Nigeria is grappling with a cholera outbreak that has resulted in 63 deaths and 2,102 suspected cases across 33 states and 122 local government areas (LGAs) as of June 30, 2024. The case fatality rate stands at 3.0% since the year’s beginning.

Ten states, including Lagos, Bayelsa, Abia, Zamfara, Bauchi, Katsina, Cross River, Ebonyi, Rivers, and Delta, account for about 90% of the cases. Seven of these states are in the southern part of the country.

Dr. Jide Idris, Director General of the Nigeria Centre for Disease Control and Prevention (NCDC), highlighted several challenges in the ongoing cholera response. These include open defecation, inadequate toilet facilities, lack of safe water, and poor sanitation. Idris noted that only 123 (16%) of Nigeria’s 774 LGAs are open defecation-free. “More than 48 million Nigerians practice open defecation,” he stated. Additionally, inadequate toilet facilities plague many government establishments, and poor sanitation affects schools, health facilities, and public spaces.

Idris pointed out gaps in healthcare capacity at state and LGA levels, alongside weak regulation of soakaway and borehole construction. “We face delayed disease reporting and response actions, inadequate capacity among healthcare workers, and poor regulation of food vendors and commercial water suppliers on hygiene,” he said.

The NCDC has activated the National Cholera Multisectoral Emergency Operation Centre (EOC), which includes experts for strategic coordination. These experts meet daily to provide situation reports, ensuring effective resource mobilization to support affected states.

The center has distributed medical supplies for case management, infection prevention, and control across all 36 states and the Federal Capital Territory (FCT). Idris stated, “We have provided guidelines, SOPs, and advisories to enhance technical readiness and response.”

The NCDC has been conducting sub-national level training for laboratory scientists on sample collection and analysis and for community mobilizers on cholera key messages. Capacity building has been supported by LGA disease surveillance and notification officers nationwide.

Additionally, the NCDC has supported capacity building for LGA risk communication, community engagement, and health promotion officers across the country. Public health advisories have been issued regularly, and the NCDC has engaged with the media to sensitize the public on taking responsibility for breaking the transmission chain.

Idris acknowledged the strong political will to control the outbreak, demonstrated by the President’s constitution of an inter-ministerial cabinet committee. This committee includes ministers from health, environment, water resources, sanitation, education, information, and other relevant departments. Their collective effort supports ongoing control measures through specific interventions related to their respective ministries and agencies.

The NCDC continues to provide technical support to states and follows up daily on response activities. They are committed to enhancing surveillance, improving diagnostic capacity, and ensuring effective treatment for affected individuals. With these efforts, Nigeria aims to control the cholera outbreak and mitigate its impact on public health.