Nigeria: Score Justification Summary

1.1.1a National plan for AMR priority pathogens

Score: 100

A national AMR plan is in place in Nigeria, and it covers surveillance, detection, and reporting of priority AMR pathogens. ^{1 2}

In October 2024, the Nigeria Centre for Disease Control and Prevention (NCDC) introduced the One Health Antimicrobial Resistance National Action Plan 2.0 2024 – 2028, which lays down strategies to improve surveillance and detection capabilities of AMR. ³ Strategic Objective 3 of the action plan aims to strengthen ‘One Health’ AMR surveillance systems and operations research, aligning with priority actions recommended in a 2023 mission report by the joint external evaluation of the International Health Regulations (2005) core capacities of Nigeria. ^{4 5} Under Activity 3.1.3., the plan aims to conduct workshops to identify priority pathogens, review surveillance data collection tools to formulate the AMR Surveillance Guidelines in Environmental Health, and conduct national resistance trend assessment on the Nigerian priority pathogens to address AMR surveillance gaps. Under Activities 3.1.8. and 3.2.2., the plan will integrate molecular characterisation to detect AMR as well as deploy systems and offer periodic technical support to AMR labs to standardise data entry and reporting. ⁶ Focus Area 2 of Nigeria’s first National Action Plan for Antimicrobial Resistance 2017 – 2022 published by NCDC also contains strategies to develop sector-specific surveillance protocols to detect early AMR trends and implement WHONET Tools for improved reporting of resistances. ^{7 8}

1.1.1b Capacity of national lab/lab system to test for AMR priority pathogens

Score: 50

There is a national laboratory or laboratory system which provides testing for some but not all priority AMR pathogens. ⁹

According to 2023 mission report from the joint evaluation of the International Health Regulations (2005) core capacities of Nigeria (p. 32), the country has a designated National Reference Laboratory which functions to support national and subnational laboratory systems on quality and testing. While there are national laboratory testing capacity and external quality testing programmes for most priority pathogens in human and animal health laboratories, the mission report recommends an action to develop a plan to implement laboratory information systems that cover all priority pathogens at all tiers of laboratories across all sectors. ¹⁰ Highlighting the lack of laboratories for priority pathogens in environment and plant health sectors, the One Health Antimicrobial Resistance National Action Plan 2.0 2024 – 2028 (p.62) also provides strategies to set up a national reference laboratory for priority pathogens within the plant health sector. ¹¹ In October 2024, NCDC issued an invitation to tender for the procurement and installation of equipment to support priority pathogens testing at the NCDC Central Public Health Laboratory. ¹² However, there is insufficient evidence of the progress of the bid on the NCDC website. ¹³

1.1.1c National environmental surveillance for AMR residues/organisms

Score: 100

Nigeria conducts environmental detection or surveillance activities for AMR organisms and residues. ^{14 15}

Nigeria has set up a comprehensive AMR surveillance system in environmental health sector, which is supported by national reference and sentinel laboratories. ¹⁶ Nigeria’s One Health Antimicrobial Resistance National Action Plan 2.0 2024 – 2028 (p. 35) states that the country has sentinel sites in place to detect AM residues, Antimicrobial Resistance Patterns (ARPs), and Antimicrobial Resistance Genes (ARGs) in environmental health sector, but those sites have poor capacity. To respond to this issue, the action plan calls for an action to upgrade sentinel laboratories to detect AM residues by designating the National Veterinary Research Institute (NVRI), National Environmental Standards and Regulations Enforcement Agency (NESREA) labs (Kano and Rivers), and Federal Fisheries Laboratory as AMR residue surveillance sites. Developing Standard Operating Procedures (SOPs) and protocols for AM residue testing and reporting also falls under the actions to implement the residence monitoring and control plan in environmental sector (p. 69). ¹⁷

1.1.2a National law(s) requiring prescription for antibiotic use (humans)

Score: 50

There is evidence of a national legislation or regulation in place that requires prescriptions for antibiotic use for humans in Nigeria. ^{18 19 20}

The 2017 Mission Report from the Joint External Evaluation of International Health Regulations core capacities of Nigeria stated there was an enacted law that required antimicrobials used in humans be available only by prescription. However, the report provided that data on antimicrobial use in humans was limited (p. 11). ²¹ The National Action Plan of Antimicrobial Resistance 2017 – 2022 and the 2017 Situation Analysis and Recommendations on Antimicrobial Use and Resistance in Nigeria confirmed this assessment. ^{22 23} In May 2025, the Nigerian Medical Association has refused to accept the proposal on the developing national prescription policy. ²⁴ While the current 2021 National Drug Policy states that only qualified and licensed medical practitioners may prescribe medicines, it does not impose any provision on prescriptions for antibiotic use for humans. ²⁵ The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria (p. 18) also mentions that there are guidelines available for the appropriate use of antimicrobials in human health in the country, but there is insufficient evidence of the guidelines. ²⁶

1.1.2b National law(s) requiring prescription for antibiotic use (animals)

Score: 0

There is no evidence of national legislation or regulation that requires prescriptions for antibiotic use for animals. ^{27 28 29 30 31}

Nigeria’s One Health Strategic Plan 2019 – 2023 (p. 24) and One Health Antimicrobial Resistance National Action Plan 2.0 2024 – 2028 (p. 86) both mention the lack of regulation that requires prescription for antimicrobial use for animals. ^{32 33} The current 2021 National Drug Policy also recommends the government of Nigeria to enact appropriate legislation on the use of antibiotics in livestock product. ³⁴ While a national prescription policy is in its developing stage, there has not been sufficient update on its finalisation and implementation as per media reports published in May 2025. ^{35 36}

1.2.1a Laws/plans on zoonotic disease

Score: 100

In Nigeria, there exist strategic documents on zoonotic disease. ^{37 38}

Nigeria’s One Health Antimicrobial Resistance National Action Plan 2.0 2024 – 2028 which aims to address the AMR issues in the country outlines strategies to develop priority pathogen list for zoonotic diseases and deploy zoonotic surveillance protocol in animal handlers (p. 63). ³⁹ The country’s One Health Strategic Plan 2019 – 2023 added that reporting of zoonotic diseases within Nigeria’s surveillance system was carried out “with set reporting timelines against which timelines of reporting is measured” (p. 12). A list of prioritised zoonotic diseases, the responsibilities of Nigeria Integrated Disease Surveillance and Response (IDSR), and strategies to enhance surveillance of zoonotic diseases were also included in the strategic plan (p. 13). ⁴⁰

1.2.1b Laws/plans on zoonotic disease spillover from animals to humans

Score: 0

There is no national legislation, plans or equivalent strategic document(s) that includes measures for risk identification and reduction for zoonotic disease spillover events from animals to humans. ^{41 42 43 44}

According to Nigeria’s One Health Antimicrobial Resistance National Action Plan 2.0 2024 – 2028, there are strategic measures that focus more on improving zoonotic surveillance system rather than identifying risks and reducing zoonotic disease transmission from animals to humans (p. 63). ⁴⁵ On the other hand, both the One Health Strategic Plan 2019 – 2023 (p. 25) and the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria (p. 20) highlight the objective to establish functional multisectoral, multidisciplinary policies and systems to reduce the transmission of zoonotic diseases from animals to humans. The strategies included reviewing outbreaks to enhance outbreak identification and reporting as well as designating NCDC to review guidelines and protocols on coordinated research on zoonotic diseases. However, there is lack of sufficient evidence whether these strategies have been implemented. ^{46 47 48}

1.2.1c Laws/plans for surveillance & control of multiple zoonotic pathogens

Score: 100

There are national strategic plans that account for the surveillance and control of multiple zoonotic pathogens of public health concern exists in Nigeria. ^{49 50}

According to Nigeria’s One Health Strategic Plan 2019 – 2023, the national Integrated Disease Surveillance and Response (IDSR) has put up efforts to report of zoonotic diseases within surveillance system with set reporting timelines. IDSR has collected data on 41 listed priority diseases on a weekly and monthly basis and reported the data to the Surveillance Outbreak Response Management and Analysis System (SORMAS) database tool which aimed to improve quality and timeliness of surveillance and effective control of disease outbreaks (p. 13). Moreover, the Department of Veterinary and Pest Control Services have played a significant role in coordinating zoonotic disease surveillance in animal, and the diseases have been reported regularly through the National Animal Disease Information and Surveillance (NADIS) system (p. 14). ⁵¹ The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria also stated that the country has gathered a high level of coordination in information systems for zoonotic diseases and that the local laboratories have been able to identify priority diseases of both human and animal origins (p. 20). ⁵²

1.2.1d Cross-ministerial department/agency/unit for zoonotic disease

Score: 0

There is no evidence of a department, agency, or similar unit dedicated to zoonotic diseases that works across ministries. ^{53 54 55}

Nigeria’s One Health Strategic Plan 2019 – 2023 provides that there is no single department or unit that functions across ministries to oversee zoonotic diseases in the country. Under the strategic plan, NCDC serves as a national public health institute whose functions are to conducting surveillance of zoonotic diseases and providing outbreak management in human health in Nigeria (p. 11). On the other hand, the Department of Veterinary and Pest control under the Federal Ministry of Agriculture and Rural Development involves in preventing and controlling zoonotic diseases in animals (p. 14). These departments also collaborate with the National One Health committees which play a role in planning, implementing, and monitoring of One Health related activities, such as enhancing collaborations between animal, human and environmental sectors to control endemic zoonoses and outbreak response (p. 32 & p. 35). ⁵⁶ Despite the existence of these departments and committees, there is no evidence of department or unit that focuses on zoonotic diseases and works across different ministries. ^{57 58 59}

1.2.1e Presence of One Health strategic plan

Score: 100

Nigeria has a a One Health strategy. The One Health Strategic Plan 2019–2023 was published in 2019. This plan was jointly developed with Department of Veterinary and Pest Control Services in the Federal Ministry of Agriculture and Rural Development, Federal Ministry of Health, Federal Ministry of Environment, Academia, development partners, the private sector as well as non-governmental organisations. ⁶⁰ The plan addresses some of the gaps identified in the Joint External Evaluation of the IHR core capacities. ⁶¹

1.2.2a Surveillance/reporting mechanism for zoonotic disease for livestock owners

Score: 100

Nigeria has a national voluntary mechanism for owners of livestock to conduct and report on disease surveillance to a central government agency. ^{62 63 64}

Surveillance system like National Animal Disease Information and Surveillance (NADIS) exists in Nigeria for reporting transboundary animal diseases through the Animal Resources Information System platform (p. 20). ⁶⁵ NADIS functions to receive and gather information from the surveillance agents at the local government areas where animal diseases are reported by farmers to the closest Area Veterinary Officer (AVO) who then inform their zonal veterinary officer in each of the 15 zones of the Surveillance compartments. ⁶⁶ According to Nigeria’s One Health Strategic Plan 2019 – 2023, animal owners or farmers were also in the position to report any disease suspicion to surveillance agents, such as local government veterinary officer and state area veterinary officer. The officers in return pass on the information to other bodies, including NADIS or epidemiology unit and disease desk officer (p. 16). ⁶⁷

1.2.2b Laws/regulations on data confidentiality to protect livestock owners

Score: 0

Nigeria does not have legislation and regulations that safeguard the confidentiality of information generated through surveillance activities for animals (for owners). ^{68 69 70 71}

There is no evidence of legislation and regulations that provide information protection through surveillance activities for animals. ^{72 73 74 75} The 2019 National Technical Guidelines for Integrated Disease Surveillance and Response, which are Nigeria’s latest guidelines on disease surveillance, placed great importance on data protection and the confidentiality of health data during outbreaks of infectious diseases. However, the guidelines focused heavily on protecting patient confidentiality and privacy rather than extending this scope to the animal health sector (p. 100). ⁷⁶

1.2.2c Wildlife zoonotic disease surveillance

Score: 100

Nigeria has conducted surveillance of zoonotic disease in wildlife, poultry and livestock by 2025. ^{77 78}

As per Section 2.4.1.2 of the One Health Strategic Plan 2019 – 2023, Nigeria has conducted zoonotic disease surveillance in animal, and such surveillance is coordinated by the Department of Veterinary and Pest Control Services under the Federal Ministry of Agriculture and Rural Development (FMARD). The strategic plan also adds that information about Transboundary Animal Diseases (TADs) and potential zoonotic diseases, including rabies, avian influenza, brucellosis, bovine tuberculosis and anthrax in animals is reported regularly through the National Animal Disease Information and Surveillance (NADIS) system. For instance, reports from surveillance points, such as live bird and livestock markets, animal health facilities, and wildlife parks are shared on a monthly, biannually, and annually basis. ⁷⁹ The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria also states that surveillance systems, such as a wildlife surveillance committee, are in place in animal health; and that the country has capacity for surveillance and management of zoonotic diseases, including wildlife surveillance at subnational levels (p. 20). ⁸⁰

1.2.3a Annual reporting to OIE on zoonotic disease incidence

Score: 100

There is publicly available evidence of a mechanism for reporting notifiable diseases to the World Organisation for Animal Health (WOAH) by 2025. ^{81 82}

Section 2.4.1.2 of the One Health Strategic Plan 2019 – 2023 provides that reports of animal diseases which are gathered through the Animal Resource Information System (ARIS) are generally shared to the State Director of Veterinary Services (DVS). The State DVS then validates the reports before sending them to OIE through World Animal Health Information System (WAHIS) Platform. ⁸³ According to WOAH, WAHIS is the global animal health reference database that collects validated information reported by the Veterinary Services on WOAH-listed diseases in domestic animals and wildlife as well as on emerging diseases and zoonoses. ⁸⁴

1.2.4a Number of veterinarians per 100,000 people

Score: 0

1.2.4b Number of veterinary para-professionals per 100,000 people

Score: 0

1.2.5a Inclusion of private sector in national plan/law on zoonotic disease

Score: 0

There is no national plan on zoonotic disease or other legislation, regulations or plans that include mechanisms for working with the private sector in controlling or responding to zoonoses. ^{85 86 87 88}

To control zoonotic diseases, Nigeria has put up efforts to engage relevant stakeholders through its One Health networks, including the National One Health Technical Committee, National One Health Coordinating Unit (NOHCU), National One Health Risk Surveillance and Information Sharing (NOHRSIS) group, and Technical Working Groups (TWGs) for zoonotic diseases. ⁸⁹ However, there is no evidence of collaboration with the private sector to respond or control the diseases, and private stakeholders are not members of the committees. ^{90 91} While the One Health Antimicrobial Resistance National Action Plan 2.0 2024 – 2028 outlines strategies to strengthen collaborations with the private sector on the country’s efforts in addressing AMR issues, the action plan does not mention any involvement from the private sector in combating zoonoses (p. 23). ⁹²

1.3.1a Updated national records of especially dangerous pathogen/toxin inventories

Score: 0

Nigeria does not have an existing record of the facilities in which especially dangerous pathogens and toxins are stored or processed, including details on inventories and inventory management systems of those facilities by 2025. ^{93 94 95 96}

According to the thematic area on biosecurity information and database of the National Biosecurity Policy and Action Plan 2022 – 2026, Nigeria has yet to develop a harmonised national bio-threat inventory or database. The action plan calls for an action to design and harmonise a national database that links bio-threat inventories and databases to sectoral facilities. ⁹⁷ Similarly, the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria states that Nigeria does not have comprehensive coordination of records and inventory of high-consequence pathogens in the country. Yet, the mission report mentions that the country is in the stage of starting the process of monitoring and developing an updated record and inventory of pathogens within the facilities that store or process dangerous pathogens and toxins (pp. 24 – 25). ⁹⁸ Evidence of such record is also not available on the One Health Antimicrobial Resistance National Action Plan 2.0 2024 – 2028 or NCDC’s website. ^{99 100}

1.3.1b Biosecurity laws on facility security for especially dangerous pathogens

Score: 100

Clear references to physical containment, operational practices, failure reporting, and cybersecurity of biosecurity facilities are contained in Nigeria’s National Biosecurity Policy and Action Plan 2022-2026 a ^{101 102}

