INTEGRATED NATIONAL AVIAN AND PANDEMIC INFLUENZA
RESPONSE PLAN - 2007 -2009.
CONTENTS
EXECUTIVE SUMMARY
CHAPTER 1. INTRODUCTION
1. Background to avian influenza and the threat of a human influenza pandemic
2. Current status of H5N1 in the world and in Nigeria
3. Socio-economic impact of avian influenza in poultry
4. Potential for emergence of new human influenza viruses and a potential pandemic strain
5. Integrated planning and preparedness
CHAPTER 2. STRATEGY AND OBJECTIVES OF THE INTEGRATED PLAN
1. Objectives for avian influenza prevention and control
2. Objectives for pandemic influenza containment, mitigation and recovery
3. Objectives for cross-cutting communications
4. Objectives for coordination and cooperation
5. Strategy to address short, medium and long term requirements
6. Ethical issues
CHAPTER 3. ROLES, RESPONSIBILITIES AND COORDINATION MECHANISMS
1. The Incident Command and Control System
2. Roles and responsibilities at Federal, State, and Local Government levels
3. Mechanisms for coordination across sectors and across tiers of Government
CHAPTER 4. AVIAN INFLUENZA PREVENTION AND CONTROL
1. Surveillance and detection
2. Control and prevention
3. Compensation and restocking
4. Restructuring of poultry production
5. Communications strategies
6. Poultry vaccination strategies
7. Ethics
CHAPTER 5. HUMAN INFLUENZA PANDEMIC PREPAREDNESS IN THE INTERAND PRE-PANDEMIC PERIODS
1. Pandemic alert phases defined by the WHO and associated actions and implementers
2. Surveillance and detection
3. Communications strategies
4. Standard operating procedures
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CHAPTER 6. HUMAN INFLUENZA PANDEMIC CONTAINMENT, MITIGATION,
AND RECOVERY
1. Pandemic planning assumptions about scale and severity
2. Surveillance and detection
3. Rapid response and containment
4. Pandemic mitigation strategies
5. Communications strategies
6. Anti-viral strategy
7. Personal protective equipment
8. Pandemic vaccine strategy
9. Management of mass fatalities
10. Ethics
CHAPTER 7. PREPARING FOR THE WIDER CONSEQUENCES OF A HUMAN
INFLUENZA PANDEMIC
1. Essential services and vital supplies
2. Financial systems
3. Leadership and governance
APPENDIX
1. Implementation plans and risk analyses
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EXECUTIVE SUMMARY
Highly Pathogenic Avian Influenza (HPAI) virus A/H5N1 causes a disease in domestic and wild
birds. From Asia it has spread to Europe, reaching Nigeria in January 2006 and affecting 69 of
the 774 Local Governments by February 28th 2007. The first confirmed human case in SubSaharan Africa was reported on January 28th 2007 in Nigeria, linked to a poultry market in
Lagos. Globally 281 human cases have been confirmed including 169 deaths. A major risk is
that this virus develops the capability to pass easily between people and so cause a human
influenza pandemic. The Plan sets out an integrated, cross-sectoral framework for addressing the
risks to poultry and people.
The overall strategic approach is to ensure that all stakeholders work in a coordinated and
collaborative way to address the threats posed by avian and human pandemic influenza. The
plan is based on international “best practice” which emphasises:
 a strong commitment to ensuring plan implementation at the highest political level,
accompanied by effective leadership of all concerned stakeholders;
 clear procedures and systems for managing the rapid implementation of priority actions;
 primary attention to improved functioning of veterinary and human health services at all
levels, with a transparent approach to the sharing and dissemination of information about
suspected disease outbreaks, immediate efforts to establish their cause, and prompt responses
(including restriction of movement of animals that are at risk);
 incentive and/or compensation schemes combined with effective communication to
communities on the importance of immediate reporting of disease outbreaks in animals to
the responsible authorities;
 dialogue at the community and household levels through local channels to address
knowledge gaps and inappropriate hygiene and AI prevention practices;
 effective mobilisation of civil society and the private sector;
 public education through mass communication campaigns that promote healthy behaviour
and focus on reducing the extent to which humans might be exposed to HPAI viruses; and
 Health education for home-based care in case of a pandemic and the health facilities are
over-burdened.
The plan addresses avian influenza prevention and control; pandemic influenza containment,
mitigation and recovery; and the wider non-health consequences of a human influenza
pandemic. Critical areas of activity are cross-cutting communications, and mechanisms for
enhancing coordination across sectors of health (animal and human) and non-health (essential
services, vital supplies, financial systems, governance, security) activity. Major ethical issues
concern the balance between individual autonomy and community interest. The plan’s proposals
are made in the context of short, medium, and long term requirements and capacity-building
needs.
The plan proposes an Incident Command and Control System (ICCS) under the overall authority
of the Presidency to ensure a unified command of the many multi-sectoral actors and
stakeholders involved in the response to avian and human pandemic influenza. The ICCS
comprises the Crisis Management Centre at Federal level (APIP&CC), with counterpart Centres
at State level. Each Centre will oversee the activities of ministries and agencies involved in the
response to the crisis and the management of its consequences.
Existing coordination mechanisms comprise the inter-ministerial Federal Steering Committee,
supported by a Technical Committee and a Public Enlightenment Committee, with State level
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counter-parts. The consequences of avian and human pandemic influenza involve multiple
sectors beyond animal and human health. Therefore, the plan proposes to strengthen these
coordination mechanisms by establishing an independent National Coordinator for Avian and
Pandemic Influenza to be located in the APIP&CC, with counterparts at the State level.
Avian influenza in poultry is an existing reality in Nigeria. The plan proposes measures to
increase animal diseases surveillance points from 170 to 5000, and to align veterinary health
surveillance with that of the human health Integrated Disease Surveillance and Response system.
Community Animal Health Workers will be trained and deployed to work with rural poultry
producers, including regular cleaning activities. The plan proposes to establish a Joint
FMAWR/FMH/FMST/FMIC Surveillance Team for early reporting and response and to shorten
time to diagnostic confirmation. The Reference laboratories in the country would therefore, be
strengthened to carry out the molecular epidemiological surveillance to detect any molecular
genetic changes that may start a pandemic. The Pandemic Influenza Surveillance Plan will
provide timely molecular epidemiological information that will enable us nip the pandemic
before it gets hold. The plan includes prompt compensation of owners of compulsorily
depopulated poultry, and restructuring of production systems to enhance their bio-security. The
Community Dialogue System will play a critical role in these proposals.
The plan recognises that it is critically important, in the present pre-pandemic period, to be able
rapidly to detect changes in avian influenza virus characteristics which could signal the
emergence of a strain capable of causing a human influenza pandemic. The Pandemic Influenza
Surveillance Plan will provide timely epidemiological information. Passive surveillance of
human cases of avian influenza is dove-tailed into the existing Integrated Disease Surveillance
and Response system (IDSR). The plan also proposes active surveillance by Rapid Response
Teams working closely with the Ministry of Agriculture to track exposure to avian influenza
outbreaks in poultry. In the medium to longer term, the IDSR will be developed jointly by the
FMOH and FMAWR into an electronic real-time reporting system for both zoonotic and human
infectious diseases. Standard Operating Procedures will guide cross-sectoral reporting by Health
Officers at the Local Government and Community levels. The Community Dialogue System will
play a critical role in these proposals.
If emerging cases signal the possible onset of a pandemic in Nigeria, then the WHO’s protocol
for rapid response and containment at source will be implemented in an attempt to prevent its
development. This will require treatment of cases, quarantine of those exposed to infection, and
use of anti-viral medicines. If this protocol for containment fails and an influenza pandemic
takes hold, then social distancing measures may be adopted to reduce its spread and mitigate its
impact. Anti-viral medicines and a pandemic vaccine are unlikely to be accessible, or may be
available gradually and in only limited quantities, leaving personal hygiene and social distancing
measures to be the primary methods of prevention. Such measures could in principle extend to
closure of schools and work places, discouragement of mass gatherings, and restrictions of
movement. The plan proposes urgent mathematical modelling studies to identify feasible
pandemic mitigation strategies appropriate for the Nigerian population. Many ethical issues are
raised by the proposed implementation and enforcement of social distancing measures, by the
need to specify priority access to scarce medicines, and by the management of mass fatalities.
The plan proposes open discussion of these ethical issues supported by community engagement
through dialogue and other forms of communication. The Community Dialogue System will
play a critical role in these proposals.
A pandemic is likely to cause extensive absenteeism from work through illness. The wider
consequences of a human influenza pandemic are therefore likely to affect sustainability of
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essential services, vital supplies, financial systems, governance and security. The plan proposes
preparation and dissemination of guidance to help organisations in all sectors to plan for their
operational and business continuity.
An implementation plan is appended to the main policy document. The estimated costs of
implementation are conservatively put at about US$195 million over five years. An analysis is
included of many possible future risks which could impede or prevent implementation of the
plan, and of possible ways to address these risks.
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CHAPTER 1. INTRODUCTION
Background to avian influenza and the threat of a human influenza pandemic
Avian influenza viruses
1. Influenza viruses are of three general types known as A, B, and C. Each type is further
divided into sub-types. Sub-types are conventionally named according to two characteristics
denoted H (for the haemagglutinin surface protein) and N (for the neuraminidase surface
protein). The first major human influenza virus to be characterised was called H1N1, and
was responsible for the “Spanish” influenza pandemic of 1918-19. The H characteristic is
now known to take 16 forms, and the N characteristic 9 forms. In total over 40 different
combinations have been identified. To date all highly pathogenic avian influenza viruses
which cause disease in animals belong to H5 or H7 sub-types. In humans, types A and B are
responsible for epidemics while C is of little epidemiological significance.
2. Birds are a natural reservoir of influenza viruses. The Highly Pathogenic Avian Influenza
(HPAI) virus A/H5N1 causes a disease affecting the digestive, nervous and respiratory
systems of many types of domestic and wild birds. The disease shows respiratory,
reproductive, digestive and/or nervous signs and causes high mortality in poultry; but in
some species of ducks and related waterfowl the virus is present without causing symptoms.
The disease in birds has an incubation period of few hours to a few days. It is highly
contagious. A/H5N1 has been found to cross species to infect cats, dogs, pigs, and humans
leading to disease and a high rate of fatality. In humans, A/H5N1 has affected victims of
both sexes and all ages depending largely on their contact with poultry and wild birds.
3. Influenza viruses evolve rapidly and unpredictably. It is possible that A/H5N1 or another
avian influenza virus could acquire a greater affinity for humans by undergoing significant
structural change through mutation or by mixing (“reassorting”) its genes with those of an
existing human influenza virus. If such a virus were to become easily transmissible between
people, then it could cause an influenza pandemic with a virulence leading to widespread
and devastating illness and death. The persistence and spread of A/H5N1 in poultry and
people in Asia, Europe and Africa has led the World Health Organisation to state that the
world is now in a pandemic alert phase (phase 3). For these reasons, an integrated and crosssectoral plan is needed which ensures that Nigeria is prepared to address both the causes and
consequences of avian and human pandemic influenza.
Current status of H5N1 in the world and in Nigeria
4. Although limited serological studies showed the presence of Influenza Virus Type A
antibodies in Nigeria, there was no evidence of clinical disease from A/H5N1 in poultry in
Nigeria until 22nd January 2006 when the disease was first reported in SAMBAWA farms,
Kaduna. Samples were diagnosed positive by the National Veterinary Research Institute
(NVRI), Vom, Nigeria and confirmed by the OIE World Reference Laboratory, Padova,
Italy on 7Th February 2006, and formally announced on the 8th February 2006. Since then,
the HPAI has been confirmed in 22 States and the Federal Capital Territory (FCT) spread
over 69/774 Local Government Areas as at 28th February 2007. The first confirmed human
case in Nigeria (and in sub-Saharan Africa) was reported on 28th January and the source was
traced back to a poultry market in Lagos.
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5. Current surveillance for human cases has resulted in the identification of individuals with
Influenza-like Illness (ILI) who have had a history of exposure to sick or dying birds. As at
August 2006, more than 300 human samples were collected and screened for H5N1 but none
was confirmed positive.
6. The densities of human and poultry populations are generally lower in Nigeria than in many
South-east Asian countries. The poultry production systems have many similarities, although
domesticated ducks probably play a more important role in disseminating infection in Southeast Asia than in Nigeria. These systems create multiple opportunities for human exposure.
In Nigeria, large numbers of households keep backyard flocks, which often mingle freely
with wild birds. Most of such flocks scavenge for food, often entering households or sharing
outdoor areas where children play.
7. With few exceptions, notably in large commercial farms, surveillance for avian disease is
limited. Nutrition of the birds is poor and high mortality common, increasing the likelihood
that outbreaks of H5N1 will be missed. As experience in Asia has shown, the late detection
of outbreaks increases the likelihood that the virus will become enzootic. Deaths of large
numbers of poultry, whether due to disease or culling for control purposes, would deprive
already impoverished populations of an important source of income and protein, particularly
for women and children.
8. It is worth mentioning that while elimination of the virus from the commercial poultry sector
alone will aid agricultural recovery; it may not significantly reduce risks of human exposure,
as there are also exposures to small rural infected flocks. No case has yet been detected
among workers in the commercial poultry sector. It is therefore recognised that control of
disease in rural “backyard” flocks will be the most difficult challenge. Strong support from
the health sector helps gather the political will to meet this challenge. In addition, it is
imperative that measures for controlling disease in rural flocks are assisted by risk
communication to farmers and their families.
Socio-economic impact of avian influenza in poultry
9. The livestock sector is vital to the socio-economic development of Nigeria. It contributes
about 9-10% of agricultural GDP. Moreover, Nigeria’s poultry population is about 140
million of which 25% are commercially farmed, 15% semi-commercially, and 60% in
backyards. Consequently, livestock represents an important source of high quality animal
protein, providing about 36.5 per cent of the total protein intake of Nigerians. It is one of the
highest investments in agriculture with net worth of N30b (US$230m). Until the A/H5N1
outbreaks began, Nigeria’s poultry sector had potential to enter export markets.
10. A UNDP survey on the socio-economic impact of HPAI indicates that the panic caused by
the outbreak led to an initial boycott of poultry products resulting in a sharp decline in sales.
Eggs and chicken sales declined by about 80% within 2 weeks following the outbreak report.
Four months later, the market had recovered by less than 50 %. Poultry feed sales dropped
by 82% in February after the initial announcement and by May had recovered by only 43%.
11. The HPAI outbreak in the country has caused a loss of approximately one million birds
through deaths and culling exercises plus an additional 45% drop in the flock size for the
non-affected farms. These have further worsened the gap between supply and demand of
poultry products, with potential implications for nutritional well-being. In addition, 80% of
workers in the affected farms and 45% of those working in non-affected farms lost their jobs
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as a result of the outbreak. The Poultry Association of Nigeria (PAN) has estimated the lost
sales revenue and total uncompensated mortality to amount to N15.2 billion up to early
March 2007.
Potential for emergence of new human influenza viruses and a potential pandemic strain
12. From a historical perspective, there have been three human influenza pandemics over the
past century: the “Spanish flu” of 1918-19, where over 50 million persons died, the “Asian
flu” of 1957-1958, where 2 million deaths were recorded and the “Hong Kong flu” of 19681969 with 1 million deaths. The worst case scenario in the present circumstance according to
public health experts is for a highly infectious and virulent strain of the virus to emerge and
overwhelm health and medical defences of even the developed world.
13. Avian influenza viruses are highly specific to birds, but have on occasion crossed species
barriers to infect various mammalian species including humans. This can be explained by the
chemical difference between human and avian cellular receptor sites for influenza viruses.
Pigs possess both of these types of receptors (the sialic acid receptors) and are therefore
susceptible both to human and to avian influenza viruses. It is thought that pigs could
therefore be ideal “mixing vessels” which may result in new types of influenza virus through
the process of genetic re-assortment. For this reason, there is widespread concern of public
and animal health experts that the current H5N1 Avian Influenza virus, which is prevalent in
Asia and some parts of Europe and Africa, may acquire some human influenza virus genes
resulting in easy spread between people and a potentially devastating pandemic.
14. For these reasons, rapid detection of human cases of avian influenza is of great importance.
However, laboratory confirmation of human H5N1 infections is technically challenging,
expensive, and demanding on human resources. Management of H5N1 patients is currently
also very demanding; but the human costs of a pandemic will be very much greater.
15. Pandemic influenza is a public health emergency of international concern and a community
disaster. It is considered to be a relatively high probability event, even inevitable by many
experts, yet no one knows when the next pandemic will occur; there may be very little
warning. The effect of influenza on individual communities will be relatively prolonged –
perhaps lasting six to eight weeks or more, and to arrive in waves over many months – when
compared to the minutes-to-hours observed in most other natural disasters.
16. The occurrence of human cases in the early stages of a pandemic – even when sporadic –
would create enormous new challenges for health systems and services that are already
fragile and overburdened. Should human cases occur, their early detection within 2 days of
onset of symptoms is critical if treatment with antiviral drugs is to improve prospects of
survival. Surveillance systems are weak and unlikely to pick up cases of a disease with
symptoms similar to illness from many other common causes. Health capacity, human and
financial resources have already been greatly stretched by the demands of diseases such as
AIDS, tuberculosis and malaria.
17. Infection control in most hospitals is difficult to introduce and sustain. Sporadic cases of
H5N1 infection and (in the absence of an effective communications strategy) the possible
reluctance of residents to comply with recommended reporting and isolation measures
during outbreaks of severe diseases could push fragile health systems close to the brink of
collapse.
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18. There is therefore a need to strengthen both animal and human infectious disease
surveillance systems, and to engage communities directly, so as to be able promptly to detect
the emergence of threatening changes in the genetic composition of influenza viruses.
Integrated planning and preparedness
19. The control of avian influenza and preparation for a human influenza pandemic pose issues
which require an integrated cross-sectoral approach going beyond multi-sectoral planning.
This involves coordinating stakeholders in health, agriculture, information, economics,
finance, and planning among others. It therefore needs a response based on shared strategic
objectives. The response should therefore address the causes of avian and human pandemic
influenza as well as their wider consequences. The need to involve other authorities outside
the animal and human health sectors poses a major challenge.
20. The purpose of this plan is to provide a framework for the Federal, State, Local Government,
private sector, non-governmental organisations, and Development Partners to work together
to address avian influenza and the risk of a human influenza pandemic. The plan describes
incident management activities, concepts and structures for avian influenza control and
pandemic preparedness and response activities. The plan is a “living document” subject to
review and revision.
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CHAPTER 2. STRATEGY AND OBJECTIVES OF THE INTEGRATED PLAN
21. The overall strategic approach is to ensure that all stakeholders work in a coordinated and
collaborative way to address the threats posed by avian and human pandemic influenza. The
Government therefore intends to follow international best practice by seeking to ensure:
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a strong commitment to ensuring plan implementation at the highest political level,
accompanied by effective leadership of all concerned stakeholders;
clear procedures and systems for managing the rapid implementation of priority actions;
primary attention to improved functioning of veterinary and human health services at all
levels, with a transparent approach to the sharing and dissemination of information about
suspected disease outbreaks, immediate efforts to establish their cause, and prompt responses
(including restriction of movement of animals that are at risk);
incentive and/or compensation schemes combined with effective communication with
communities on the importance of immediately reporting disease outbreaks in animals to
responsible authorities;
dialogue at the community and household levels through local channels to address
knowledge gaps and inappropriate hygiene and AI prevention practices;
effective mobilisation of civil society and the private sector;
public education through mass media communication campaigns that promote healthy
behaviour and focus on reducing the extent to which humans might be exposed to HPAI
viruses; and
Health education for home-based care in case of a pandemic and the health facilities are
over-burdened.
Objectives for avian influenza prevention and control
22. The overall policy for HPAI emergency response in Nigeria is to restrict the disease to the
primary foci in poultry, to eradicate the disease in the shortest possible period, to limit the
socio-economic impact, and significantly to reduce the risk of progression from avian
influenza to a human pandemic situation by limiting human exposure to infection.
23. Policy measures adopted by the Ministry of Agriculture and Water Resources conform to the
FAO/OIE Global Strategy. These comprise aggressive control measures for the country
through the deployment of the conventional control methods of culling, bio-security and
movement control. Other measures include community engagement to raise public
awareness and change behaviour; strengthening diagnostic capacity and veterinary
quarantine services; and enhancing research capability and carrying out epidemiological
surveys to understand the route of transmission as well as the role of wild birds in the spread
of infection. In addition, for the long term success of the strategy, the restructuring of the
poultry industry is being considered in relation to enhancement of bio-security and farm
restocking.
24. A critical element in this approach is to strengthen the capacity of the veterinary services at
all levels for early detection and diagnosis of any avian influenza emergency. This is an
essential pre-requisite for a prompt and effective response.
Objectives for pandemic influenza containment, mitigation and recovery
25. To address the immediate threats to human health posed by avian influenza in poultry, the
health sector will work closely with the Ministry of Agriculture and Water Resources and
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with the Ministry of Information and Communication. The health sector will use a policy
framework aimed at strengthening surveillance and laboratory diagnosis, responding to
human cases, planning for measures such as case isolation and quarantine, and preparing
hospitals for treating influenza patients. This policy framework will ensure a sustainable
approach by designating selected health institutions as regional reference centres to support
surveillance, isolation and management of cases. The Health sector will work closely with
the Ministries of Science and Technology, Education and Defence.
26. In preparing to contain a possible pandemic at a source in Nigeria, the health sector will base
its approach on the protocol for rapid response and containment proposed by the World
Health Organisation.
27. If pandemic containment fails and an influenza pandemic spreads in Nigeria, Government
will implement public health and social distancing measures for pandemic mitigation and
recovery described in this plan, which are in accord with current international guidance and
best practice.
Objectives for cross-cutting communications
28. The information sector is a leading cross-sectoral force for pro-active moves to counter avian
influenza in poultry and a possible future human influenza pandemic. This requires
developing appropriate communication strategies in the areas of focused advocacy; massive
awareness creation; community sensitisation and social mobilisation of diverse stakeholders
through the use of appropriate channels; and through customised public enlightenment
materials and programmes.
