Foreword...... 6 Acknowledgement...... 8 Abbreviations and Acronyms...... 9 Executive Summary...... 13 1. Background...... 16 Country Profile...... 16 Health system...... 16 2. AMR Situation in Nigeria...... 18 Introduction...... 18 Antimicrobial Use and Resistance...... 18 AMR Governance...... 22 Key Achievements and Challenges...... 25 3. Strategic Plan...... 30 Focus Area 1: Increasing Awareness and Knowledge of AMR and Related Topics...... 31 Focus Area 2: Building a ‘One Health’ AMR Surveillance System...... 32 Focus Area 3: Intensifying Infection Prevention and Control in the Tripartite Sectors...... 33 Focus Area 4: Promoting Rational Access to Antibiotics and Antimicrobial Stewardship...... 35 Focus Area 5: Investing in AMR Research and Development...... 36 4. Operational Plan...... 37 5. Monitoring and Evaluation...... 93 Monitoring and Evaluation Framework...... 95 References...... 98 List of Contributors...... 100 Tables Table 1: SWOT Grid of AMR Situation Analysis...... 26

Figures Figure 1: Organogram of the National Amr Prevention and Control Governance Structure...... 25 Figure 2: Proposed information Flow Structure for AMR Activities...... 94

5

We wish to express our immense gratitude to the leadership of the Federal Ministries of Health, Agriculture and Environment for the leadership, coordination and support towards the development of this National Antimicrobial Resistance (AMR) Action Plan for Nigeria.

We are grateful for the financial support from the World Health Organisation (WHO) towards the printing of this document. And the invaluable support from the Center for Disease Dynamics, Economics and Policy (CDDEP) under the Global Antibiotic Resistance Partnership (GARP). We also thank our partners from the African Field Epidemiology Network (AFENET) and experts from academia for their collaborative support.

Thank you to Professors Iruka Okeke and Oladipo Aboderin, as well as all the individuals and organisations that provided expert opinion, essential input, and valuable comments on the many drafts that preceded this document. These contributions ensured the prompt development of this plan, which will guide efforts aimed at slowing down the development and impact of antimicrobial resistance on human, animal and environmental health in Nigeria and globally..

A full list of organisations contributing to this work is provided after the bibliography.

Chikwe Ihekweazu Dr Chikwe Ihekweazu National Cordinator /Chief Executive Officer, Nigeria Centre for Disease Control (NCDC) ACSM Advocacy, Communication and Social Mobilisation ADR Adverse Drug Reaction AFENET African Field Epidemiology Network AIDS Acquired Immunodeficiency Syndrome AMR Antimicrobial Resistance AMR-TWG Antimicrobial Resistance Technical Working Group AMS Antimicrobial Surveillance APIN AIDS Prevention Initiative in Nigeria ARI Acute Respiratory Infections BCC Behaviour Change Communication BSI Blood Stream Infections CBO Community Based Organisations CDDEP Center for Disease Dynamics, Economics and Policy CEO Chief Executive Officer CFR Case Fatality Rate CHW Community Health Worker COMO Community Mobilisation Officer CORP Community Resource Person CPD Continuous Professional Development CRE Carbapenem-Resistant Enterobacteriaceae CSMC Communication and Social Mobilisation Committee CSO Civil Society Organisation; ECOWAS Economic Community of West African States EDL Essential Drugs List ESBL Extended-Spectrum Beta-Lactamase FAO Food and Agricultural Organisation FAQ Frequently Asked Questions FBO Faith Based Organisations National Action Plan for Antimicrobial Resistance, 2017-2022

FCT Federal Capital Territory FDS Food and Drug Services FMARD Federal Ministry of Agriculture FMEnv Federal Ministry of Environment FMoEd Federal Ministry of Education FMoF Federal Ministry of Finance FMoH Federal Ministry of Health FMoI Federal Ministry of Information GARP Global Antibiotic Resistance Partnership GDP Gross Domestic Product GLASS Global Antimicrobial Resistance Surveillance System GMP Good Manufacturing Practices HAI Healthcare associated infections HCP Health care practitioner HIV Human Immunodeficiency Virus HMO Health Management Organisation HPD Health Promotion Department IEC Information, Education, Communication IHVN Institute of Human Virology IPC Infection Prevention and Control LGA Local Government Area MDAs Ministries, Departments and Agencies M&E Monitoring and Evaluation MOEBP Ministry of Economy and Budget Planning MOTI Marketing On The Internet NAFDAC National Agency for Food and Drug Administration and Control NAP National Action Plan NBCCCG National Behaviour Change Communication Consultative Group