Section 2.6 “Scope of the Policy” (p. 17) stipulates mechanisms for monitoring and handling agents/toxins, including physical containment and operational controls for listed high-risk biological materials. Section 3.4 “Biosecurity Incident Management” (p. 25) details the establishment of an incident management system to report, respond, and monitor failures or breaches. Section 3.3.2 “Institutional Governance” (p. 23) makes provision for institutional responsibility for facility security, both physical and digital, including protection of data and operational controls against unauthorized access or cyber attacks. ¹⁰³ In March 2017, the National Biosafety Management Agency also introduced the Biosafety Containment Facility Guidelines which impose fitting, capacity, and behaviour requirements for certification of biosafety physical containment facility that handles genetically modified organisms (GMOs). ¹⁰⁴

1.3.1c Agency for enforcement of biosecurity laws/regulations

Score: 0

Nigeria does not have an established agency (or agencies) responsible for the enforcement of biosecurity legislation and regulations. ¹⁰⁵

According to the 2015 National Biosafety Management Agency (NBMA) Act, NBMA has the responsibilities in ensuring the effective management of Nigeria’s biosafety, including proposing and implementing the overall policy guidance surrounding the issues of biosafety in Nigeria and safeguarding biodiversity, human health, and the environment from any adverse effect of genetically modified organisms (p. 5). However, under the Act, NBMA governs the regulation of genetically modified organisms, and there is no mention of biosecurity safeguarding from dangerous pathogens. ¹⁰⁶

1.3.1d Consolidation of especially dangerous pathogens into minimum # of facilities

Score: 50

There is public evidence of Nigeria’s efforts to consolidate its inventories, but there is insufficient evidence of active steps to reduce the number of facilities permitted to hold pathogens by 2025. ^{107 108}

The NBMA has published the National Biosecurity Policy and Action Plan 2022 – 2026 to develop a harmonised national bio-threat inventory and to regulate on the establishment, management and security of facilities where Valuable Biological Materials (VBMs) are handled or stored. The action plan aims to develop and harmonise a national database that links to the sectoral facilities and bio-threat inventories and to ensure all facilities function and manage VBMs through a coordinated system (p. 49). Apart from maintaining an inventory of VBMs in facilities, the action plan also imposes requirements of physical containment, operational practice, performance and verification testing for facilities where VBMs are handled and stored (p.47). Despite the strategic approaches, the action plan does not provide any measures to reduce the number of facilities permitted to manage VBMs or other pathogens. ¹⁰⁹ The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria states that the country has yet to have comprehensive coordination of records and inventory of high-consequence pathogens (p. 24). The mission report also reports that there is poor implementation of the national biosafety and biosecurity framework, including the National Biosecurity Policy and Action Plan 2022 – 2026 (p. 25). ¹¹⁰

1.3.1e Capacity to conduct tests for anthrax/Ebola without culturing live pathogens

Score: 100

There is public evidence of Nigeria’s capacity to conduct PCR-based diagnostic testing for anthrax and/or Ebola that would preclude culturing a live pathogen. ¹¹¹

Public evidence of Nigeria’s capacity to carry out PCR-based diagnostic testing for anthrax and/or Ebola that would preclude culturing a live pathogen is evident in a 2016 journal article on Ebola Virus Epidemiology and Evolution in Nigeria. According to the article, a filovirus PCR testing was performed at Lagos University Teaching Hospital, and the result of the testing showed filovirus positive. Redeemer's University (RUN) then used the samples for EBOV-specific PCR testing, which was confirmed on 25 July 2014 when the index patient died. ¹¹²

1.3.2a Biosecurity training using a standardised, required approach

Score: 33.33

There is publicly available evidence of biosecurity and biosafety training in Nigeria, but the training is provided on an ad hoc basis. ^{113 114}

The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria states that Nigeria has finalised the Nigerian universities’ biosafety and biosecurity curriculum to support bio-risk training in academic institutions. The mission report adds that the training is being conducted in all facilities that handle high-consequence agents with standardised biosafety and biosecurity risk assessment templates (p.24). ¹¹⁵ The National Biosecurity Policy and Action Plan 2022 – 2026 also aims to provide specialised trainings and refresher courses for biosecurity personnel at all levels to build personnel capacity and strengthen facilities that manage and operate Valuable Biological Materials (VBMs) (p.50). In addition, the action plan calls for strategic measures to develop biosecurity curriculum for relevant tertiary institutions and engage with national and institutions to provide specialised training for biosecurity officers (p.77). ¹¹⁶ However, there is no evidence that the specialised trainings are undertaken regularly. ^{117 118}

1.3.3a Personnel checks for permission to access to especially dangerous pathogens

Score: 0

Nigeria does not have existing regulations or licensing conditions that require security and other personnel who has access to dangerous pathogens, toxins, or biological materials with pandemic potential to undertake drug testing, background checks, and psychological or mental fitness checks. ^{119 120 121}

Nigeria’s National Biosecurity Policy and Action Plan 2022 – 2026 calls for actions to set up and strengthen physical security measures in biosecurity facilities while developing and enhancing personnel suitability and reliability criteria for the purpose of establishment of a biorisk management system (p. 56). However, there is no further explanation on the physical security measures or the criteria for personnel suitability and reliability. ¹²² According to the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria, the country has yet to provide sustained academic training for personnel working with high-consequence pathogens although they are trained in biorisk management (p. 25). The report also does not mention whether such personnel is subject to any testing and background or fitness checks when handling the pathogens. ¹²³

1.3.4a National transport regulations for Category A and B infectious substances

Score: 100

Nigeria has publicly available information on national regulations on the safe and secure transport of infectious substances (specifically including Categories A and B). ¹²⁴

Nigeria has Guidelines on Safe Transportation of Infectious/Exempt Substances established by the Medical Laboratory Science Council of Nigeria (MLSCN) in March 2018. The guidelines aim to govern the processes involved in packaging and transportation of specimens and emphasises on the importance of collaboration between the involving parties, including the sender, the carrier and the receiver in order to provide for the safe and expeditious transport of these materials. The guidelines also provide comprehensive details for all the persons, facilities and other stakeholders who are involved in the processes of handling the packaging and transportation of infectious substances, including those of Categories A and B (p. 3 & p. 5). ¹²⁵

1.3.5a Laws/regulations on cross-border transfer and end-user screening

Score: 0

There is no existing legislation and/or regulations in Nigeria to oversee the cross-border transfer and end-user screening of especially dangerous pathogens, toxins, and pathogens with pandemic potential. ^{126 127}

Nigeria’s National Biosecurity Policy and Action Plan 2022 – 2026 has strategies in place to strengthen national border control and management from threatening Invasive Alien Species (IAS), pests, and diseases by imposing and reviewing inspection procedures for bio-threat detection and deploying biosecurity personnel at important borders, including airport, seaport, and land borders (p. 59 – p. 63). In addition, the action plan aims to conduct regular surveillance of zoonotic diseases at Nigeria’s borders to ensure protection of humans from animal, insect bites, and diseases (p. 31). However, the action plan provides limited evidence on protocols to conduct screening of dangerous pathogens, toxins, and pathogens with pandemic potential during the cross-border transfer and at border points. ¹²⁸ The One Health Antimicrobial Resistance National Action Plan 2.0 2024 – 2028 also does not mention any focus on the dangerous materials in its strategies to strengthen procurement and supply chain systems at entry points and porous borders for the human and animal health sectors. ¹²⁹

1.4.1a Biosafety laws/regulations

Score: 100

Nigeria has an existing national biosafety legislation. ^{130 131}

In 2022, Nigeria introduced its National Biosecurity Policy and Action Plan which would be implemented from 2022 to 2026. The action plan is designed for the Nigerian government to ensure protection and safety against biological threats and to strengthen collaborative engagements between relevant stakeholders in their biosecurity efforts. ¹³² Under the action plan, the National Biosafety Management Agency (NBMA) plays a key role in working with other ministries, departments, and agencies to set up a framework for the design and implementation of programmes that facilitate effective communication and coordination of activities in a multi-sectoral biosecurity environment (p. 9). ¹³³

1.4.1b Agency for enforcement of biosafety laws/regulations

Score: 100

There is an established agency that is responsible for the enforcement of biosafety legislation and regulations. ^{134 135}

Entering into force in 2022, the National Biosecurity Policy and Action Plan 2022 – 2026–which aims to ensure effective coordination of biosecurity activities, including prevention, mitigation and response to biosecurity events/incident–provides that the National Biosafety Management Agency (NBMA) is the main body that has the responsibilities to collaborate with other ministries, departments, and agencies in designing and implementing programmes that support the goals and objectives of the action plan (p. 9). ¹³⁶ According to the NBMA Act 2015, NBMA has duties and powers to provide and implement regulatory framework that ensures the effective management of all component of Nigeria’s biosafety (p. 4). ¹³⁷

1.4.2a Biosafety training using a standardised, required approach

Score: 33.33

There is publicly available evidence of biosecurity and biosafety training in Nigeria, but the training is provided on an ad hoc basis by 2025. ^{138 139}

The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria states that Nigeria has finalised the Nigerian universities’ biosafety and biosecurity curriculum to support bio-risk training in academic institutions. The mission report adds that the training is being conducted in all facilities that handle high-consequence agents with standardised biosafety and biosecurity risk assessment templates (p.24). ¹⁴⁰ The National Biosecurity Policy and Action Plan 2022 – 2026 also aims to provide specialised trainings and refresher courses for biosecurity personnel at all levels to build personnel capacity and strengthen facilities that manage and operate Valuable Biological Materials (VBMs) (p.50). In addition, the action plan calls for strategic measures to develop biosecurity curriculum for relevant tertiary institutions and engage with national and institutions to provide specialised training for biosecurity officers (p.77). ¹⁴¹ Yet, there is no evidence that the specialised trainings are undertaken regularly. ^{142 143}

1.5.1a Evidence of national assessment of dual-use research

Score: 0

Publicly available evidence that Nigeria has conducted an assessment to determine whether ongoing research is occurring on especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research is limited. ^{144 145}

Nigeria’s One Health Antimicrobial Resistance National Action Plan 2.0 2024 – 2028 has strategic measures in place to conduct a national resistance trend assessment and workshops to identify priority pathogens in the country (p. 95). However, the action plan provides no evidence whether the assessment has been conducted. ¹⁴⁶ According to One Health Strategic Plan 2019 – 2023, Nigeria has conducted a situation analysis on the most common human pathogens and resistance patterns of these pathogens, but the strategic plan does not mention whether the conducted assessment involves especially dangerous pathogens, toxins, pathogens with pandemic potential and/or dual-use research (p. 23). ¹⁴⁷

1.5.1b National law/regulation on oversight of dual-use research

Score: 0

Nigeria does not have legislation and/or regulation that requires oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research. ^{148 149}

In absence of research agenda for AMR, Nigeria’s One Health Antimicrobial Resistance National Action Plan 2.0 2024 – 2028 provides that there are strategic plans to develop prioritised national research agenda for AMR by setting up an AMR One Health scientific committee to review specific priority and emerging AMR pathogens (p. 93). However, the action plan does not mention whether the committee will be specifically responsible for the oversight of research pertaining to dangerous pathogens, pathogens with pandemic potential, toxins and/or other dual-use research. ¹⁵⁰ The National Biosecurity Policy and Action Plan 2022 – 2026 also seeks to strengthen the capacity of biosecurity research ethical committee, enforce regulation of biosecurity researches, and work with relevant organisations to provide information on Valuable Biological Materials (VBMs) and disease incidents (p. 77 – p. 79). However, there is no evidence on the action plan that imposes requirement regarding oversight of research with dangerous pathogens and toxins. ¹⁵¹

1.5.1c Existence of agency responsible for oversight of dual-use research

Score: 0

There is no agency responsible for oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research. ^{152 153 154}

On 26 November 2016, Nigeria’s Ministry of Health established the National AMR Coordinating Body at the Nigeria Centre for Disease Control (NCDC). The body includes a National AMR Technical Working Group (AMR-TWG) and an AMR National Steering Committee, both of which are tasked with oversee AMR-related activities coordinated by NCDC within all sectors in Nigeria. However, there is lack of information on the body’s roles and responsibilities in overseeing research with dangerous pathogens and toxins. ¹⁵⁵ According to the One Health Antimicrobial Resistance National Action Plan 2.0 2024 – 2028, NCDC will serve as a lead agency in implementing the strategic interventions to support the action plan’s objectives, which do not address any oversight of research with dangerous pathogens, pathogens with pandemic potential, toxins and/or other dual-use research. ¹⁵⁶ There is also insufficient evidence on the National Biosecurity Policy and Action Plan 2022 – 2026 or the 2015 National Biosecurity Management Agency (NBMA) Act that demonstrates the oversight power from NBMA on research with dangerous pathogens and toxins. ^{157 158}

1.5.2a Requirement to screen synthesised DNA against list prior to sale

Score: 0

There is no evidence of legislation or regulation that requires the screening of synthesised DNA against lists of known pathogens and toxins before it is sold. ^{159 160 161 162 163 164 165 166}

There is no available evidence of any draft strategic plan or policy regarding screening synthesised DNA against lists of known pathogens and toxins before it is sold on the public websites of the Nigeria Centre for Disease Control and Prevention (NCDC), Federal Ministry of Health and Social Welfare, Federal Ministry of Agriculture and Food Security (FMAFS) or NBMA. ^{167 168 169 170} Relevant legislation and policies, such as the One Health Antimicrobial Resistance National Action Plan 2.0 2024 – 2028, the National Biosecurity Policy and Action Plan 2022 – 2026, and One Health Strategic Plan 2019 – 2023, also provide no information on screening synthesised DNA against known pathogens and toxins before it is sold. ^{171 172 173} The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria also provides no evidence on this. ¹⁷⁴

1.6.1a Immunization rate for humans (measles/MCV2)

Score: 0

1.6.1b Availability of vaccination figures for livestock (FMD) through OIE database

Score: 0

Public information on official foot-and-mouth disease (FMD) vaccination figures in Nigeria are not available through the OIE database. ¹⁷⁵

1.6.1c Equitablenature of national immunization strategy/plan

Score: 100

Nigeria has a national immunisation strategy by 2025, but the strategy does not address equitable distribution, socioeconomic inequalities, geography, cultural/linguistic differences and/or gender barriers to vaccination. ^{176 177 178 179 180}

In September 2021, Nigeria’s National Institute of Medical Research (NIMR) published the Nigeria Vaccine Policy whose objective is to promote availability and self-sufficiency of vaccines in the country. ¹⁸¹ While there is no publicly evidence of a new or recently updated vaccine policy in Nigeria, the 2021 Nigeria Vaccine Policy sets forth strategic measures, some of which aims to be met by 2026 (p.17). ^{182 183 184 185} The vaccine policy supports access to vaccines through ownership of vaccines supply chain management process, including material sourcing, importation, manufacturing, distribution and use), but it does not include any plan to ensure equitable distribution or overcome socioeconomic barriers and other differences in the country. ¹⁸⁶ The vaccine policy also mentions the existence of a national immunisation policy in Nigeria (p. 4), but there is no evidence that the immunisation policy has been published. ^{187 188 189 190} Similarly, the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria states that National Measles Elimination Strategic Plan 2019 – 2028 exists in Nigeria, but the strategic plan cannot be found on relevant ministries’ websites. ^{191 192 193 194}

1.6.1d Vaccine hesitancy and build public trust coverage in vaccines in national immunization strategy/plans

Score: 100

Nigeria’s national immunisation policy includes measures to address vaccine hesitancy and build public trust in vaccines by 2025. ^{195 196}

The 2021 Nigeria Vaccine Policy which aims to improve availability and self-sufficiency of vaccines in Nigeria includes strategic measures to address vaccine hesitancy and resistance by promoting advocacy and public enlightenment to mitigate vaccine hesitancy and resistance to opinion leaders and communities and empowering the opinion leaders in the advocacy efforts by December 2022 (p. 15, p. 17 & p. 24). ¹⁹⁷ The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria also reports that vaccine hesitancy exists in some communities in Nigeria, and the mission report calls for priority actions to improve working relations and vaccination efforts to identify missed populations for priority vaccines. ¹⁹⁸ The mission report states that Nigeria has a National Measles Elimination Strategic Plan 2019 – 2028 in place (p. 28), but there is no publicly available evidence that the strategic plan exists nor that it also includes measures to address vaccine hesitancy and build public trust in vaccines. ^{199 200 201 202}

1.6.1e National advisory group for immunization strategy/plan

Score: 100

There is a national advisory group that provides technical guidance and advice on the immunisation strategy/plan to Nigeria’s government by 2025. ^{203 204 205 206 207}