29. The main objective is to create awareness, address knowledge gaps and family concerns and
influence positive behaviour change through increased information, knowledge and
understanding leading to commitment to and adoption of healthier and more biologically
secure behaviour. An important way to achieve this will be to train animal health, health,
information and other frontline workers/stakeholders in the principles and practice of
communicating risks and crises, particularly in relation to avian and pandemic influenza.
Furthermore, it is important that local communities and individuals actively participate in
local surveillance as partners. Feedback will be used to evaluate effectiveness of messages
and programmes and their subsequent fine-tuning.
Objectives of coordination and cooperation
30. Coordination and cooperation are essential to a successful and strategic response to the
threats posed by avian and human pandemic influenza. The central objectives are to
coordinate preparedness and response planning and operational activities at National, State
and Local levels; to create synergies between existing programmes and interventions for
optimal resource use; and to ensure that all stakeholders cooperate to form a concerted effort.
31. This poses a big challenge for Nigeria given its federal structure and given the many sectors
involved. The plan proposes a unified command and control system as an element critical to
effectively coordinated incident and consequence management across sectors and across tiers
of government. This should address risks of inefficiency and duplication of effort which can
occur when agencies from different functional sectors and levels of government act without
a shared organisational and strategic framework.
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32. For tackling a disease which does not respect territorial borders, coordination and
cooperation are also important between neighbouring countries. Nigeria will therefore seek
to implement best practice in international coordination through policies of alignment and
harmonisation in line with the Paris Declaration on Aid Effectiveness.
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Strategy to address short, medium and long term requirements
33. The avian and pandemic influenza plan seeks to address immediate needs for an effective
response; but it also identifies constraints which are in practice likely only to be addressed
over the medium (2-4 years) and longer term (5 or more years).
34. In the short term, the national plan proposes training and re-training of animal health
workers on bio-security, surveillance activities, culling and decontamination of farms,
vaccination and control of animal movement, input supply and logistical support. This is
being carried out by the Veterinary Council of Nigeria, Federal and State Governments, the
UN system and other Development Partners.
35. Also in the short term, systematic training is proposed for health workers to ensure an
effective medical response to avian influenza. This involves training of trainers at the
national level. The participants are expected to deliver training to health workers at state
level and local government level. The World Health Organisation’s modules for training on
avian influenza control will be adapted and used in this. The beneficiaries of the training will
include doctors, nurses, laboratory personnel, Disease Surveillance and Notification
Officers, and other public health personnel.
36. Health-care providers will be alerted to suspect avian influenza in patients presenting with
influenza-like illness and having an epidemiological link to affected animal species;
implement infection control measures; report cases immediately to public health authorities;
provide algorithms to assist in case-finding and management.
37. Training will be given to information and National Orientation Agency (NOA) officers on
behaviour change and risk communication management by the Federal Ministry of
Information and Communications in collaboration with the UN system and Development
Partners. Training should address community engagement with leaders, community
influencers and journalists.
38. Responsible Organisations: The office of the Director of Special Duties of the Federal
Ministry of Health and the Federal Department of Livestock and Pest Control Services are
charged with the responsibilities specified in paragraphs 34-37 in collaboration with the
Federal Ministries of Information and Communication, \’Science and Technology,
Education, Defence, the UN system and Development Partners.
39. The objectives in the medium and longer term are to strengthen capacity building of
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organisations and manpower working on surveillance and control at all levels, based on the
following measures:
Develop the capacity of disease surveillance and control in humans, with the establishment
of efficient epidemiology units in every district, in addition to training of professional field
epidemiologists and experts in other fields.
Develop diagnostic capacity in humans, by developing a network of laboratories at the
central, state and hospital levels to support prompt and accurate diagnosis of avian influenza
in humans.
Control of avian influenza in hospitals, by training medical personnel in areas of infectious
disease management and by establishment of isolation rooms for confirmed or suspected
cases of specified communicable diseases.
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Develop a viable epidemio-surveillance network and control capacity for animal diseases by
training and development, provision of incentives for professional field veterinary
epidemiologists, and promotion of the role of wild life conservationists.
Develop the capacity of laboratories for diagnosis of and research on avian influenza in
animals, with high bio-safety levels.
Enhance supply of technical inputs and logistical support.
Revive and strengthen the Community Dialogue System so as to reach wider audiences
through inter-personal communication, promote community ownership and appraisal of their
situation and the identification of the most appropriate steps to address the identified
challenges.
40. Basic and operational research will entail the following:
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Monitoring of the circulating strain of the virus and sharing the information generated with
all tiers of government, the private sector and international community.
Collaborating with our international partners to ensure access to ‘state-of-the-art’ technology
for the control programme.
Research on new pharmaceutical and non-pharmaceutical interventions which may reduce
local and international spread of a pandemic virus.
Research into risk perception, knowledge, attitude and beliefs of the public regarding avian
and pandemic influenza, and use of this information to assist the communications strategy.
Epidemiological investigations into the role of local wild birds, including vultures, cattle
egrets and guinea fowls in the spread of avian influenza in Nigeria.
Molecular characterisation of AI isolates in Nigeria and identification of potential vaccine
candidate isolates.
Development of an avian influenza vaccine for poultry which can be administered through
water or feed.
Improvements in poultry husbandry and marketing practices.
Ethical issues
41. The plan includes contingencies for health-care delivery and proposes guidelines for the
maintenance of essential services, vital supplies, and financial systems. The various
jurisdictions in the framework of the plan will assess the legal basis of all animal and public
health measures proposed. These may include: surveillance; international collaboration
including sharing of data and biological materials; travel or movement restrictions (leaving
and entering areas where infection is established); closure of educational institutions and
places of work; cancellation of mass gatherings; enforced isolation or quarantine of
infectious cases or of persons exposed to infection including those from areas of an influenza
pandemic.
42. The Government will undertake further assessment of the legal basis for influenza
vaccination of health-care workers, workers in essential services, and persons at high risk.
An official working group may be formed to advice on vaccination policy and on possible
measures to increase uptake during a pandemic alert phase and in pandemic periods.
43. A legislative framework to ensure compliance with the International Health Regulations will
be put in place. This may require the declaration of a state of emergency by the President
based on the recommendation of the Special Assistant on Avian and Pandemic Influenza, or
at the request of a State government in consultation with the Special Assistant. The
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geographical scope of the state of emergency will depend on the size of the outbreak and the
actions needed to control it.
44. Ethical issues are closely related to legal issues as mentioned above. They are part of the
normative framework needed to assess cultural acceptability of measures such as culling and
compensation, quarantine, contact tracing, selective vaccination of predefined risk groups,
resource allocation, prioritisation of specified groups for access to scarce medical supplies,
and the conduct of research during a pandemic.
45. The risk of avian influenza in poultry and in human populations, the pre-pandemic planning
and preparedness activities, the management of a human influenza pandemic and its
aftermath, all pose significant ethical challenges. These challenges arise from the impact of
disease on individuals, communities, organisations and governments, and from their
responses to it.
46. These challenges are amplified in Nigeria by a high level of income inequality, a high
prevalence of poverty, corruption and illiteracy which compromise its ability to engage
scientifically and ethically with avian and pandemic influenza threats. Weak political, social,
economic and judicial institutions reduce trust in government and government-led initiatives.
These factors increase general vulnerability and worsen that of inherently more vulnerable
social groups such as those with diminished or compromised autonomy, the very young, the
old, women, people living with chronic diseases, and the very poor. Social, economic and
cultural injustices and inequalities are likely to be exacerbated by the consequences of avian
and human pandemic influenza. Past colonialism and militarisation of society, relatively
young democratic traditions, poor access to the judiciary, and persisting governance
structures weaken participation in democratic decision-making and may undermine effective
community engagement in the effort to address avian and human pandemic influenza threats.
47. Modern work in bioethics has paid little attention to infectious diseases and their
management. Pandemics present a major challenge because they combine elements of both
medical emergencies and natural disasters. Pandemics create a tension between the duty to
protect the health of the public and the rights and autonomy of the individual. The public
health consequences of pandemic influenza in the absence of effective medical countermeasures are sometimes held to justify overriding individual rights to autonomy, privacy and
liberty to the degree necessary to protect public health. Further challenges are posed by
disease containment strategies in poultry and in people, allocation of scarce resources, the
rights and responsibilities of health care workers, inter-governmental and international
obligations, and the conduct of research on the efficacy of innovative interventions.
48. Such policies raise questions about fundamental values of liberty, privacy, governance,
proportionality, and trust. Procedural issues of reasonableness, openness, inclusiveness, and
accountability also need to be addressed at every level. Appropriate principles and guidance
are based on the general principles of bioethics, on current work in progress by an Expert
Committee of the World Health Organisation, and on the ethics of public health and disaster
response.
49. Government will establish a high-level committee to develop proposals for an ethical
framework to address these and related human and animal health issues. The National Health
Research Ethics Committee of the Federal Ministry of Health will take lead responsibility
for this working in close collaboration with the Federal Ministries of Agriculture and Water
15
Resources and of Information and Communications, the UN system and Development
Partners.
16
CHAPTER 3. ROLES, RESPONSIBILITIES AND COORDINATION MECHANISMS
50. Existing roles and responsibilities for avian and pandemic influenza control and planning are
described in this section together with proposed enhancements. Modified arrangements may
be needed to address crisis response and consequence management in a human influenza
pandemic.
The Incident Command and Control System
Federal level
51. Any crisis requires rapid and coordinated strategic decision-making, with efficient
communications and information dissemination, in order to ensure timely operational
response and effective management of consequences across all sectors. This plan proposes
establishing an Incident Command and Control System (ICCS) as a framework for fulfilling
these functions during avian influenza outbreaks in poultry and in human influenza
pandemic containment, mitigation and recovery. The ICCS consists of the Avian and
Pandemic Influenza Preparedness and Control Centre (APIP&CC) and the organisations
which the APIP&CC oversees in order to ensure a coherent and well-coordinated response to
avian and human pandemic influenza. The Federal APIP&CC structure is replicated at State
level. This system is shown in the diagram below.
THE INCIDENT COMMAND AND CONTROL SYSTEM
THE PRESIDENT
CRISIS MANAGEMENT CENTRE
Security
& other
agencies
as needed
Pandemic
Influenza
Office
(FMOH)
National Animal
Disease Control
Centre
(FMOAWR)
Influenza
Information
Office
(FMOIC)
National Emergency
Management
Agency
(NEMA)
STATE CRISIS MANAGEMENT CENTRES
LOCAL GOVERNMENT EXECUTIVE COUNCILS
52. The APIP&CC will be under the overall authority of the Presidency, supported by the
Chairman of the National Steering Committee and the Head of the Rapid Response Team
against avian and pandemic influenza of the Ministries of Health, Agriculture, and
Information. The APIP&CC should be headed by an Administrative Manager who should
oversee the implementation of the decisions of the Steering committee by the line Ministries
and he should report administratively to the Chairman of the Multi-sectoral Steering
Committee. The APIP&CC will coordinate and oversee and coordinate the contributions to
17
the response made by the specialist line ministries, by the National Emergency Management
Agency (NEMA), by the Security Agencies, and by other branches of government as may be
needed to secure an effective and coherent inter-sectoral response.
53. The Federal specialist line ministries will work through the Pandemic Influenza Office
(PIO), which will be located in and administered from the National Clinical Research Centre
(NCRTC, Asokoro), the National Animal Disease Control Centre (NADCC, Abuja), and a
new Influenza Information Office (IIO) established by the Ministry of Information to
manage strategic communications. Desk Officers from the PIO, NADCC, and IIO will be
located within the APIP&CC.
54. The PIO will collaborate with the Federal Epidemiology Division of the Ministry of Health
so as to ensure the development of information and guidance and support emergency
planning activities, exercises, training, laboratory work, and conduct national and
international liaison on the public health dimensions of avian influenza and a human
influenza pandemic. On avian influenza outbreaks, the NADCC will collaborate closely with
the FMAWR to ensure coordinated information flows, targeted support for the emergency
response to outbreaks, and undertake training and associated work.
55. At the onset of a pandemic, Mr. President will convene meetings of National Council of
State and the National Security Council and issue directives in accordance with the
Integrated National Avian and Pandemic Influenza Plan.
State level
56. The State Governor will activate the command and control structure which will include:




State Commissioner of Health
State Commissioner of Agriculture
State Commissioner of Information
State Commissioner of Local
Governments




Commandants of Military formations in
the States
State Commissioner of Police
Director of State Security Services
State Commandant of the Civil Defence
and Security Corps.
57. At the onset of avian influenza outbreaks, and separately at the onset of a human influenza
pandemic, the State Governor will convene a meeting of the State Executive Council,
Chairmen of Local Government Areas and Traditional Rulers and issue directives in
accordance with the Integrated National Avian and Pandemic Influenza Plan as it applies to
the States. The State should give support to local pandemic containment and mitigation
activities.
Local government
58. At the onset of avian influenza outbreaks, and of a human influenza pandemic, the Chairman
of the Local Government shall mobilise the Local Government Executive Council. The
community, the traditional rulers, opinion and religious leaders will collectively activate and
support the response. This will include supporting pandemic containment and mitigation
activities proposed in this Plan for implementation by Local Government Authorities and in
the community.
18
59. At the local level, the objectives in avian influenza and human pandemic influenza response
include to strengthen the roles of civil society and private sectors in prevention and control
of disease outbreaks, based: on promoting coordination between the small-scale farmers and
those in the concerned occupations; developing a network of volunteers to monitor and
control disease outbreak in the community; and developing effective public communications
at all levels for diverse stakeholders.
Mr President
Minister of
Agriculture
State M of Ag
Veterinary
Teaching
Hospitals
LGA Ag Dept
Minister of
Defence
National
Veterinary
Research
Institute
Armed Forces
Inspector
General
of Police
Civil Defence
Corps
Minister of
Health
State Police
Formation
Specialist &
Teaching
Hospitals
LGA Police
Formation
State M of
Health
Director General
Of NEMA
Research
Institutes
and
Laboratories
NEMA State
Offices
Minister of
Information &
Communication
Federal
Information
Centres
State
Information
Commissioner
State General &
Specialist
Hospitals
LGA
Information
Offices
LGA Health
Depts
LGA Health
Centres
Figure 1. An outline of the Federal, State and Local Government structure
Roles and responsibilities at Federal, State, and Local Government levels
60. Avian influenza control and pandemic influenza preparedness in Nigeria require well-
coordinated action. The leading body in the planning and command hierarchy is a Multisectoral Steering Committee which is Co-chaired by the Ministers of Health and Agriculture.
Other members include the Minister of Information, Minister of Environment, the Director
General of National Emergency Management Agency (NEMA), security agencies,
representatives of development partners, and representatives of the United Nations System
among others. The committee serves as the apex policy-making body for the preparedness
and response. The details of the preparedness and response are handled by a Technical
Committee which is co-chaired by the Ministers of State, Agriculture and Health. It draws
membership from Ministries of Health, Agriculture and Information. Others include
development partners, the UN system, academic institutions and the private sector.
19
61. The primary implementation agencies of the control and preparedness are the Ministries of
Health, Agriculture, and Information and Communication collectively under the supervision
of the Technical Committee. The general awareness creation, health promotion and social
mobilisation aspects of the plan are handled by the Ministry of Information.
62. The existing structure at state level is similar to that obtained at the national level with a
Steering committee at the apex overseeing a Technical Committee, which in turn oversees
the avian influenza activities of the State Ministries of Agriculture, Health, and Information.
63. The various local governments in each state have Technical Committees which support the
local government departments.
64. The following sectors and agencies have been assigned roles and responsibilities in support
of the national response to avian influenza and a human influenza pandemic.
Agriculture Sector
65. The sector is expected to carry out the following:
Federal level
66. The Director FDL&PCS coordinates surveillance, laboratory testing, and response regarding
influenza illness in poultry and other potentially at-risk livestock, domesticated or exotic
animals that continue to present a threat to human health and the animal population.
67. In collaboration with NVRI Vom, the FDL&PCS provides laboratory technicians to support
clinical analysis operations; activates communication protocol for early notification of the
health and information sectors of any unusual zoonoses that may continue to present a threat
to humans or animals; oversees and/or implements destruction and safe disposal of livestock,
domesticated or exotic animals that may be required to protect human health and the animal
population; establishes and strengthens quarantine facilities and movement controls; sets
restocking policies and guidelines; ensures prompt and adequate compensation of animal
owners as required; and monitors and evaluates the implementation of these measures.
State level
68. The State Director of Veterinary Services implements national plans and standard operating
procedures (SOPs); notifies the health sector and information sector at the state level of any
unusual zoonoses that may represent a threat to humans or animal population; continues with
depopulation, disposal and decontamination of livestock, domesticated or exotic that may be
required to protect the human and animal population; ensures compliance with strict biosecurity measures at infected and non-infected farms and animal markets; and ensures
availability of equipment and materials needed by the various teams, where necessary with
support from NEMA and its State-level counterparts.
Local Government Level
69. The Local Government Veterinary Officer (LGVO) liaises with the community; collaborates
with the Local Government health and information officers to exchange information; and
undertakes disease surveillance and reporting. LGVOs are not available in many LGAs.
20
Health Sector
70. The health sector will serve as the hub for a coordinated medical response to avian influenza
in people and to a human influenza pandemic. In a human influenza pandemic, the sector
will be responsible for the following actions.
Federal Level
71. The Honourable Minister of Health in consultation with the steering committee and WHO
will advise Mr President to declare a state of public health emergency in the country. Mr.
President will activate the Avian and Pandemic Influenza Preparedness and Control Centre
(APIP&CC).
State Level
72. The State Governor, following declaration of a public health emergency by Mr President,
will activate the State Avian and Pandemic Influenza Preparedness and Control Centre
(APIP&CC). The state may issue orders for enforcement and monitoring of communitybased isolation, quarantine and other social distancing measures. The State will implement
contingency plans to maintain provision of essential services and vital supplies.
Local Government Health Departments and Health Care Providers
73. Local health departments are responsible for community-wide influenza preparedness
activities. Specific activities of the local health department staff will include distributing
available medical treatment and vaccine to public and private providers across the
community; implementing surveillance and outbreak control; investigate outbreaks; and
provide educational and motivational resources through community engagement.
Information and communications sector
74. During a human influenza pandemic, the information sector will ensure effective



coordination of all information and communication activities at Federal, State and
LGA/community levels.
Federal Level: The National Reference laboratories and Health Research Institutes in the
country will participate in the monitoring of the circulating strain of the virus and sharing the
information generated with Steering the Committee. These centres will collaborate with
local and international partners to ensure access to ‘state-of-the-art’ technology for the
control of the virus.
State Level: The States should collaborate with animal and human avian influenza
diagnostic laboratories in the areas of diagnostics through strengthening of their various
laboratories and also the collection of samples from affected poultry and humans
LGA Level: The LGAs should report promptly any suspected cases of die-offs and any
human case meeting the WHO case definition for AI to enable immediate response from the
laboratories
21
Federal Level
75. The Federal Minister of Information and Communications will oversee commitment and
support for communication services (mass media and community and household level
behaviour change communication) and work to retain the confidence of interested partners.
He or she will also serve as the official spokesperson of the APIP&CC. He or she will serve
as a member of the National Response Team and act to facilitate mobilisation of the mass
media for public information; use of private and traditional media channels to support
influenza information flow; maintain contact with and brief the foreign media on the state of
an influenza pandemic in the country; issue frequent news bulletins and situation reports on
the pandemic; and regularly up-date the dedicated influenza website. Also provide oversight
for high level advocacy among policy makers and community level communication to
engage community leaders and influencers in addressing knowledge gaps, and inappropriate
attitudes and practices.
State level
76. State Commissioners of Information will work with all sectors to ensure the coordinated
implementation of all communication activities (mass media and community level) and will
serve as the official spokespersons of the State APIP&CC; develop and distribute messages
and communication products to critical media actors and the public; engage with and provide
relevant information to the media on pandemic influenza; mobilise and brief state level
media institutions on pandemic influenza in the state; prepare and issue daily pandemic updates from the State APIP&CC. Establish partnerships with civil society organisations to
ensure a broad base of networks are available to reach all categories of the society.
LGA and community level
77. Local Government will disseminate simple guidelines for collecting and reporting public
concerns, questions, perceptions, constraints, attitudes and related information to guide
message content; and engage with identified community leaders who may be able to give
hope and encouragement to the public; and will distribute IEC materials to community
animators, health educators and influential target groups; coordinate with the health sector to
empower town announcers to disseminate messages. Take the lead in building an alliance
with local community-based organisations and traditional institutions to ensure community
ownership and appraisal of their situation and the identification of the most appropriate steps
to address the identified challenges. Also to ensure remote communities are reached.
The role of the National and State Emergency Management Agencies
78. National Emergency Management Agency (NEMA) is the statutory body established for
coordination of national emergency situations in the country. As a member of the National
APIP&CC, NEMA will perform the following activities: manage and coordinate the
logistical elements of the State's disaster response and recovery efforts; maintain a 24-hour
communications centre for communicating with emergency response personnel from all
agencies and organisations; support overall State efforts involving the collection, analysis,
planning, reporting, and displaying of information; provide logistical and resource
operations with the assistance of the designated support agencies; allocate response
resources effectively and according to need; and monitor their location when in use.
22
79. State Emergency Management Agency (SEMA) will perform similar activities at State level.
At the local Government level, Local Government Emergency Management Committee will
perform similar functions.
The Armed forces and other Security Agencies
80. In the early stages of pandemic emergence, the efforts of Government may be overwhelmed.
It is envisaged that the armed forces, security agencies, and paramilitary forces (customs,
immigration and prison officers) may be called upon to support pandemic containment
activities at their source. They will then be called upon to provide vehicles, aircraft and
operators to move personnel, equipment and supplies, as requested by the APIP&CC;
provide logistical support and air/ground transportation of disaster relief supplies, personnel
and equipment; provide personnel and equipment for triage and emergency medical care and
portable medical aid stations; provide space, as available to serve as resource staging areas;
and provide/and or coordinate traffic control and expedited routing for supply missions or
personnel movements.