10 National Action Plan for Antimicrobial Resistance, 2017-2022

NCA National Council on Agriculture NCC National Coordinating Centre NCDC Nigeria Centre for Disease Control NCH National Council on Health NGO Non-Governmental Organisation NHIS National Health Insurance Scheme NHMIS National Health Management Information System NICA Nigeria Infection Control Association NIDS Nigeria Infectious Disease Society NIMR National Institute of Medical Research NOA National Orientation Agency NOTAP National Office for Technology Acquisition and Promotion NPHCDA National Primary Healthcare Development Agency NSA National Security Adviser NSC National Steering Committee NTS Non-Typhoidal Salmonella NTWG National Technical Working Group NUC National Universities Commission NUJ Nigeria Union of Journalists NVMA Nigerian Veterinary Medical Association NVRI National Veterinary Research Institute OIE World Organisation for Animal Health OOP Out-of-Pocket PPMVs Patent and Proprietary Medicine Vendors PT Proficiency Testing PTA Parent-Teacher Association PVC Pharmacovigillance committee OIE-PVS OIE Performance, Vision and Strategy

Federal Ministries of Agriculture, Environment and Health; September 2017 11 National Action Plan for Antimicrobial Resistance, 2017-2022

REDDISE Regional Disease Surveillance Systems Enhancement SBCC Social and Behaviour Change Communication SCSMC State Communication and Social Mobilisation Committee SLIPTA Step-wise Laboratory Improvement Process Towards Accreditation SMARD State Ministry of Agriculture SMC Social Mobilisation committee SME Small and Medium-sized Enterprise SMoEnv State Ministry of Environment SMoH State Ministry of Health SMoI State Ministry of Information SQHN Society for Quality in Healthcare STG Standard Treatment Guidelines STWG State Technical Working Group SWOT Strengths, Weakness, Opportunities and Threats TOR Terms of Reference TWG Technical Working Group UN United Nations UNICEF United Nations International Children's Emergency Fund $ United States Dollar UTI Urinary Tract Infection VCN Veterinary Council of Nigeria VRE Vancomycin Resistant Enterobacteriaceae WER Weekly Epidemiology Report WHA World Health Assembly WHO World Health Organisation

12 E Executive Summary

Nigeria has an estimated population of 182 million people, which is expected to rise to over 200 million by the year 2025. In 2013, the life expectancy at birth in Nigeria was estimated at 54 years. Poverty is a major contributor to the worsening health status of Nigerians, which has declined over the decade. Orthodox health care services in Nigeria are provided from the private and public sectors at primary, secondary and tertiary levels. The primary health care level is entry point into the health care system and includes health centres, clinics, dispensaries and health posts. Despite rapid urbanization, health and economic inequalities continue to exist and significantly contributes to health care access. Whilst non-communicable illnesses are gaining prominence, infections continue to be the most common cause of illness and death in all parts of Nigeria. Treatment of the most common infections – malaria, tuberculosis, respiratory infections, diarrhoeal diseases and sexually transmitted infections, including HIV is presently being compromised by antimicrobial resistance. There is therefore a pressing need to contain the problem.

Antimicrobial Resistance and Governance Antimicrobial resistance (AMR) has grown in prominence to compromise treatments for almost all human and animal diseases caused by bacteria, parasites, viruses and fungi. The most vulnerable patients bear the brunt of the impact, as AMR increases treatment costs and can also prolong illness, worsen disability and increase mortality. The precise magnitude of AMR and its true impact on health care delivery and its costs are still largely unknown. In May 2015, the 68th World Health Assembly (WHA), recognising AMR as a threat to global health, passed WHA resolution 68.7 requesting that Member States develop or adopt country-specific action plans in line with the Global Action Plan on AMR. The Global Antimicrobial Resistance Surveillance System (GLASS) was also instituted in September 2015, five months after adoption of Global Action Plan. The

Federal Ministries of Agriculture, Environment and Health; September 2017 13 National Action Plan for Antimicrobial Resistance, 2017-2022