According to the 2021 Nigeria Vaccine Policy, Nigeria has a technical advisory group called Nigeria Immunisation Technical Advisory Group (NGITAG) that plays a role in providing guidance and advice on the immunisation plan to the government (p. 10). ²⁰⁸ After its establishment being proposed to Nigeria’s Ministry of Health in March 2014, NGI-TAG was inaugurated on August 17, 2015 and was chaired by the Permanent Secretary of the Ministry of Health. ^{209 210} NGI-TAG has served as an independent expert technical advisory committee whose function is to offer guidance to the Ministry of Health and the NPHCDA regarding making evidence-based immunisation-related policy and programme decisions. ^{211 212}

1.6.1f Presence of an immunization programme for influenza

Score: 0

Nigeria does not have an immunisation programme for influenza as of 2025. ^{213 214 215 216 217}

Nigeria’s One Health Strategic Plan 2019 – 2023 provided that the country has developed a policy document and a response plan for avian influenza, but there is no publicly evidence of an immunisation programme for influenza on a public website or websites of relevant ministries. ^{218 219 220 221} Despite the absence of an immunisation programme for influenza, Nigeria has published an immunisation schedule for young infants and children, and the schedule includes the use of vaccine for Haemophilus Influenza Type b (Hib) for infants aged from 6 weeks to 14 weeks. ²²²

1.7.1a Strategy/plan for resilience of health system

Score: 50

Nigeria has a national action plan to develop a health system that is resilient to climate change and changing seasonal weather patterns by 2025, but there is insufficient evidence that it addresses the threat of infectious diseases. ^{223 224 225}

Nigeria’s One Health Antimicrobial Resistance National Action Plan 2.0 2024 – 2028 was introduced to set forth strategic measures to tackle challenges posed by AMR in human, food, animal, plant, and environmental sectors. One of the action plan’s strategies is to investigate the contribution of socioeconomic and environmental factors on the spread of AMR by conducting meta-analysis to understand existing knowledge on climate change and AMR and undertaking a study to establish the association between climate change effects and emergence of new variants of AMR genes in Nigeria (p. 97). However, there is no evidence that the action plan aims to address the threat of infectious diseases as a result of climate change or changing seasonal weather patterns. ²²⁶ Strategic approaches to address this issue also cannot be found in other relevant action plans or policies. ^{227 228}

2.1.1a Capacity of national lab system to conduct 5 or more WHO core tests

Score: 0

There is limited evidence that the national laboratory system in Nigeria has the capacity to conduct diagnostic tests for at least 5 of the 10 WHO-defined core tests. ^{229 230}

According to the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria, the country has the capacity to conduct advanced diagnostic testing, such as polymerase chain reaction and genomic sequencing, which are among the WHO-defined core tests. Other tests that are not WHO-defined core tests but Nigeria has the capacity to conduct include cholera, viral haemorrhagic fevers, rubella, cerebrospinal meningitis, mpox, measles, anthrax, rabies, and diphtheria (p. 32). ²³¹ Under the One Health Strategic Plan 2019 – 2023, there is also no evidence of strategic measures that aim to expand the national testing capacity and perform the WHO-defined core tests. ²³²

2.1.1b Plan to conduct testing during a public health emergency

Score: 100

Nigeria has a national plan, strategy or similar document for conducting testing during a public health emergency, and there is sufficient evidence that the plan includes considerations for testing for novel pathogens, scaling capacity, and defining goals for testing. ²³³

On April 15, 2020, NCDC published the National Strategy to Scale Up Access to Coronavirus Disease Testing in Nigeria which aims to rapidly scale up diagnositic testing to cover all 36 states and the Federal Capital Territory (FCT) and contain the Coronavirus outbreak. Based on the national strategy, there are measures to increase laboratory testing capacity, repurpose Tuberculosis laboratory testing into COVID-19 testing, and engage private sector to provide facilities, technical capacity and resources for the national response. In addition, the national strategy sets up clear testing strategy based on the WHO-defined phases of the pandemic, including containment phase, transition phase, and localised community transmission phase. For instance, the national strategy provides that all suspect cases should be identified for isolation and testing in the containment phase while testing for all hospitalised Severe Acute Respiratory Illnesses (SARI) patients and ill contacts of confirmed patients should be conducted in the transition stage. ²³⁴

2.1.2a Existence of an accredited national lab serving as a reference facility

Score: 100

There is a national laboratory that serves as a reference facility which is accredited to ISO 15189. ^{235 236}

According to the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria, Nigeria has national clinical laboratories, such as National Veterinary Laboratory in Vom (National Veterinary Research Institute), which are accredited to ISO 15189 while other national laboratories, including the National External Quality Assurance Laboratory in Zaria and the National Reference Laboratory, are accredited to ISO 17025 and WHO Guidelines for the Stepwise Laboratory Improvement Process Towards Accreditation in the Africa Region rating four and five stars respectively (p. 30). ²³⁷ According to the National Veterinary Research Institute (NVRI)’s website, many laboratories in the Institute are also undergoing twinning programmes with international reference laboratories to obtain accreditation to reference laboratory status. ²³⁸

2.1.2b External quality assurance of a national lab serving as a reference facility

Score: 100

Nigeria has a national laboratory that serves as a reference facility subject to external quality assurance review. ^{239 240}

Nigeria has its first National External Quality Assessment Laboratory (NEQAL) in the National Tuberculosis and Leprosy Training Centre (NTBLTC) in Zaria. ²⁴¹ Dedicated to improving the quality and reliability of laboratory testing across Nigeria, NEQAL is designed to provide external quality assessments, implement quality assurance protocols for various testing methods, and support laboratories in meeting high standards of accuracy and precision in their testing processes. ²⁴² The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria stated that NEQAL is also accredited to ISO 17025 for testing and calibration laboratories (p. 32). ²⁴³

2.2.1a Nationwide specimen transport system

Score: 100

There is a nationwide specimen transport system in Nigeria. ^{244 245}

The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria provides that specimen referral and transport system exist at the national level for all priority diseases and that in-country third party logistics are also available for shipping biological specimens (p. 31). ²⁴⁶ In 2018, Nigeria’s Ministry of Health introduced the National Integrated Specimen Referral Network (NiSRN) to facilitate a coordinated sample transport system. Organisations like Akesis Health Nigeria have been supporting NiSRN by working with Chemonics International under USAID-funded Global Health Supply Chain Program-Procurement Supply Management (GHSC-PSM) to provide sample transport and result dispatch services for various institutions, such as government health facilities, private hospitals, and pharmacies. ²⁴⁷ According to the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria, the country also established the NCDC Guidelines for Specimen Transport in 2022, but the guidelines cannot be found on NCDC’s website. ^{248 249}

2.2.2a Plan to rapidly authorize/license laboratories to scale-up testing during an outbreak

Score: 0

Nigeria does not have a plan in place to rapidly authorise or license laboratories to supplement the capacity of the national public health laboratory system to scale-up testing during an outbreak. ^{250 251 252 253}

Nigeria has established the 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan which supports the aim to establish an effective, efficient and coordinated public health multi-hazard emergency preparedness and response system, but available strategic measures under the plan do not include relevant provisions to authorise or license laboratories to expand its capacity to scale-up testing during a disease outbreak. ²⁵⁴ While the One Health Strategic Plan 2019 – 2023 stated that Nigeria has reference laboratories in place for all priority diseases at the federal level and in academic institutions, there were no relevant provisions in the strategic plan that allows those laboratories to supplement its capacity for testing during an outbreak. ²⁵⁵ Similarly, there are no relevant provisions in the One Health Antimicrobial Resistance National Action Plan 2.0 or the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria. ^{256 257}

2.3.1a Evidence of ongoing event-based and indicator-based surveillance and analysis

Score: 50

There is evidence that Nigeria has ongoing event-based and indicator-based surveillance and analysis for notifiable and novel infectious diseases by 2025, but there is no evidence that the data are being analysed on a daily basis. ^{258 259}

The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria provides that Nigeria has established both event-based and indicator-based surveillance systems and that the country conducts regular analysis and dissemination of event-based surveillance reports (p. 22 & p. 35). However, the mission report does not state whether the analysis and dissemination of the data is conducted on a daily basis. ²⁶⁰ According to the 2019 National Technical Guidelines for Integrated Disease Surveillance and Response, Nigeria has used the two surveillance systems which offer immediate notification to detect and provide early warning and response to disease outbreaks. However, information whether the country analyses data from the two surveillance systems on a daily basis is limited. ²⁶¹

2.3.1b Evidence of a mechanism (such as IHR focal point) for reporting notifiable diseases to the WHO within the set timeline

Score: 100

In Nigeria, there is publicly available evidence of a mechanism for reporting notifiable diseases to the WHO. ^{262 263}

The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria states that NCDC serves as the designated National Focal Point (NFP) under NCDC Act of 2018 and that it has the responsibilities to coordinate International Health Regulations (IHR) functions across relevant ministries, departments, and agencies (p. 13). ²⁶⁴ According to the 2019 National Technical Guidelines for Integrated Disease Surveillance and Response, the IHR NFP is responsible for notifying WHO of notifiable diseases or any event that is a potential public health emergency of international concern (PHEIC) (p. 88). ²⁶⁵ While there is evidence of an existing functional process for timely reporting to WHO through dedicated NFP email, WhatsApp, and phone calls, the NFP is also reported to be available 24/7/365 to communicate with WHO (p. 14). ²⁶⁶

2.3.2a Electronic national and sub-national reporting surveillance system

Score: 100

Nigeria’s government operates an electronic reporting surveillance system at both the national and the sub-national level. ^{267 268}

According to the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria, immediate and weekly reporting of events are available at all levels, and the laboratory results are integrated with surveillance data on an electronic-based Surveillance Outbreak Response Management and Analysis System (SORMAS) (p. 34). Specifically, electronic Integrated Disease Surveillance and Response (e-IDSR) like SORMAS is used for immediate surveillance reporting while a mobile Strengthening Epidemic Response System (mSERS) is for weekly reporting (p. 35). ²⁶⁹ The One Health Strategic Plan 2019 – 2023 also stated that IDSR routine data is normally forwarded to local government areas (LGAs) using SMS or paper forms and to the states which then entered the data using customised excel spreadsheet (p.12). ²⁷⁰ At the national level, Nigeria’s government is responsible for managing SORMAS, updating electronic tools, ensuring linkages with other platforms to facilitate interoperability, and monitoring alerts (p. 350). ²⁷¹

2.3.2b Collection of ongoing/real-time lab data by electronic surveillance system

Score: 50

Nigeria has an electronic reporting surveillance system that collects ongoing or real-time laboratory data, but there is limited evidence showing that the data can be disaggregated and analysed by characteristics, such as age or ethnicity. ^{272 273 274}

According to Nigeria’s One Health Strategic Plan 2019 – 2023, data from reporting within the country’s surveillance system is collected and reporting weekly by the Local Government Areas (LGAs) or via an electronic based diseases surveillance and outbreak management platform called Surveillance Outbreak Response Management and Analysis System (SORMAS) (p. 12). ²⁷⁵ The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria reported that laboratory results are integrated with surveillance data on SORMAS while other electronic tools, such as Auto Visual Alert Detection and Reporting of Multi Disease, used to detect and report events also exist (p. 35). ²⁷⁶ However, there is no evidence that SORMAS disaggregates and analyses its inputs by specific characteristics, such as age or ethnicity. ²⁷⁷

2.3.3a National wastewater surveillance programme or initiative

Score: 100

Nigeria has an active national wastewater surveillance program for polio. Environmental surveillance (ES), a key part of Nigeria’s public health strategy, uses genomic testing of wastewater to detect poliovirus. Since its initial introduction in 2011, in selected urban centres, ES has expanded to over 140 wastewater sites across multiple states and the Federal Capital Territory. ²⁷⁸

One site, Makoko, is a critical surveillance site because of its environmental and demographic characteristics. The local community’s reliance on the lagoon for sanitation means that any poliovirus present can be detected in the water, providing an early warning system for potential outbreaks.²⁷⁹

Additionally, the AFENET Nigeria Facebook page suggests that Nigeria CDC is "launching of a broad-based National Environmental Surveillance Programme (ESPN)" as of August 2024.²⁸⁰

The WHO and GPEI Q4 2025 Polio ES Bulletin lists the country as having 91 ES sites as of Q4 in 2025.²⁸¹

2.4.1a Common usage of electronic health records

Score: 50

Electronic health records are not commonly in use in Nigeria, but there is evidence they are used. ^{282 283}

A 2024 journal article on the implementation of electronic health records in Nigeria provides that many Nigerian healthcare facilities – both public and private – are shifting towards using the electronic method of keeping health records. However, the adoption of the electronic health records stands at a very low rate. ²⁸⁴ Similarly, according to a 2023 journal article on electronic health record in Nigeria’s healthcare system, electronic health records have been implemented in Nigeria. However, the findings from the literature report a low utilisation rate of electronic health records in Nigerian hospitals where the adoption of the records stands between 18% and 23%. ²⁸⁵

2.4.1b Public health system access to individual electronic health records

Score: 0

There is no evidence that a national public health system has access to electronic health records of individuals in Nigeria. ^{286 287}

According to the National Health ICT Strategic Framework 2015 – 2020 which is the latest national policy on health ICT and outdated, there was a proposal to support different forms of national health ICT architecture, one of which included a shared digital patient record by the National Primary Health Development Agency (NPHCDA), the National Agency for Control of AIDS (NACA) and others. ^{288 289 290} A shared health record aimed to collect and store electronic health information about individual patients in a centralised system where the data could be shared across different healthcare settings. ²⁹¹ However, there was limited evidence of its implementation and whether the national public health system has access to the electronic data. ^{292 293}

2.4.1c Existence of data standards for health record data comparability

Score: 100

Nigeria has provisions to ensure data is comparable to ISO standards. ^{294 295}

The 2020 Guidelines for the Management of Personal Data by Public Institutions in Nigeria were established as guidelines for the implementation of the 2019 Nigeria Data Protection Regulation (NDPR) within public institutions in the country. Under the guidelines, every public institution has the duty to implement measures to promote the confidentiality, integrity, availability, and resilience of data. To do so, the public institutions must demonstrate that they comply with international information security standards, such as ISO 27001:2013 or any similar standard. ²⁹⁶ However, there is no evidence in the governmental National Information Technology Development Agency database clarifying whether the guidelines remain in force as new or updated guidelines regarding the data standards have yet to be introduced. ²⁹⁷

2.4.2a Data sharing mechanisms

Score: 100

There is evidence of established mechanisms at the relevant ministries responsible for animal, human, and wildlife surveillance to share data (e.g., through mosquito surveillance, brucellosis surveillance). ²⁹⁸

The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria states that different systems across different sectors exist to share data related to animal, human, and wildlife surveillance. For example, surveillance data from human health sector is collected and shared via the District Health Information System 2 (DHIS2) or Surveillance Outbreak Response Management and Analysis System (SORMAS) by NCDC, surveillance data from animal health sector via a wildlife surveillance committee or National Animal Disease Information and Surveillance (NADIS) which is managed by Nigerian Federation Veterinary Epidemiology Unit, and environmental surveillance data from Integrated National Environmental Surveillance System. ^{299 300 301}

2.4.3a Availability of de-identified health surveillance data on disease outbreaks

Score: 100

Nigeria makes de-identified health surveillance data on infectious diseases publicly available via reports on government websites. ^{302 303}

NCDC has published its disease situation reports on its website where the public can access information and surveillance data on infectious diseases, such as Lassa Fever, Yellow Fever, Avian Influenza, Covid-19, and other diseases. The reports are updated and published weekly and include summary of reported surveillance data, number of cases infected by each disease, and response activities conducted to prevent and control the disease outbreak in the country. ³⁰⁴ The National Veterinary Research Institute (NVRI) under the Federal Ministry of Agriculture and Rural Development has also published updates of infectious diseases, such as Monkeypox Virus and Avian Influenza (HPAI) H5N1, on its websites although the reports are not comprehensive. ³⁰⁵

2.4.4a Confidentiality legislation/regulations for identifiable health information

Score: 100

There is legislation and/or regulations that safeguard the confidentiality of identifiable health information for individuals, such as that generated through health surveillance activities. ^{306 307}

