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| Nigerian Health Minister Onyebuchi Chukwu |
Communique of Second Emergency National Council on Health (NCH) Meeting on the Ebola Virus Disease Outbreak in Nigeria at Barcelona Hotel, Abuja, 1st September, 2014, as presented by the Minister of Health, Prof. Onyebuchi Chukwu
COUNCIL COMMUNIQUE
1. The National Council on Health (NCH) held the 2nd emergency meeting at the Barcelona Hotel Abuja on 1st September, 2014. The purpose of the meeting was to provide an update on the Ebola Virus Disease outbreak in Nigeria and also review the status of implementation of the resolutions reached at the 1st Emergency NCH meeting.
2. The meeting was held under the Chairmanship of the Honourable Minister of Health (HMH), Prof. C. O. Onyebuchi Chukwu, and was attended by the Hon. Minister of State for Health, Dr. Khaliru Alhassan, 19 State Commissioners for Health and the Representative of the Secretary of Health & Human Services, Federal Capital Territory, Abuja and the Permanent Secretary Federal Ministry of Health, Mr. L. N. Awute who is the Secretary of Council. Other participants at the meeting were Directors of Departments and Agencies of Federal Ministry of Health, as well as Military and Para-Military organisations and the Media.
3. Council received three technical presentations, one by Dr. Akin Oyemakinde, Chief Country Epidemiologist, Nigeria Centre for Disease Control, Federal Ministry of Health, on the current status of outbreak and prevention measures for the Ebola Virus Disease (EVD) in Nigeria, Medical Waste- fundamental solution by the Country Director, Sunflower Group and a presentation by the Project Director NCDC, Prof. A. Nasidi on the status update in Port Harcourt, to which council members commented on.
4. The Council Chairman in his address gave a summary update of the EVD in Nigeria as of 31st August, 2014 as follows: the total number of cases of EVD in Nigeria stands at seventeen (17).The total number of cases treated at the isolation ward in Lagos State stands at thirteen (13).The total number of those discharged is seven (7). The total number of deaths among those treated in Lagos is five (5), and the total number currently under treatment in Lagos as two (2) and both patients are stable. The three (3) confirmed cases not treated in Lagos comprise i. a surviving primary contact of the index case (Patrick Sawyer): an ECOWAS Commission staff who became symptomatic, evaded surveillance in Lagos, travelled to Port Harcourt and infected his attending physician. He is currently under quarantine in Lagos at the moment, undergoing further tests to ensure he is totally free from the virus; 2. a private medical practitioner who was infected while treating the ECOWAS Commission staff. He died from EVD and 3. a female patient who was on admission in the same hospital where the late Port Harcourt Doctor was also admitted. She is presently under treatment in the Isolation ward in Rivers State.
5. The Chairman reiterated the commitment of the Federal Government of Nigeria to control the spread of EVD as a National Health Emergency as declared by Mr. President; he called on Council members and all stakeholders to work together to urgently halt and reverse the trend. He pointed out that the strategies for containing the EVD in Nigeria are focused on appropriate information, education and communication; sustaining our surveillance systems; provision and equipping of isolation wards/centres; provision of adequate care for confirmed cases; active and aggressive contact tracing; and reduction in harmful practices that promote the spread of the virus.
6. The Chairman expressed happiness with the progress made so far, in line with the resolutions of the last emergency NCH, strengthening of Emergency Operations Centre in Lagos with financial and other support from the WHO, Dangote Foundation, Total Nigeria Plc, Shell petroleum; adherence to safety by health workers who track and provide care for EVD patients and provision of incentives for the health workers. He also revealed that plans have been concluded to conduct two major trainings in all the states. He briefed Council members that the Nigerian Medical Association (NMA) has now suspended its strike as urged by Council at its last meeting. He thanked Mr. President for his magnanimity in lifting the suspension of the Residency Training Programme, and also used the opportunity to express his appreciation to the President of the Senate of the Federal Republic of Nigeria whose intervention was key to the resolution of the industrial crisis.
7. Council recieved and deliberated on the progress reports on the status of implementation of the resolutions reached at the first Emergency Council meeting on EVD and agreed as follows:
i. Council approved that all PPEs procured must be in accordance with WHO specifications and from WHO accredited and certified manufacturers. Furthermore, Universal Precaution must be adhered to by all health workers as well as proper sanitation in all the health facilities;
ii. Council requested the Federal Ministry of Health to work out guideline in collaboration with all the relevant stakeholders especially the Federal Ministry of Agriculture, NAFDAC and Customs Services to regulate the importation of bush meat into the Country and also discourage the consumption of bush meat locally and also the eating of dead animals .