The Nongovernmental and Volunteer Organisations (NGO)
81. NGOs collaborate with first responders, Federal, State, local government and community
levels. They will provide relief services to sustain life, reduce physical and emotional
distress, and promote recovery of disaster victims.
The Private Sector
82. Private veterinarians and health care workers play an important role in disease surveillance
and reporting. The Government will seek to strengthen the role of the private sector in
prevention and control of disease outbreaks by promoting coordination between small and
medium sized enterprises and those in concerned occupations; developing voluntary
networks to monitor and control disease outbreaks in the community; developing effective
public communications at all levels for diverse stakeholders; and promoting ethical conduct
including adherence to registration and licensing requirements. In the context of a human
influenza pandemic, Government will also enable all private sector critical personnel
necessary for the maintenance of essential services and vital supplies to be mobilised to
support disease containment and mitigation activities.
The International and Development Partners
83. In accordance with the International Health Regulations, the World Health Organisation will
formally declare the existence of a global influenza pandemic. The international and
development partners will provide technical and material support to Nigeria according to the
evolving situation.
Mechanisms for coordination across sectors and across tiers of Government
84. An important aim of this Plan is to ensure efficient and united mechanisms for coordinating
the management of avian influenza problems in poultry and people, and for addressing a
human influenza pandemic. For avian influenza outbreaks these mechanisms are based on a
national level committee and national level operations centre, and on management systems at
23
local levels which will be enhanced. In association with these mechanisms, robust methods
are needed to manage outbreak information flows.
85. Coordination across tiers of government is essential to coherent implementation of response
plans among the States and Local Government Authorities. Innovative mechanisms may be
needed to secure this objective.
86. Government structures at Federal, State and Local Government Area levels pose major
challenges for efficiently coordinating policy and operations across tiers and across sectors.
There is an added inter-governmental dimension to planning and plan implementation issues
for infectious disease prevention and control at the regional level in the ECOWAS
community.
87. At Federal level, the current coordinating mechanism is the Multi-sectoral Steering
Committee, co-chaired by the Ministers of Health and Agriculture. There is ministerial
representation of the Federal Ministries of Information & Communications, Finance, Culture
& Tourism, Science & Technology, Environment, Foreign Affairs, and Education. The
Director General of National Emergency Management Agency (NEMA), and the State
Security Service are also members. The Steering Committee includes representatives of
development partners, the UN system, academic institutions and the private sector. The
Steering Committee serves as the main policy-making body for avian and pandemic
influenza preparedness and response.
88. The technical elements of preparedness and response are handled at Federal level by a
Technical Committee co-chaired by the Ministers of State for Agriculture and Health. Its
membership includes representatives of the Ministries of Health, Agriculture, and
Information, and of development partners, the UN system, academic institutions and the
private sector.
89. The Federal Public Enlightenment Committee (FPEC), also termed the Communications
Committee, coordinates the development and implementation of an integrated
communications strategy and action plan. The FPEC is chaired by the Federal Minister of
Information and Communications. Its membership includes representatives of the Ministries
of Health and Agriculture, NEMA, Development Partners, the UN system, and the private
sector.
90. The existing structures at State level are similar to those at the Federal level in that there is a
Steering Committee at the top which oversees a Technical Committee and a State Public
Enlightenment Committee, which in turn oversee the activities of the State Ministries of
Agriculture, Health, and Information. At the Local Government level in each state there are
Technical Committees which support the local government departments.
91. At the community level, community representation in decision-making, communication and
advocacy is critical. Care must be taken to avoid entanglement with community politics and
reification of power centres which may be, or have been, on the verge of losing community
credibility. In urban areas, where traditional ruler-ship and kinship ties are weak, ad hoc
organisations like “landlord associations”, professional organisations, community
development and social clubs are veritable channels of community communication and
mobilisation.
24
92. Avian influenza and human influenza pandemics may affect non-health sectors including
provision of essential services, vital supplies, financial systems, security, governance and
other non-health sectors of the economy and society including international relations. Wellcoordinated participation of all sectors in formulating and implementing the response to
these threats is therefore of great importance, both nationally and internationally. This is
recognised in the Libreville Declaration of March 22nd 2006, the final communiqué of the
ECOWAS meeting in Abuja on 23rd June 2006, and at global level by the Bamako
Declaration of 7th December 2006.
93. In order to strengthen existing coordination of strategic policy-making at Federal and State
levels, to support consistency in policy implementation at all levels, and to ensure that policy
addresses the wider non-health (economic and social) consequences in addition to the
specific health-related causes and impacts of avian and pandemic influenza, the Federal
Government will appoint a senior official to be a strategically independent and non-political
national coordinator for avian and pandemic influenza. The national coordinator will
strengthen the coordinating authority of the existing inter-ministerial committees and
agencies for avian and pandemic influenza which will be retained in accord with the
organisational diagram below. The national coordinator will be based at the APIP&CC (see
paragraph 51).
94. The terms of reference of the coordinator will be designed specifically to focus on
coordination and cooperation across all sectors, across tiers of government, and in relation to
external partners. The national coordinator will be independent of the professional sectors
directly involved in the avian and pandemic influenza response, will be non-political, and
will have a strong commitment to the coherence of the organised response to crises such as
avian and pandemic influenza and to the community for which the response is implemented1.
95. The national coordinator will have authority from and be responsible to the Presidency, and
will have the designated status of National Coordinator on Avian and Pandemic Influenza. In
the absence of Ministers, the National Coordinator will chair the National Influenza Steering
Committee.
96. The equivalent appointment at State level will be a new State Coordinator on Avian and
Pandemic Influenza with terms of reference designed specifically to complement those of the
National Coordinator, and to enhance coordination between tiers of government.
97. The place of the coordinators in relation to the existing committee structures of Government
is indicated in the diagram below.
A similar role is described as a “Hubmaster” and is fully expounded by M. Granatt and A. Paré-Chamontin
“Cooperative structures and critical functions to deliver resilience within network society” International journal of
emergency management 2006, 3 (1), 52-57.
1
25
Federal
Steering Committee
Federal public
enlightenment
committee
Technical
committee
Federal executive ministries
State-level Steering
Committees
State public
enlightenment
committees
National Coordinator
State-level
independent coordinators
Technical
committees
State executive ministries
Local Government
AHI Committee
Local executive departments
26
CHAPTER 4. AVIAN INFLUENZA PREVENTION AND CONTROL
Surveillance and detection
98. The objectives of this strategy are rapidly to detect and control outbreaks of avian influenza
in poultry and closely to follow up on the changing situation. The measures will include:
establishing a viable epidemio-surveillance and laboratory network to undertake disease
surveillance and control in animals through proactive surveillance measures; ensuring
disease outbreak reporting within 12 hours; culling infected animals and destroying their
carcases; disinfecting farms; and restricting the movement of animals.
99. These measures are designed to help prevent emergence of a human influenza pandemic







from avian influenza in poultry. In addition, in order to prevent the spread and reintroduction of avian influenza to the country, the Government of Nigeria will:
Ban import of poultry and poultry products from countries where HPAI is known to exist.
Enforce the requirement for import permits for poultry and poultry products issued by the
FDLPCS.
Enhance animal disease surveillance in high risk areas such as poultry markets, wet lands,
and among poultry located along known migratory bird fly ways, poultry abattoirs, and
targeted farms.
Develop a traceability mechanism for animals with strict monitoring of movement of poultry
and poultry products through registration and licensing of poultry farms, hatcheries and other
poultry enterprises.
Enhance National Veterinary Quarantine Services (NVQS) by rehabilitating and revitalising
existing veterinary quarantine infrastructure, control posts and manpower capabilities.
Promote targeted community-based training of rural backyard poultry farmers in HPAI
recognition and control including bio-security procedures for small-scale poultry enterprises
and the role of animal disease surveillance agents.
Develop a community-based, participatory rural livestock and poultry disease surveillance
system and integrate it into the existing epidemio-surveillance network.
National Animal Disease Surveillance and Information system
A national animal disease surveillance system has been developed by the Pan-African
Programme for the Control of Epizootics (PACE) project. Under the PACE, an active
epidemio-surveillance network has been established with trained agents located at 170
surveillance points all over the country including livestock markets, control posts and
abattoirs (see map below). The project has also enhanced and streamlined passive
surveillance disease reporting through state veterinary services.
100.
In addition, 109 National Special Programme for Food Security (NSPFS) animal health
service providers, mainly para-veterinary and some professional veterinarians one at each
site are involved in disease surveillance and reporting. These networks are involved in HPAI
surveillance and reporting. Government will seek to increase the capacities and active
collaboration of these reporting systems, including through enhancement of the NSPFS’s
animal diseases and trans-boundary pest control programme.
101.
27
Figure 2. Map of Nigeria showing the locations of the NADIS epidemio-surveillance agents
Avian Influenza Disease Surveillance
Active avian influenza disease surveillance is being carried out in the 36 states of the
Federation and the FCT. Disease data as well as samples for laboratory diagnosis are being
collected from selected commercial farms, live bird markets and villages chosen using
explicit survey criteria.
102.
The survey is designed to be carried out using the structure of the PACE National
Animal Disease Information and Surveillance (NADIS) system, which has been effectively
used in rinderpest surveillance in the country. Subject to further consideration, the overall
coordination of active disease surveillance would be handled by the FAO/PACE
Headquarters in Abuja.
103.
In addition to the existing nationwide PACE Zonal/Desk-officers, veterinarians from the
Federal and State services, VTHs, NVRI as well as private veterinarians are involved in the
avian influenza active disease surveillance. Active surveillance teams comprise four
technical support staff (PACE/FDLPCS, State veterinary departments, VTH and private
veterinarians) per state for states with no reported outbreak and 2 teams for states with
confirmed outbreak. The country is zoned into those states where to date no avian influenza
outbreak has been reported and other states where this has been documented. A separate
team carries out surveillance within a radius of 1 km of farms from where outbreaks have
been reported while another carries out surveillance in other parts of the state.
104.
The active disease surveillance is being jointly carried out by the FDL&PCS and the
FAO with funding from the EU and USAID. Although this is currently a “one-off” exercise,
Government will establish active avian influenza disease surveillance on a sustainable basis.
105.
28
The NVRI, Veterinary Teaching Hospitals (VTHs) at Zaria, Ibadan, Maiduguri, Nsukka
and Sokoto will undertake diagnosis of HPAI. Each of these laboratories will in due course
be able to carry out screening direct antigen detection tests, immuno-fluorescent and
serological tests for antibody detection.
106.
The NVRI is able to carry out virus isolation, identification and characterisation.
Samples will normally be sent to the Regional and World Reference laboratories for HPAI
as part of the prescribed global laboratory network for HPAI diagnosis and control. There is
need for synergy between the Ministries of Agriculture, Health and Science and Technology
particularly with respect to advanced molecular genetic diagnostics. At National, State and
LGA levels public and private laboratories with the capability to conduct tests will be
supported and assisted under strict supervision and will be subject to existing bio-safety
regulation in accord with international standards. The Government is studying the prospects
for a Technical Cooperation Project (TCP) to enhance the existing HPAI diagnostic capacity
with the support of the FAO, WHO, IAEA and OIE.
107.
The existing surveillance and detection arrangements could be improved by training
Community Animal Health Workers (CAHW) and Community Leaders in surveillance and
the implementation of bio-security in the backyard/rural production system. The expansion
of CAHW will facilitate the enhancement of surveillance points from the present number of
170, perhaps to reach 5000 points which may then be aligned with the existing 5038 Disease
Surveillance and Notification Officers in the human health sector. On a model implemented
successfully for avian influenza in Thailand, the CAHWs could plan and supervise cleaning
days at regular intervals for the bio-containment and bio-exclusion of the virus found in the
backyard/village poultry sector.
108.
There is a compelling need to operationalise Joint FMAWR/FMOH/FMOIC Avian
Influenza Surveillance and Control Operations so as to enhance the factors for success. The
Health Team will provide medical cover for veterinary operatives and will also have
opportunity to identify and monitor those who have been exposed through contact with
infected birds. Similarly, by participating at the frontline, the Communication Experts
(FPEC, SPEC and LPEC) are well placed to develop, present and manage messages which
are both appropriate and tailor-made for their audiences.
109.
Control and prevention
There are many challenges for bio-security in Nigeria. The structure of poultry industry
in Nigeria consists predominantly of backyard poultry with little or no bio-security, while
peri-urban and urban commercial poultry production has minimum to moderate bio-security.
The constant introduction of new birds from relatively unknown and unverifiable sources
adds to bio-security problems. The rearing together of flocks of different species compounds
the problem of controlling spread of infection between them. Livestock and poultry
movement within the country is poorly regulated in practice. There is close contact between
poultry and people. Poultry markets in general are not rigorously organised. Open live
poultry markets are characterised by inter-species mixing and poor sanitary conditions.
Poultry farms, hatcheries and other such establishments are not generally registered or
licensed as provided by law. Hence, early warning and rapid response capabilities are
inadequate. Most animal health workers and members of the public have limited experience
in recognition and diagnosis of HPAI. Facilities for disseminating information on HPAI and
other trans-boundary animal diseases (TADs) are currently weak.
110.
29
There has until recently been a limited policy to compensate livestock or flock owners in
the event that their animals are slaughtered to control disease. Carcase disposal facilities are
poor. There is a general lack of public awareness, sensitisation and social mobilisation
around HPAI control and prevention, and little understanding of its symptoms and potential
risks to the health and wellbeing of poultry and people.
111.
Against this background, Government’s policy on avian influenza control and prevention
rests on early detection of suspect cases and rapid response, compensation and restocking,
industry restructuring, communications, and the possibility of vaccination. These measures
are undertaken in accord with established standard operating procedures.
112.
Compensation and restocking
The Government policy on compensation payable to farmers whose birds are culled for
purposes of AI control is summarised below. The amount paid differs depending on the
species of birds that are depopulated.
113.
The compensation plan is aimed at encouraging prompt reporting of outbreaks by poultry
owners. Compensation may be either in cash or in kind in terms of assistance with
restocking and feeding of birds. Present experience has shown that the amounts initially paid
were not sufficient compared to market prices, and were generally not paid rapidly enough to
promote early outbreak reporting by farmers. Government has therefore with urgency
reviewed the current compensation scheme and revised the rates to reflect the cost of
production. The table below shows the initial and revised rates, which now vary with growth
status
114.
Initial and revised rates of compensation to owners of poultry
Species
Initial compensation paid per
animal (N)
Chickens (commercial)
250
Eggs (commercial)
Chickens (free ranging, rural)
250
Guinea fowl
250
Pigeons (fully grown)
250
Ducks and geese
1,000
Turkeys (local)
2,500
Emus
10,000
Ostriches
20,000
Ostrich eggs
Range of revised compensation rates paid
per animal depending on growth status (N)
350 to 1,500
15
100 to 750
100 to 500
250
100 to 700
300 to 1,600
15,000 to 100,000
4,000
NB: $ = N127
Responsible Organisation: Federal Ministry of Agriculture & Water Resources in
collaboration with the UN system, development partners and other stakeholders.
115.
Restocking will be undertaken after a period of 3 months provided decontamination has
been carried out according to the standard operating procedures and affected farms have
been devoid of live birds and free of active infection during the period. In addition,
restocking is subject to the minimum required bio-security measures being introduced to
such farms and verified by the State veterinary services. It is envisaged that the animal health
services at both Federal and State levels will assist farmers with identification of reliable and
safe sources of replacement stock.
116.
30
Responsible Organisation: The Federal Ministry of Agriculture & Water Resources and
their state counterpart are charged with the responsibility of approving restocking of farms
following adequate assessment.
117.
Restructuring of poultry production
The Nigerian poultry industry has been a major source of agricultural growth because of
its rapid expansion during the last three or more decades. Beef accounts for almost 50% of
the national meat supplies; and the poultry industry has played a stabilizing role in
maintaining demand-supply equilibrium for animal protein. Unlike cattle, sheep, goats, and
pigs, poultry are produced in all Nigeria’s agro-ecological zones, and are widely accepted as
food. The expansion is largely attributable to adoption of modern technology, but the poultry
industry remains a major employer of agricultural labour and a source of livelihood to over 1
million farming families. Moreover, it has become a major point of entry into agriculture and
food production by the educated class.
118.
The existing structure
The poultry industry in Nigeria as in many other parts of Africa is largely based on
chickens. The structure of the industry consists predominantly of backyard or family poultry
which include scavenging free-range, village poultry with little or no bio-security. Other
forms of poultry which provide substantial source of animal protein and income are guinea
fowls, ducks, and turkeys which are reared around the homestead. Urban and peri-urban
semi-commercial production has minimum to moderate bio-security; and this system is
based on broilers and egg production to feed the urban markets. The average flock sizes for
semi-commercial production units are 500-10,000 birds. These all obtain their supply of dayold chicks from well-known breeding farms in Europe, USA, Israel and recently also from
parts of Asia.
119.
Large-scale commercial poultry production operates on farms that are usually vertically
or horizontally integrated with other allied businesses, and managed with state-of-the-art
equipment and operations. Here stockholdings run in excess of 50,000 – 200,000 birds.
These farms strive to provide their own feeds, process their broilers, and even breed and
hatch their own commercial day-old chicks while offering the excess to small farms.
120.
Since commercial poultry production began in Nigeria in the mid-1960s, many breeds
and strains have been imported without genetic evaluation or risk analysis. The integration
of turkeys and sometimes pig production on the same farm complex is a cause for some
concern over bio-security. Ornamental birds such as peacocks, pheasants, emus and ostriches
in homesteads and sometimes within poultry production units have also become fashionable
but extend the risks of close inter-species contact.
121.
To return to its pre-avian influenza position of strength, the industry must build on the
lessons learnt from tackling HPAI. Industry restructuring could make for a more bio-secure
system at all levels of production and marketing. Every effort must be made to mitigate the
risk factors for the spread and persistence of HPAI in Nigeria.
122.
31
The elements of restructuring
The main elements of restructuring include:
Enhancing bio-security in the backyard and family poultry production system. Currently this
system depends mainly on scavenging and free range with little or no investment in
purchased inputs. The bio-security of the system can be enhanced by providing targeted
production inputs for feeding and hygiene, as well as animal health/advisory services. The
Local Government Authorities should be encouraged to give leadership in this respect since
markets fall within their legislative list.
Segregation of poultry species. The emerging trend of mixed species production system must
be discouraged. Licensing poultry farms or markets to produce or trade one poultry species
of its choice would promote greater bio-security; and such a policy could apply in all
production systems and markets as a condition for licensing under the law.
Restructuring of mixed production systems. As in the segregation of poultry species, poultry
production units should be discouraged from integrating other animal production businesses
such as pigs, goats and sheep on the same farm or within close proximity. This condition
will be stipulated in the licensing of their business.
All-in and all-out production system. It is inadvisable to rear birds of different ages together.
It is good management practice to complete one production cycle, clean up /disinfect and
rest the unit, before restocking. This system of production is inherently highly bio-secure.
Most of the semi-commercial and large commercial operators are aware of this good
practice.
Enhancing bio-security in poultry markets. Apart from licensing poultry markets to do
business on only one species, the Local Government Authorities should be encouraged to
establish a system of market monitoring and surveillance, including veterinary services to
carry out ante-mortem and post-mortem inspection of poultry in the markets.
Improved transport of birds. In the long-run, to enhance bio-security, specialised vehicles for
poultry movements that can be easily cleaned and disinfected should be introduced. While it
will take time to shift the people’s tastes away from fresh poultry, efforts should be made to
provide mechanised custom/toll processing of poultry in the approved markets. This
arrangement will reduce to a greater extent the exposure of human to infection. The bird
markets need to enhance their bio-security regime.
123.






Communications strategies
Risky behaviour in the community is the target of all communication interventions for
control of avian influenza threats. Engaging community leaders and influencers as social
mobilisers is essential to disease containment at the farm and at the household levels.
124.
The Government of Nigeria through the Federal Ministry of Information and
Communications has initiated the Community Dialogue System (CDS). The system will
enhance an integrated approach to consultation and involvement at the community level. It
will do this by training community leaders in identifying risky behaviour, attitudes,
perceptions and beliefs among community members through participatory methods before,
during and after avian influenza outbreaks. It will seek also to integrate animal and human
surveillance teams at community level at all times.
125.
The findings of these interventions will be used to define or adjust communication
strategies. To facilitate this evidence-based and collaborative process, each PEC at LGA,
State and Federal level will maintain a data base available to stakeholders nationwide for
126.
32
emergency use or any other related activity. Databases should include contact details of
stakeholders.
The Federal Minister of Information and Communications is responsible for the response
in communication issues (mass media and behaviour change communication at community
level). The Ministry will therefore supervise, monitor and evaluate the communication action
plans. The Ministry will identify and determine the appropriate methods to be used, and will
prepare guidelines for dissemination at State and Local Government levels.
127.
The Community Dialogue System
The Community Dialogue System (CDS) is designed to engage both service providers
and community residents in appraising their situation and taking appropriate actions as well
as to nurture a culture in which appropriate bio-security and AI prevention behaviours are
seen as a sine qua non to the well being of families and the community. For quality
dialogues to take place, it is necessary to strengthen, create and train at least six core
members of SPECs and LPECs. The CDS is established as part of the Public Enlightenment
Committees at all levels. It is coordinated by the Federal PEC at national level. The system
allows LGA, State and Federal levels to collect, analyse and act upon information about
communities’ perceptions, knowledge, attitudes and practices regarding avian influenza and
a human influenza pandemic on a regular basis or as the situation requires. A manual of the
CDS system will be prepared by an immediate call from the Federal level to those SPECs
already trained and from high risk areas, jointly to finalize the manual as well as to identify
the flow of information that will allow all levels to be informed on a sustainable basis. CDS
has also been used extensively in polio. It is quite labour intensive. Information on
community perceptions etc could be more efficiently collected through a survey.
