CDC S PUBLIC HEALTH ROLE IN NIGERIA: ROLE OF FIELD EPIDEMIOLOGY LISA ESAPA, MPH CDC-Nigeria NFELTP 1 st Annual Scientific Conference March 15, 2016 Center for Global Health
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FIELD EPIDEMIOLOGY AND CDC Epidemic Intelligence Service (EIS) established 1951 1966: EIS officers (EISO) are on the scene as CDC begins a worldwide smallpox eradication campaign in Africa. 1971: EISOs join the local health department in El Paso, Texas, to investigate lead exposure associated with an ore smelter. 1976: EISOs in Zaire and Sudan investigate a mysterious fever that sends its victims into shock with massive external and internal hemorrhages. 1976: CDC investigators discover that a bacterium causes Legionnaires disease. 1981: EISO and a Los Angeles physician publish an MMWR article describing the occurrence of Pneumocystis cariniipneumonia among young, previously healthy homosexual males. 1987: EISOs assist health departments in conducting HIV seroprevalencesurveys. 1992: After Hurricane Andrew decimates much of southern Florida, EISOs find an extensive need for mental health services among people affected by disasters. EIS: A Snapshot of Public Health Achievements; http://www.cdc.gov/eis/downloads/eis-timeline-booklet.pdf
Historically, FIELD EPIDEMIOLOGY AND CDC IN NIGERIA 1968: EIS officers work on malnutrition and famine relief in the Nigerian-Biafran war zone. 1976: EIS officers help set up a field laboratory in Sierra Leone to investigate the cause of a deadly fever found in Lassa, Nigeria, in 1969. More recently, 2010: EIS officers and NFELTP work with partners to investigate the largest outbreak of acute fatal lead poisoning in modern history. 2014: CDC sends EIS officers to West Africa, including Nigeria, in response to Ebola outbreak and activates the Emergency Operations Center (EOC). It is the largest international outbreak response in CDC s history. EIS: A Snapshot of Public Health Achievements; http://www.cdc.gov/eis/downloads/eis-timeline-booklet.pdf
CDC NIGERIA STRATEGIC FOCUS CDC Nigeria HIV/TB office was launched in February 2001 HIV/TB Control DGHT/PEPFAR Immunization (Polio) - GID Global Health Security (Ebola, Lassa, etc.) - DGHP
CDC NIGERIA AND NFELTP NFELTP was modelled after CDC s Epidemic Intelligence Services (EIS) program and established in Abuja in 2008 in partnership with GoN ministries (FMOH, FMARD) and universities (ABU and UI) Aims to build local capacity for epidemiology, develop workforce for response to public health emergencies and ensure global health security CDC/NFELTP collaboration supports HIV, TB and Polio eradication program implementation, and other diseases of public importance Ebola, Lassa etc.
CDC NIGERIA AND NFELTP/2 NFELTP works with CDC/PEPFAR to support HIV/AIDS and TB implementation research and surveys, e.g. AIDS Indicator Surveys HIV/AIDS Impact Assessments PMTCT Cascade Evaluation and Option B plus Evaluation Supports CDC/PEPFAR partners in routine HIV data reporting quality assessments NFELTP also facilitates, on behalf of CDC, the building of other health systems infrastructure for GoN, e.g. Roll-out of GoN District Health Information System (DHIS2) instance
HIV/TB DGHT/PEPFAR: Current Issues in HIV/TB Control in Nigeria Supports Government of Nigeria (GoN) FMOH and NACA in their efforts to: Prevent new HIV infections, including PMTCT Treat and care those already infected with HIV Develop laboratory capacity for HIV diagnosis and monitoring Ensure HIV/TB service integration Strengthen health systems including HRH and infrastructure to help support a sustainable national response
HIV/TB DGHT/PEPFAR: Current Issues in HIV/TB Control in Nigeria/2 With other PEPFAR agencies (USAID and DOD), continues to work with GoN and Global Fund (GF) to achieve HIV epidemic control in Nigeria Focused efforts in select high burden areas (32 PEPFAR priority LGAs), and on populations at risk; while ensuring service delivery maintenance in other areas Aim of prioritization is to achieve UNAIDS Goal of 90:90:90 (2014): 90% of PLWHIV are tested and diagnosed 90% of those diagnosed placed on ART 90% of those on ART virally suppressed.
GLOBAL IMMUNIZATION DIVISION - POLIO 2012: CDC activates its Emergency Operations Center (EOC) for polio eradication. EISOs begin polio surveillance as part of CDC s efforts. July 2012, National Stop Transmission of Polio (NSTOP) program established Provides trained field epidemiologists Flexible, rapidly deployable workforce Focus on data for decision making Targeted activities for underserved populations Focus on building capacity for polio eradication and routine immunizations
GLOBAL HEALTH SECURITY AGENDA Prevent avoidable catastrophes Detect threats early Respond rapidly and effectively
GHSA - FETP Advanced and Basic Curriculum Workforce Development Expansion and Collaboration with FMoH Legacy Programs FETP-Basic is a 3-month in-service program that focuses on detection of and response to diseases and events of public health importance or international concern Participants learn and practice the fundamental skills used in frontline surveillance: use of case definitions disease detection and reporting summarization of data using simple tables and graphs case investigation outbreak investigation and response surveillance monitoring and evaluation data analysis and interpretation for decision-making
SUMMARY Shoe leather epidemiology is a critical component for public health systems As Nigeria s Field Epidemiology program continues to mature, GON should plan for sustainability of this vital resource
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