The 2023 Nigeria Data Protection Act (NDPA), under Section 1, aims to ensure uniformity in the processing of personal data while safeguarding the fundamental interests of data subjects across sectors, notably including the health sector. The Act’s provisions explicitly extend to public and private institutions, and also cover surveillance agencies functioning as part of the government, as detailed in Section 11. Under NDPA, data controllers and processors, such as organisations or service providers in the health sector, must implement organisational and technical safeguards to protect personal data against misuse or unauthorised access pursuant to Sections 24, 25, and 40 of the Act. ³⁰⁸

2.4.4b Inclusion of cyber protections in health data confidentiality law/regulation

Score: 0

There is legislation and/or regulations that safeguard the confidentiality or identifiable health information for individuals in Nigeria, but there is no mention of protections from cyber attacks or ransomware. ^{309 310}

Section 26 of Nigeria’s National Health Act of 2014 which includes provision on confidentiality of individuals’ health data provides that “all information concerning a user, including information relating to his or her health status, treatment or stay in a health establishment is confidential”. Section 29 of the Act also imposes the duty on the person who is in charge of a health establishment and possesses a user’s health records to develop control measures to prevent unauthorised access to these records or record-keeping systems. The Act yet does not specifically mention any provisions that address the protection of individuals’ health information that is obtained through surveillance data or from cyber attacks and ransomware. ³¹¹ Similarly, Section 24 of the 2023 Nigeria Data Protection Act provides that a data controller or data processor shall “use appropriate technical and organisational measures to ensure confidentiality, integrity, and availability of person data”. However, the provision offers a broad protection of personal data rather than focusing specifically on health data of individuals, and it does not address the protection from cyber attacks or ransomware. ³¹²

2.4.5a Cooperative commitments or agreements within regions

Score: 100

The Nigerian government has made a commitment via public statements, legislation and/or a cooperative agreement to share surveillance data for more than one disease during a public health emergency with other countries. ^{313 314 315 316 317 318}

On 13 February 2018, Nigeria Centre for Disease Control and Prevention (NCDC), Federal Ministry of Health and Federal Ministry of Agriculture and Rural Development implemented the Regional Disease Surveillance Systems Enhancement (REDISSE) project to improve regional cross-sectoral capacity for collaborative disease surveillance and epidemic preparedness in West Africa. ³¹⁹ The project was designed to respond to the 2014 Ebola outbreak and then the Covid-19 outbreak while providing immediate and effective response in events of eligible health emergencies. ³²⁰ Having lasted until December 2023, the project has funded regional level policy dialogue and activities that promote information exchange and sharing of resources for disease surveillance and response. ^{321 322} Based on the 2019 National Technical Guidelines for Integrated Disease Surveillance and Response, the Nigerian government has also previously engaged in sharing cross-border surveillance data and information on travel history of cases during an emergency or outbreak response. ³²³ Nigeria was also a signatory to the Abuja Commitment in 2010, which commits it to share information on cross-border public health issues with the World Health Organisation (WHO) and sub-regional health organisations to enable joint planning, coordination and timely response to disease outbreaks. ³²⁴ Under the Abuja Commitment, in 2016 and again in 2018 Nigeria participated in developing roadmaps for sub-regional collaboration and information-sharing on cholera in the Chad Basin area; and it is one of the countries implementing the regional strategy for cholera in West and Central Africa, which involves strengthening cross-border collaboration in the surveillance and response to cholera epidemics between the countries of the Lake Chad Basin. ^{325 326}

2.5.1a National support to conduct contact tracing in the event of a public health emergency

Score: 50

There is a national system in place to offer support at the sub-national level to conduct contact tracing in the event of active public health emergencies rather than future public health emergencies. ^{327 328}

According the 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan, there is a Public Health Emergency Rapid Response Team (PHERRT) available to provide support at the sub-national levels during public health emergencies. PHERRT is a technical, multidisciplinary, trained, and equipped team whose responsibilities include tracing reported outbreaks, conducting visits and interviewing with exposed individuals, and conducting risk assessments to determine if the outbreak is a potential public health emergency of international concern. However, there is no information whether the team is responsible for conducting contact tracing at sub-national levels for future public health emergencies. ^{329 330}

2.5.1b Provision of wraparound services to enable self-isolation/quarantine as recommended

Score: 0

Nigeria does not provide wraparound services to enable infected people and their contacts to self-isolate or quarantine as recommended, particularly economic support and medical attention. ^{331 332 333 334}

The 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan and the 2019 National Technical Guidelines for Integrated Disease Surveillance and Response do not address any economic support or medical attention for infected people and their contacts when self-isolating or staying in quarantine. Both documents rather outline strategies to strengthen isolation facilities and reinforce infection prevention and control measures. ^{335 336} During the Covid-19 outbreak, for example, there was also no evidence of support or wraparound services from the Nigerian government for those who were infected. ^{337 338}

2.5.2a Strategy for tracing and quarantining international travelers

Score: 50

There is a joint plan or cooperative agreement between the public health system and border control authorities to identify suspected and potential cases in international travellers and trace and quarantine their contacts in the event of a public health emergency, but the plan is in place in response to active public health emergencies only. ^{339 340}

The 2019 National Technical Guidelines for Integrated Disease Surveillance and Response which aims to strengthen cross-border surveillance and response provides comprehensive details of how the public health system and border control authorities work together to trace suspected and potential cases in ill travellers. For example, the guidelines contain a list of designated Points of Entry (POEs) where measures are in place to detect ill travellers, report to health authorities, conduct rapid public health assessment, and access to healthcare. There is also evidence of arrangements to conduct travel screening or other border health measures during a declared public health emergency, as recommended by WHO. In an event of suspected cases of acute haemorrhagic fever syndrome, for example, the suspected cases are isolated from other people while case-contact tracing and follow-up are conducted. However, there is limited evidence whether any government plans regarding the joint efforts to detect ill international travellers also cover future public health emergencies. ^{341 342}

2.6.1a Access to field epidemiology training program in country and/or abroad

Score: 100

Nigeria has applied epidemiology training programme (such as FETP) in place, but there is lack of evidence that the Nigerian government provides resources to send citizens to participate in applied epidemiology training in another country. ^{343 344 345 346}

In October 2008, the Federal Ministry of Health and the Federal Ministry of Agriculture and Rural Development introduced the Nigeria Field Epidemiology and Laboratory Training Program (NFELTP). ^{347 348} Funded and technically supported by the United States Centres for Disease Control and Prevention (US CDC) through the African Field Epidemiology Network (AFENET), NFELTP is designed “to strengthen and coordinate Nigeria’s ability to respond to public health emergencies through training public leaders in interventional epidemiology and developing institutionalised and sustainable public health workforce capacity”. The Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET)-accredited programme has trained more than 400 Field Epidemiologists who have helped control over 300 outbreaks, such as avian influenza, Ebola, Lassa fever, among others. ³⁴⁹ While the programme also aims to strengthen affiliations with international organisations and other applied epidemiology and laboratory training programmes in other countries, there is limited information that shows the government’s support for trainees to participate in applied epidemiology training in another country. ^{350 351 352 353}

2.6.1b Existence of field epidemiology training for animal health professionals

Score: 100

There is no specific animal health field epidemiology training programme, such as FETPV, offered in Nigeria, but the existing field epidemiology training programmes are explicitly inclusive of animal health professionals. ^{354 355 356}

The Nigeria Field Epidemiology and Laboratory Training Programme (NFETLP) led by the Federal Ministry of Health and the Federal Ministry of Agriculture and Rural Development instructs veterinarians within the same programme, and veterinary epidemiology-related elements are incorporated in course content, field assignments, degrees awarded, and post-training deployments. ^{357 358} Moreover, the programme is designed to strengthen public health surveillance systems and develop capacity not only for human health but also animal and environmental health. ^{359 360}

2.6.2a Evidence of at least 1 trained field epidemiologist per 200,000 people

Score: 0

There is no public evidence that Nigeria has at least 1 trained field epidemiologist per 200,000 people. ^{361 362}

According to the CIA World Factbook, Nigeria has a total population of approximately 236 million in 2024. ³⁶³ The Nigeria Centre for Disease Control and Prevention (NCDC) reported that its Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP) which was introduced in October 2008 has trained over 400 Field Epidemiologists to support the control outbreaks in the country. ^{364 365} According to a senior executive for Africa at the Global Health Services Network, Nigeria needs to train and sustain 1,000 epidemiologists to be able to manage epidemiological challenges, considering the large population of the country. ³⁶⁶ Given the number of trained field epidemiologists in Nigeria, it is estimated that the ratio of trained field epidemiologists stands at around 0.36 out of 200,000 people.

3.1.1a National emergency response plan for diseases with pandemic potential

Score: 66.67

Nigeria has an overarching national public health emergency response plan in place that addresses planning for multiple communicable diseases with epidemic or pandemic potential. ³⁶⁷

In December 2020, the Nigeria Centre for Disease Control and Prevention (NCDC) published the National Public Health Multi-Hazard Emergency Preparedness and Response Plan which aims to ensure a timely, efficient, and effective response to events, including local and national outbreaks of infectious diseases that have cross-border potential, epidemics and pandemics, and other types of emergencies. The plan is accessible to the public, and it contains hazards and risks characterisation based on degrees of impact as listed in Table 4, the use of early detection and alert systems, and information on the roles of Public Health Emergency Rapid Response Team (PHERRT) which is responsible for investigating and responding to the public health events (p. 52). However, there is no evidence of funds being allocated to support the plan. ³⁶⁸

3.1.1b National public health emergency response plan published in past 3 years

Score: 0

There is limited evidence that the overarching plan has been updated in the last 3 years. ^{369 370 371}

The Nigeria Centre for Disease Control and Prevention (NCDC) published the National Public Health Multi-Hazard Emergency Preparedness and Response Plan in December 2020, aiming at ensuring a timely, efficient, and effective response to events, including local and national outbreaks of infectious diseases that have cross-border potential, epidemics and pandemics, and other types of emergencies. ³⁷² However, there is no publicly available information that the plan has been updated in the last 3 years or that there is a new plan on the websites of relevant ministries. ^{373 374}

3.1.1c One health principles by covering multiple threat types

Score: 100

Nigeria’s national public health emergency response plan is in place, and it covers multiple threat types, including zoonotic disease spillover, biological accidents or deliberate acts. ^{375 376}

The 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan which seeks to set up an effective and coordinated public health multi-hazard emergency preparedness and response system addresses response to threats such as zoonotic diseases and biological hazards. For example, the response plan classifies zoonotic diseases, such as Ebola and Lasser fever, in moderate and very high risk levels and as the diseases that can cause severe impacts. ³⁷⁷ Similarly, the 2019 National Technical Guidelines for Integrated Disease Surveillance and Response considers zoonoses as diseases of international concern and requires reporting of such diseases to WHO. The guidelines also outline strategies, such as risk mapping, to manage and control of public health hazards, including zoonotic and biological threats. ³⁷⁸

3.1.1d Vulnerable populations in national public health emergency response plan

Score: 100

Nigeria’s national public health emergency response plan exists, and it covers consideration of the impact of health equity and mechanisms for identifying and considering the needs of vulnerable populations. ³⁷⁹

Aiming at providing effective public health emergency preparedness and response, the 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan contains a recovery framework that seeks to re-establish the economic, social, and cultural life of disaster-affected people and to restore damaged infrastructure and resources. The objective of the recovery framework, outlined on page 74, is to offer safer and improved infrastructure delivering equitable and affordable health services for all. Moreover, the recovery framework considers issues of accessibility and benefits for the poor and other vulnerable population sub-groups, and it calls for the government to address critical health sector issues, including health financing (pages 74–78), to reduce expenditure for disaster-affected populations and enhance health service insurance coverage for vulnerable groups. ³⁸⁰

3.1.2a Mechanism to engage private sector in outbreak preparedness/response

Score: 100

Nigeria has specific mechanisms to engage with the private sector to assist with outbreak emergency preparedness and response. ^{381 382}

According to Section 1.4 (Audience) of the 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan, the private sector, specifically private clinics and hospitals, is included as a targeted audience for the plan and plays an important part in the Nigerian surveillance system, where data from Integrated Disease Surveillance and Response (IDSR) reporting is regularly exchanged with relevant stakeholders. Section 2.2.1 further describes that private clinics and hospitals operate at both primary and secondary levels in the health system, contributing data for epidemiological surveillance through the IDSR mechanism ³⁸³ The 2019 National Technical Guidelines for Integrated Disease Surveillance and Response also emphasize the critical role of the private sector as community sources for reporting potential outbreaks from community surveillance and response functions. Additionally, according to Section 2.4 of the Plan and guidelines, representatives from the private sector, such as private health facilities, laboratories, and professional associations, are recognized as members of the Public Health Emergency Management Committees (PHEMC), which meet regularly to review the national public health emergency preparedness and response plan and facilitate the exchange of information on risk monitoring. ³⁸⁴

3.1.3a Policy/plan/guidelines in place to implement non-pharmaceutical interventions (NPIs)

Score: 100

Nigeria has a policy, plan and/or guidelines in place to implement non-pharmaceutical interventions (NPIs) for more than one disease during an epidemic or pandemic. ^{385 386 387 388}

During an outbreak of COVID-19, Nigeria’s President published the 2020 COVID-19 Regulations that imposed non-pharmaceutical interventions (NPIs) to the public. Under the regulations, all movements in Lagos, FCT, and Ogun States were ceased for 14 days, and all citizens in the areas were required to stay in their homes. ³⁸⁹ In addition, an implementation guidance for lockdown policy was introduced in Nigeria to contain the spread of COVID-19 by prohibiting people from leaving their homes, banning mass gathering, restricting movement, closing retail shops, and suspending commuter services. ³⁹⁰ The Nigeria Centre for Disease Control and Prevention (NCDC) also published the Self Isolation and Quarantine Guide which provides guidance to the public about the process of self-isolation and quarantine during the COVID-19 outbreak. ³⁹¹ Apart from COVID-19, NCDC published in September 2013 the Nigeria National Pandemic Influenza Preparedness and Response Plan which includes NPI guidance, listing responses to different phases of an influenza pandemic, starting with "consider increasing level of community mitigation measures and social distancing strategies, including cancellation of large public events and possible closure of schools in outbreak areas" and escalating to "significant community mitigation measures, including cancellation of large public events and closure of schools. Consider closure of offices and limitation of public transport for limited periods of time in major outbreak areas." ³⁹²

3.2.1a Completion of biological-focused IHR exercise with the WHO in past year

Score: 100

Nigeria has activated its national emergency response plan for an infectious disease outbreak in the past year, but there is limited evidence that the country has completed a national-level biological threat-focused exercise with WHO or separately in the past year. ^{393 394 395}

The 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan aims to coordinate rapid response actions to outbreaks by deploying a Public Health Emergency Rapid Response Team (PHERRT) which is responsible for investigating and responding to public health events that pose threats to the public at all levels. The response plan also stresses the importance of multi-sectoral collaboration in outbreak preparedness and response where ministries, departments, and agencies work together with other key stakeholders to implement response activities. ³⁹⁶ In 2024, for example, the Nigerian government implemented the response plan by dispatching rapid response teams at the Local Government Area (LGA) level to rapidly diagnose and respond to the cholera outbreak. In addition, Nigeria Centre for Disease Control and Prevention (NCDC) has collaborated with WHO in the WASH initiative – an initiative that offers preventive measures for treating cholera – to improve safe water services through several programmes, such as the Rural Water Supply and Sanitation Agency (RUWASSA) and the World Bank’s Nigerian Urban Water sector reform project. Public health awareness campaign has also been conducted by the Nigerian government to encourage people experiencing diarrhea to seek medical attention as soon as possible at public health facilities where free treatment is provided. ³⁹⁷

In 2024, WHO was also supporting the NCDC, Federal and States government across the priority states to strengthen laboratory activities, including offering training on Bio-risk management and enrolment into External Quality Assessment (EQA) programme amid the Mpox outbreak. ³⁹⁸ While more than 75 of the state government’s community team and healthcare workers were reported to have been provided with technical guidance on effective sample collection and other laboratory activities in the country, there is limited evidence whether the training was conducted nationwide instead of only in priority states of Nigeria. ^{399 400}