128.
The core roles within PECs of the CCP System (coordination, media liaison, training,
logistics, data management, and supervision and monitoring) should ensure that action plans
are implemented. Other positions may be added in each case as need arises. The core
members are representatives from:
Federal Ministry of Information and
 Ministry of Local Governments
Communications
 Poultry Association of Nigeria
National Orientation Agency
 PACE
Ministry of Health
 Community leader
Ministry of Agriculture
129.




Government will prepare an action plan to address short, medium and long term training
needs. This will need to include supervision and monitoring interventions intended to
strengthen the system at all levels in participatory methods for community dialogue, in-depth
interviews, observation methods, quantitative surveys and other methods that will facilitate
community thinking, education and behavioural change. Action plans will seek to ensure
that community members of LGA PECs are aware of and can engage with animal and
human health surveillance systems.
130.
Active surveillance will be highlighted in the manual for LGA level. Integrated response
teams are generally intended to intervene each in relation to their respective field (human
health, animal health, and the community). In terms of passive surveillance, community
leaders and members of LGA PEC will need to agree on participation in the system; for
example, community members would support passive surveillance by regular visits to health
facilities.
131.
33
A training manual is being prepared and will be disseminated. A LGA level manual must
be finalised in a joint effort with community leaders. At the State level, schedules for all
electronic media (radio and television) will be needed so that every broadcast programme
has the opportunity to contribute in the short, medium and long term. This mechanism will
engage imams, pastors, and priests who have a morning or evening prayer, young boys
handling music programmes, agricultural programmes, educational programmes and other
offerings.
132.
Mass media campaigns and news
Government will propose a national media plan to improve quality in reporting. This
could include a monthly breakfast for up-dates and continuing sensitisation with editors and
specialist reporters. On a regular basis, the honourable Minister of Information and
Communication will hold a high level consultation with media executives and proprietors.
133.
A weekly situation report will be disseminated among all journalists trained in avian and
pandemic influenza, and to the media in general, in a sustained and transparent manner
including through the web-site of the Federal Ministry of Information and Communications.
134.
Poultry vaccination strategies
Poultry vaccination against HPAI in Nigeria will be considered only if the present
strategy of stamping out fails to contain the disease. At present it is illegal to bring HPAI
vaccines into the country. Current HPAI vaccines pose a range of challenges for mass
immunisation and for disease control. Some poultry vaccines enable vaccinated and
unvaccinated birds to be distinguished (the DIVA strategy) but do not completely prevent
persistence of H5N1 virus in bird populations. Therefore if these vaccines are used, sentinel
(unvaccinated) birds may also be needed to enhance H5N1 detection in flocks of otherwise
vaccinated poultry. The current plan accommodates the use of HPAI vaccines in poultry
only when the disease is enzootic.
135.
Where modified culling (“stamping out”) fails to contain HPAI outbreaks, ring or mass
vaccination of poultry, as the case may be, would accompany the following actions as part of
a comprehensive control strategy: movement restriction of poultry and poultry products;
depopulation of clinically infected farms with payment of compensation; sanitary disposal of
dead and destroyed poultry and contaminated poultry products according to standard
operating procedures; disinfection and decontamination of affected premises according to the
standard operating procedures; active disease surveillance to determine the source and extent
of the infection; and effective inter-personal communication and public awareness
campaigns to elicit cooperation from large scale commercial and back yard poultry owners.
136.
Responsible Organisation: The decision to commence vaccination would be taken by the
Federal Ministry of Agriculture & Water Resources.
137.
Ethics
Culling as a measure to control epizootic disease is widely recognised and accepted. In
Nigeria, the ethical basis for this activity is rooted in virtue-ethics and natural law ethics. For
most people, disease reporting to limit the spread of infection and to protect others is
considered virtuous and God’s will. The public readily acknowledge the necessity and
138.
34
effectiveness of culling, and that it is proportionate when associated with timely, accessible
and competitive rates of compensation and with re-stocking to prevent loss of social and
economic value of rural poultry farming.
Culling, compensation and re-stocking may disproportionately affect women and young
people who keep backyard poultry. These groups are less likely to claim compensation than
are men, and not being household “heads” they may not be perceived as appropriate
recipients. This problem may affect many rural Nigerians, particularly in the North. This
factor must be considered in the design and implementation of compensation programmes.
139.
Adequate attempts must be made to establish ownership of birds by giving opportunity to
women and children to make claims. Deployment of female field workers in certain parts of
the country may facilitate this. Every effort must be made to prevent impoverishment of
vulnerable women and children.
140.
Segregating poultry from pigs so as to reduce the risk of virus genetic reassortment may
be more practicable ethically in the commercial farming sector than in the community.
Piggery is confined to the Christian part of southern Nigeria. In the North, substantial
Christian communities live alongside Muslims but are culturally distinct from them. These
communities have historically experienced tensions and social disturbances. A public health
programme which indirectly suggests problems with pig farming is a potential flash point for
crisis in such communities. The avian influenza control measures should be implemented
with care and address the risk of disrupting inter-communal relations.
141.
In the medium to long term, educational initiatives may be needed to discourage illegal
but widely practised domestic poultry and pig farming in non-bio-secure conditions.
Enforcement of the law is not currently viable.
142.
Persistent use of foreign terms in communications material is likely to be considered
elitist and disrespectful of community knowledge and sensibilities leading to alienation.
Efforts must be made to respond promptly to all inquires, concerns, alarms and fears,
whether rational or irrational. Communication must be based on full and prompt disclosure.
143.
35
CHAPTER 5. HUMAN INFLUENZA PANDEMIC PREPAREDNESS IN THE INTERAND PRE-PANDEMIC PERIODS
Pandemic alert phases defined by the WHO and associated actions and implementers
PHASE
Phase 1
Phase 2
Phase 3
Phase 4
Phase 5
Phase 6
DEFINITION
POSSIBLE ACTIONS
Inter-pandemic period
No new influenza virus subtypes have been
Development of national
detected in humans. An influenza virus
Integrated Plan
subtype that has caused human infection
Surveillance & containment
may be present in animals. If present in
Public Awareness Creation
animals, the risk of human disease is
Training
considered to be low.
No new influenza virus subtypes have been
Surveillance & containment
detected in humans. However, a circulating
Public Sensitisation &
animal influenza virus subtype poses a
Education
substantial risk of human disease. This
Research & Development.
threat justifies public health measures to
protect persons at risk.
Pandemic alert period
Human infection with a new subtype, but no Surveillance & containment
human-human spread, or at most rare
Public Sensitisation &
instances of spread to a close contact.
Education
Nevertheless, with high tendency of
Research & Development.
mutation (a common characteristic of
influenza viruses), the virus may adapt or
re-assort to become transmissible from man
to man especially if it coincides with a
seasonal outbreak of influenza. Measures
are needed to detect and prevent spread of
the disease. This is the stage where the
world is now.
Small cluster(s) with limited human-tohuman transmission but spread is highly
Surveillance & containment
localised, suggesting that the virus is not
Public Sensitisation,
well adapted to humans.
Education & Mobilisation
Research & Development.
Clinical Management of Cases
IMPLEMENTERS
Where there are larger clusters but man to
Enhanced Surveillance &
man spread is still localised, suggesting that containment
the virus is becoming increasingly better
Public Sensitisation,
adapted to humans, but may not yet be fully Education & Mobilisation
transmissible (substantial pandemic risk).
Research & Development.
In view of possible delays in documenting
Clinical Management of Cases
spread of infection during pandemic phase
4, it is anticipated that there would be a low
threshold for progressing to phase 5.
Pandemic period
There is increased, sustained and efficient
Social Distancing; Quarantine
transmission in the general population. The
Isolation & Case Mgt; Antinational response at this stage is determined virals; Vaccination
primarily by the disease impact within the
Risk Communication &
country.
Management; Enlightenment,
Mobilisations
FMA&RD, FMOH,
SMOA, SMOH, LG
FMIC, SMOI, LG
All Sectors
Multi-sectoral
FMA&RD,FMOH,
SMOA, SMOH, LG
FMIC, SMOI, LG
All Sectors
FMA&RD, FMOH,
SMOA, SMOH, LG
FMIC, SMOI, LG
All Sectors
FMA&RD, FMOH,
SMOA, SMOH, LG
FMIC, SMOI, LG
All Sectors
FMA&RD, FMOH,
SMOA, SMOH, LG
FMIC, SMOI, LG
All Sectors
FMOH, SMOH, LG,
NEMA, Information
sector, Development
Partners, UN System,
Other Stakeholders
36
Surveillance and detection
A major element of human infectious disease control is an effective early warning and
rapid response system. Early detection of the potential source of a pandemic depends on the
ability to detect and track closely the spread of infection: this capability is critical to rapid
deployment of resources to contain virus spread.
144.
The Pandemic Influenza Surveillance Plan involves detection and characterisation of
circulating strains of human influenza virus, and provision of timely epidemiological
information, through passive and active surveillance methods. This information will be used
to guide the actions of public health officials during a pandemic. The pandemic surveillance
system will build upon the existing infectious disease surveillance infrastructure in the
country. In the short, medium and longer term intensive nationwide training is planned for
epidemiologists and other public health officials in Nigeria to strengthen the existing
surveillance system.
145.
Responsible Organisation: the Federal and state Ministries of Health, through their
epidemiological units are to take action for surveillance and early detection of human cases.
146.
Passive Surveillance
The strategy adopted for passive surveillance of human case of avian influenza is the
Integrated Disease Surveillance and Response (IDSR) which is already in place. Hitherto the
IDSR in Nigeria captures 21 notifiable diseases, with the advent of pandemic influenza
threat, avian influenza has been included. The system uses a framework that involves the
collation and reporting of the targeted disease by Disease Surveillance and Notification
Officers (DSNOs) located in all the Local Government Areas in 5,038 focal sites nationwide.
Community engagement is a critical means to support passive surveillance. The information
flows in the IDSR framework are shown in the diagram below. A reporting system for
Influenza-like-Illnesses (ILI) will be established and incorporated into the communicable
disease surveillance system and data base.
147.
Information flow for human AI cases
Suspected case of AI
Cluster of ILI in high risk group
Health facility
public/private
LGA fills contact
monitoring form
Immediate notification
(IDSR001)
LGA
Health Department
SMOH rapid response team fills case
investigation form
SMOH
Epidemiology Unit
Partners &
MOA
FMOH
Epidemiology Division
37
However, the relevant levels of Government involved in the existing IDSR need to be
strengthened. There may be a case for taking short term measures to address lack of
commitment and failure to live up to one’s responsibilities, for example through workshops,
seminars and conferences across the country.
148.
Active Surveillance
In addition to passive surveillance for human case of AI, the DSNOs are to be involved
in active case search in their domains. A national Rapid Response Team (RRT) which
consists of epidemiologists, laboratory and public health personnel, environmental heath
officers and health promotion experts has been constituted. The same structure is expected to
be replicated at states and local government levels. The RRTs are to be engaged in active
surveillance in all communities and hospitals across the country, and to work closely with
the Ministry of Agriculture in tracking exposure to avian influenza in poultry.
149.
The active surveillance system will focus on detecting early warning signs of human
respiratory infection associated with unexplained or unusual mortality in commercial bird
flocks or animal herds; and unusual respiratory disease clusters or unusual/unexplained
mortality associated primarily with respiratory disease in people exposed to risk.
150.
Active surveillance also involves monitoring:
People involved in culling birds or animals infected with influenza.
Other people exposed to birds or animals infected with influenza, for example farmers and
veterinarians (single cases and/or clusters).
Health-care workers caring for patients with suspected or confirmed avian or pandemic
influenza infection (single cases and/or clusters).
Laboratory workers handling clinical specimens from patients with suspected or confirmed
pandemic strain influenza infection (single cases and/or clusters).
Mortuary room workers.
151.





152. Responsible Organisation: The office of the Director of special Duties of the federal
Ministry of health is charged with this responsibility in collaboration with UN system and
Development.
Capacity building and inter-ministerial collaboration
153. Further gradual development of manpower and institutional capacity building should
address avian and human pandemic influenza surveillance needs over a longer timescale of
3-5 years. There are also immediate short-term training needs. DSNOs will be trained
nationwide within the next 6 months. All State epidemiologists will undergo training on
avian influenza surveillance and detection within the next 1 year. The Avian and Pandemic
Influenza Preparedness and Control Centre (APIP&CC) will host all avian influenza
surveillance training. This training is intended to equip all DSNOs and State epidemiologists
with a sound knowledge of avian influenza surveillance in people. It will also include
training sessions led by veterinary experts to ensure familiarity with those HPAI symptoms
in poultry which could lead health professionals to anticipate and detect cases of human
infection.
154. At the Local Government level, the Departments of Health and Agriculture will establish
a joint surveillance team to ensure that avian influenza in birds and in people is jointly and
closely monitored. Surveillance information would readily be exchanged between these
38
sectors. The public enlightenment units of the LGA will be involved in community
communication issues. Participatory communication will be encouraged through the CDS.
155. A similar collaboration will be established between the States and Federal Ministries of
Health and Agriculture, with the Ministry of Information taking a cross-sectoral bridging
role.
156. Laboratory support centres for the prompt diagnosis of avian influenza in people will be
established in each of the six geopolitical zones of the country. These laboratories would
work closely with the National Institute for Human Virology in Abuja, and with the National
Veterinary Research Institute in Vom.
157. Intensified surveillance will be carried out when a reported signal is confirmed to be an
influenza alert requiring immediate interventions. Surveillance activities will also be
intensified immediately within the initial outbreak zone. The surrounding area, and the
geographically at ‘risk areas’, will also intensify their surveillance and remain on alert for
possible introduction of the virus. Within the outbreak zone, enhanced detection and
reporting of individual cases and clusters of human-to-human transmission will be achieved
through institution of active surveillance to identify all potential cases and those for which
there is increased diagnostic suspicion.
IDSR net System
158. The Government intends in the medium term to develop and implement a replicable and
scaleable electronic Integrated Disease Surveillance & Response system (IDSRnet) to help
Nigeria combat avian influenza. To be designed and implemented through close
collaboration between the Federal Ministries of Health, Agriculture and Water Resources,
and Information and Communication this system should strengthen Nigeria’s existing
communicable and zoonotic disease control efforts on a sustainable basis.
159. The IDSRnet system is intended for use by human and animal health facilities at local,
LGA, State and Federal levels. It will allow human and animal health workers at the facility
and LGA levels to report data into the system using multiple information technologies
including mobile telephones using SMS, PDAs, and PCs via the World Wide Web. Once
entered into the system, the data will be accessible via the Internet to authorised users at the
LGA, State and National Levels. They will be able to see the data mapped in real time
through interactive GIS maps, to view automatically generated charts and graphs of the data,
and to send summary reports. The system will support:
 Routine Monthly Disease Reporting
 Supervisory visit
 Weekly Disease Reporting
 Emergency Disease Reporting (including AI)
 Reporting and Dissemination of Lab Results
 Data access, mapping and analysis at LGA, State and National Levels
 Automated SMS alerting of key events.
 Broadcast SMS messages to the field
 Data access from the field via SMS
 Information sharing and data exchange with major stakeholders
39
160. The System will be managed at the national level but it will be deployed so as to make it
an effective tool for supporting disease surveillance at the State and LGA levels. The
conceptual structure of the system is shown in the diagram below.
National
Surv.Unit
IDSRnet
System
State
Surv.Unit
LGA
Surv.Unit
Labs
Health Facilities
161.
IDSRnet will allow for reporting both case and aggregate case numbers. When
emergency reports are submitted, the system will automatically notify the Surveillance
Officers at the LGA and State levels as well as the National Surveillance Unit and the
appropriate laboratory. Once the corresponding samples have been tested, the laboratory
technician will be able to update the case record as confirmed or not. The results can then be
sent automatically back to the notifying facility and LGA Surveillance Officer. The system
will also allow supervisors at National, State and LGA levels to send broadcast SMS
messages back to the field to coordinate the response. This system will also facilitate the
exchange of data with other stakeholders. Subject to further feasibility planning,
Government will determine the earliest practicable time scale over which such a system
could be put in place and made operational.
162. Responsible Organisation: The Focal persons at LGA Focal sites, State Ministry of
Health and Federal Ministry of Health; LGA, State, and Federal Veterinary Services.
Communications strategies
163. Following the first human case confirmed in Lagos in January 2007, an integrated
communications mission researched fears, perceptions, attitudes, and practices among
stakeholders in markets and at hospital. The findings of this exercise suggested a need to
plan for continuous supervision, simulation exercises, and promotion of good hygiene, and
bio-security and related behaviour through interpersonal communication approaches.
40
164. The Federal Ministry of Information and Communications has in place a Community
Dialogue System (CDS) as well as a defined media strategy. Its role in preparedness will
also focus on strengthening the capacities at the community level with the involvement of
the national and state media at all times. The CDS manual will contain specific guidance on
how to proceed with avian influenza, pre-pandemic preparedness, pandemic containment and
pandemic mitigation. This manual will be prepared by a team of communicators from FMIC,
UNICEF and other partners.
Advocacy
165. At the Federal level, the Minister of Information and Communication will have monthly
review meetings with Minister of Special Duties and Intergovernmental Relations. There
may also be regular review meetings with media executives and with development partners.
Communication for Behavioural Change:
166. During the initial phase of a pandemic, Government will use varied methods of
community participation in order to address issues such as social distancing, management of
the dead, contact tracing, and other aspects of policies likely to affect livelihoods. These
methods would include interviews, surveys, community dialogue, observation exercises, and
religious meetings as part of a concerted drive to promote shared priority actions by wellinformed communities.
167. Communities will be mobilised through their leaders to carry out observation activities,
in-depth interviews for simulation exercises, and with affected partners where appropriate, as
well as to prepare actions for a well-informed community in search of common urgent
actions to be taken. Guidelines for each situation need to be tested and disseminated and are
expected to be shared at all levels in the two days after a human case has been confirmed.
168. Coordination mechanisms should ensure that all groups implement the plan, and that
Federal integrated teams will oversee the State level activity and preparedness. In the short,
medium and long term, training and supervision will build further capacities and skills.
169. Non-news media will urgently intensify interventions in State radio and television
programmes.
Mass media campaigns and news
170. The State PEC with support from Federal level will guide media intervention when
human cases occur at the onset of a potential pandemic. State PECs should be able to
propose to news outlets audio, audio-visual, or visual materials appropriate to their local
cultural context. Target groups may need specific materials such as notebooks with covers
containing contact details; advice on behaviour being promoted at the farm and household
levels, and for staff in health facilities, markets, religious places and elsewhere. Stories
regarding well-adjusted behaviour may also be contained in the news. Mass media
campaigns where required should be based on research findings of teams working within the
Community Dialogue System.
Standard operating procedures
41
171. Immediately on suspicion of a case, the health facility will report suspicions to the public
health unit for investigation at the LGA level. The LGA Health Desk Officer informed of the
suspect case will immediately inform the LGA Desk Officers of Animal Health and
Information. The information team will then report the findings to the community leader.
The community leader may call a community meeting to provide information about the case.
172. The State PEC should meet to review the situation and allocate tasks and responsibilities.
The SPEC should notify the Federal level about recommended actions at State level. These
actions may include media messages on preventative measures and household care, and
intensified information exchange with community and religious leaders.
42
CHAPTER 6. HUMAN INFLUENZA PANDEMIC CONTAINMENT, MITIGATION,
AND RECOVERY
Pandemic planning assumptions about scale and severity
173. The scale of a future pandemic cannot be predicted with certainty. However it is
important to state clearly the assumptions which underlie this plan. These assumptions are
that a pandemic is likely to cause illness in between 10% and 35% of the population; and
that of those who fall ill between 0.5% and 2.5% will die as a result. For the 2006 population
of Nigeria, the following table shows the numbers of ill and dead predicted from these
assumptions. Recent analysis of mortality and socio-economic inequality during the 1918-20
“Spanish” influenza pandemic suggests that a virus strain of similar severity could cause
around 2.3 million Nigerians to die (median estimate for the 2004 population of 128.7
million; with 10%-90% percentile range of from 1.1 million to 5.0 million)2.
Planning assumptions for pandemic cases and fatalities in Nigeria for the 2006 population of 140,003,542
Numbers of dead predicted at specified case fatality rates
Case Fatality Rate
Clinical attack rate (%)
Number ill
0.5%
1.0%
2.5%
10%
14,000,000
70,000
140,000
350,000
25%
35,000,000
175,000
350,000
875,000
35%
49,000,000
245,000
490,000
1,225,000
Surveillance and detection
174. It is clear that a virus with pandemic potential like avian influenza, presents a risk to the
global population. Once a signal of sustained and efficient human-to-human spread of the
virus has occurred within Nigeria, a cascade of response mechanisms will be initiated from
the site of the documented transmission to locations around the country. It then becomes
absolutely necessary to institute measures aimed at containing the disease so as to prevent its
spread. Speed is an essential attribute of a successful response at this stage. It should be
facilitated by an effective IDSR system and communications strategy now, and in the future
enhanced by the proposed IDSRnet.
Rapid response and containment
175. Based on WHO’s recommended protocol for rapid response and containment at source,
and on modelling studies of quarantine and other community-based measures for addressing
the risk of an emerging pandemic, the Government of Nigeria has considered a range of
social distancing measures to assist the initial rapid response to signs of an emerging
pandemic.
176. To contain the spread of a contagious illness, public health authorities rely on many
strategies. Two of these strategies are isolation and quarantine. Both are common practices
in control of communicable diseases, and both aim to control exposure to infected or
potentially infected persons. Both may be undertaken voluntarily or compelled by public
health authorities.
.
2
C.J.L. Murray, A.D. Lopez, B. Chin, D. Feehan, K.H. Hill. Estimation of potential global pandemic influenza
mortality on the basis of vital registry data from the 1918-20 pandemic: a quantitative analysis. The Lancet
2006:368:2211-18.