Nigerian Honourable Minister of Health, on the 26th of November 2016, approved the establishment of Nigeria’s National AMR Coordinating Body at the Nigeria Centre for Disease Control (NCDC). A National AMR Technical Working Group (AMR-TWG) was created comprising stakeholders from human health, animal health, food animal production and environment sectors. The AMR-TWG was tasked with conducting a situation analysis of AMR in Nigeria and designing a National Action Plan for AMR containment in the country. The full situation analysis is contained in a separate document. This Action Plan details objectives derived from analyzing the strengths, weaknesses, threats and opportunities of the National AMR situation and making recommendations based on the five strategic objectives of the Global Action Plan on AMR. The following priority gaps were identified; 1. Poor public awareness and weak coordination of AMR awareness activities by government and partners such as vertical disease control programmes. 2. Poor ‘One Health’ coordination of animal and human national disease surveillance systems, non-existence of a national AMR laboratory surveillance system and no dedicated funding for AMR control activities 3. Non-existence of a national Infection Prevention and Control (IPC) coordinating body or guidelines, and poor budgetary support for IPC activities in health facilities 4. Lack of antimicrobial stewardship in both private and public sectors 5. A complete absence of studies on the health and economic impact of AMR in Nigeria and poor coordination of research on antibiotic use

14 National Action Plan for Antimicrobial Resistance, 2017-2022

Strategic Plan The goal of the action plan is to reduce, prevent and slow the evolution of resistant organisms and their impact on health care while ensuring optimal use and improved access to effective, safe and quality-assured antimicrobials for continued successful management of infections. The plan incorporates the one health approach and aims at implementing proposed actions by strengthening and utilizing existing national systems or by creating new structures where they do not exist. The focus areas are; 1. Increasing awareness and knowledge on AMR and related topics 2. One health AMR surveillance and research 3. Infection Prevention and Control in the tripartite sector 4. Promote rational access to antibiotics and Antimicrobial stewardship 5. Invest in research to quantify the cost of resistance and develop new antimicrobials and diagnostics This document also details the strategic interventions for each objective, activity, budget and the monitoring/evaluation plan for all activities.

Federal Ministries of Agriculture, Environment and Health; September 2017 15 1 Background

Country Profile

Nigeria is the most densely populated country in Africa being a federation of 36 States and a Federal Capital Territory at Abuja, operating a three-tiered government structure. It has an estimated population of 182 million people which is expected to rise to over 200 million by the year 20251,2. The official language is English but there are about 374 identifiable ethnic groups in Nigeria with Igbo, Hausa, and Yoruba representing the major groups and languages spoken3. The country’s different religions include Islam, Christianity, and traditional African beliefs. The national median age is 17.2 years and the proportion of children aged below 15 years is around 46%, while the proportion of individuals aged 65 years and older is 4%3,4. The literacy rate for persons 15 years and older in 2015 was 60%5. In 2013, the life expectancy at birth in Nigeria was estimated at 54 years6. The infant mortality rate is 69 per 1,000 live births while the under-five mortality rate is 128 per 1,000 live births3. The maternal mortality ratio is 576 deaths per 100,000 live births in the country, one of the highest in the world3.

In 2015, Nigeria’s Gross Domestic Product (GDP) was $481bn with an annual growth rate of 2.7%7.The National Bureau of Statistics reported that the contribution of agriculture to the total GDP was 23%8in that year. Poverty remains a major contributor to the worsening health status of Nigerians as 76% of its population still live on $3.10 a day or less9. In the face of rapid urbanisation, health and economic inequalities continue to contribute to poor health care access2,3. Health System

Orthodox health care services in Nigeria are provided by both private and public sectors with the public health service organised into primary, secondary and tertiary levels. In 2005, it was estimated that 23,640 health facilities existed in Nigeria; 85.8% being primary health care facilities, 14% secondary and 0.2% tertiary care

16 National Action Plan for Antimicrobial Resistance, 2017-2022

institutions 10. About 60% of the public primary health care facilities are in Nigeria’s northern geopolitical zones10. This primary level of care is the usual entry point of communities into the health system and it includes health centres, dispensaries, and health posts which typically provide general preventive, curative and pre-referral care2. Community Health Workers (CHWs) provide the majority of the services at primary care centres2. Secondary care facilities provide both general medical services as well as some specialised health services2. Tertiary facilities which provide the highest level of health care in the country, are also training centres for medical students and they include specialist/teaching hospitals and Federal Medical Centres2. There is a tertiary facility in every State, with a few having more than one.