3.2.1b Evidence of bio-focused exercise to identify gaps/best practices

Score: 100

There is evidence that Nigeria in the past year has identified a list of gaps and best practices in response and developed a plan to improve response activities. ^{401 402}

On its website, Nigeria Centre for Disease Control and Prevention (NCDC) has published weekly disease situation reports which offer details of the outbreak situation, number of cases, key actions taken, response challenges, and the next steps to overcome those challenges. ⁴⁰³ In case of a cholera outbreak, the NCDC made weekly situation reports available to the public since 1 January 2024. For instance, the Cholera Situation Report from 1 January 2024 to 28 January 2024 outlines key response activities, such as conducting ongoing surveillance in all states through the Integrated Disease Surveillance and Response (IDSR), providing technical support and response commodities to affected states, and implementing the WASH initiative in the affected states. At the same time, the report identifies gaps and challenges, which include difficulty in accessing commodities, poor hygiene practice, inadequate health facility infrastructure, and poor and inconsistent reporting from states. To improve these response activities, the report encourages relevant stakeholders to continue distributing response commodities across states, scale up risk communications and maintain communication between states for data reporting and response, and continue advocacy to state governments to increase funding in WASH initiative. ⁴⁰⁴

3.2.2a Evidence of national-level biological threat-focused exercise that includes private sector

Score: 0

There is no evidence that Nigeria in 2024 has undergone a national-level biological threat-focused exercise that has included private sector representatives. ^{405 406 407}

In 2024, there is evidence that biological threat-related trainings were conducted in Nigeria. ^{408 409} For example, the Biotechnology Centre of the Federal University of Agriculture, Abeokuta (FUNAAB) has conducted a two-day biorisk management awareness training for scientists and technologists in the university with regards to how to efficiently handle and coordinate activities related to biological materials. ⁴¹⁰ In June 2024, the Obafemi Awolowo University also held a biorisk management training in which participants were trained on promoting responsible, safe, and secure practices when dealing with biological agents and toxins. ⁴¹¹ However, there is lack of information that the trainings were engaged by participants across all states and that representatives from the private sector attended the training. ^{412 413} Between March 12, 2018 and March 15, 2018, NCDC joined hands with the West African Health Organisation (WAHO) to organise a Yellow Fever Simulation Exercise (SIMEX) which was conducted in Lagos, Nigeria. The exercise involved participation from partners and representatives from various organisations, including Economic Community of West African States (ECOWAS), Africa Field Epidemiological Network (AFENET), and USAID, but there is no evidence that private partners participated in the exercise. ⁴¹⁴

3.3.1a Existence of Emergency Operations Center (EOC)

Score: 100

Nigeria has established an Emergency Operations Centre (EOC). ^{415 416 417}

The 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan provides that NCDC EOC has been activated several times, and the centre has played a key role in contributing to the successful control of several public health emergencies. According to the plan, emergency operations centres function to provide communication and information tools and services, and a management system during a response to an emergency. The plan also included a guidance for implementing a framework for a public health emergency operations centre as shown in the Handbook for Developing a Public Health Emergency Operations Centre (PHEOC). ⁴¹⁸ In Nigeria, the national EOC is located in the capital city of Abuja, and it provides guidance, regulations, and policy directives for implementation in the seven state-level EOCs in Bauchi, Borno, Kano, Kaduna, Sokoto, Katsina, and Yobe. ⁴¹⁹ In 2023, there was also evidence that the Nigeria Centre for Disease Control and Prevention (NCDC) had activated the national multisectoral EOC for Lassa Fever (LF-EOC) at level 2 to strengthen and coordinate ongoing response activities in the country. ⁴²⁰

3.3.1b Requirement for EOC to conduct/evidence EOC conducts at least annual drills

Score: 100

There is publicly available evidence that the Emergency Operations Centre (EOC) has been conducted a drill for a public health emergency scenario at least once a year. ^{421 422}

According to the 2019 National Technical Guidelines for Integrated Disease Surveillance and Response, Nigeria has in place a national Public Health Emergency Operation Centre (PHEOC) and state PHEOCs which act as a command-and-control centre that improves coordination and oversees public health emergency preparedness and response activities (p. 188). ⁴²³ The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria adds that the national PHEOC has activated the Incident Management System (IMS) in response to 23 incidents over the last 5 years and has conducted simulation exercises to test coordination and communication during emergencies across 22 states (p. 44). ⁴²⁴

3.3.1c EOC activation within 120 minutes of identification of emergency/scenario

Score: 0

There is public evidence of an activation of EOC in 2024, but there is no information that the activation occurred within 120 minutes of the identification of the public health emergency/scenario. ^{425 426}

In early 2024, the Nigeria Centre for Disease Control and Prevention (NCDC) through the National Lassa Fever Technical Working Group (LF-TWG) had activated the national multisectoral EOC for Lassa Fever (LF-EOC) following a “High Risk” outcome from a risk assessment conducted by subject matter experts from relevant ministries, departments, agencies, and other stakeholders. ⁴²⁷ Similarly, in late 2024, the country has also launched an EOC after recording 190 deaths from Lassa fever. ⁴²⁸ However, there is no evidence that confirms the activation was initiated within 120 minutes of the outbreak being identified. ^{429 430}

3.4.1a Joint exercise/procedures for potential deliberate biological events

Score: 100

There is publicly available evidence that public health, animal health, the private sector and national security authorities in Nigeria have carried out an exercise to respond to a potential deliberate biological event and that there exist standard operating procedures, guidelines, memorandums of understanding (MOUs), or other agreements between the public health, animal health, the private sector and security authorities to respond to a potential deliberate biological event as of 2025. ^{431 432}

Between 16 March 2021 and 19 March 2021, the United Nations Counter-Terrorism Centre (UNCCT) had conducted the Virtual Training on Outbreak Containment for Law Enforcement with a focus on bioterrorism for Nigeria. The training was organised in alignment with the framework of the UNCCT programme on Preventing and Responding to Weapons of Mass Destruction (WMD)/Chemical, Biological, Radiological and Nuclear (CBRN) Terrorism, and it provided an overview of the bioterrorism threat and the role performed by law enforcement in response to serious public health emergencies. The four-days virtual training was attended by representatives of various agencies and entities, including the Federal Ministry of Health, the Federal Ministry of Agriculture, the Federal Ministry of Environment, the National Biosafety Management Agency, Federal Fire Service, the Nigerian Navy, the Nigerian Police Force, and other relevant institutions. ⁴³³ Nigeria also has in place the National Biosecurity Policy and Action Plan 2022 – 2026 which involves collective efforts from various responsible ministries, agencies, departments and organisations to address the deliberate acts of bioterrorism and biowarfare by establishing adequate prevention and detection systems, ensuring appropriate response, and developing post-exposure management (pp. 50 – 54). ⁴³⁴

3.5.1a Risk communication plan for specific use during a public health emergency

Score: 100

Nigeria has a risk communication plan in its national public health emergency response plan that is specifically intended for use during a public health emergency. ^{435 436}

The 2019 National Technical Guidelines for Integrated Disease Surveillance and Response attaches the importance of risk communication during disaster and emergency preparedness and response in Section 7.0, titled “Risk Communication and Community Engagement,” beginning on page 256. According to Section 7.1 of the guidelines, the purpose of the risk communication framework is to ensure that everyone at risk can make informed decisions to reduce the effects of threats, such as disease outbreak, and to take protective and preventive action. Section 7.2 and 7.4 outline strategic approaches for effective emergency risk communication and community engagement, including stakeholder relations and community surveillance, precautionary advocacy, crisis communication, and outrage management. ⁴³⁷ The 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan includes a coordination framework for state risk communication in Section 4.3, describing the inter-agency and hierarchical coordination mechanisms used during emergency response. This framework involves coordination between the National Emergency Management Agency (NEMA), State Emergency Management Agency (SEMA), and Local Emergency Management Committee (LEMC) to ensure an organized, effective response across federal, state, and local levels. Section 4.3.1 specifically outlines how these agencies interact to facilitate timely risk communication and response activities at each jurisdictional tier. ⁴³⁸

3.5.1b Inclusion of different population & sector needs in risk communication plan

Score: 100

Nigeria’s risk communication plan used to guide national public health response outlines how messages will reach populations and sectors with different communications needs. ⁴³⁹

According to the 2019 National Technical Guidelines for Integrated Disease Surveillance and Response, strategic measures for effective risk communication are outlined in Section 7.3, "Strategic Approaches for Risk Communication". These measures include deciding what information to communicate, how to convey the message, identifying appropriate communication methods available in local government areas, and delivering health education messages to communication groups, service organizations, and trusted community leaders through local government area and state medical officers. The risk communication framework under the guidelines emphasizes using local terminology; crafting messages that are culturally sensitive, acceptable, clear, and concise; considering local traditions; and addressing beliefs about the disease to enhance message effectiveness (Section 7.3.1). Additionally, the framework recommends using diverse communication channels such as mass media, meetings, educational and communication materials, and social media to disseminate messages broadly within community populations (Section 7.3.2). ⁴⁴⁰

3.5.1c Designation of a specific government spokesperson during a public health emergency

Score: 100

The risk communication plan used to guide national public health response designates a specific position within the government to serve as the primary spokesperson to the public during a public health emergency. ^{441 442}

According to the 2019 National Technical Guidelines for Integrated Disease Surveillance and Response, strategic measures for effective risk communication and feedback include identifying a spokesperson who has undertaken training on required protocols (Section 7.5, page 265). The Nigeria Centre for Disease Control (NCDC) holds the responsibility to identify this spokesperson and to outline the risk communication plan, which includes media engagement and the sharing of information before, during, and after a public health emergency (Section 7.5). ⁴⁴³ The 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan further states that the Public Health Emergency Rapid Response Team (PHERRT) plays a role in establishing an appropriate and coordinated risk communication system through a trained spokesperson during the public health emergency and response (Section 5.2.3, page 78). This ensures consistent, accurate communication to the public and stakeholders throughout the emergency response cycle. ⁴⁴⁴

3.5.2a Government use of media platforms to share info on public health emergencies

Score: 100

There is evidence that the public health system has actively shared messages via online media platforms in the past year to inform the public about ongoing public health concerns and/or dispel rumours, misinformation or disinformation. ⁴⁴⁵

The Nigeria Centre for Disease Control (NCDC) published the Social Media Strategy in 2022. This strategy governs the use of NCDC social media platforms to provide timely or real-time information on public health threats and events to the public, promote preventive information for informed and healthy decisions during public health emergencies, and engage with the public through two-way communication and feedback (p. 11). According to the strategy, content shared on NCDC social media platforms includes behavioural change messages for priority diseases, articles, disease situation reports, field response updates, events, emergency updates, media appearances, interviews, and more (p. 15). Additionally, the social media team is required to carry out content posting for each platform, with a minimum of 5 posts scheduled daily on NCDC’s Twitter, Telegram, and Facebook accounts (p. 16).⁴⁴⁶ with the most recent X (formerly Twitter) update being from 6 September 2025. ⁴⁴⁷

3.5.2b Evidence that senior leaders have shared mis/disinformation on infectious diseases

Score: 100

There is no evidence that senior leaders in Nigeria have shared misinformation or disinformation on infectious diseases in the past 2 years. ^{448 449}

During Nigeria’s general elections in February 2023, there had been reports of several websites which spread disinformation and false news about sports, entertainment, and politics. However, there is no information that the disinformation and false news were shared by senior leaders in Nigeria or that it involved disinformation on infectious diseases in the country. ⁴⁵⁰ In 2020, Nigeria Health Watch launched the Health Misinformation Management Project in partnership with a technology not-for-profit organisation named Meedan and NCDC to prevent misinformation during the COVID-19 outbreak, and the project was in its 4th year of implementation in 2024. ⁴⁵¹

3.6.1a Percentage of households with Internet

Score: 40.12

3.6.2a Mobile-cellular telephone subscriptions per 100 inhabitants

Score: 53.26

3.6.3a Gender gap in access to a mobile phone (percentage points)

Score: 60

3.6.4a Gender gap in access to the Internet (percentage points)

Score: 54.17

3.7.1a Restrictions on export/import of medical goods due to an infectious disease outbreak

Score: 100

There is no evidence that Nigeria has implemented restrictions on trading of medical goods due to an infectious disease outbreak in 2024. ^{452 453 454}
Information about Nigeria’s restrictions on export/import of medical goods due to an infectious disease outbreak in 2024 cannot be found on a public website or websites of Nigeria Centre for Disease Control (NCDC), Federal Ministry of Health and Social Welfare, or Federal Ministry of Agriculture. ^{455 456 457}

3.7.1b Restrictions on movement and/or exports/imports due to disease outbreak

Score: 100

There is no evidence that Nigeria has implemented restrictions on trading of non-medical goods due to an infectious disease outbreak in 2024. ^{458 459 460}
Information about Nigeria’s restrictions on export/import of non-medical goods due to an infectious disease outbreak in 2024 cannot be found on a public website or websites of Nigeria Centre for Disease Control (NCDC), Federal Ministry of Health and Social Welfare, or Federal Ministry of Agriculture. ^{461 462 463}

3.7.2a Evidence of travel ban due to an infectious disease outbreak

Score: 100

There is no evidence that Nigeria has implemented inbound or outbound travel restrictions in 2024 due to an infectious disease outbreak. ^{464 465}

On 16 August 2024, Nigeria Centre for Disease Control (NCDC) said it has been closely monitoring the Mpox situation in Nigeria after the disease has been declared a Public Health Emergency of International/Continental Concern (PHEIC/PHECC) by both the WHO and the Africa Centres for Disease Control and Prevention (Africa CDC). While the country acknowledged the concern over the cross-border transmission of the disease and required travellers to declare their travel history in the last 90 days, there was no evidence that Nigeria imposed any travel restrictions in response to the Mpox outbreak. ^{466 467} After declaring the Mpox outbreak as a Public Health Emergency of Continental Security (PHECS) on 13 August 2024, Africa CDC also confirmed that travel restrictions were not necessary during that time. ⁴⁶⁸

3.7.2b Risk-based approach to international travel-related measures

Score: 100

Nigeria has used a risk-based approach to international travel-related measures by 2025. ⁴⁶⁹

The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria reports that a central coordination system and the national public health emergency response committees for point of entry have been used for the development of travel-related protocols. The mission report adds that Nigeria has also used the Public Health Emergency Management Team (PHEMT) meeting to activate public health emergency contingency plans on travel-related measures (p. 63). ⁴⁷⁰

4.1.1a Doctors per 100,000 people

Score: 5.21

4.1.1b Nurses and midwives per 100,000 people

Score: 21.93

4.1.1c Updated health workforce strategy to address human resource shortfalls

Score: 100

In the past 5 years, Nigeria has a health workforce strategy in place to identify fields where there is insufficient workforce and strategies to address these shortcomings. ⁴⁷¹

In August 2024, Nigeria’s Ministry of Health published the 2023 National Policy on Health Workforce Migration which was introduced to address the complex dynamics of health worker migration. ⁴⁷² The policy aims to produce appropriate and adequate human resources for people-centred healthcare delivery at all levels and to have an adequate and equitably distributed health workforce in Nigeria (p. 9). To meet its objectives, the policy calls for an expansion of training capacity of the training facilities to develop an adequate number of healthcare professionals, utilisation of benefits and security to attract health workers in rural and underserved areas, and support for on-the-job training opportunities that allow health workers to advance their careers without relocation (p. 9). ⁴⁷³

4.1.1d Health system capacity for essential health services

Score: 0

There is limited information on sufficient capacity within Nigeria’s health system to deliver essential health services. ^{474 475 476}

The Joint External Evaluation of the International Health Regulations (2023) for Nigeria, states that Nigeria has a nationally defined package of essential or critical health services. However, there are no strategic or operational plans or guidelines available that detail the mechanism for the continuity of EHS during times of emergency. There is a need for the development and dissemination of working plans and advisories on the continuity of EHS during emergencies. Disruptions in EHS have occurred during times of emergencies, insecurity and elections in recent crises including COVID-19 pandemic. The frequency of simulation exercises and post-event reviews to evaluate EHS performance are not regular. Post-event reviews do not always inform improvement of EHS measures.⁴⁷⁷