43
Quarantine and Isolation
177. Isolation applies to persons who are known to be infectious. Quarantine refers to the
separation and restriction of movement of persons who, while not ill, have been exposed to
an infectious agent and therefore may become infectious. Quarantine of exposed persons is a
public health strategy like isolation, in that it is intended to stop the spread of infectious
disease. Quarantine and isolation are effective ways to protect the public from disease.
Government is prepared to enforce, legally and operationally, individual and communitybased quarantine measures if warranted. The strategies include examination of the ethical
dimensions of enforced quarantine or compliance with other recommended measures [see
paragraphs 41-44].
178. Quarantine may be applied where exposure has occurred in a defined group of persons
as, for example, in a household setting, at the workplace or school, or at a well-defined and
circumscribed public gathering, or in a defined site or building (such as a hospital or an
apartment building). The quarantine may involve confinement at home or in a designed
facility with appropriate equipment.
179. A policy of isolation means that people who are known to be infectious will be separated
from those who are healthy and their movement will be restricted so as to stop the spread of
infection. This will allow focused delivery of specialised health care to the ill, and protect
others from infection. Isolation may take place in homes, in hospitals, or in designated
healthcare facilities. In implementing isolation measures, efforts will be made to ensure that
the isolation is voluntary. However, Federal, State and Local Government authorities have
the power to compel isolation of infectious people to protect the public.
180. Isolation and containment policy implementation will be supported by a participatory
community communication network established to ensure exchange of information between
the communities and the Government, and to address any related public concerns.
181. Responsible Organisation: Federal, State Ministries of Health and LGA health
departments in collaboration with Federal and State Ministries of Information and LGA
information units and other stakeholders.
182. In a pandemic containment phase, when there is a manageable number of cases, patients
may be hospitalised and managed in single rooms. When the number of cases exceeds
available number of rooms, patients may be grouped and managed in cohort isolation rooms
or in other designated facilities. Potential isolation facilities nationwide will be identified and
designated. The surge capacity of such facilities will be an important constraint on the
pandemic response. Existing and potential capacity will be documented.
183. Where a geographically defined containment zone applies, antiviral drugs will where
possible be given to treat cases of moderate-to-severe respiratory illness so as to reduce
morbidity, risk of hospitalisation, and mortality. Antiviral prophylaxis of case contacts could
help to reduce further spread in accord with the rapid response and containment protocol.
184. Once the reported signal is confirmed to be a pandemic influenza alert requiring
immediate intervention, surveillance activities will be intensified immediately within the
initial outbreak zone and the areas geographically at risk. A team of 3-5 health care workers
will be assigned to the outbreak zone (for an area with average population of 500 persons).
44
Information gathered from such intensified surveillance will be reported to the relevant LGA
department of health for further necessary action.
185. During investigation and response, contact tracing must be implemented to include the
identification of extended social networks and the travel history of all cases and close
contacts during the preceding period of up to 14 days. Contacts of cases will be traced and
followed up for evidence of respiratory illness for at least 7 days after the last contact.
186. Social distancing measures to be implemented will be determined by the extent and
severity of the pandemic. Such measures may include closing of schools and workplaces,
postponement or cancellation of mass gatherings, and advice against use of crowded mass
public transport. International border screening may be introduced.
187. Voluntary quarantine will be encouraged as a containment strategy where applicable.
Such quarantine measure will be applied using the principle of proportionality, whereby the
least restrictive measures are applied first, followed by a graded application of more
restrictive measures including enforced quarantine and isolation when evidence indicates
their necessity. Quarantine may involve confinement at home or in a designated facility.
Generally speaking, movement within a containment zone will be restricted and persons
inside the area will not be allowed to leave. The ethical dimensions of these measures need
to be considered.
Pandemic mitigation strategies
188. If containment at source fails, and an influenza pandemic spreads, then Government may
introduce wider social distancing measures in order to slow its rate of progression and to
mitigate its consequences.
189. Social distancing measures are an extension of the principles underlying isolation and
quarantine, and are intended to reduce risk of infection by reducing contact between people.
They comprise:
a. quarantine of areas in which someone is ill;
b. closing schools, other educational or residential institutions;
c. closing workplaces or encouraging “distance working”;
d. postponing, cancelling or discouraging mass gatherings including those of a religious,
cultural, commercial, or sporting nature;
e. advising against use of crowded mass transport facilities; and
f. Restricting movement within or between zones or countries in the region.
190. Combining measures could have consequences which are simply the sum of the separate
effects of each measure applied alone (“additive”), or such measures could interact and
positively reinforce each other so generating a greater impact (“synergistic”). Recent studies
suggest ways to combine such measures so as to contain a potentially pandemic virus at
source, and quite separately to mitigate the health impact of a pandemic should containment
fail. This plan proposes using WHO’s protocol for rapid response and containment at source
(see paragraphs 175-187), and in this section proposes social measures to mitigate a
pandemic. The potential value of social measures arises partly from the scarcity of anti-virals
and other medical counter-measures.
191. Uncertainty in the general value of social measures results from uncertainty in the
models which underlie them. If school or workplace closure does not significantly alter the
45
contact patterns among children and adults in the community, then closing schools or
workplaces would be unlikely to have any impact on the spread of infection in these groups.
Such measures might be justifiable on precautionary grounds and because they could ensure
that the steps taken to combat a pandemic would be seen as both reasonable and
proportionate. Government will therefore as a matter of urgency undertake modelling studies
and simulation exercises to assess alternative combinations of social measures which are
likely to be both feasible and proportionate for pandemic mitigation in the general
population of Nigeria.
192. Measures suggested by the resulting evidence may be recommended for use at Local
Government level on a voluntary basis under the conditions of a mild pandemic (low clinical
attack rate and low case fatality rate as defined in paragraph 173 on planning assumptions).
Subject to the available evidence, such measures are likely to combine case isolation,
household quarantine, and advice to limit movement between affected and unaffected
geographical areas.
193. In a moderate or severe pandemic (high clinical attack rate and low or high case fatality
rate as defined in paragraph 173 on planning assumptions), such measures may be advised or
imposed as general policy by Federal, State and Local Government Authorities acting jointly
at all levels. Subject to the available evidence, such measures are likely to include avoidance
of mass gatherings and crowded forms of transport.
194. Government will impose such measures where strict enforcement is operationally
feasible, proportionate to the risks, and there is evidence that they are likely to be effective.
195. Under exceptional circumstances of severe localised outbreaks, Government may enforce
restriction of movement between affected and unaffected geographical zones where this is
operationally feasible, and where “restriction” is defined to include mandatory screening for
symptoms of infection at affected zone exit and may also extend to quarantine.
196. At international borders and following agreement with other ECOWAS Member States,
Government may implement exit screening in accordance with the International Health
Regulations.
197. To enable the ethical implementation and enforcement of such measures, Government
will introduce a legislative framework in compliance with the International Health
Regulations and other relevant international law.
Communications strategies
198. Communication is a major component of the ICCS at all levels. Federal, State and Local
Government information organs coordinate all information dissemination activities. They
implement the following activities during the pandemic:
 Liaise with health and agriculture ministries and other stake holders for correct, appropriate
and up to date materials for packaging and dissemination.
 Use appropriate communication channels to mobilize the public and disseminate regular and
sustained information.
 Conduct communication surveillance of reports, rumours, perceptions, concerns etc.
 Undertake mass distribution of IEC materials to the public.
 Use telecommunication channels such as internet, mobile telephones and other means to
reach national and international public.
46

Disseminate targeted messages on corpse handling and disposal to traditional rulers,
religious and opinion leaders.
199. Each of these communication strategies will provide community and media support to
efforts in pandemic mitigation and recovery. The human reactions in a pandemic are
essential to its management. Thus, social distancing measures must be understood and
owned so that all community members can adhere to them and avoid risk of social stigma.
Advocacy
200. The Minister of Information and Communications will intensify his meetings with
executive media as well as the staff assigned as members of the Federal PEC for information
sharing. The Federal PEC will deploy Information Officers for additional support to
community leaders as well as state media executives. Materials should be produced for
solidarity with patients and families affected (printed, radio, television and others)
Communication for behavioural change
201. The LGA PEC chairman and the State PEC Desk Officer and Coordinator should prepare
a contingency plan to implement communications to support social distancing measures with
the minimum disruptive consequences to the livelihoods and social stability of communities.
202. The LGA PEC will mobilize all their community members to form commissions to
provide support to the affected family or families; and continue active surveillance in
association with the teams of disease surveillance officers. They will also contribute
personnel to the health facility to comply with control measures by sensitizing patients.
203. Once a suspected case is confirmed, communities will be immediately informed. New
community members will be identified to accompany the additional surveillance teams.
Community leaders will support the sensitisation and promote the collaboration of all
contacts for contact tracing.
204. Printed materials will be prepared for target groups including State journalists,
community chiefs, religious leaders, drug vendors and marketers, and any other group of
leaders who – subject to any constraints on mass gatherings - will hold meetings and
community dialogues. The use of media for behavioural change will be intensified at the
State level
Mass media campaigns and news
205. Jingles and other public service announcements will be produced at State level to
complement the call on community efforts to contain the spread of infection. Ethical issues
will be part of intensive training with journalists regarding exposure of patients and their
families to the public eye. Training should involve not only journalists but cameramen and
photographers from media.
47
Anti-viral strategy
206. The Federal Government intends to purchase a significant quantity of antiviral for use
during a pandemic. These stockpiles are to be kept centrally and deployed only in time of
need. The stockpile will include oseltamivir and zanamivir. The total stockpile size will be
subject to availability and to funding constraints. Given current demand for anti-virals, it is
probable that the supplies available to Nigeria would be insufficient to treat many cases of
pandemic influenza.
207. The current stock of anti-virals is to be used only for treatment when the criteria for rapid
response and containment are met (see paragraphs 175-187). However, in accord with
WHO’s rapid response and pandemic containment protocol, anti-virals may be used for
geographically targeted or “ring” prophylaxis.
208. If mass prophylaxis is attempted, 90% coverage of the target populations should be the
goal for successful containment. This could be achieved in two ways: by mass prophylaxis
of the affected population within a radius of 5-10km from each detected case; or by targeting
administrative areas to cover “at risk” population (10,000-50,000).
209. In the containment protocol, each individual is given a single course of oseltamivir for 10
days. If more cases arise among the targeted population, a second round of prophylaxis is
administered. Mass antiviral prophylaxis ceases automatically 10 days after the date of
symptom onset in the reported case.
210. Government will provide information about possible contraindications of anti-viral use
to target communities. Anti-viral performance will be closely and continuously monitored so
as to detect resistance, and to decide the possible introduction of a second line drug like
zanamivir.
211. All purchases of anti-virals will be made directly from the manufacturers in collaboration
with FMOH, NAFDAC and WHO. Open retail sales of oseltamivir will be prohibited. State
Governments can obtain their stockpile separate from the Federal Government only after due
certification and approval by NAFDAC. Local Governments will not be permitted to
purchase anti-virals directly or to stockpile them..
212. Anti-virals for containment at source will, in accord with the WHO protocol, initially
cover a 2 week period within the containment zone. Further antiviral deployment will
depend on evaluation of the success of containment
213. Anti-virals for rapid response and containment will be deployed where appropriate
through the nearest Nigerian airport facility and in close collaboration with NEMA, Police,
Military, Immigration, Custom services and the aviation private sector. The responsibility
for subsequent deployment to points of need will lie with the State authority working
through the Ministry of Health and as appropriate with SEMA.
Personal protective equipment
214. Personal Protective Equipment (PPE) comprises a variety of physical barriers used alone
or in combination to protect mucous membranes, skin, and clothing from contact with
infectious agents. These include gloves, masks, respirators, goggles, face shields, and gowns.
Government is acquiring stocks of PPE, and will provide SOPs for its use. For example,
48
respirators (N95 or other appropriate particulate respirator) should be used within the context
of a respiratory protection programme which includes fit-testing, medical clearance, and
training. To date, Government has issued some PPE sets to States.
215.
Responsible Organisation: The Federal Ministry of Health and the UN system.
Pandemic vaccine strategy
216. The exact characteristics of a pandemic influenza virus will not be known before the
onset of a pandemic, therefore a well-matched pandemic vaccine is unlikely to be available
in advance of need. Seasonal influenza vaccines for global use against inter-pandemic
influenza viruses are manufactured yearly so as to keep track of changes to virus sub-types.
Experimental vaccines against HPAI/H5N1 are undergoing trials, but may confer no
protection against an as yet unknown pandemic virus. There is as yet no generic influenza
vaccine effective against all human influenza virus sub-types.
217. Vaccination with seasonal influenza vaccine of people exposed to risk of infection from
HPAI/H5N1 might help to prevent reassortment of virus genes between avian and human
influenza viruses. Such groups would include poultry keepers and workers, including those
involved in culling poultry under HPAI control programmes. Pneumococcal vaccine may
protect against secondary bacterial pneumonia, which is an important causes of death
associated with influenza. The Government will work with UN system agencies and
Development Partners to assess potential needs for seasonal influenza vaccine and
pneumococcal vaccines. The needs assessment will include vulnerable groups among the
elderly, women and children, those with underlying chronic diseases, and those who are
immuno-compromised. Government will continue to track closely developments in influenza
virus vaccines with potential to address pandemic vaccine needs.
Management of mass fatalities
218. Because of the understanding of the need for timely, safe, and respectful disposition of
the deceased corpse, an essential component of the integrated plan is the mortuary service.
Pandemic influenza may quickly rise to the level of a catastrophic incident that results in
mass fatalities, which will place extraordinary demands (including religious, cultural, and
emotional burdens) on local authorities and the families of the victims. A catastrophic
incident involving mass fatalities will require federal assistance to transport, process, and
store deceased victims and support final disposition and personal effects processing. Most
local authorities will be overwhelmed by the mass fatalities or may experience profound
difficulties.
Disposal of corpses
219. All concerned will take universal precautions. Appropriate risk communication will be
disseminated to the traditional rulers, religious and opinion leaders. Trained community
members will dispose of corpses according to local traditions without putting themselves at
risk. The relevant local health and hospital authorities will prepare corpses for burial at the
designated burial sites. The designated sites will be selected so as not to pose a threat to
environmental health.
49
Medical Waste Management
220. Medical waste generated from management of human cases of AI at household,
community, and local government levels will be properly collected, handle and disposed at
designated sites.
Ethics
221. An influenza pandemic is likely to overwhelm health care infrastructure, to cause fear
and panic, and potentially disrupt law and order. In such situations, ethical principles
developed to address clinical and research issues are insufficient. Control of public health
emergencies may warrant measures which compromise individual autonomy, rights and
liberties. They may affect the freedom of individuals to pursue self preservation. The aim of
protecting the public as distinct from personal welfare tilts the balance of moral choices
away from individual autonomy towards communitarian, paternalist and utilitarian ethics.
222. The individual may be both a cause and a victim of a pandemic. Communitarian
perspectives favour limiting individual autonomy in order to enhance public safety and
security.
223. Initial public health measures may restrict movement of and access to individuals who
are potentially infectious. This is justifiable on the basis that such restrictions are effective,
necessary and proportionate to the likelihood that such individuals will spread the infection
if their contact is unrestricted.
224. Movement may also be restricted for individuals exposed to risk of infection. This is
justifiable by the precautionary principle, which advocates acting in anticipation of serious
harm. In this instance, the precautionary action is designed to reduce the risk that individuals
will contract the infection and subsequently spread it.
225. Experience with HIV/AIDS suggests that the least restrictive or intrusive measures
should be used first in a pandemic. However, a pandemic which starts explosively from a
single locality is likely to require a different initial approach in accord with WHO’s rapid
response and containment protocol. The balance of moral choices here favours the use of
more coercive and restrictive measures.
226. Community engagement through dialogue should be designed to prevent stigmatization
of individuals and communities associated with avian and pandemic influenza.
227. Determining who should be given priority in allocation of anti-virals and other scarce
medical supplies has proven difficult. Many of the characteristics of a future pandemic
cannot be known in advance, including the rates of morbidity and mortality, and the identity
of particularly vulnerable sub-groups. Health care and emergency service workers would be
at the forefront of the response to a pandemic. Some may be exposed to a higher risk of
infection. It may therefore be just to protect these sub-groups as a priority. Outside these
sub-groups, it is difficult to discern what priorities Nigerians would accept.
228. It is therefore necessary to engage the population is open discussions about this before
the onset of a pandemic. In addition, in order to enhance credibility of the response, there
must be transparency, equity and justice in the method of resource allocation adopted.
50
229. Allocation of scarce hospital resources is likely to be equally contentious. Responsible
professional groups need to be engaged in order for effective choices to be made. Each major
hospital should set up working groups to determine available resources, establish a
management protocol to be used during both localised and generalised pandemic phases, and
determine how the cost of these resources will be met.
230. Uncertainties about pandemic influenza, including the biology of the virus and the
impact of pharmaceutical and non-pharmaceutical measures, are issues which may justify
research during a pandemic. Research protocols should be submitted to the National Health
Research Ethics Committee for review and possible approval in advance of a pandemic.
231. Transfer of biological materials will be covered by materials transfer agreements. Such
agreements will where possible protect the interests of the communities from which the
materials were obtained and those of all other parties.
51
CHAPTER 7. PREPARING FOR THE WIDER CONSEQUENCES OF A HUMAN
INFLUENZA PANDEMIC
Essential services and vital supplies
232. The “essential services” are defined to be those which respond directly to emergencies
(fire service, veterinary service, public health service, police force). The “vital supplies” are
those of fuel, water, power, telecommunications, food, and more generally the other supplies
without which the operational continuity of an essential service organisation will be
jeopardised.
233. All organisations providing essential services or vital supplies should, as a matter of
good practice, adopt operational continuity plans for use in emergencies in general and in
this case in a pandemic. Such contingency plans should:
i.
ii.
iii.
iv.
v.
vi.
vii.
viii.
Identify the functions and personnel critical for sustaining operational continuity.
Address explicitly the implications of absenteeism, movement restrictions, and other
possible pandemic counter-measures for the sustainability of operations dependent on
skilled workers and on supplies of critical materials.
Identify alternate personnel and cross-train staff where appropriate.
Establish agreed procedures for infection control in the work place.
Establish agreed protocols for monitoring the health of workers and for reporting
notifiable cases to public health authorities.
Prepare plans for closing down and re-opening operations in the event that official
measures are introduced to enforce workplace closure.
Prepare plans which allow for pandemics varying in severity between “mild” and
“severe” (as defined in the planning assumptions detailed in paragraph 164).
Seek to ensure that providers of supplies critical for the organisation themselves have
operational continuity plans in place.
234. Government will in the short term provide guidance to encourage all organisations
providing designated essential services or vital supplies to adopt pandemic operational
continuity plans in accordance with good business management practice. In the medium
term, Government will act to ensure adoption of such plans by these organisations.
235. As a general principle of good business practice, all organisations should have in place
up-to-date operational continuity plans. Government will in the short term make available
general guidance on operational continuity planning for all public, private and voluntary
sector organisations.
236. Federal and State Ministries will in the short term develop sector-specific guidance for
operational continuity planning on the basis of generic good practice. Specialised line
Ministries will work closely with the Ministry of Information and Communication and with
stakeholder groups to ensure that such guidance is well-coordinated, practical, and consistent
across sectors.
237. In the medium term, Government will seek to ensure adoption of operational continuity
plans by providers of essential services and vital supplies.
238. Consular offices of the Ministry of Foreign Affairs will implement the response to assist
Nigerians overseas, including repatriation of the deceased.
52
Financial systems
239. Economic and trade disruption in a pandemic are risks for which financial and banking
systems need to plan if they are to ensure their operational continuity. Government will in
the immediate term encourage banking and financial institutions to develop plans to ensure
continuity in systems for payments, clearing, settlement, cash flow and trading in financial
markets.
240. Government will in the immediate term issue guidance to encourage development of
plans to identify and manage the risks to financial systems which may result from pandemicrelated disruption to information and communication technology systems. This guidance will
seek to ensure that contingency plans address associated risks of fraud and corrupt practice
which would undermine good governance, integrity and trust in financial systems and
institutions.
Leadership and governance
241. A pandemic will pose risks to leadership, good governance and security if social and
economic disruptions occur on a significant scale. Government will therefore in the short
term ensure that ministries and agencies develop operational continuity plans in accord with
the general principles of business continuity planning (summarised in paragraph 233). These
operational continuity plans will seek to ensure sustainability of the functions of government
in a pandemic.
242. Simulation exercises will be used to test this national plan, and operational continuity
plans, under a range of pandemic scenarios (slow/rapid onset, mild/severe impact). Exercises
will involve participation of a range of non-governmental stakeholders from the private
sector, civil society, UN system and Development Partners, and will extend to regional
exercises at inter-governmental level.
53
ANNEX: IMPLEMENTATION PLANS AND RISK ANALYSES
IMPLEMENTATION PLAN FOR AVIAN INFLUENZA PREVENTION AND CONTROL
Policy
Activities needed to implement
the policy
Surveillance and
Raising public awareness
Disease Detection in Training of Veterinary,
Birds
CAHWs, Village poultry
producers, and Community
leaders
Increase surveillance points
from 170 to 5000
Joint Veterinary / Medical /
Communication Team in field
operations
Roles and responsibilities
Strengthening
Diagnostic
Capabilities
Enhancing Biosecurity at all levels
Estimated costs
FGN, States and LGA
States and LGA
Time-frame and relation
to influenza phase
-1year Phase3
-2 to 4years Phase3-4
-N 10 million
-N 25 million
Indicators of performance in
achieving the activities
Behaviour change
Early detection
FMAWR
-1 to 3years Phase3-4
-N 7 million
Geographical spread
FMAWR/FMH/FMIC
-Immediate
-N 20 million
Effective field operations
Upgrading NVRI lab to P3 and
5 Vet Teaching Hospital labs
to P2
Training laboratory and
diagnostic teams personnel
Developing inter-Regional
capacity for rapid diagnosis
World Bank Project
-1 to 2years Phase3
US dollars 3
million
Early turn-around from
suspicion to typing virus
FMAWR
-1 to 3years Phase3
-N 13 million
OIE/FAO, CDC/USAID
-1 to 3years Phase3
-US Dollars 2
million
Enhanced capacity for sample
collection and analysis
Service availability to neigh
bouring countries
Proper disposal of carcasses
States and LGAs
- 1 to 2years Phase3
N 20 million
Developing more bio-secure
(registered) farms
Undertake regular inspection
of poultry and decontamination
of bird markets
Setting up custom-processing
plants in city bird markets
Implementing regular cleaning
days for village poultry
producers.
