Thread by @Chikwe_I

I've had interesting and very stimulating discussions this week, that highlight the critical difference the government structure in a Federal Republic like #Nigeria creates for health security, compared to countries with unitary systems of government

#NCDCSundayReflections

Our role at @NCDCgov as included in the #NCDCAct requires us to 'support' states in outbreak preparedness and response. However, the dependence from states on the national agency is very high. Yet, we cannot ignore, because when we do, people die.

Health is on the "concurrent" list in #Nigeria, i.e responsibility of Federal & Sate govts. Unlike our security architecture which is centralised, our #healthsecurity is de-centralised. No clear line of control & we've to work hard to collaborate & cooperate across govt levels

I have been pleased to work with Governors who have risen to the challenge in responding to outbreaks- Edo and Ebonyi states readily come to mind, with the political committment to #Lassafever outbreaks

More recently, we've seen a positive shift in the hiring of trained state epidemiologists- a critical role for health security at state level. I am proud of state epis like @Assad_HY in Kebbi, @DAworabhi in Bayelsa, @rabiusman_360 in #Zamfara & others who often go the extra mile

Major priorities for us at @NCDCgov this year are to:
-Understand the #IHR capacities of states in #Nigeria
-Define a structure for state level outbreak preparedness and response coordination
-Redefine NCDC's support to states
-Learn from our experience

We #keeppushing