technical knowledge to accurately report on epidemic preparedness.  To achieve this, Nigeria Health Watch organised a series of journalism workshops with journalists around the country. As a result, reportage of epidemic preparedness in Nigeria became quite widespread. Since 2020, the #PreventEpidemicsNaija Journalism Awards (PEJA) has recognised and rewarded exceptional reporting of epidemic preparedness stories in Nigeria.

Between 2018 and 2020, online engagement has increased significantly, with the campaign hashtag, #PreventEpidemicsNaija, a prominent hashtag in social media conversations about the COVID-19 pandemic in Nigeria.

LISDEL collaborated with BudgIT and other civil society organisations, including the Health Sector Reform Coalition (HSRC), to build a Health Security Financing Accountability Framework. This approach can be used to track federal, state, and local government budget allocations, expenditure and outcomes, as well as to identify expenditure constraints and to inform advocacy. 

In Kano State, LISDEL collaborated with BudgIT to establish the Kano State Health Security Advocacy Team (KSHSAT). LISDEL and GHAI built relationships with epidemic preparedness champions in politics and the media to demonstrate the value of investing in health security. This engagement built trust which led to invitations for LISDEL and KSHSAT members to participate in government-led budget review and planning sessions, as well as meetings to assess the state’s preparedness.

Furthermore, LISDEL, GHAI, and KSHSAT collaborated with the Kano State Ministry of Local Government and Chieftaincy Affairs on budget advocacy efforts which was aimed at getting each of the 44 LGAs to allocate funding for epidemic preparedness and response in their budgets. The project recorded successes, as a line item of N300 million was created in the budget for epidemic preparedness, as well as an additional allocation of N2 million per LGA.

“The COVID-19 pandemic has given us additional impetus that the work we do in advocacy for epidemic preparedness is extremely important, more so, prioritising Nigeria’s health security has to be front and centre for policymakers, especially as we are in an election year,” said Vivianne Ihekweazu, Managing Director, Nigeria Health Watch.

The #PreventEpidemicsNaija coalition will continue to advocate for increased funding for Nigeria’s health security at the federal and state level; transparency; accountability; and sustainable government investments in epidemic preparedness must be a priority. As Senator Utazi said at the Legislating Epidemics Breakfast meeting, “It is during the time of peace that you prepare for war…We all have to make epidemic preparedness a culture in Nigeria”.

 

 Oguntola wrote from Abuja