According a 2025 article by Humanitarian Action, the functionality of the health infrastructure and critical shortage of health-care workers make up a big concern that limits the access especially for those living in remote areas to essential health services in the country. ^{478 479} Despite having strong antenatal care coverage, Nigeria has still faced the challenges and barriers, including the lack of service delivery, financial restraints, low number of health workforce, and reduction in healthcare demand. Yet, there is evidence of new and adapted interventions to overcome the challenges for essential health services, and those interventions include subnational coordination between state governments to maintain essential health services, seeking support from the private sector, promoting the use of technology and digital health, conducting task shifting among community health workers, and deploying health service delivery adaptations, such as geolocated, mobile health vans in several states. ⁴⁸⁰

According to the "Strategy and Implementation Plan 2023 – 2027" published by the Nigeria Centre for Disease Control and Prevention (NCDC) in 2023, the Nigerian health system is underfunded, inefficient, and poorly regulated, with the private sector being the main healthcare provider but largely unregistered and poorly regulated, making up about 62% of health facilities (sections 16-17). Despite government efforts to expand primary healthcare, the system remains severely under-resourced, and high out-of-pocket healthcare payments limit population access to essential services (sections 17-18). Additional challenges such as high poverty rates, ongoing security issues, and inadequate infrastructure further constrain the health system's capacity (sections 18-19). The NCDC strategy highlights these gaps and emphasizes the need to strengthen surveillance and response systems within this constrained context (sections 18-19). ⁴⁸¹

4.1.1e Essential health services continuity plan for public health emergencies

Score: 100

There is a plan to ensure continuity of essential health services during a public health emergency. ^{482 483 484}

The "Strategy and Implementation Plan 2023 – 2027" by the Nigeria Centre for Disease Control and Prevention (NCDC), published in 2023, outlines efforts to strengthen health emergency preparedness and response to ensure continuity of essential health services during public health emergencies. The plan includes strategic goals focused on optimizing coordination infrastructure and support systems for effective health security interventions, strengthening surveillance and epidemiology systems, and enhancing subnational support to improve response capacity at all levels (sections 26-32, 72-74). The NCDC also emphasizes building resilient health systems through multisectoral collaboration and integration of One Health approaches to mitigate disruptions during emergencies (sections 18, 72-74). ⁴⁸⁵

In June 2025, the United Nations Children’s Fund (UNICEF) joined forces with IHS Nigeria (a private real estate company) to deliver urgent humanitarian support to communities affected by floods that struck Mokwa Local Government Area (LGA) in Niger State. The collaboration also brought about efforts to restore access to essential health services in Mokwa by calling for emergency grant to renovate and solarising a primary healthcare centre damaged by the disaster. ⁴⁸⁶ In 2022, WHO had also supported Nigeria in delivering critical health services through mobile-health teams to three states in northeast Nigeria, targeting the most vulnerable persons prone to disease outbreaks and hard-to-reach groups. ⁴⁸⁷

4.1.2a Hospital beds per 100,000 people

Score: 8.6

4.1.2b In-country capacity to isolate patients with highly communicable diseases

Score: 0

Nigeria does not have the capacity to isolate patients with highly communicable diseases in a biocontainment patient care unit and/or patient isolation room/unit located within the country. ^{488 489}

In September 2020, Nigeria Centre for Disease Control and Prevention (NCDC) published the Infection Prevention and Control Recommendations During Health Care Provision for Suspected and Confirmed Cases of COVID-19 to address the transmission of COVID-19 in healthcare settings. The guidelines adopted the Screen, Isolate and Notify approach in which screened patients suspected of having COVID-19 should be isolated from other patients in a well-ventilated room, windows open to the outside with doors closed. ⁴⁹⁰ In 2020, Nigeria also transformed its sport stadiums into emergency hospitals to support the growing number of COVID-19 patients. For instance, the Lagos State Government turned a 5,000-capacity stadium into an isolation medical facility with 110 beds as part of effort to contain the spread of the disease. ⁴⁹¹ However, there is no publicly evidence of a biocontainment patient care unit or patient isolation room in Nigeria nor that the country has the capacity to isolate the patients with highly communicable diseases. ^{492 493}

4.1.2c Demonstrated capacity / evidence of plan to expand isolation capacity

Score: 100

There is evidence that Nigeria has demonstrated capacity to expand isolation capacity in response to an infectious disease outbreak in the past two years, and the country has developed a plan to expand isolation capacity in response to such outbreak in the past two years. ^{494 495}

A 2025 journal article on critical analysis of infectious disease surveillance and response system in Nigeria mentions that there was evidence of investments to create and modernise isolation centres in Nigeria’s big cities, such as Lagos. The critical care capacity of the isolation centres nationwide was also boosted by providing crucial medical equipment, including oxygen concentrators and ventilators. ⁴⁹⁶ The 2019 National Technical Guidelines for Integrated Disease Surveillance and Response outline strategies to strengthen isolation facilities and recommend opening isolation units that are separate from health facilities during outbreaks. While the guidelines emphasize strengthening capacities and infrastructure for effective surveillance and response, detailed strategies related to isolation include ensuring the availability of dedicated isolation spaces to prevent disease transmission within health facilities and to safely manage suspected and confirmed cases (Section 8.5, page 300). ⁴⁹⁷

4.2.1a National procurement protocol for the acquisition of routine laboratory/medical supplies

Score: 100

There is a national and/or international procurement protocol in Nigeria that can be utilised by the Ministries of Health and Agriculture for the acquisition of laboratory supplies and medical supplies for routine needs. ⁴⁹⁸

Nigeria’s Bureau of Public Procurement (BPP), Federal Ministry of Health (FMoH), Standards Organisation of Nigeria (SON), and Nigerian Nuclear Regulatory Authority (NNRA) have published the 4th revision of an approved Policy for Procurement of Health and Medical Equipment/List of Manufacturers and Equipment. This policy is effective from January 2024 to December 2025 and covers tertiary hospitals, other ministries, departments, and agencies, as well as federal government-funded non-tertiary settings such as primary health centers. The policy provides a selection of health and medical equipment and lists approved manufacturers and suppliers to be procured in Nigeria. The list includes laboratory supplies such as dental equipment and surgical microscopes, as well as medical supplies including medical trolleys and diagnostic sets. The policy aims to ensure standardized, quality equipment acquisition while promoting local content in public procurement in line with Executive Order 003 of 2017.⁴⁹⁹

4.2.2a Stockpile of medical supplies for national use during a public health emergency

Score: 33.33

As of 2025, Nigeria has a stockpile of medical supplies for national use during a public health emergency defined by an overarching national public health emergency response plan, but there is limited evidence about what the stockpile contains. There is also no plan to ensure equitable distribution during an emergency. ^{500 501}

The 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan has been implemented to provide a holistic, multisectoral and multidisciplinary approach needed to address gaps and improve health emergency preparedness and response in Nigeria. The plan reports that Nigeria has surge capacity and strategic stockpiles in place to be disseminated to the intermediate health tiers during a public health emergency (p. 28). In addition, the plan contains a strategy to return any remaining resources, supplies, and equipment to the stockpile upon completion of each emergency response (p. 72). ⁵⁰² The 2019 National Technical Guidelines for Integrated Disease Surveillance and Response include strategies to set up contingency stocks of medicines, vaccines, reagents, and supplies to ensure readiness for outbreak response (Section 9.3, page 320). The guidelines also emphasize effective stock management practices, including regular inventory checks, timely replenishment, and proper storage conditions to maintain the quality and availability of these critical resources during public health emergencies (Section 9.4, page 321). These measures are designed to enhance outbreak preparedness and ensure a rapid and effective response to public health threats. ⁵⁰³ However, both strategic plans do not mention whether Nigeria should consider equitable distribution of the stockpile in an emergency. ^{504 505}

4.2.2b Stockpile of laboratory supplies for national use during a public health emergency

Score: 50

Nigeria has a stockpile of laboratory supplies for national use during a public health emergency, but there is limited evidence of what the stockpile contains. ^{506 507}

The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria states that Nigeria Centre for Disease Control and Prevention (NCDC) has a strategic stockpile for emergency supplies and that there is a national stockpile system in place to track the supply of commodities (p. 30 & p. 46). However, the mission report does not give further details of what is contained in the stockpile. ⁵⁰⁸ Similarly, the 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan states that Nigeria has surge capacity and strategic stockpiles in place to be disseminated to the intermediate health tiers during a public health emergency (p. 28). The plan also contains a strategy to return any remaining resources, supplies, and equipment to the stockpile upon completion of each emergency response (p. 72). The plan, however, does not mention what the stockpile contains. ⁵⁰⁹

4.2.2c Annual review of national stockpile to ensure sufficient supply

Score: 0

There is no evidence that Nigeria conducts or requires an annual review of the national stockpile to ensure the supply is sufficient for a public health emergency. ^{510 511}

While the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria provides that the country has a strategic stockpile for emergencies supplies, the mission report does not mention whether the country requires an annual review of the national stockpile to ensure sufficient supply for a public health emergency. ⁵¹² On the other hand, the 2019 National Technical Guidelines for Integrated Disease Surveillance and Response states that the subnational level should conduct a regular and careful monitoring of contingency stock of medicines, vaccines, reagents and supplies. The guidelines also suggest that the stockpile should be checked every 4 months to make sure the supplies are dry, clean, not expired, accessible, and ready for use (p. 207). However, the guidelines do not mention whether the review should ensure the supply is sufficient in a public health emergency. ⁵¹³

4.2.3a Plan/agreement to produce/procure medical supplies during a public health emergency

Score: 100

In Nigeria, there is evidence of a plan or agreement that (1) leverages public and/or private sector domestic or regional manufacturing capacity to produce medical supplies for national use during a public health emergency, but there is no evidence of a plan or agreement that (2) procures medical supplies for national use during a public health emergency, or (3) expedites medical supplies through points of entry. ^{514 515 516}

The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria provides that Nigeria has the capacity to manufacture antibiotics, personal protective equipment and some lab consumables, but the country has no capacity to produce human vaccines and commodities are often distributed with needy countries during emergency. It also does not mention the involvement of public or private sector in leveraging domestic or regional manufacturing capacity to produce medical supplies for national use during a public health emergency. ⁵¹⁷

Based on the 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan, a logistician of the Public Health Emergency Rapid Response Team (PHERRT) plays a role in procuring equipment and supplies during a public health emergency. However, the details on the procurement of medical supplies under the plan are not comprehensive. ⁵¹⁸

The 2019 National Technical Guidelines for Integrated Disease Surveillance and Response provide that logistics, such as medical supplies, vaccines, and PPEs should be available at the site of the outbreak investigation. However, there is no information that points of entry should have medical supplies in place during a public health emergency. ⁵¹⁹

4.2.3b Plan/agreement to produce/procure lab supplies during a public health emergency

Score: 100

There is no evidence of a plan to leverage public and/or private sector domestic manufacturing capacity to produce laboratory supplies for national use during a public health emergency or a plan to expedite laboratory supplies through points of entry, but a plan to procure laboratory supplies for national use during a public health emergency exists by 2025. ^{520 521 522}

Nigeria has limited in-country capacity to manufacture laboratory supplies, such as diagnostic reagents, according to the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria (p. 32). The mission report also adds that there are no regional agreements on the procurement, sharing and distribution of countermeasures although commodities are shared with needy countries in an emergency (p. 46). ⁵²³ There is no publicly available evidence of a national plan or mechanism used to expedite laboratory supplies through points of entry. ^{524 525} However, the 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan states that Nigeria has a plan and mechanism to procure laboratory supplies during a public health emergency. According to the plan, the Epidemic Preparedness and Response Committee (EPR) mechanism at the state level is responsible for taking stock of materials, including laboratory supplies, and ensuring procurement by the responsible department in the State Ministry of Health (p. 23). The Emergency Response Team-Advance Element (ERT-A) and the Emergency Response Team-National (ERT-N) also plays a role in coordinating mission assignments for procurement of goods and services (p. 25). ⁵²⁶

4.2.3c Mechanism emergency logistics and supply chain management

Score: 100

Nigeria has a system or mechanism for national and subnational levels for emergency logistics and supply chain management, but there is insufficient evidence that the system or mechanism is exercised and reviewed regularly, that it covers specific considerations such as cold chain management for vaccines, and that it covers the public and private sector. ⁵²⁷

According to the "Strategy and Implementation Plan 2023–2027" published by the Nigeria Centre for Disease Control (NCDC) in 2023, comprehensive strategic measures are outlined under Section 4.2, "Emergency Logistics and Supply Chain Management," to be implemented at both national and subnational levels. Specifically, the plan mandates a review of logistics and warehouse capacity based on the National Multi-Hazard Preparedness and Response Plan, scheduled for January 2024, and the capacity building of logistics and supply chain officers on emergency supply chain management, slated for September 2024. The plan includes monitoring and evaluation of subnational units through key performance indicators but does not provide for regular review or evaluation of these strategic measures. Furthermore, Section 4.2 does not explicitly address specific considerations such as cold chain management for vaccines or clarify whether these measures apply to the public, private, or both sectors. ⁵²⁸

Complementing this, the "Good Cold Chain Management for Vaccines and Other Biopharmaceutical Products Guidelines 2021," published by the National Agency for Food and Drug Administration and Control (NAFDAC) in 2021, comprehensively governs the management of medicines requiring cold chain handling. As detailed in Section 3.1, "Storage and Transport Requirements," these guidelines specify standards for the storage, transport, and handling of vaccines and biopharmaceutical products to ensure their efficacy and safety. ⁵²⁹

4.3.1a Plan/program/guidelines for dispensing MCMs during a public health emergency

Score: 0

Nigeria does not have in place a plan, programme, or guidelines for dispensing medical countermeasures for national use during a public health emergency. ^{530 531}

Nigeria does not have regional agreements on the procurement, sharing and distribution of countermeasures, according to the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria. However, the mission report states that commodities are often distributed with needy countries during an emergency (p. 46). ⁵³² Previously, the 2017 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria reported that Nigeria did not have any existing national plans or guidelines for sending and receiving medical countermeasures during emergencies. Sending and receiving of medical countermeasures in response to emergencies has rather been ad-hoc with no documents to guide the process. Yet, the mission report provided that Nigeria had several institutional plans developed by agencies, such as NCDC and NEMA, to guide the process of sending and receiving medical countermeasures during public health emergencies (p. 43). ⁵³³

The "Strategy and Implementation Plan 2023 – 2027" by the Nigeria Centre for Disease Control and Prevention (NCDC), published in 2023, includes mention of Medical Countermeasures (MCM) as part of the agency’s public health preparedness and response framework. The strategic goals emphasize strengthening health emergency preparedness and response, which would encompass the management and deployment of MCM such as antibiotics, vaccines, therapeutics, and diagnostics (sections 17, 26-32, 72-74). Although the document outlines objectives related to optimizing coordination infrastructure and surveillance capacity, it does not provide explicit details of a standalone, comprehensive plan, program, or specific guidelines solely dedicated to the dispensing of MCM during public health emergencies. However, the integration of MCM within broader emergency response systems is implied as part of NCDC’s mandate to coordinate and lead response efforts nationally and subnationally (sections 17, 26-32). ⁵³⁴

4.3.2a Plan to receive foreign health personnel during a public health emergency

Score: 0

Nigeria does not have a public plan to facilitate workforce surge in an emergency. ^{535 536 537}

Nigeria’s 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan and 2019 National Technical Guidelines for Integrated Disease Surveillance and Response do not mention any strategic measures that aim to facilitate workforce surge during an emergency. ^{538 539} While the 2023 National Policy on Health Workforce Migration seeks to address the shortage of healthcare professionals through improving working conditions and providing professional development opportunities especially for those in underserved areas, there is limited information that shows the policy facilitates the surge in workforce in events of emergency. ⁵⁴⁰

4.3.2b Plan to facilitate workforce surge in an emergency

Score: 0

There is no evidence of a public plan to receive health personnel from other countries during a public health emergency. ^{541 542 543 544}

According to the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria, Nigeria has the Rapid Response Team Guidebook in place to guide pre-deployment, deployment and post-deployment actions of health personnel in a public health emergency, and surge capacity also exists at a national level (p. 45). The mission report, however, provides no information on deploying health personnel from other countries in a public health emergency. ⁵⁴⁵ There is also no evidence of the relevant provision on the 2023 National Policy on Health Workforce Migration. ⁵⁴⁶ While the 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan suggests that countries should have a process in place to send or receive health care personnel in public health events of international concern, there is no information on the plan that states whether Nigeria has adopted any strategic measures to support the suggested action (p. 27). ⁵⁴⁷ Similarly, the 2017 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria states that a personnel deployment plan to guide future receiving or sending of technical personnel during a public health emergency has yet to exist in Nigeria. ⁵⁴⁸