iii. In view of the communication strategy for mass awareness creation and sensitization for individuals and communities on EVD already adopted by all the States at the first Emergency NCH. Council directed that particular attention should continue to be paid to vulnerable groups such as market women and other women groups, patent medicine vendors, road transport workers, fishermen in the riverine areas, hunters and bush meat sellers, school children, morticians and mortuary attendants, traditional healers and faith based groups;
iv. Council noted that Emergency Operations Centres remain the responsibility of the Federal Government in collaboration with the State governments and Development partners and urged all stakeholders to support the Centres;
v. The Federal Ministry Health to continue to provide State Ministries of Health and HHSS of FCTA as well as military and para-military groups with support to strengthen training of health care workers at the State and LGA levels on proper infection prevention and control; and EVD containment strategies;
vi. Federal, State Ministries of Health as well as Health & Human Services Secretariat of the Federal Capital Territory Administration are also to continue to provide adequate incentives to health workers who participate in the management of EVD patients to encourage them to be active in the containment of the EVD. Council further directed that they should be provided with life insurance coverage;
vii. The Nigeria Centre for Disease Control (NCDC) to re-circulate protocols and SOPs for management of EVD cases as well as protocol for submitting samples to the laboratories and burying of EVD victims. The Federal Government should provide specifications and support States with special Personal Protective Equipment (PPE);
viii. Council noted that though there is no ban on mass gatherings, States should ensure the avoidance of mass gatherings and where this is unavoidable to ensure that health practices are observed;
ix. Council reaffirmed the urgent need for the Federal Ministry of Health to continue to support the establishment of additional laboratories for EVD diagnosis and also directed the NCDC to conduct detailed mapping of location, capacities and categorization of existing laboratories to inform this scale up plan. Council noted that there has been an increase in the capacity of the laboratories;
x. The Federal Ministry of Health, State Ministries of Health and HHSS of FCTA are to devise means of ensuring that private sector health providers are sensitized and cases with high index of suspicion are promptly referred;
xi. The Port Health Services Division of the Federal Ministry of Health to provide and ensure the implementation of guidelines for cross border monitoring of EVD,
xii. The Armed Forces, Customs, prisons, Immigration and other services to collaborate with the Port Health Services to strengthen the monitoring for EVD at ports of entry;
xiii. Ideally, all corpses should be accompanied with death certificates. All States are to be encouraged to have legislation to support this resolution. The corpses of all persons confirmed to have died of EVD must be buried according to standard WHO protocol;
xiv. Council also approved the adherence by all health workers to universal precaution and training of at least two epidemiologist from the states in the NFELTP programme of NCDC
xv. Council approved the recommendation of the TRG in the participation of clinical trials with the three identified experimental drugs;
xvi. Council also noted the sensational headlines in the national media and urged the Honourable Minister of Information to urge Nigerian media to use appropriate language in their reporting
xvii. Council recognized the leadership role of Federal Ministry of Health in the management of EVD and reaffirmed that the spokesperson on the EVD remains the Honourable Minister of Health;
xviii. Council noted the presentation on the preparation for Hajj by the Representative of the Federal Ministry of Health in the Hajj Commission;
xix. Council endorsed the training plan for the TOT and other trainings as presented by the NCDC;
xx. Council endorsed the decisions of the ECOWAS Council of Ministers which took place in Ghana on the 26th-28th of August, 2014;
xxi. Council noted that at today, EVD can be diagnosed in the following locations:
i. NCDC laboratory, Asokoro, Abuja;
ii. NCDC laboratory at LUTH, Lagos;
iii. NCDC laboratory at University College Hospital, Ibadan;
iv. Irrua Specialist Teaching Hospital Irrua, Edo State;
v. Virology laboratoryof Redeemers University, Ogun State;
vi. The Irrua-based mobile laboratory which has now been relocated from Enugu to Port Harcourt.
xxii. Council also noted that Plans are at advanced stage to enable the following laboratories:
o NCDC laboratory at Aminu Kano Teaching Hospital, Kano;
o NCDC laboratory at UPTH, Port Harcourt.
And further noted that the Federal Ministry of Health plans to procure additional mobile laboratories to be based in the following locations: Abakaliki, Port Harcourt, Bauchi, Jos and Sokoto.
xxiii. Council reaffirmed the ban on the repatriation of Corpses into Nigeria as well as inter-state transportation until further notice except with approved waivers that are issued by the Federal Ministry of Health;
7. Council extended its appreciation to Mr. President as well as the State Governors/Minister of Federal Capital Territory Administration for the unprecedented political support they are providing Council in this difficult period and gave assurances that it will do all that is necessary to ensure that EVD is contained in Nigeria. Council commended the efforts of the Rivers state Government in their response to the EVD outbreak.
8. Council also conveyed its appreciation to all the State Ministries of Health, FCT Health and Human services and their delegates for the commitment they have demonstrated in containing the spread of the EVD; the press for its efforts in sensitizing the public and creating awareness about the EVD; and the Federal Ministry of Health, the NCDC, Port Health Services Division, Lagos State Government, WHO, US-CDC, for their efforts so far in controlling the EVD
Council also appreciated the FMOH, state Ministries of Health, particularly Lagos Ministry of Health, Enugu Ministry of Health and Rivers state Ministry of Health on their efforts to contain the EVD;
Thank you all
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