States
- Immediate Phase3
N 19 million
LGAs
- 1 to 3years Phase3 -4
N 20 million
No of Birds markets with
services
LGAs
- 1 to 3years Phase3-4
N 20 million
No of plants installed
States and Communities
- 1 to 5years Phase3-5
N 12 million
Reduced no of outbreaks in
Village flocks
No of LGAs with carcass
disposal facilities
No of farms registered
54
Restructuring of the
Poultry Industry
Improving Turn
around time from
culling of birds to
compensation
Improving the
Public-Private
Partnership in HPAI
control
Providing targeted inputs and
advisory services(feeding and
hygiene)
Segregation of birds species on
all licensed farms
Disintegrating other animal
production enterprises from
poultry business
Design and commissioning of
specialised vehicles for birds
movement
Encourage Stakeholders to
become part of decisionmaking
Establish a Compensation
Fund with Contributions made
by States Governments and
Private sector
Involvement of Community
leaders at all stages of
compensation to rural poultry
producers
Enhanced dialogue with
Private sector stakeholders
Involve Private sector in
Awareness, Advocacy, and
Governance issues
Developing insurance cover for
losses due to HPAI
LGAs and States
- 1 to 5years Phase3-5
N 20 million
States
- 1 to 3years Phase3
N10 million
States
- 1 to 3years Phase3
N 10 million
FGN
- 1 to 3years Phase3
N 20 million
Reduction of scavenging
system
Single species on all poultry
farms
Discontinuation of mixed
animal production system
Enhanced bio-security and bioexclusion
More stakeholders involvement
FGN
- 1 to 2years Phase3
N 5 million
FGN/States and Private
Stakeholders
- 1 to 5years Phase3-5
N 5 billion
Sustainability and reduced
pressure on Government budget
States and LGA
- 1 to 5years Phase3-5
N 5 million
Enhanced fiduciary
arrangements
FGN
- 1 to 3years Phase3
N 5 million
More Stakeholders aboard
FGN and Private Sector
- 1 to 3years Phase3
N 10 million
Increased awareness
FGN and Insurance
industry
- 1 to 3years Phase3
N 5 million
No of Insurance companies
underwriting losses
55
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR AVIAN INFLUENZA PREVENTION AND CONTROL
Action needed to
implement policy
Early detection of
HPAI and early
response
Threat (technical, commercial, management,
external, other) to the success of the action
Difficulties in the clinical differentiation of
HPAI from other endemic poultry diseases
especially among village producers
Probability
(high, low)
high
Impact
(high, low)
high
Rapid diagnosis
of field samples
Slow turn around time between
rumour/suspicion to investigation and
confirmation of disease
low
high
Bio-containment
and bio-exclusion
of HPAI virus in
birds, farms and
markets
Restriction of
HPAI virus only
in the birds
Slow mobilisation of response team and
inadequate supplies of trained personnel and
materials at the critical points
low
high
Slow rate of adoption of bio-security
measures by village producers
Inadequate facilities for carcasses disposal
high
high
high
high
Early payment of
compensation to
affected farms
and farmers
Engender PublicPrivate
Partnership in
HPAI control
Joint veterinary,
medical and
communications
teams in field
operations
Backlog and delays in payment of
compensation to farmers
Slow replenishment of compensation fund
from Government budget
Apathy by the Private sector or lack of
awareness concerning the risk posed by HPAI
high
high
low
high
low
high
Slow detection and reporting of outbreaks to
Federal Ministry of Health for follow-up on
human cases
High
High
Actions or contingency plans needed to manage
the risk to the success of the action
-capacity building for veterinarians, CAHWs,
and community leaders/informants
-mobilising all trained personnel to areas where
there are none
-capacity building for personnel and laboratory
-effective management of veterinary stockpiles
-prompt collection and professional handling of
specimens
-enforcement of movement restriction and
quarantine
-provision of transport for the Rapid Response
teams
Responsibility
for the actions
FGN and
States
-institutionalising Monthly Cleaning Up among
the Community and Village Producers
-identifying and constructing facilities in every
Local Government Area
Setting up of Compensation Fund and
involvement of Stakeholders to make Annual
contributions and management of funds
States and
LGA
“
-regular dialogue with the Organised Private
Sector to buy into the HPAI control plan
- options of cost-sharing through sponsored
activities
Joint surveillance and response by Health,
Agriculture and Information sectors
FGN and
Stakeholders
FGN and
States
FGN and
States
FGN, States
and
Stakeholders
FGN and
stakeholders,
States and
LGAs
56
IMPLEMENTATION PLAN FOR HUMAN INFLUENZA PANDEMIC PREPAREDNESS, CONTAINMENT AND MITIGATION
Policy
To Strengthen AI
surveillance system
and ensure prompt
detection and
management of AI
cases across
Nigeria
Activities needed to implement
the policy
Identification and recruitment
of surveillance focal persons
at Federal, State and Health
facility levels
Roles and responsibilities
Time-frame and relation
to influenza phase
3-6 Months, Phase 3
Estimated costs
Training of state
Epidemiologists and DSNOs
FMOH, SMOH, WHO
WB, CDC, DFID
3-6 Months, Phase 3
N3, 500 000.00
State epidemiologist and
DSNOs trained
Training of LGA surveillance
focal persons
FMOH, WB, WHO,
SMOF, CDC
3-6 Months, phase 3
N26, 000 000.00
Focal persons at LGA level
trained
Adapt and produce technical
guides/tools for AI surveillance
FMOH, WB, WHO,
CDC,
3-6 Months, phase 3
N50, 000 000.00
Guidelines/tools produced
Establish AI sentinel
surveillance sites
FMOH, WHO,CDC,WB
1-2 Years, phase 3-4
N1,130,000 000
Sentinel sites functional
Establish IDSR net
FHOH,FM0A& WR,
CDC,WB,WHO
2-3 Years, phase3-4
N1,300,000,000
Functional IDSR net
established
Identify and assess AI
laboratories
FMOH, WHO, DFID,
USAID,CDC, FMOA
&WR
3-6 Months, phase 3
N4,500 000.00
AI laboratories identified and
assessed.
FMOH, SMOH, CDC,
WHO, JICA, USAID,
DFID, WB
N1, 300 000.00
Indicators of performance in
achieving the activities
Focal persons identified and
recruited
57
Policy
To institute Rapid
Response and
Containment
strategies for the
disease
Activities needed to implement
the policy
Training of laboratory staff on
AI diagnosis
Roles and responsibilities
Estimated costs
FMOH, FMOA & WR,
CDC, FAO, WHO,DFID
Time-frame and relation
to influenza phase
6 months-1 year,
phase 3
Upgrade Laboratories at
NCRTC, Asokoro, Abuja; UI
Virology Lab, UMTH
Virology Lab, Maitduguri
UPTH Lab, Port Harcourt, and
other designated laboratories
Conduct capacity building for
clinicians at National, Zonal,
State and LGA levels
FMOH, WB, WHO,
CDC, USAID, DFID
6 months-1 year,
phase 3
N1,500,000,000
Designated labs upgraded
FMOH,WB,CDC,SMOH,
WHO
6months-1 year
N50,000 000.00
Clinicians trained on AI
management nationwide
Procure Vaccine against
Seasonal influenza A
FMOH,NPI,UNICEF,
WHO,SMOH, CDC, U.E
1-2 years, phase 3-4
N1,200,000,000
Vaccines procured
Stockpile antiviral drugs to
cover 10% of Nigeria’s
population
FMOH,WB,WHO,
USAID, DFID, NAFDAC
SMOH
1-3 years, Phase-3-4
N4,500,000,000
Antiviral stockpiled
Procure antibiotics
FMOH, WB,WHO,
NAFDAC
1 year, phase 3
N400,000,000
Antibiotics procured
Procure Pneumococcal vaccine
FMOH, WB, WHO, CDC
NAFDAC, SMOH
1-2 years, Phase 3-4
N100,000,000
Pneumococcal vaccine procured
N6,500 000.00
Indicators of performance in
achieving the activities
Laboratory staff trained on AI
diagnosis.
58
Policy
To institute
pandemic
mitigation
strategies
To institute
environmental
measures to
combat pandemic
Activities needed to implement
the policy
Identify and upgrade isolation
and quarantine facilities
Roles and responsibilities
Time-frame and relation
to influenza phase
1-2 years, phase 3
Estimated costs
Procure and distribute PPEs
FMOH, WB, DFID,
WHO, USAID, CDC
6 months-1 year,
phase 3
N 1,300,000,000
PPEs procured and distributed
Conduct simulation and drills
on outbreak response
FMOH, WB,WHO,CDC
1-2 years, phase 3
N 260,000,000
Simulation and drills carried out
Undertake mathematical
modelling of the impact of
alternative social and medical
measures on pandemic spread
Implementation and
enforcement of social
distancing measures
FMOH, FMS&T, WHO,
US CDC
6 months – 1 year,
phase 3
N 11,000,000
Modelling outcomes inform
policy and implementation plan
options
FMOH, NEMA, Security
Agencies
Phase 6
To be assessed
and to depend on
enforcement
Successful mitigation by
reducing spread of infection
Establish a medical waste
management system
FMOH, WHO, UNICEF,
CDC, USAID
3-6 months, phase 3
N300,000,000
Medical waste management
system established
Provide personal hygiene
manual
FMOH, WHO, CDC,
DFID, USAID, SMOH
6 months- 1 year,
phase 3
N20,000,000
Personal hygiene manual
produced
Provide corpse disposal bags
FMOH, WHO, CDC
1-2 years, Phase 4
N50,000,000
Disposal bags provided
FMOH, CDC, WHO,
SMOH, USAID, DFID
N1,000, 000, 000
Indicators of performance in
achieving the activities
Isolation and quarantine
facilities identified and upgraded
59
Policy
To ensure
appropriate
co-ordination
mechanism and
management of
outbreak
To ensure a
comprehensive AI
Monitoring and
Evaluation system
Provide safe drinking water
FMOA &WR, FMOE,
SMOA & WR, UNICEF,
UNDP
1-2 years
Activities needed to implement
the policy
Formally establish the Incident
Command and Control System
(ICCS).
Roles and responsibilities
Time-frame and relation
to influenza phase
3-6 months, phase 3
Estimated costs
FMOH, FMOA, FMIC,
WB, UN System
Immediate, sustained
for at least 24 months
N65,500,000
Establish data management
system
FMOH, WB, CDC
1-2 years, phase 3
N30,000, 000
Develop an M& E manual
FMOH, FMOA & WR,
CDC, WHO
6 months-1 year,
phase 3
N15,000,000
M&E manual developed and
adopted
Establish monitoring and
evaluation system
FMOH, FMOA &WR,
WHO, CDC
1 year, phase 3
N100, 000,000
M& E system established
Maintain and support the Crisis
Management Centre.
FMOH, WHO, CDC,
FMOA, FMOI, WB
Safe drinking water provided
N10, 000,000
Indicators of performance in
achieving the activities
ICCS established formally.
Coordination and operational
continuity maintained through
permanence of the Crisis
Management Centre.
Data system established and
staff recruited and trained
60
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR HUMAN INFLUENZA PANDEMIC PREPAREDNESS, CONTAINMENT AND
MITIGATION
Action needed to
implement policy
Threat (technical, commercial,
management, external, other) to the success
of the action
Probability
(high, low)
Impact
(high, low)
Actions or contingency plans needed to manage
the risk to the success of the action
Responsibility
for the actions
Conduct Capacity
building
Funding and technical expertise
Low
High
Engage technical experts that will conduct the
capacity building and source for funding from
government and development partners.
FMOH,
World Bank,
CDC,
Identification and
recruitment of
surveillance focal
persons.
Funding
Low
High
Ensure availability of funds
FMOH, CDC,
World Bank
Establishment of
sentinel surveillance
sites
Funding, Personnel, equipment
Low
High
Provide funds and equipment, recruit needed
personnel
World bank,
FMOH, WHO
Provision of
surveillance tools
Funding for the tools, sustainability
Low
High
Ensure availability of tools always
FMOH, CDC,
WHO, World
Bank
Identification and
strengthening of
laboratories
Funds, manpower, equipment
Low
High
Upgrade identified laboratories, train the lab.
Personnel and Provide a sustainable source of
funding.
FMOH,WHO,
World bank
Establishment of
IDSR Net.
Funds, Technical expertise
High
Low
Provide funds and technical expertise
FMOH,
FMOA & WR
Strengthening of
Surveillance and
detection system
61
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR HUMAN INFLUENZA PANDEMIC PREPAREDNESS, CONTAINMENT AND
MITIGATION
Action needed to
implement policy
Threat (technical, commercial,
management, external, other) to the success
of the action
Probability
(high, low)
Impact
(high, low)
Actions or contingency plans needed to manage
the risk to the success of the action
Responsibility
for the actions
Conduct Capacity
building for
clinicians
Funds, training materials, instructors
Low
High
Ensure availability of funds, identify experts
for the training and provide training materials
World bank,
CDC, FMOH
Provision of
vaccine against
seasonal influenza
A
Stockpile Antiviral
drugs disinfectants
and antibiotics
Availability of the vaccine, funds, storage
and transportation
High
High
Identify viral strain early ahead of the influenza
season and place order for the vaccine. Also
ensure storage and transportation facilities
World bank,
FMOH, NPI,
E.U, UNICEF
Availability of Tamiflu, shelve life and
funds.
High
High
Provide adequate funds and place order for the
drugs ahead of time. Expiry date should be
closely monitored.
FMOH,
World Bank,
WHO
Identification and
upgrading isolation
and quarantine
facilities
Provision of
Personal protection
equipment
Funds, equipment
High
High
Provide funding and materials needed in
isolation facilities
FMOH, CDC,
World bank
Funding
Low
High
Provide PPEs to all relevant centres.
Conduct simulation
and drill exercise
Funding, technical expertise
Low
Low
Ensure that drills and simulation are conducted
in pre pandemic phase
DFID,
FMOH,
WHO, WB
FMOH, CDC,
WB
Rapid response
and containment of
the disease.
62
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR HUMAN INFLUENZA PANDEMIC PREPAREDNESS, CONTAINMENT AND
MITIGATION
Action needed to
implement policy
Threat (technical, commercial,
management, external, other) to the success
of the action
Probability
(high, low)
Impact
(high, low)
Actions or contingency plans needed to manage
the risk to the success of the action
Responsibility
for the actions
Establishment of
medical waste
management
Comprehensive plan, funding and
sustainability.
Low
High
Ensure availability of medical waste
management plan ahead of time and budget for
it.
Provision of Safe
and Wholesome
water supply
Lack of adequate Community mobilisation,
availability of disinfectants for treating
water for drinking
Low
Low
Provision of a
personal hygiene
manual on AI
Funding, Technical expertise, mobilisation
of the community
High
High
Ensure that water for drinking is treated before
consumption, community mobilisation and
provide subsidised liquid chlorine especially in
rural areas.
Ensure production of the manual, adequate
community mobilisation
WB, FMOH,
USAID,
DFID,
UNICEF
WB,FMOA &
WR, FMOE,
UNDP
Provision of AI
corpse disposal
polythene bags
Funding
High
High
Ensure availability of disposal bags at all
relevant health facilities, community
mobilisation
FMOH,
WB,CDC
Funding, Accommodation, equipment
Low
High
Provide funding, accommodation and needed
equipment before take off.
Funding, manpower, Training and
equipment
Low
Low
Ensure prompt establishment of data
management centre and recruit staff
WB, FMOH,
CDC,
UNICEF, E.U
WB, FMOH,
CDC
Environmental
management.
FMOH, WB,
WHO
Coordination and
Outbreak
Management.
Establishment of
Crisis Management
Centre.