4.3.2c Plan to redeploy existing health personnel within the country

Score: 0

Nigeria does not have a public plan to redeploy existing health personnel within the country. ^{549 550 551}

The "National Policy on Health Workforce Migration," published by the Federal Ministry of Health (FMoH), Nigeria, in 2023, aims to retain and attract skilled health workers within and to the country. The policy, detailed in Sections 3.1 to 3.4, outlines strategic measures to address internal and external migration by establishing incentive programs for health workers in rural and underserved areas, providing funding to sustain the management of health centers, and strengthening the deployment of qualified health workers to available facilities in these areas. These initiatives seek to improve health workforce distribution, motivation, and retention across Nigeria. The policy, however, does not address redeployment of existing health personnel within the country. ⁵⁵²

Yet, evidence of collaborative efforts between the Nigerian government and external organizations to manage health workforce migration is available. For example, the UK government, through its Foreign, Commonwealth & Development Office (FCDO), supports the implementation of this policy by planning to equip at least 12 health training institutions across six states, enhancing the quality of training for students in these institutions. This collaboration is highlighted in the report by Dateline Health Africa, published in September 2024. ^{553 554}

4.4.1a Constitutional guarantee of citizens’ right to medical care

Score: 75

Nigeria’s constitution explicitly guarantees citizens’ right to medical care, but there is no information on the constitution that guarantees medical care is free. ⁵⁵⁵

Right to Health is guaranteed under the Nigeria’s constitution. Section 17(3)(d) of the 1999 Constitution of the Federal Republic of Nigeria makes it clear that the State must direct and implement its policy to ensure that there are adequate medical and health facilities for all persons in the country. However, there is no evidence that it addresses right to free medical care for all Nigerian people. ⁵⁵⁶

4.4.1b Access to skilled birth attendants (% of population)

Score: 27.94

4.4.1c Out-of-pocket health expenditures per capita, PPP (current international $)

Score: 73.56

4.4.1d Coverage of essential health services through universal health coverage

Score: 22.92

4.4.1e Total population pushed below a relative poverty line by household health expenditure (60% of media daily per capita consumption or income)

Score: 49.12

4.4.1f Rate of mortality amenable to health care

Score: 55.62

4.4.2a Guaranteed paid sick leave

Score: 100

Paid sick leave is guaranteed for workers in Nigeria, and sick leave is available for mental and physical health problems. ^{557 558 559}

The 1971 Labour Act of Nigeria which provides comprehensive legislation on conditions of work and employment contains a provision that governs sick leave for workers. ^{560 561} Section 16 of the Act states that a worker shall be entitled to paid wages up to 12 working days during absence from work caused by temporary illness that is certified by a registered medical practitioner. ⁵⁶² While the Act does not mention the entitlement of sick leave for workers with mental health problems, Section 13(1) of the 2021 National Mental Health Act provides that a person with a mental health condition shall be subject to equal access to work and employment opportunities while having the right to receive remuneration similar to those without mental health condition. ^{563 564 565} In addition, Section 13(2) of the Act prevents an employer from depriving the person of any benefit that the person is entitled to, regardless of their present or past mental health condition or while the person is receiving treatment for the mental health condition. ^{566 567}

4.4.3a Government prioritisation of care for healthcare workers during response

Score: 0

Nigeria’s government has yet to issue legislation, policy or public statement to provide prioritised healthcare services to healthcare workers who become sick as a result of responding to a public health emergency. ^{568 569 570 571}

Within the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria, there is no publicly available evidence of a legislation or policy in Nigeria that gives priority of healthcare services to healthcare workers who become sick as a result of responding to a public health emergency. ⁵⁷² Similarly, information about the existence of such policy also cannot be found on relevant plans, such as One Health Strategic Plan 2019 – 2023, the 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan or the 2019 National Technical Guidelines for Integrated Disease Surveillance and Response. ^{573 574 575} Despite of the absence of such policy, there is evidence that the Nigeria’s government had worked with WHO to invest in training their health workers and making personal protective equipment and other essential supplies more readily available to health workers during the COVID-19 outbreak in 2020. ⁵⁷⁶ The Nigeria’s government also provided life insurance to health workers as part of the compensation package during the COVID-19 response. ⁵⁷⁷

4.5.1a Existence of system for communication during a public health emergency

Score: 100

There is a system in place for public health officials and healthcare workers to communication during a public health emergency. ⁵⁷⁸

The 2019 National Technical Guidelines for Integrated Disease Surveillance and Response provide that Nigeria has established a National Public Health Emergency Operations Centre (PHEOC) to serve as a coordination unit that improves communication between public health and emergency management personnel (p. 188). The Public Health Emergency Management Committee (PHEMC) also exists to facilitate the communication and deployment of the Public Health Emergency Rapid Response Team (PHERRT) (p. 189). According to the guidelines, the PHEMC through the PHEOC is responsible for ensuring communications with relevant stakeholders are consistent (p. 275). The guidelines provided that the PHEMC should communicate regularly with healthcare workers by providing correct information relating to an outbreak and providing any outbreak or event response reports to participating healthcare workers for future references (p. 281). Appropriate communication methods, such as meeting, should also be used to communicate with health personnel in local government areas (LGAs) (p. 227). ⁵⁷⁹

4.5.1b Inclusion of public and private sector in healthcare communication system

Score: 0

The system for public health officials and healthcare workers to communication during an emergency does not encompass healthcare workers in both the public and private sector. ^{580 581}

Within the 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan, there is no evidence of a mechanism that facilitates communication between public health officials and healthcare workers in both public and private sector. ⁵⁸² According to the "National Technical Guidelines for Integrated Disease Surveillance and Response," published by the Nigeria Centre for Disease Control (NCDC) in 2019, communication between health partners and other stakeholders during outbreak response is emphasized as critical. Section 6.2 of the guidelines highlights the importance of the Public Health Emergency Management Committee (PHEMC), operating through the Public Health Emergency Operation Centre (PHEOC), as the primary body responsible for ensuring that communications during public health emergencies are consistent, accurate, and transparent. However, the guidelines do not explicitly specify whether health workers from both the public and private sectors are involved in these communication activities. The document focuses primarily on the roles of the PHEMC and PHEOC in coordinating communication rather than detailing the involvement of individual health workers across sectors. ⁵⁸³

4.6.1a Evidence of national public health system monitoring and tracking of HCAIs

Score: 100

There is evidence that the national public health system in Nigeria is monitoring for and tracking the number of HCAI that take place in healthcare facilities. ^{584 585}

The "Nigerian Manual of Infection Prevention and Control," published in 2021 by the Nigeria Centre for Disease Control (NCDC), aims to prevent and minimise the risk of healthcare-associated infections (HCAI) at the strategic level in all health facilities and across all types of healthcare settings (Section 1.1, Introduction). According to the manual, the rates of HCAI are monitored monthly by the Infection Prevention and Control (IPC) team or focal person, who is responsible for ensuring the effective implementation of IPC practices across all relevant units (Section 5.2, Monitoring and Surveillance). Additionally, the collected data are reviewed regularly at the IPC Committee meetings to guide continuous improvements (Section 5.3, Data Review and Feedback). ⁵⁸⁶ The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capabilities of Nigeria also states that the country has an active national HCAI surveillance programme and established a national HCAI surveillance strategic plan 2023 – 2028. ⁵⁸⁷ However, information about the programme and strategic plan is not found on government’s websites. ^{588 589}

4.6.1b Infection prevention and control programme

Score: 100

There is evidence of an infection prevention and control programme in place nationally in Nigeria by 2025. ^{590 591 592 593}

According to the "2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) Core Capacities of Nigeria," under the "Turn Nigeria Orange" project launched by the Nigeria Centre for Disease Control (NCDC) in 2019, a manual was published to guide healthcare workers on the safe provision of healthcare services across facilities, and the program remains active as of 2023 (p. 54). The "Turn Nigeria Orange" project aims to enhance infection prevention and control (IPC) practices in Nigerian healthcare settings, particularly targeting viral haemorrhagic fevers (VHF). ^{594 595}

4.6.1c National plan to ensure a safe environment in health facilities

Score: 0

There is no evidence of a plan to ensure a safe environment in health facilities nationally by 2025. ^{596 597 598}

As stated in the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria, the country has not adopted any standards for safe environment in health facilities (p. 54). While IPC programmes exist in the country, there are no dedicated personnel to manage the programmes at the facility level, including state and private health facilities (p. 55). ⁵⁹⁹ There is also no publicly available evidence of strategic measures to ensure a safe environment in health facilities on the NCDC’s Strategy and Implementation Plan 2023 – 2027 or the One Health Strategic Plan 2019 – 2023. ^{600 601}

4.7.1a Requirement for ethical review before beginning a clinical trial

Score: 100

There is a national requirement for ethical review (e.g., from an ethics committee or via Institutional Review Board approval) before beginning a clinical trial in Nigeria. ^{602 603}

In November 2024, the National Agency Food and Drug Administration and Control (NAFDAC) published the Guidelines for Clinical Trial Application in Nigeria 2024 which are intended for individuals and organisations planning to conduct clinical trials in the country (p. 2). Under the guidelines, a clinical trial application form is required to be attached with evidence of accreditation of Ethics Committee (EC) by the National Health Research Ethics Committee (NHREC) as well as an EC approval from participating centres (p. 4). ⁶⁰⁴ According to the National Agency Food and Drug Administration and Control Act of 2004, NAFDAC has the authority which is responsible for protocol review and to grant permit of clinical trial before it is conducted in Nigeria. The NHREC, on the other hand, is responsible for accreditation of Independent EC and or Institutional Review Board (IRB) that provide ethical opinion on study protocols for the clinical trial. For a clinical trial application to be processed, an ethical opinion must be obtained before NAFDAC issues final authorisation for the conduct of the trail subject to satisfactory review. ⁶⁰⁵

4.7.1b Expedited approval for clinical trials of unregistered MCMs during epidemics

Score: 100

Nigeria has an expedited process for approving clinical trials for unregistered medical countermeasures (MCM) or mutual recognition of clinical trial results taking place elsewhere to treat ongoing pandemics or epidemics. ^{606 607}

The "Guidelines for Clinical Trial Protocol Development," published by the National Agency for Food and Drug Administration and Control (NAFDAC) in 2024, aim to facilitate the approval process of clinical trials by assessing potential risks using a label or insert on a package or device from a licensed or approved product as the primary source of risk information (Section 2.3, Risk/Benefit Assessment). ⁶⁰⁸

According to the "Guidelines for Conduct of Clinical Trials During Emergencies," also published by NAFDAC in 2024, NAFDAC is the main body responsible for facilitating the processing and approval of clinical trials during public health emergencies. The guidelines specify that any application to provide an investigational product for use during emergency conditions in non-trial participants cannot proceed without prior approval from NAFDAC (Sections 4.2 and 6.0 on the role of NAFDAC and filing an application). ⁶⁰⁹

4.7.2a Existence of agency responsible for approving new human MCMs

Score: 100

The National Agency for Food and Drug Administration and Control (NAFDAC) is the government agency in Nigeria responsible for approving new medical countermeasures (MCM) for humans.

According to the NAFDAC document titled "Guidance on Emergency Use Authorization for Medical Products" (reference DR&R-GDN-008-00, published on September 10, 2024), NAFDAC regulates the emergency use authorization of unlicensed vaccines, therapeutics, and in vitro diagnostics during public health emergencies (Sections 1-4). This guidance establishes the agency's role in evaluating, authorizing, and monitoring the safety and efficacy of medical countermeasures in emergency contexts. ⁶¹⁰

4.7.2b Expedited approval for human MCMs during public health emergencies

Score: 100

There is an expedited process for approving medical countermeasures (MCM) for human use or recognition of approval decisions taking place elsewhere during public health emergencies in Nigeria. ^{611 612}

According to the "Guidelines for Clinical Trial Process Timelines" published by the National Agency for Food and Drug Administration and Control (NAFDAC) with document reference number DER-GDL-011-02 and effective date of September 6, 2024, the processing of clinical trial-related applications and submissions involves minimum timelines to ensure compliance with Good Clinical Practice (GCP) requirements and quality of data submitted to NAFDAC (Sections 1 and 2). These timelines cover Clinical Trial Applications (CTAs), with general processing up to 60 workdays and expedited timelines of 10 to 15 work days during emergencies for repurposed investigational medicinal products (IMPs) and new chemical entities, respectively; issuance of import permits for investigational products; quarterly progress and safety reports within 20 workdays; response to Compliance Directives within 30 workdays; review of Serious Adverse Events (SAE) reports; and GCP inspection report writing. The document further mandates that reports from foreign sites affecting product safety or use must be reported to NAFDAC within 7 calendar days to ensure ongoing regulatory vigilance (Sections 2 and 4). ⁶¹³ On February 5, 2025, the National Agency for Food and Drug Administration and Control (NAFDAC) of Nigeria joined other regional authorities, including Ghana's Food and Drugs Authority (FDA), South African Health Products Regulatory Authority (SAHPRA), Medicines Control Authority of Zimbabwe (MCAZ), and other institutions, to sign a Memorandum of Understanding (MoU) which aims to streamline application submission and evaluation processes to expedite regulatory processes, reduce costs, and ensure timely regulatory decision-making. The MoU also established mechanisms to ensure that authorised products and clinical trials meet internationally accepted regulatory standards. ⁶¹⁴

5.1.1a Submission of IHR reports to the WHO in past year

Score: 100

Nigeria has submitted an IHR Self-Assessment Annual Report (SPAR) to the WHO for the last calendar year, with the latest submission in 2024.⁶¹⁵

5.1.2a Existence of specific risk reduction strategies for epidemics and pandemics

Score: 100

Nigeria has integrated epidemics and pandemics into its national disaster risk reduction framework, as evidenced by the establishment of a standalone national disaster risk reduction strategy for these hazards.

