By Elizabeth Osayande

Dr Ogbonna Eugene Chikere is a prominent public health expert and emergency physician known for his extensive work in infectious disease control and strengthening health systems in Nigeria. He has made significant contributions to public health, particularly in response to outbreaks of diseases such as COVID-19, Lassa fever, and diphtheria. His experiences during the COVID-19 pandemic at the Federal Medical Center in Abeokuta showcased his leadership in implementing effective infection prevention and control strategies that notably reduced transmission and mortality rates.

Dr Chikere advocates for enhanced surveillance systems, emphasising the importance of early detection, real-time data collection, and effective inter-agency communication. His insights on the need for proactive rather than reactive approaches to public health challenges highlight his commitment to strengthening Nigeria’s health infrastructure.

Public Health speaks on topical issues, especially the persistent outbreaks of infectious diseases and ways to address them, among others.

Insights on his findings

The persistent outbreaks of infectious diseases in Nigeria reveal a troubling reality: our surveillance infrastructure is not keeping pace with the growing complexity and frequency of health threats. The recent diphtheria outbreak has once again put our public health preparedness under scrutiny. Simultaneously, the annual Lassa fever season continues to claim lives, exposing the limitations of our existing response mechanisms. These events are not isolated incidents; they are symptomatic of a systemic challenge that calls for urgent reform.

The resurgence of diphtheria, a disease that can be prevented through routine immunization, is concerning. Its spread among vulnerable populations, especially children, highlights not only the gaps in immunization coverage but also the weaknesses in early detection, public health education, and inter-agency coordination.

Likewise, despite decades of battling Lassa fever, we remain largely reactive, deploying containment measures only after communities have been severely affected. This cyclical pattern reflects an over-reliance on emergency response rather than proactive, sustained surveillance.

At the heart of effective infectious disease control lies a robust and integrated surveillance system. In my experience as an emergency physician and public health researcher, the importance of early detection, real-time data collection, and efficient communication cannot be overstated. During the height of the COVID-19 pandemic, I served on the frontline at the Federal Medical Center, Abeokuta, a major tertiary institution in Nigeria. Alongside a dedicated team, we implemented a comprehensive infection prevention and control policy that transformed our response to the crisis, reducing transmission and mortality by 65%.

This policy included the establishment of a localized surveillance unit that tracked suspected COVID-19 cases, conducted rapid triage at emergency points, enforced strict isolation protocols, and ensured continual staff education. The result was a significant reduction in intra-facility transmission and COVID-19-related mortality. Our success demonstrated the power of evidence-based interventions, real-time communication among clinical teams, and a unified strategy rooted in both public health and clinical care. It proved that with the right systems and commitment, disease transmission can be curbed, even in resource-limited settings.
Importantly, Nigeria has succeeded before on a national scale. The swift and strategic response to the 2014 Ebola virus outbreak is a shining example of what is possible when coordination, political will, surveillance, and public engagement align. Through rapid identification, contact tracing, isolation, and aggressive public health messaging, Nigeria successfully contained the virus within a matter of weeks, earning global recognition for its efforts. This response saved countless lives and prevented what could have been a national catastrophe.

However, institutional and national success stories need to be scaled consistently. Surveillance must not begin at tertiary hospitals when symptoms become severe. It must start at the community level through well-equipped primary healthcare centres, trained community health workers, and tools that track health anomalies before they evolve into outbreaks. Real-time reporting platforms, such as those used in other African nations to flag zoonotic spillovers and viral outbreaks, can be adopted and localized.

Moreover, Nigeria must prioritise health systems strengthening in its national budget and treat surveillance as a core element of national security. Diseases do not respect state boundaries, political affiliations, or socio-economic status. The damage caused by recurring outbreaks extends beyond human loss; it destabilizes local economies, strains healthcare systems, and erodes public trust.

We also need to invest in behavioural health education, particularly in rural and semi-urban communities where mistrust of the healthcare system remains high. Health surveillance is not merely about data; it is about people and how they perceive risk, respond to public health messages, and engage with services.

Closing the gap in surveillance means engaging communities as active partners, not passive recipients of aid.

In conclusion, the recent diphtheria and ongoing Lassa fever outbreaks are stark reminders that Nigeria cannot afford to be complacent. We must shift from a reactive to a preventive public health culture.

Strengthening infectious disease surveillance from grassroots reporting to national response frameworks is not just a healthcare priority; it is a national imperative. The cost of inaction will be not only in lives lost but also in decades of economic and developmental setbacks.

Let us commit to building a future where every outbreak is met not with panic, but with preparedness and where every Nigerian, regardless of location, is protected by a resilient and responsive public health system.