Establishment of
data management
system
63
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR HUMAN INFLUENZA PANDEMIC PREPAREDNESS, CONTAINMENT AND
MITIGATION
Action needed to
implement policy
Threat (technical, commercial,
management, external, other) to the success
of the action
Probability
(high, low)
Impact
(high, low)
Actions or contingency plans needed to manage
the risk to the success of the action
Responsibility
for the actions
Funding, Technical expertise
Low
High
Funding, personnel
Low
High
Hire a consultant to develop manual and
employ M&E officers
Provide funds and personnel
FMOH, WB,
WHO
FMOH, CDC,
WHO
Monitoring and
evaluation
Development of M
& E manual
Establishment of
routine monitoring
and periodic
evaluation of AI
activities
nationwide
64
IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Policy
Activities needed to implement
the policy
Roles and responsibilities
Time-frame and relation
to influenza phase
Meeting among MINFOC and
development partners (30),
(UNICEF, UNDP, CDC, AED,
WB) to discuss this proposal and
assign clear roles and
responsibilities to all
FMIC
WB
UNICEF
UNRC
UNDP
CDC
On going-Phases 3-4-5
Procurement of 1 (4x4) project
vehicle for field operations
($50,000x1) one delivery
van($30,000) One van for 18
seats bus ($35,000) Utility car
($35,000) Motor bike for
dispatch ($1,000)
Office rent equip, furniture,
news monitoring, public
enlightenment, subscription to
periodicals, books, online
resources, internet facilities,
local runs and tours for officers,
generators
Procurement of office
equipment for all 36 state PECs
Field operations
WB
Phase 3
FPEC
WB
Phase 3
Field operations
WB
SPECs
3-6 months Phase 3
One vehicle for supervision and
monitoring in each state
FPEC
SPECs
WB
2-3 month, Phase 3
Estimated costs
(Naira)
Indicators of performance in
achieving the activities
Advocacy
Creation of
awareness and
influence positive
behaviour change
60,000 -Roles and responsibilities
assigned to each actor
-100% of partners has a
contingency plan to comply
with IP
19,328.000 -National Desk Office with
vehicles to supervision and
monitoring
280,000 -Desk Office at national level
fully equipped to function
13,824.000 -All 36 Desk Office at State
level fully equipped to function
162,000.000 -Vehicle used as a means of
social mobilisation
65
IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Policy
Activities needed to implement
the policy
Breakfast meeting with media
executives at the highest level
for a medium and long term
commitment
Roles and responsibilities
Breakfast meetings (4/year) with
media executives at the highest
level for follow-up on their
commitment and phase new
challenges
Meeting with traditional
andreligious leaders at the
highest level (Emirs,
Archbishop, Iman)
FMIC
FPEC
Dev. Partners
Phase 4
Phase 5
FMIC
Dev. Partners
Immediately, Phase 3
Meetings (4/year) with
traditional and religious leaders
at the highest level
FMIC
Dev. Partners
Phase 4
Phase 5
FMIC
UNICEF
UNDP
CDC
AED
Immediately, Phase 3
FMIC
Dev. Partners
Time-frame and relation
to influenza phase
Immediately, Phase 3
Estimated costs Indicators of performance in
(Naira)
achieving the activities
60,000 -100% Media executives
commit at medium and long
term to assign reporters
-50% media executives commit
to free-of-charge broadcasting
on AI issues
240.000 -50% media executives commit
240,000 to free-of-charge broadcasting
on AI issues
60.000 -100% agreed on preparing
instructions to nationwide
coverage
-100% of state religious leaders
contact SPEC for preparing
lecture at religious cult
240,000 -100% of state religious leaders
240,000 contact SPEC for preparing
lecture at religious cult
Communication for Behavioural Impact
Influence positive
behaviours
change (for
human health and
bio-security at
farm) through
IPC intervention
at grassroots
level
Urgent meeting of GoN and
development partners (15) to
finish the production of a
Manual for Community
Dialogue System (CDS) with
flow diagram for information
sharing among tiers of
Government
1,036,800 -CDS Manual ready to
distribute among all states
-Plan for training ready
66
IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Policy
School
engagement
through students,
teachers and
parents
Activities needed to implement
the policy
Strengthening Federal PEC with
training and physical
infrastructure at Crisis
Management Centre as HQ
Roles and responsibilities
Strengthening all 36 States
structures according to needs
and do simulation exercises
Poster (2) for health facilities:
one intended to health workers
(20,000) showing signs and
symptoms and standard
procedures
SPECs
March 12-31, 2007
Phase 3
FPEC- FMIC
SPEC for distribution and
dissemination
Dev. Partners
Private Hospitals
April-May 2007
Phases III, IV and V
2,500.000 -100% health facilities have a
poster with basic behaviours,
signs and symptoms
Immediate printing and
dissemination of Zandi’s song in
all 5,000+ schools
FPEC- FMIC
SPECs
LPECs
Dev. Partners
CDC
FPEC
SPEC for distribution and
dissemination
Dev. Partners
Private hospitals
SPEC Coordinator
Dev. Partners
1-6 months, Phase 3
5,120.000 -Publication distributed in all
5,000+ schools
-Trained teachers in use of
publication
1-3 months, Phases 3, 4
and 5
3,500.000 -100% health facilities have a
poster with basic behaviours,
signs and symptoms
A second one (40,000) intended
to be located in waiting rooms
or corridors with messages for
patients
Meetings with traditional and
religious leaders at technical
level in all States to develop
messages for followers
FMIC
Dev. Partners
Time-frame and relation
to influenza phase
1-3 month, Phase 3
April-May 2007, Phase 3
Estimated costs Indicators of performance in
(Naira)
achieving the activities
640,000 -Physical arrangements made
-Phone lines in place
-Data Base with all PECs
nationwide
-Plans to monitor in place
4,608,000 -36 states with physical location
for SPEC
473,600 -Religious leaders and FPEC
write instructions to followers
to be read at cults
67
IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Policy
Activities needed to implement
the policy
Meetings (3/year)with
traditional and religious leaders
in a regular basis to develop
messages for followers
Roles and responsibilities
Meetings with teachers and
transport unions and
associations
FPEC Coordinator
SPEC Coordinator
Dev. Partners
NARTO
FPEC
NARTO
Dev. Partners
April-May 2007, Phase 3
FPEC
SPEC
MOE
MOH
CSO reps
FMIC
F-State Liaison Officer
SPEC Coordinators (35)
LGA Coordinators (560)
Dev.Partners
May 2007
Phase 111
Immediately, Phase 3
1,433.600 -Plans to be implemented
-Collection of information done
-Analysis of data
-Sharing of data
22,937,600
LPEC-Coordinator
SPEC-Monitoring Officer
Community leaders
Immediately, Phase 3
281,600 -Information collected,
analysed and sent to State level
-Information analysed at State
and sent to Federal to analyse
Meetings (3/year) with teacher
and transport unions and
associations for development of
messages and collection of
information
Risk communication strategy
and quick action plan
Contingency plans based on
LGAs affected (Plateau=38,
Kaduna=19, Kano=14,
Bauchi=14, Lagos=12
Katsina=9
Nasarawa=6)
For immediate collection of
information using participatory
methods
Implementation of Rapid
Assessment in 10% of 112 high
risk LGAs
SPEC Coordinator
Dev. Partners
Time-frame and relation
to influenza phase
Phase 4
Phase 5
Estimated costs Indicators of performance in
(Naira)
achieving the activities
1,420,800 -Writing instructions as
situation evolves
1,420,800 -90% of religious followers
understand and agree to comply
with new improved behaviours
473,600 -70% of drivers on the road
transporting chicken comply to
bio-security measures
Phase 4
1420,800 -75% of drivers participate in
Phase 5
1,420,800
68
IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Policy
Activities needed to implement
the policy
Rapid training of LGA staff and
LPEC membership in CDS and
its tools using participatory
methods
Roles and responsibilities
Plan for Non-news media
contribution in affected States
SPEC-Lagos
Federal Info Officer
State Media Liaison Officer
All volunteer media people
SPEC-Kano
Federal Info Officer-Kano
State Media Liaison
All volunteer media people
SPECFederal Info Officer
State Media Liaison Off
All volunteer media people
SPECs
Federal Officers
State Media Liaison
Dev.Partners
All volunteers
Commissioner for
Education
SPECs
Dev. Partners
Plan for Non-news media
contribution in remaining nonaffected 17 States
Plan for Non-news media
contribution in Phase IV
Immediate call to all schools for
engaging students and teachers
FPEC- FMIC
F-State Liaison Officer
SPEC Coordinators
LPEC Coordinator
Dissemination of good improved LPEC/SPEC/FPEC
behaviours to theatre groups in
all LGAs
Dev. Partners
Time-frame and relation
to influenza phase
April 1-30, 2007-03-06
Phase 3
Estimated costs Indicators of performance in
(Naira)
achieving the activities
1,484,800 -Plans to be implemented
Immediately, Lagos
Phase 3
80,000 -Non-News media contribution
established and agreed on a
Media Plan to follow-up
Immediately, Kano
Phase 3
40,000 -Non-News media contribution
established and agreed on a
Media Plan to follow-up
April, 2007 in the
remaining 17 affected
states
Phase 3
Phase 4
-Non-News media contribution
85,000 established and agreed on a
Media Plan to follow-up
Phase 5
April 2007 and on
Phase 3
Phase 4
Phase 5
April and on
Phases 3, 4 and 5
120,000 -Non-News media contribution
established and agreed on a
120,000 Media Plan to follow-up
4.736.000 -100% of teachers are trained
on good behaviours to be
promoted among students
-90% students can name three
good behaviours for prevention
infection of AI
9,216,000 -Dissemination of good
behaviours to serve as a base in
theatre presentations
69
IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Policy
To support
community
surveillance of
avian influenza
and human
pandemic
Activities needed to implement
the policy
FPEC surveillance teams to visit
all SPECs and agree on method
of reporting
Roles and responsibilities
SPEC and LPEC members
accompany animal health and
human surveillance teams
regularly
SPECs
LPECs
WB
Phase 4
FPEC- FMIC
SPECs Coordinators
LPEC Coordinators
Dev. Partners
April 2007
Phases 3,
Phases 4 and 5
FPEC
SPECs
WB
Time-frame and relation
to influenza phase
April 2007
Phase 3
Estimated costs Indicators of performance in
(Naira)
achieving the activities
2,304.000 -100% of SPEC know their
contact person in FCT and
viceversa
4.736.00 -Reports on surveillance
findings share with all levels
Phase 5
Mass Media Campaigns and News
Strengthening of
genuine
engagement of all
groups through
the production of
specific materials
of day-to-day use
Message testing training for all
material production at
Federal/State and LGA levels
3,000.000 -Messages tested among target
groups
70
IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Policy
Training and
promotional
material to
support Livestock
community
workers
Activities needed to implement
the policy
To produce new poster to all
health facilities if social
distancing measure must be in
place
Production of a Notebook for
Community Health Educators
(1500) with behaviours on cover
pages and blank pages to be
used for them
Production of a Notebook with
behaviours to be promoted and
questions collected from
communities/correct answers on
cover pages and blank pages to
be used in work by community
leaders (1500)
Production and distribution of a
car sticker (1.0 million) with
logo and prevention measure
Roles and responsibilities
FPEC- FMIC
SPECs Coordinators
WB
Phase 3
250,000.000
-One million vehicles in
Nigeria carry and show a
promotional sticker
Production and distribution of a
car sticker (1.0 Million) with
logo and preventive measures
FPEC- FMIC
SPECs Coordinators
WB
Phase 4
Phase 5
250,000.000
-One million vehicles in
Nigeria carry and show a
promotional sticker
To produce one booklet with
basic information regarding
behaviours, general hygiene
practices and essential low-cost
bio-security measures to be used
by extension workers at backyard poultry
FPEC
SPEC
Dev. partners SPECs
FAO
1-3 months
Phase 3
FPEC/SPEC
MoH
Dev. partners
Private hospitals
FPEC- FMIC
SPEC for distribution and
dissemination
Dev. Partners
FPEC- FMIC
SPEC for distribution and
dissemination
Dev. Partners
Time-frame and relation
to influenza phase
Phase 4
Phase 5
1-3 months, Phase 3
Phase 4
Phase 5
1-3 months, Phase 3
Phase 4
Estimated costs Indicators of performance in
(Naira)
achieving the activities
3,500.000 -100% of health workers
practice and promote social
distancing jointly with
communities leaders
2,800.000 -100% community health
educators receive and use
2,800.000 notebooks for mobilisation
2,800.000 -100% of community leaders
(including religious are engaged
2,800.000 in disseminating accurate
behaviours to avoid infection)
Phase 5
2,800.000
-70% of livestock staff receive
and use a booklet when visiting
farms
71
IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Policy
Training and
promotional
material to road
transports drivers
and assistants
School
engagement
through students,
teachers and
parents
Engagement of
Nollywood
States Mass
campaigns
according to
situation
Activities needed to implement
the policy
To produce one booklet with
basic information regarding
behaviours, general hygiene
practices and essential measures
to avoid infection at commercial
farms
Key-holders with a key
behaviour to be comply by road
transport drivers and assistants
Immediate printing and
dissemination of Zandi’s song in
all 5,000+ schools
Immediate contact with film
production to advocate for the
creation of a character with an
AI event in his/her home a part
of a popular soap-opera or series
Production of jingles for radio in
each State
Production of TV PSAs in each
State
Roles and responsibilities
FPEC
PAN
MoA
Dev. Partners
Time-frame and relation
to influenza phase
1-2 months, Phase 3
Estimated costs Indicators of performance in
(Naira)
achieving the activities
2,800.000 -100% commercial farms
workers can mentioned all biosecurity measures for their
protection
FPEC/SPEC
PAN
NARTO
Dev. Partners
WB
FPEC- FMIC
SPECs
LPECs
Dev. Partners
CDC
FMIC
FPEC- FMIC
1-3 months, Phase 3
-50% of transport drivers
receive and use a key-holder as
a reminder of a good behaviour
SPEC
UNICEF
WB
June 2007 and on
Phases 3, 4 and 5
???
-Jingles airing according to
plans agreed with State radio
stations
FPEC- FMIC
SPECs Coordinator
SPEC Media Liaison
WB
June 2007 and on
Phases 3, 4 and V
???
-Jingles airing according to
plans agreed with State TV
station
Phase 4
Phase 5
1-6 months, Phase 3
1-3 months, Phase 3
5,120.000 -Publication distributed in all
5,000+ schools
-Trained teachers in use of
publication
550,000 Soap-opera or series broadcast
72
IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Policy
Activities needed to implement
the policy
Production of jingles for
nationwide airing
Engage with and
provide relevant
information to
the news media
on pandemic
influenza
To immediately collect all
names of journalists having been
trained and create a data-base
for follow-up interventions and
analysis of press materials
produced as part of on-going
training
Production of a Journalist’s
Notebook with behaviours to
promote on cover pages and
blank pages to be used in work
for journalists trained and part of
data-base
Immediate call to all journalists
((national level) having been
trained for a follow-up exercise
(news produced by them after
first training should be identified
and analysed)
Regular meetings with
journalists for follow-up
Roles and responsibilities
FPEC- FMIC
SPECs to adopt
SPEC Media Liaison to
distribute
WB
UNICEF
FMIC
FPEC
UNICEF-Media
FMIC
FPEC- FMIC
Time-frame and relation
to influenza phase
As situation arises
Phase IV
Phase V
Estimated costs
(Naira)
Indicators of performance in
achieving the activities
-Jingles airing according to
situation
April-May 2007
10,000 -Data-base of journalists doing
avian influenza material
April-May 2007
Phase 3
25,000 -5000 copies of notebook to be
distributed at national and state
levels
25,000
25,000
Phase 4
Phase 5
FPEC- FMIC
SPEC Media Liaison
Officer
All trained journalist
UNICEF
April 2007
Phases 3
-25% of all journalists trained
1,597.440 have a product to analyse
-100% received a Journalists
Notebook
FPEC
SPEC Media Liaison Of
All trained journalists
UNICEF
Phase IV and
Phase V
1,500.000 -Minutes of meetings are shared
2.000.000 and agreements complied
Supervision and Monitoring
73
IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Policy
Capacity building
at all levels in
communication
strategies
Activities needed to implement
the policy
Supervision plans at all levels
should have tools for reporting
potentials and specific needs
Roles and responsibilities
FPEC- FMIC
SPEC-Coordinator,
Monitoring OfficerWB
Time-frame and relation
to influenza phase
On-going, starting March
2007
Phase 3
Phase 4
Phase 5
Performance and
communication indicators to be
defined in each State, according
to guidelines provided from
FPEC
FPEC- FMIC
SPEC-Coordinator
Monitoring Officer
WB
April 2007
Phase 3
Phase 4
Phase 5
Estimated costs
(Naira)
Indicators of performance in
achieving the activities
-70% of all LGAs report
supervision mission
122,880 -100% of all State capital report
122,880 supervision mission
122,880 -100% of all LGA identified
best social mobilizers???
-100% of changes
recommended by States are
considered and act upon
-Indicators defined and shared
120,000
TOTAL BUDGET
*Lacks cost of production of jingles, provided these will be aired for free. This applies to cost of printed materials.
74
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Action needed to implement
policy
Threat (technical, commercial,
management, external, other) to
the success of the action
Probability
(high, low)
Impact
(high, low)
Actions or contingency plans
needed to manage the risk to the
success of the action
Responsibility for
the actions
Advocacy
Meeting among MINFOC and
development partners (UNICEF,
UNDP, CDC, AED, WB) to
discuss this proposal and assign
clear roles and responsibilities to
all
Uncertainty or lack of clarity about
roles and responsibilities
High
High
Immediate proposal for this meeting
to FMIC from development partners
and other line ministries
FMIC
Breakfast meeting with media
executives at the highest level for
a medium and long term
commitment
Media apathy
High
High
Development partners to lobby
FMIC
Meeting with religious leaders at
the highest level (Archbishop,
Imam)
None
High
High
Notebook with messages and empty
pages should be printed to distribute
among religious leaders to be used as
a reminder of all behaviours
recommended
FMIC
Communication for Behavioural Impact
Urgent meeting to finish the
Manual for Community Dialogue
System (CDS) with organogram
for information sharing among
tiers of Government
Funding
Low
High
High level advocacy with Minister
and UN High level advocacy
Representatives
FMIC
Strengthening Federal PEC with
training and physical
infrastructure at Crisis
Management Centre as HQ
Funding
High
High
Idem as above
Dev. Partners
75
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Action needed to implement
policy
Threat (technical, commercial,
management, external, other) to
the success of the action
Funding, training
Probability
(high, low)
Impact
(high, low)
Actions or contingency plans
needed to manage the risk to the
success of the action
Responsibility for
the actions
Lack of funds
Weak initial training and/or
strengthening of structures in place
as well as networking with all
stakeholders at state level
High
High
Keep high level advocacy going as
well as technical assistant identified
from all sources (UNICEF, UNDP,
CDC, AED, etc.)
SPECs
Dev Partners
Implementation of Rapid
Assessment in high risk LGAs
Funding, manpower, resources
High
High
Identification tools, personnel,
analysis planned for quick findings to
be shared
FPEC
SPEC
Plan for Non-news media
contribution
Training in non-news media
engagement
High
High
Identification of all States (20)
affected to begin involvement in a
medium, long term basis
FPEC
SPEC
Dev. Partners
Training of all staff in remaining
States in community participation
methods
Lack of funds
High
High
Continuing training at State and LGA
level, with simulation exercises
Dev.
Partners/SPEC
Strengthening States structures
according to needs and do
simulation exercises
Contingency plans based on
LGAs affected (Plateau=38,
Kaduna=19, Kano=14,
Bauchi=14, Lagos=12
Katsina=9, Nasarawa=6) and nonaffected. For immediate
collection of information using
participatory methods
Rapid training of LGA staff and
LPEC membership in CDS and
its tools
76
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Action needed to implement
policy
Threat (technical, commercial,
management, external, other) to
the success of the action
Probability
(high, low)
Impact
(high, low)
Actions or contingency plans
needed to manage the risk to the
success of the action
Responsibility for
the actions
Mass Media Campaigns and News
Immediate call to all journalists
(national level) having been
trained for a follow-up exercise
(news produced by them after
first training should be identified
and analyzed)
Immediate call to all journalists
(state level) having been trained
for a follow-up exercise (news
produced by them after first
training should be identified and
analyzed)
Material production
Lack of designated personnel to do
follow-up
High
High
Development partners to provide
support in developing a data base of
journalists at national level
FMIC
Media Liaison person in SPEC
should be trained
Funding, training
High
High
UNICEF’s media personnel should
offer training on journalist data base
and follow-up
All SPEC
Coordinators
Capacity of identifying useful
materials according to target group
(e.g. basic signs and symptoms on
a poster for health facilities,
notebook for
journalists/leaders/extension
workers/health educators, keyholders for transport staff) instead
of sticking to conventional
materials such as “posters for all”
or fliers
High
High
Dev. Partners
FMIC /FPEC
Dev Partners
Contingency plans to supervise
capacity building at all level
FMIC /FPEC
SPEC
LPEC
Supervision and Monitoring
Supervision plans at all levels
should have tools for reporting
potentials and specific needs
Funding, resources
High
High
77
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Action needed to implement
policy
Performance and communication
indicators to be defined in each
State, according to guidelines
provided from FPEC
Threat (technical, commercial,
management, external, other) to
the success of the action
Funding, training
Probability
(high, low)
Impact
(high, low)
High
High
Actions or contingency plans
needed to manage the risk to the
success of the action
Dev. partners to support defining
indicators and preparing guidelines to
be proposed
Responsibility for
the actions
FMIC /FPEC
Dev. Partners
78
IMPLEMENTATION PLAN FOR THE WIDER CONSEQUENCES OF A HUMAN INFLUENZA PANDEMIC
Policy
Guidance on
operational and
business continuity
planning for
essential services,
vital supplies,
financial systems,
and government
functions
Activities needed to implement
the policy
Consultation with stakeholders
on required content of
guidance; preparation and
dissemination of guidance.
Roles and responsibilities
Simulation exercises across
government and in nongovernmental sector
organisations
FGN, UN system and
Development Partners
FGN, FMIC,
Development Partners
Time-frame and relation
to influenza phase
6-9 Months, Phase 3
Estimated costs
1-2 years
To be assessed
To be assessed
Indicators of performance in
achieving the activities
Guidance issued on web-site
and in material form
Number and size of exercises
held; lessons identified and
implemented
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR THE WIDER CONSEQUENCES OF A HUMAN INFLUENZA PANDEMIC
Action needed to
implement policy
Preparation,
dissemination and test
exercising of
operational and
business continuity
guidance
Threat (technical, commercial,
management, external, other) to the
success of the action
Low level of engagement in planning and
exercises by organisations with competing
priorities
Probability
(high, low)
Impact
(high, low)
High
High
Actions or contingency plans
needed to manage the risk to the
success of the action
Vigorous stakeholder engagement
through face-to-face dialogue and
wider communications
Responsibility for
the actions
FGN, FMIC,
Development
Partners, UN
system
79
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR AVIAN INFLUENZA PREVENTION AND CONTROL
Action needed to
implement policy
Early detection of
HPAI and early
response
Threat (technical, commercial, management,
external, other) to the success of the action
Difficulties in the clinical differentiation of
HPAI from other endemic poultry diseases
especially among village producers
Probability
(high, low)
high
Impact
(high, low)
high
Rapid diagnosis
of field samples
Slow turn around time between
rumour/suspicion to investigation and
confirmation of disease
low
high
Bio-containment
and bio-exclusion
of HPAI virus in
birds, farms and
markets
Restriction of
HPAI virus only
in the birds
Slow mobilisation of response team and
inadequate supplies of trained personnel and
materials at the critical points
low
high
Slow rate of adoption of bio-security
measures by village producers
Inadequate facilities for carcasses disposal
high
high
high
high
Early payment of
compensation to
affected farms
and farmers
Engender PublicPrivate
Partnership in
HPAI control
Joint veterinary,
medical and
communications
teams in field
operations
Backlog and delays in payment of
compensation to farmers
Slow replenishment of compensation fund
from Government budget
Apathy by the Private sector or lack of
awareness concerning the risk posed by HPAI
high
high
low
high
low
high
Slow detection and reporting of outbreaks to
Federal Ministry of Health for follow-up on
human cases
High
High
Actions or contingency plans needed to manage
the risk to the success of the action
-capacity building for veterinarians, CAHWs,
and community leaders/informants
-mobilising all trained personnel to areas where
there are none
-capacity building for personnel and laboratory
-effective management of veterinary stockpiles
-prompt collection and professional handling of
specimens
-enforcement of movement restriction and
quarantine
-provision of transport for the Rapid Response
teams
Responsibility
for the actions
FGN and
States
-institutionalising Monthly Cleaning Up among
the Community and Village Producers
-identifying and constructing facilities in every
Local Government Area
Setting up of Compensation Fund and
involvement of Stakeholders to make Annual
contributions and management of funds
States and
LGA
“
-regular dialogue with the Organised Private
Sector to buy into the HPAI control plan
- options of cost-sharing through sponsored
activities
Joint surveillance and response by Health,
Agriculture and Information sectors
FGN and
Stakeholders
FGN and
States
FGN and
States
FGN, States
and
Stakeholders
FGN and
stakeholders,
States and
LGAs
80
IMPLEMENTATION PLAN FOR HUMAN INFLUENZA PANDEMIC PREPAREDNESS, CONTAINMENT AND MITIGATION
Policy
To Strengthen AI
surveillance system
and ensure prompt
detection and
management of AI
cases across
Nigeria
Activities needed to implement
the policy
Identification and recruitment
of surveillance focal persons
at Federal, State and Health
facility levels
Roles and responsibilities
Time-frame and relation
to influenza phase
3-6 Months, Phase 3
Estimated costs
Training of state
Epidemiologists and DSNOs
FMOH, SMOH, WHO
WB, CDC, DFID
3-6 Months, Phase 3
N3, 500 000.00
State epidemiologist and
DSNOs trained
Training of LGA surveillance
focal persons
FMOH, WB, WHO,
SMOF, CDC
3-6 Months, phase 3
N26, 000 000.00
Focal persons at LGA level
trained
Adapt and produce technical
guides/tools for AI surveillance
FMOH, WB, WHO,
CDC,
3-6 Months, phase 3
N50, 000 000.00
Guidelines/tools produced
Establish AI sentinel
surveillance sites
FMOH, WHO,CDC,WB
1-2 Years, phase 3-4
N1,130,000 000
Sentinel sites functional
Establish IDSR net
FHOH,FM0A& WR,
CDC,WB,WHO
2-3 Years, phase3-4
N1,300,000,000
Functional IDSR net
established
Identify and assess AI
laboratories
FMOH, WHO, DFID,
USAID,CDC, FMOA
&WR
3-6 Months, phase 3
N4,500 000.00
AI laboratories identified and
assessed.