According to the 2020 National Public Health Multi-Hazard Emergency Preparedness and Response Plan published by the Nigerian Ministry of Health (Section on Epidemic Preparedness and Response, 2020), an Epidemic Preparedness and Response Committee (EPR) exists to review epidemiological trends and formulate multisectoral, state-specific operational preparedness and response plans. ⁶¹⁶ The 2018 National Disaster Risk Management Policy (Federal Government of Nigeria, Section 3.2, 2018) assigns the National Emergency Management Agency (NEMA) the responsibility for managing all disasters, including epidemics and emergencies requiring coordinated state or local efforts. ⁶¹⁷ Nigeria also implements key national strategic frameworks such as the 2020 National COVID-19 Pandemic Multi-Sectoral Response Plan (Federal Ministry of Health, Section 4, 2020) and the 2013 Nigeria National Pandemic Influenza Preparedness and Response Plan (Federal Ministry of Health, 2013), which provide targeted responses to specific pandemic threats. Notably, the 2020 COVID-19 Plan established the Presidential Task Force (PTF) tasked with mitigating the pandemic’s impact through transmission control and ensuring access to essential treatment services (Section 4.2, 2020). ^{618 619}

5.2.1a Existence of public health emergency agreements with regional neighbors

Score: 100

Nigeria has cross-border agreements, protocols, or MOUs with neighbouring countries, or as part of a regional group, with regards to public health emergencies. ^{620 621}

Nigeria is a member state of African Union (AU) and has joined other AU member states in developing the 2024 Strengthening Cross-Border Surveillance and Information Sharing in Africa Strategic Framework established by the Africa Centres for Disease Control and Prevention (Africa CDC). The framework places the Africa CDC at the centre of regional coordination in responding to public health emergencies. In addition, the framework lays down several strategic interventions to strengthen coordination and collaboration for cross-border surveillance, and the interventions include promoting cross-border collaborative response mechanisms within the Incident Management System (IMS) of member states that would improve the response to health events and emergencies crises. ⁶²² Furthermore, in 2018, Nigeria formalized a partnership with the United Kingdom by signing a Memorandum of Understanding (MOU) to bolster health security efforts in Nigeria, including funding for the International Health Regulations (IHR) strengthening programme focused on emergency preparedness and response (Federal Ministry of Health Nigeria and UK Government, 2018). ⁶²³ In 2025, although Nigeria did not join six other African countries in signing a joint strategy MOU for cross-border disease control, it expressed interest in establishing a similar MOU with neighboring countries to collaboratively address visceral leishmaniasis (Federal Ministry of Health Nigeria, 2025). ⁶²⁴

5.2.1b Existence of animal health emergency agreements with regional neighbors

Score: 50

Nigeria has cross-border agreements, protocols, or MOUs with neighbouring countries, or as part of a regional group, with regards to animal health emergencies, but there is evidence of gaps in implementation. ^{625 626}

Nigeria hosts the Emergency Centre for Transboundary Animal Diseases (ECTAD) programme, an initiative established by the Food and Agriculture Organization (FAO) to facilitate veterinary assistance planning and delivery to member states. Through ECTAD, the FAO supports Nigeria by enhancing the capacities of national and local stakeholders for managing animal disease emergencies, including prevention, detection, and response to both zoonotic and non-zoonotic disease outbreaks (FAO, ECTAD Programme Overview, 2021). In that same year, FAO, under the ECTAD programme, conducted a capacity-building training in Nigeria for field-based animal health professionals, focusing on the prevention, control, and early response to zoonotic disease spread. This training was delivered through the In-Service Applied Veterinary Epidemiology Training (ISAVET) programme, which aims to reinforce veterinary epidemiology skills among frontline workers to improve animal and public health outcomes (FAO ECTAD Nigeria, ISAVET Training Report, 2021). ⁶²⁷ However, there is no recent update whether the ECTAD programme still exists in Nigeria. on the FAO webpage on ECTAD. ⁶²⁸

5.3.1a Biological and Toxin Weapons Convention status

Score: 100

Nigeria has signed and ratified the Biological Weapons Convention. ^{629 630}

According to the Biological Weapons Convention National Implementation Measures Database, Nigeria has ratified the Biological Weapons Convention since 3 July 1973, and the country has incorporated measures relevant for the implementation of the Biological Weapons Convention in its Criminal Code and the Terrorism Prevention Act of 2022. ⁶³¹ The United Nations Digital Library provides that Nigeria was also among the early states parties that signed the Biological and Toxin Weapons Convention (BTWC) on 10 July 1972 and ratified the Convention on 9 July 1973. ⁶³²

5.3.1b Submission of CBMs to the Biological and Toxin Weapons Convention

Score: 100

Nigeria has submitted its confidence building measures for the Biological Weapons Convention (BWC) in the past 3 years. ⁶³³

The BWC Confidence Building Measures website of the United Nations provides that Nigeria has submitted its latest confidence building measures on 11 August 2025. ⁶³⁴

5.3.1c Submission of UNSCR 1540 reports

Score: 100

Nigeria has provided the required UNSCR 1540 report to the Security Council Committee established pursuant to resolution 1540 (1540 Committee). ⁶³⁵

On October 28, 2004, Nigeria submitted the required UNSCR 1540 report to the Security Council Committee established pursuant to resolution 1540 (1540 Committee). ⁶³⁶

5.3.1d Extent of UNSCR 1540 implementation on public health emergencies

Score: 25

5.3.2a Membership in global health security and/or biological weapons agreements

Score: 0

Nigeria is not a member in the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction (GP) nor the Australia Group (AG). ^{637 638} However, the country is a member of the Proliferation Security Initiative (PSI). ⁶³⁹

5.4.1a Completion and publication of JEE (or GHSA pilot external assessment) report

Score: 100

Nigeria has completed a JEE and published a full public report in the last 5 years. ^{640 641}

Nigeria has published its 2023 JEE report to the website of WHO where a full report offers details of the JEE mission which took place in Abuja from 14 to 18 August 2023. ^{642 643}

5.4.2a Completion and publication of PVS report (past five years)

Score: 0

Nigeria has completed and published its PVS assessment, but the assessment was not submitted in the last 5 years. ^{644 645}

There is evidence that Nigeria has completed and published its World Organisation for Animal Health (OIE) PVS evaluation follow-up mission report which was conducted between 14 January and 1 February 2019. ⁶⁴⁶ However, there is no evidence of the publication within the last 5 years. ^{647 648}

5.4.2b Completion and publication of PVS gap analysis (past five years)

Score: 0

Nigeria has completed and published its PVS gap analysis, but it was not in the last 5 years. ^{649 650 651}

Nigeria has published its completed PVS gap analysis in September 2010, and there is no recent publication of the report. ^{652 653 654}

5.5.1a Evidence of allocated national funds to improve capacity to address epidemic threats

Score: 0

There is no evidence that Nigeria has allocated national funds to improve capacity to address pandemic or epidemic threats within the past 3 years. ⁶⁵⁵

In 2024, Nigeria’s government proposed the Global Fund to act as the Implementing Entity (IE) for the Pandemic Fund project and for its USD 13 million portion of a multi-country proposal to establish regional Biomedical Engineering centres of excellence and to enhance regional oxygen supply. ⁶⁵⁶ Launched in September 2022, the Pandemic Fund is a collaborative project aimed at enhancing pandemic prevention, preparedness, and response capacities in low- and middle-income countries. ^{657 658} The collaboration between the Global Fund, the Pandemic Fund, and Nigeria aims to strengthen critical pandemic prevention, preparedness, and response (PPR) functions at the national level as well as at the regional and global levels. The investment to expand the oxygen capabilities through the regional biomedical engineering centres of excellence aims to last for 3 years starting in February 2025. ⁶⁵⁹

5.5.2a National budget to address gaps identified in JEE, NAPHS or GHSA roadmap

Score: 0

There is no evidence that Nigeria’s National Action Plan for Health Security (NAPHS) allocates specific funding from the national budget to address the identified gaps, covering a time-period within the past 5 years. ⁶⁶⁰

The 2023 Mission Report from the Joint External Evaluation (JEE) of the International Health Regulations (IHR) (2005) core capacities of Nigeria, published by the World Health Organization (WHO), records progress in identifying both domestic and external financing sources for health security implementation within Nigeria (Section 4.3, 2023). Although the report does not specify allocations from the national budget, it references the Nigeria National Action Plan for Health Security (NAPHS) 2018–2022, which delineates specific funding arrangements for each strategic action item within the plan. ⁶⁶¹ The NAPHS allocates funding across two distinct periods: an initial phase from 2018 to 2019 and a broader phase extending from 2018 to 2022 supporting the implementation of health security measures across Nigeria (Federal Ministry of Health Nigeria, NAPHS 2018–2022, Sections 5 and 6). ^{662 663}

5.5.2b National budget to address gaps identified in PVS assessment or gap analysis

Score: 0

Nigeria’s PVS gap analysis and/or assessment report does not allocate or describe specific funding from the national budget covering a time-period within the past 5 years or in the future to address the identified gaps. ^{664 665}

According to the 2019 OIE PVS Evaluation Follow-Up Mission Report, there is no evidence that the report allocates or describe specific funding from the national budget to cover a time-period in the past 5 years, and the report provides that funding for the National Peste des Petits Ruminants (PPR) strategy has not been obtained from national or international sources. ⁶⁶⁶ On the other hand, the 2010 PVS gap analysis report allocates specific fundings for operational activities and emergency fund. For example, the report allocates an exceptional budget of USD 15 million for an emergency fund in the country. However, the funding covered a time period that was not in the last 5 years. ⁶⁶⁷

5.5.3a Emergency public financing during a public health emergency

Score: 100

There is a publicly identified special emergency public financing mechanism and funds which Nigeria can access during public health emergency. ^{668 669 670}

Established in February 2017, the Nigeria Humanitarian Fund (NHF) has served as a rapid and flexible funding mechanism that supports national and international non-governmental organisations (NGOs) and UN agencies in responding to critical emergencies in the country. The fund is operationally managed by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA)’s Humanitarian Financing Unit (HFU) which ensures that the fund is managed for the emergencies with allocation processes and monitoring. ⁶⁷¹ In February 2025, the UN Emergency Relief Coordinator has made pre-arrangement of US 5 million from the Central Emergency Response Fund (CERF) available to support government-led efforts through an anticipatory action initiative for floods in Nigeria. The fund is managed by the OCHA. ⁶⁷² A 2020 Report on the Implementation of ‘Basic Health Care Provision Fund’ for Public Health Emergencies also provides that the Nigerian government can have access to 50% of the 5% of the Basic Health Care Provision Fund which is used for the medical emergencies for the preparation and response to public health emergencies. ⁶⁷³

5.5.4a Commitments to improve domestic or foreign capacity for epidemic threats

Score: 100

There is evidence that Nigeria’s senior leaders, in the past 3 years, have made a public commitment to improve the country’s domestic capacity and support other countries to improve capacity to address pandemic or epidemic threats. ^{674 675}

According to a 2022 article on the Nigeria Centre for Disease Control and Prevention (NCDC) website, the NCDC Director-General, Dr Ifedayo Adetifa, has made a public agency’s commitment to strengthen Nigeria’s capacity to respond to public health emergencies by continuing to invest in national health security as part of its contributions to all efforts aimed at developing a resilient health system. Moreover, the agency’s Director-General supported actions towards the establishment of a peer-to-peer exchange programme to foster learning between Nigerian and Zambian National Public Health Institutes to strengthen the capacity for epidemic preparedness and response. ⁶⁷⁶ In 2023, the Director-General also aligned the agency’s commitment to strengthen health security with President Bola Ahmed Tinubu’s Renewed Hope agenda for Nigeria and the Federal Ministry of Health’s four-point agenda on national health security. In addition, the Director-General attached great importance of Africa CDC’s contribution in promoting capacity-building opportunities for health workers in Nigeria. ⁶⁷⁷

5.5.4b Investments to improve domestic or foreign capacity for epidemic threats

Score: 100

There is evidence that Nigeria has, in the past 3 years, requested financing or technical support from donors to improve the country’s domestic capacity to address epidemic threats, but information on Nigeria’s financial or technical support to other countries is limited. ^{678 679}

There is insufficient evidence that Nigeria has offered financial or technical support to other countries to improve capacity to address epidemic threats in the past 3 years. ^{680 681} However, Nigeria has received funding and technical support from donors in response to epidemic threats in the past 3 years. ⁶⁸² In February 2025, for example, Nigeria has requested a USD 300 million loan from World Bank to strengthen national health care capacities to prevent, detect and respond to health emergencies in the country. ⁶⁸³ On 7 August 2025, the request for the USD 300 million loan got approved. ⁶⁸⁴ In the meantime, NCDC is receiving support from Public Health England (PHE) through an Official Development Assistance (ODA) funding to establish strong national public health systems that ensures timely and effective response and control of public health threats. ⁶⁸⁵

5.5.4c Evidence that the country has fulfilled its full WHO contribution within the past two years

Score: 0

There is limited evidence that Nigeria has fulfilled its full contribution to the WHO within the past 2 years. ^{686 687 688}

Information that Nigeria has fulfilled its full contribution to the WHO within the past 2 years is not sufficiently documented. ^{689 690 691} A 2025 report by WHO also stated that Nigeria has outstanding balance in arrears in the payment of their contributions. ⁶⁹² However, there is evidence that Nigeria has actively engaged with WHO through partnership and collaborative efforts to address health-related issues in the country. ^{693 694} For example, WHO has been working with the Nigerian Ministry of Health and partners to support the urgent need for healthcare, including supply of essential medicines, care for pregnant mothers and infants, and outbreak control. ⁶⁹⁵

5.6.1a Sharing of genetic/biological data and materials beyond influenza

Score: 0

There is no publicly available plan or policy for sharing genetic data, clinical specimens, and/or isolated specimens along with the associated epidemiological data with international organisations and/or other countries that goes beyond influenza. ⁶⁹⁶

Nigeria’s National Genomics Surveillance Strategy which was introduced in October 2024 aims to support the use of multisectoral One-Health data and biospecimen resources to discover, develop, and implement evidence-based innovative solutions for the prevention and control of diseases and other public health threats. ^{697 698} The strategy calls for measures to support and facilitate data, specimens, and information sharing through multi sectoral partnerships and collaborations across institutions. In addition, the strategy governs the protection of data sharing by ensuring that recipients of data or biospecimen cannot transfer the data to a third party and only use the data or biospecimen for the purpose stated in their application only. While the strategy also aims to address data sharing and collaboration risks by fostering collaborative networks and partnerships between international organisations, it does not mention that data or biospecimen can be shared with those organisations or other countries. ⁶⁹⁹

5.6.1b Evidence of non-compliance with sample sharing element of PIP framework

Score: 100

There is no public evidence that Nigeria has not shared samples in accordance with the PIP framework in the past 2 years. ^{700 701 702}

Government websites, such as NCDC and Federal Ministry of Health, do not provide any public information on influenza data sharing or the PIP framework in the past 2 years. ^{703 704} That being said, according to the 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria provides that sequencing data for priority pathogens is regularly shared on the Global Initiative on Sharing All Influenza Data (GISAID) platform, but further information about Nigeria’s data sharing performance on the platform in the past 2 years cannot be found. ^{705 706}

5.6.1c Evidence of non-sharing of pandemic pathogen samples during an outbreak

Score: 100

There is no public evidence that Nigeria has not shared pandemic pathogen samples during an outbreak in the past 2 years. ^{707 708}

The 2023 Mission Report from the Joint External Evaluation of the International Health Regulations (2005) core capacities of Nigeria states that sequencing data for priority pathogens is regularly shared on the Global Initiative on Sharing All Influenza Data (GSAID) platform. However, there is no further information about Nigeria’s data sharing performance on the platform in the past 2 years. ^{709 710} The One Health Antimicrobial Resistance National Action Plan 2.0 2024 – 2028 also provides no evidence that Nigeria has shared pandemic pathogen samples during an outbreak in the past 2 years. ⁷¹¹

6.1.1a Policy formation

Score: 50

6.1.1b Quality of bureaucracy

Score: 0

6.1.1c Excessive bureaucracy/red tape

Score: 25

6.1.1d Vested interests/cronyism

Score: 0

6.1.1e Corruption

Score: 26

6.1.1f Accountability of public officials

Score: 25

6.1.1g Human rights risk

Score: 25

6.1.2a Orderly transfers of power

Score: 25

6.1.3a Risk of social unrest

Score: 25

6.1.4a Risk of terrorism

Score: 25

6.1.4b Level of illicit arms flows within the country

Score: 50

6.1.4c Risk of organized criminal activity

Score: 25

6.1.5a Presence or risk of armed conflict

Score: 25

6.1.6a Government territorial control

Score: 0

6.1.7a International tensions

Score: 75

6.2.1a Adult literacy rate (15+ years old, both sexes)

Score: 74.53

6.2.2a UNDP Gender Inequality Index score

Score: 0

6.2.3a Poverty gap at $1.90 a day (2011 PPP) (%)

Score: 31.09

6.2.3b Share of employment in the informal sector

Score: 0

6.2.3c Coverage of social insurance programs (% of population)

Score: 33.33

6.2.4a Public confidence in government

Score: 50

6.2.5a Robust, open, diverse local media and reporting

Score: 50

6.2.6a Gini coefficient

Score: 64.9

6.3.1a Adequacy of road network

Score: 25

6.3.2a Adequacy of airports

Score: 25

6.3.3a Adequacy of power network

Score: 0

6.4.1a Urban population (% of total population)

Score: 47.64

6.4.2a Change in forest area (percentage points)

Score: 55.14

6.4.3a Natural disaster risk

Score: 75

6.5.1a Total life expectancy (years)

Score: 0

6.5.1b NCD mortality rate

Score: 87.44

6.5.1c Population aged 65+

Score: 90.48

6.5.1d Tobacco use (% of adults)

Score: 87.95

6.5.1e Level of adult obesity (%)

Score: 74.6

6.5.1f Age-standardised prevalence of mental health disorders (per 100 000 people)

Score: 99.52

6.5.2a Access to potable water

Score: 81.97

6.5.2b Access to at least basic sanitation facilities

Score: 47.93

6.5.2c Percentage of health-care facilities with no access to any electricity supply

Score: 72.92

6.5.3a Domestic general government health expenditure per capita (PPP)

Score: 2.84

6.5.4a Trust medical and health advice from the government

Score: 50

6.5.4b Trust medical and health advice from medical workers

Score: 100