FMOH, SMOH, CDC,
WHO, JICA, USAID,
DFID, WB
N1, 300 000.00
Indicators of performance in
achieving the activities
Focal persons identified and
recruited
81
Policy
To institute Rapid
Response and
Containment
strategies for the
disease
Activities needed to implement
the policy
Training of laboratory staff on
AI diagnosis
Roles and responsibilities
Estimated costs
FMOH, FMOA & WR,
CDC, FAO, WHO,DFID
Time-frame and relation
to influenza phase
6 months-1 year,
phase 3
Upgrade designated
Laboratories
FMOH, WB, WHO,
CDC, USAID, DFID
6 months-1 year,
phase 3
N1,500,000,000
Designated labs upgraded
Conduct capacity building for
clinicians at National, Zonal,
State and LGA levels
FMOH,WB,CDC,SMOH,
WHO
6months-1 year
N50,000 000.00
Clinicians trained on AI
management nationwide
Procure Vaccine against
Seasonal influenza A
FMOH,NPI,UNICEF,
WHO,SMOH, CDC, U.E
1-2 years, phase 3-4
N1,200,000,000
Vaccines procured
Stockpile antiviral drugs to
cover 10% of Nigeria’s
population
FMOH,WB,WHO,
USAID, DFID, NAFDAC
SMOH
1-3 years, Phase-3-4
N4,500,000,000
Antiviral stockpiled
Procure antibiotics
FMOH, WB,WHO,
NAFDAC
1 year, phase 3
N400,000,000
Antibiotics procured
Procure Pneumococcal vaccine
FMOH, WB, WHO, CDC
NAFDAC, SMOH
1-2 years, Phase 3-4
N100,000,000
Pneumococcal vaccine procured
N6,500 000.00
Indicators of performance in
achieving the activities
Laboratory staff trained on AI
diagnosis.
82
Policy
To institute
pandemic
mitigation
strategies
To institute
environmental
measures to
combat pandemic
Activities needed to implement
the policy
Identify and upgrade isolation
and quarantine facilities
Roles and responsibilities
Time-frame and relation
to influenza phase
1-2 years, phase 3
Estimated costs
Procure and distribute PPEs
FMOH, WB, DFID,
WHO, USAID, CDC
6 months-1 year,
phase 3
N 1,300,000,000
PPEs procured and distributed
Conduct simulation and drills
on outbreak response
FMOH, WB,WHO,CDC
1-2 years, phase 3
N 260,000,000
Simulation and drills carried out
Undertake mathematical
modelling of the impact of
alternative social and medical
measures on pandemic spread
Implementation and
enforcement of social
distancing measures
FMOH, FMS&T, WHO,
US CDC
6 months – 1 year,
phase 3
N 11,000,000
Modelling outcomes inform
policy and implementation plan
options
FMOH, NEMA, Security
Agencies
Phase 6
To be assessed
and to depend on
enforcement
Successful mitigation by
reducing spread of infection
Establish a medical waste
management system
FMOH, WHO, UNICEF,
CDC, USAID
3-6 months, phase 3
N300,000,000
Medical waste management
system established
Provide personal hygiene
manual
FMOH, WHO, CDC,
DFID, USAID, SMOH
6 months- 1 year,
phase 3
N20,000,000
Personal hygiene manual
produced
Provide corpse disposal bags
FMOH, WHO, CDC
1-2 years, Phase 4
N50,000,000
Disposal bags provided
Provide safe drinking water
FMOA &WR, FMOE,
SMOA & WR, UNICEF,
UNDP
1-2 years
FMOH, CDC, WHO,
SMOH, USAID, DFID
N1,000, 000, 000
Indicators of performance in
achieving the activities
Isolation and quarantine
facilities identified and upgraded
Safe drinking water provided
83
Policy
To ensure
appropriate
co-ordination
mechanism and
management of
outbreak
To ensure a
comprehensive AI
Monitoring and
Evaluation system
Activities needed to implement
the policy
Formally establish the Incident
Command and Control System
(ICCS).
Time-frame and relation
to influenza phase
3-6 months, phase 3
Estimated costs
FMOH, FMOA, FMIC,
WB, UN System
Immediate, sustained
for at least 24 months
N65,500,000
Coordination and operational
continuity maintained through
permanence of the Crisis
Management Centre.
FMOH, WB, CDC
1-2 years, phase 3
N30,000, 000
Data system established and
staff recruited and trained
Develop an M& E manual
FMOH, FMOA & WR,
CDC, WHO
6 months-1 year,
phase 3
N15,000,000
M&E manual developed and
adopted
Establish monitoring and
evaluation system
FMOH, FMOA &WR,
WHO, CDC
1 year, phase 3
N100, 000,000
M& E system established
Maintain and support the
Avian and Pandemic Influenza
Preparedness and Control
Centre.
Establish data management
system
Roles and responsibilities
FMOH, WHO, CDC,
FMOA, FMOI, WB
N10, 000,000
Indicators of performance in
achieving the activities
ICCS established formally.
84
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR HUMAN INFLUENZA PANDEMIC PREPAREDNESS, CONTAINMENT AND
MITIGATION
Action needed to
implement policy
Threat (technical, commercial,
management, external, other) to the success
of the action
Probability
(high, low)
Impact
(high, low)
Actions or contingency plans needed to manage
the risk to the success of the action
Responsibility
for the actions
Conduct Capacity
building
Funding and technical expertise
Low
High
Engage technical experts that will conduct the
capacity building and source for funding from
government and development partners.
FMOH,
World Bank,
CDC,
Identification and
recruitment of
surveillance focal
persons.
Funding
Low
High
Ensure availability of funds
FMOH, CDC,
World Bank
Establishment of
sentinel surveillance
sites
Funding, Personnel, equipment
Low
High
Provide funds and equipment, recruit needed
personnel
World bank,
FMOH, WHO
Provision of
surveillance tools
Funding for the tools, sustainability
Low
High
Ensure availability of tools always
FMOH, CDC,
WHO, World
Bank
Identification and
strengthening of
laboratories
Funds, manpower, equipment
Low
High
Upgrade identified laboratories, train the lab.
Personnel and Provide a sustainable source of
funding.
FMOH,WHO,
World bank
Establishment of
IDSR Net.
Funds, Technical expertise
High
Low
Provide funds and technical expertise
FMOH,
FMOA & WR
Strengthening of
Surveillance and
detection system
85
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR HUMAN INFLUENZA PANDEMIC PREPAREDNESS, CONTAINMENT AND
MITIGATION
Action needed to
implement policy
Threat (technical, commercial,
management, external, other) to the success
of the action
Probability
(high, low)
Impact
(high, low)
Actions or contingency plans needed to manage
the risk to the success of the action
Responsibility
for the actions
Conduct Capacity
building for
clinicians
Funds, training materials, instructors
Low
High
Ensure availability of funds, identify experts
for the training and provide training materials
World bank,
CDC, FMOH
Provision of
vaccine against
seasonal influenza
A
Stockpile Antiviral
drugs disinfectants
and antibiotics
Availability of the vaccine, funds, storage
and transportation
High
High
Identify viral strain early ahead of the influenza
season and place order for the vaccine. Also
ensure storage and transportation facilities
World bank,
FMOH, NPI,
E.U, UNICEF
Availability of Tamiflu, shelve life and
funds.
High
High
Provide adequate funds and place order for the
drugs ahead of time. Expiry date should be
closely monitored.
FMOH,
World Bank,
WHO
Identification and
upgrading isolation
and quarantine
facilities
Provision of
Personal protection
equipment
Funds, equipment
High
High
Provide funding and materials needed in
isolation facilities
FMOH, CDC,
World bank
Funding
Low
High
Provide PPEs to all relevant centres.
Conduct simulation
and drill exercise
Funding, technical expertise
Low
Low
Ensure that drills and simulation are conducted
in pre pandemic phase
DFID,
FMOH,
WHO, WB
FMOH, CDC,
WB
Rapid response
and containment of
the disease.
86
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR HUMAN INFLUENZA PANDEMIC PREPAREDNESS, CONTAINMENT AND
MITIGATION
Action needed to
implement policy
Threat (technical, commercial,
management, external, other) to the success
of the action
Probability
(high, low)
Impact
(high, low)
Actions or contingency plans needed to manage
the risk to the success of the action
Responsibility
for the actions
Establishment of
medical waste
management
Comprehensive plan, funding and
sustainability.
Low
High
Ensure availability of medical waste
management plan ahead of time and budget for
it.
Provision of Safe
and Wholesome
water supply
Lack of adequate Community mobilisation,
availability of disinfectants for treating
water for drinking
Low
Low
Provision of a
personal hygiene
manual on AI
Funding, Technical expertise, mobilisation
of the community
High
High
Ensure that water for drinking is treated before
consumption, community mobilisation and
provide subsidised liquid chlorine especially in
rural areas.
Ensure production of the manual, adequate
community mobilisation
WB, FMOH,
USAID,
DFID,
UNICEF
WB,FMOA &
WR, FMOE,
UNDP
Provision of AI
corpse disposal
polythene bags
Funding
High
High
Ensure availability of disposal bags at all
relevant health facilities, community
mobilisation
FMOH,
WB,CDC
Funding, Accommodation, equipment
Low
High
Provide funding, accommodation and needed
equipment before take off.
Funding, manpower, Training and
equipment
Low
Low
Ensure prompt establishment of data
management centre and recruit staff
WB, FMOH,
CDC,
UNICEF, E.U
WB, FMOH,
CDC
Environmental
management.
FMOH, WB,
WHO
Coordination and
Outbreak
Management.
Establishment of
Crisis Management
Centre.
Establishment of
data management
system
87
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR HUMAN INFLUENZA PANDEMIC PREPAREDNESS, CONTAINMENT AND
MITIGATION
Action needed to
implement policy
Threat (technical, commercial,
management, external, other) to the success
of the action
Probability
(high, low)
Impact
(high, low)
Actions or contingency plans needed to manage
the risk to the success of the action
Responsibility
for the actions
Funding, Technical expertise
Low
High
Funding, personnel
Low
High
Hire a consultant to develop manual and
employ M&E officers
Provide funds and personnel
FMOH, WB,
WHO
FMOH, CDC,
WHO
Monitoring and
evaluation
Development of M
& E manual
Establishment of
routine monitoring
and periodic
evaluation of AI
activities
nationwide
Poster (2) for health facilities:
one intended to health workers
(20,000) showing signs and
symptoms and standard
procedures
FPEC- FMIC
SPEC for distribution and
dissemination
Dev. Partners
Private Hospitals
April-May 2007
Phases III, IV and V
2,500.000 -100% health facilities have a
poster with basic behaviours,
signs and symptoms
A second one (40,000) intended
to be located in waiting rooms
or corridors with messages for
patients
FPEC
SPEC for distribution and
dissemination
Dev. Partners
Private hospitals
FPEC/SPEC
MoH
Dev. partners
Private hospitals
FPEC- FMIC
SPEC for distribution and
dissemination
Dev. Partners
1-3 months, Phases 3, 4
and 5
3,500.000 -100% health facilities have a
poster with basic behaviours,
signs and symptoms
Phase 4
3,500.000 -100% of health workers
practice and promote social
distancing jointly with
communities leaders
2,800.000 -100% community health
educators receive and use
2,800.000 notebooks for mobilisation
To produce new poster to all
health facilities if social
distancing measure must be in
place
Production of a Notebook for
Community Health Educators
(1500) with behaviours on cover
pages and blank pages to be
Phase 5
1-3 months, Phase 3
Phase 4
Phase 5
88
used for them
Training and
promotional
material to
support Livestock
community
workers
Training and
promotional
material to road
transports drivers
and assistants
Production of a Notebook with
behaviours to be promoted and
questions collected from
communities/correct answers on
cover pages and blank pages to
be used in work by community
leaders (1500)
Production and distribution of a
car sticker (1.0 million) with
logo and prevention measure
FPEC- FMIC
SPEC for distribution and
dissemination
Dev. Partners
1-3 months, Phase 3
FPEC- FMIC
SPECs Coordinators
WB
Phase 3
250,000.000
-One million vehicles in
Nigeria carry and show a
promotional sticker
Production and distribution of a
car sticker (1.0 Million) with
logo and preventive measures
FPEC- FMIC
SPECs Coordinators
WB
Phase 4
Phase 5
250,000.000
-One million vehicles in
Nigeria carry and show a
promotional sticker
To produce one booklet with
basic information regarding
behaviours, general hygiene
practices and essential low-cost
bio-security measures to be used
by extension workers at backyard poultry
To produce one booklet with
basic information regarding
behaviours, general hygiene
practices and essential measures
to avoid infection at commercial
farms
Key-holders with a key
behaviour to be comply by road
transport drivers and assistants
FPEC
SPEC
Dev. partners SPECs
FAO
1-3 months
Phase 3
FPEC
PAN
MoA
Dev. Partners
1-2 months, Phase 3
2,800.000 -100% commercial farms
workers can mentioned all biosecurity measures for their
protection
FPEC/SPEC
PAN
NARTO
Dev. Partners
WB
1-3 months, Phase 3
-50% of transport drivers
receive and use a key-holder as
a reminder of a good behaviour
Phase 4
2,800.000 -100% of community leaders
(including religious are engaged
2,800.000 in disseminating accurate
behaviours to avoid infection)
Phase 5
Phase 4
Phase 5
2,800.000
-70% of livestock staff receive
and use a booklet when visiting
farms
89
School
engagement
through students,
teachers and
parents
Engagement of
Nollywood
States Mass
campaigns
according to
situation
Immediate printing and
dissemination of Zandi’s song in
all 5,000+ schools
Immediate contact with film
production to advocate for the
creation of a character with an
AI event in his/her home a part
of a popular soap-opera or series
Production of jingles for radio in
each State
Production of TV PSAs in each
State
Production of jingles for
nationwide airing
Engage with and
provide relevant
information to
the news media
on pandemic
influenza
FPEC- FMIC
SPECs
LPECs
Dev. Partners
CDC
FMIC
FPEC- FMIC
1-6 months, Phase 3
SPEC
UNICEF
WB
June 2007 and on
Phases 3, 4 and 5
???
-Jingles airing according to
plans agreed with State radio
stations
FPEC- FMIC
SPECs Coordinator
SPEC Media Liaison
WB
FPEC- FMIC
SPECs to adopt
SPEC Media Liaison to
distribute
WB
UNICEF
FMIC
FPEC
UNICEF-Media
June 2007 and on
Phases 3, 4 and V
???
-Jingles airing according to
plans agreed with State TV
station
To immediately collect all
names of journalists having been
trained and create a data-base
for follow-up interventions and
analysis of press materials
produced as part of on-going
training
Production of a Journalist’s
FMIC
Notebook with behaviours to
FPEC- FMIC
promote on cover pages and
blank pages to be used in work
for journalists trained and part of
1-3 months, Phase 3
As situation arises
Phase IV
Phase V
5,120.000 -Publication distributed in all
5,000+ schools
-Trained teachers in use of
publication
550,000 Soap-opera or series broadcast
-Jingles airing according to
situation
April-May 2007
10,000 -Data-base of journalists doing
avian influenza material
April-May 2007
Phase 3
25,000 -5000 copies of notebook to be
distributed at national and state
levels
25,000
25,000
Phase 4
Phase 5
90
data-base
Immediate call to all journalists
((national level) having been
trained for a follow-up exercise
(news produced by them after
first training should be identified
and analysed)
Regular meetings with
journalists for follow-up
FPEC- FMIC
SPEC Media Liaison
Officer
All trained journalist
UNICEF
April 2007
Phases 3
-25% of all journalists trained
1,597.440 have a product to analyse
-100% received a Journalists
Notebook
FPEC
SPEC Media Liaison Of
All trained journalists
UNICEF
Phase IV and
Phase V
1,500.000 -Minutes of meetings are shared
2.000.000 and agreements complied
Supervision plans at all levels
should have tools for reporting
potentials and specific needs
FPEC- FMIC
SPEC-Coordinator,
Monitoring OfficerWB
On-going, starting March
2007
Phase 3
Phase 4
Phase 5
Performance and
communication indicators to be
defined in each State, according
to guidelines provided from
FPEC
FPEC- FMIC
SPEC-Coordinator
Monitoring Officer
WB
April 2007
Phase 3
Phase 4
Phase 5
Supervision and Monitoring
Capacity building
at all levels in
communication
strategies
-70% of all LGAs report
supervision mission
122,880 -100% of all State capital report
122,880 supervision mission
122,880 -100% of all LGA identified
best social mobilizers???
-100% of changes
recommended by States are
considered and act upon
-Indicators defined and shared
120,000
TOTAL BUDGET
*Lacks cost of production of jingles, provided these will be aired for free. This applies to cost of printed materials.
91
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Action needed to implement
policy
Threat (technical, commercial,
management, external, other) to
the success of the action
Probability
(high, low)
Impact
(high, low)
Actions or contingency plans
needed to manage the risk to the
success of the action
Responsibility for
the actions
Advocacy
Meeting among MINFOC and
development partners (UNICEF,
UNDP, CDC, AED, WB) to
discuss this proposal and assign
clear roles and responsibilities to
all
Uncertainty or lack of clarity about
roles and responsibilities
High
High
Immediate proposal for this meeting
to FMIC from development partners
and other line ministries
FMIC
Breakfast meeting with media
executives at the highest level for
a medium and long term
commitment
Media apathy
High
High
Development partners to lobby
FMIC
Meeting with religious leaders at
the highest level (Archbishop,
Imam)
None
High
High
Notebook with messages and empty
pages should be printed to distribute
among religious leaders to be used as
a reminder of all behaviours
recommended
FMIC
Communication for Behavioural Impact
Urgent meeting to finish the
Manual for Community Dialogue
System (CDS) with organogram
for information sharing among
tiers of Government
Funding
Low
High
High level advocacy with Minister
and UN High level advocacy
Representatives
FMIC
92
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Action needed to implement
policy
Strengthening Federal PEC with
training and physical
infrastructure at APIP&CC as HQ
Threat (technical, commercial,
management, external, other) to
the success of the action
Funding
Probability
(high, low)
Impact
(high, low)
High
High
Actions or contingency plans
needed to manage the risk to the
success of the action
Idem as above
Responsibility for
the actions
Dev. Partners
Strengthening States structures
according to needs and do
simulation exercises
Funding, training
Contingency plans based on
LGAs affected (Plateau=38,
Kaduna=19, Kano=14,
Bauchi=14, Lagos=12
Katsina=9, Nasarawa=6) and nonaffected. For immediate
collection of information using
participatory methods
Lack of funds
Weak initial training and/or
strengthening of structures in place
as well as networking with all
stakeholders at state level
High
High
Keep high level advocacy going as
well as technical assistant identified
from all sources (UNICEF, UNDP,
CDC, AED, etc.)
SPECs
Dev Partners
Implementation of Rapid
Assessment in high risk LGAs
Funding, manpower, resources
High
High
Identification tools, personnel,
analysis planned for quick findings to
be shared
FPEC
SPEC
Plan for Non-news media
contribution
Training in non-news media
engagement
High
High
Identification of all States (20)
affected to begin involvement in a
medium, long term basis
FPEC
SPEC
Dev. Partners
Rapid training of LGA staff and
LPEC membership in CDS and
its tools
93
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Action needed to implement
policy
Training of all staff in remaining
States in community participation
methods
Threat (technical, commercial,
management, external, other) to
the success of the action
Lack of funds
Probability
(high, low)
Impact
(high, low)
High
High
Actions or contingency plans
needed to manage the risk to the
success of the action
Continuing training at State and LGA
level, with simulation exercises
Responsibility for
the actions
Dev.
Partners/SPEC
Mass Media Campaigns and News
Immediate call to all journalists
(national level) having been
trained for a follow-up exercise
(news produced by them after
first training should be identified
and analyzed)
Immediate call to all journalists
(state level) having been trained
for a follow-up exercise (news
produced by them after first
training should be identified and
analyzed)
Material production
Lack of designated personnel to do
follow-up
High
High
Development partners to provide
support in developing a data base of
journalists at national level
FMIC
Media Liaison person in SPEC
should be trained
Funding, training
High
High
UNICEF’s media personnel should
offer training on journalist data base
and follow-up
All SPEC
Coordinators
Capacity of identifying useful
materials according to target group
(e.g. basic signs and symptoms on
a poster for health facilities,
notebook for
journalists/leaders/extension
workers/health educators, keyholders for transport staff) instead
of sticking to conventional
materials such as “posters for all”
or fliers
High
High
Dev. Partners
FMIC /FPEC
Dev Partners
94
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR COMMUNICATIONS POLICIES
Action needed to implement
policy
Threat (technical, commercial,
management, external, other) to
the success of the action
Probability
(high, low)
Impact
(high, low)
Actions or contingency plans
needed to manage the risk to the
success of the action
Responsibility for
the actions
Supervision and Monitoring
Supervision plans at all levels
should have tools for reporting
potentials and specific needs
Funding, resources
High
High
Contingency plans to supervise
capacity building at all level
FMIC /FPEC
SPEC
LPEC
Performance and communication
indicators to be defined in each
State, according to guidelines
provided from FPEC
Funding, training
High
High
Dev. partners to support defining
indicators and preparing guidelines to
be proposed
FMIC /FPEC
Dev. Partners
95
IMPLEMENTATION PLAN FOR THE WIDER CONSEQUENCES OF A HUMAN INFLUENZA PANDEMIC
Policy
Guidance on
operational and
business continuity
planning for
essential services,
vital supplies,
financial systems,
and government
functions
Activities needed to implement
the policy
Consultation with stakeholders
on required content of
guidance; preparation and
dissemination of guidance.
Roles and responsibilities
Simulation exercises across
government and in nongovernmental sector
organisations
FGN, UN system and
Development Partners
FGN, FMIC,
Development Partners
Time-frame and relation
to influenza phase
6-9 Months, Phase 3
Estimated costs
1-2 years
To be assessed
To be assessed
Indicators of performance in
achieving the activities
Guidance issued on web-site
and in material form
Number and size of exercises
held; lessons identified and
implemented
RISK ANALYSIS OF IMPLEMENTATION PLAN FOR THE WIDER CONSEQUENCES OF A HUMAN INFLUENZA PANDEMIC
Action needed to
implement policy
Preparation,
dissemination and test
exercising of
operational and
business continuity
guidance
Threat (technical, commercial,
management, external, other) to the
success of the action
Low level of engagement in planning and
exercises by organisations with competing
priorities
Probability
(high, low)
Impact
(high, low)
High
High
Actions or contingency plans
needed to manage the risk to the
success of the action
Vigorous stakeholder engagement
through face-to-face dialogue and
wider communications
Responsibility for
the actions
FGN, FMIC,
Development
Partners, UN
system
96