The National Health Policy ascribes responsibilities for primary health care to the 774 local governments, secondary care to the States and tertiary care to the federal government. At the local government level, a Chairman administers health services, assisted by an officer designated to head the health department. These officers are mandated to finance and manage primary health care facilities11. The secondary health care facilities are under the purview of State Ministries of Health, which are overseen by State Commissioners of Health. Some States have a Health Management Board to specifically manage their health facilities11. The responsibility for tertiary care and training lies with the Federal Government2,11 through the Federal Ministry of Health which is headed by the Minister. Many States periodically organise a State Council of Health meeting to obtain consensus on health issues between the local and state governments. The Minister of Health also meets with State commissioners of Health during the ‘National Council on Health’ meeting11 to obtain consensus on health issues between the state and federal levels. Each level of government is however largely autonomous in the financing and management of its health services, though guided by policies formulated by the Federal Ministry of Health.

Federal Ministries of Agriculture, Environment and Health; September 2017 17 2 AMR Situation in Nigeria

18 National Action Plan for Antimicrobial Resistance, 2017-2022

Federal Ministries of Agriculture, Environment and Health; September 2017 19 National Action Plan for Antimicrobial Resistance, 2017-2022

20 National Action Plan for Antimicrobial Resistance, 2017-2022

Federal Ministries of Agriculture, Environment and Health; September 2017 21 National Action Plan for Antimicrobial Resistance, 2017-2022

22 National Action Plan for Antimicrobial Resistance, 2017-2022

Federal Ministries of Agriculture, Environment and Health; September 2017 23

National Action Plan for Antimicrobial Resistance, 2017-2022

TABLE 1: SWOT GRID OF AMR SITUATION ANALYSIS STRENGTHS • Existence of national health policies, regulations and guidelines on treatment of infections in humans and animals, antimicrobial use (including IPC and traditional medicine use), environment protection, food safety and vaccination • Existence of regulatory councils for health, agricultural and environmental workers • Availability of the National Health Insurance Scheme • Established disease surveillance notification structure at the NCDC • Existence of potential infrastructure for laboratory surveillance of bacterial resistance • Availability of AMR training curriculum in universities (undergraduate and postgraduate) • Presence of predominantly indigenous pharmaceutical manufacturers; some have acceptable level of compliance with WHO Good Manufacturing Practices (GMP) guidelines • Availability of a national drug policy • Establishment of national procurement policy and a dedicated procurement department • Existence of waste management guidelines (including for pharmaceutical waste) • Existence of National Health Promotion Policy and institutionalised health promotion practice in Nigeria WEAKNESSES • Propensity for corruption in healthcare fund and commodities management • Poor government insurance coverage and high out-of-pocket (OOP) expenses • Studies on economic impact of AMR in Nigeria are non-existent • Guidelines on antibiotic use in humans/animals are outdated, poorly disseminated and not adhered to, policy on antimicrobial (including alternatives) use is poorly implemented and regulatory agencies are underfunded • Limited number of accredited training institutions and health worker to population ratio is low • Poor ‘One Health’ coordination of animal and human national disease surveillance systems

26 National Action Plan for Antimicrobial Resistance, 2017-2022

TABLE 1: SWOT GRID OF AMR SITUATION ANALYSIS CONT’D WEAKNESSES • Lack of antimicrobial stewardship in both private and public sectors • Weak primary healthcare systems • National committee on AMR is non-existent and there is no AMR surveillance system • Lack of a national reference laboratory for AMR and few quality-assured microbiology laboratories • Lack of coordination of, and comprehensive national reports on national antibiotics consumption • Inadequate number of indigenous pharmaceutical manufacturers and over- reliance on imported pharmaceuticals • IPC domiciled in Department of Public Health with poor collaboration with Department of Hospital Services in the Federal Ministry of Health • Weak coordination of AMR awareness activities implemented by government and partners and poor public awareness of AMR • Problem of unskilled prescribers of antibiotics OPPORTUNITIES • Development of a National surveillance system and GLASS enrolment • Increasing multi-stakeholders’ participation and interest in AMR • Integration of traditional medicine into the national health system and increasing government commitment to research on antimicrobial alternatives to reduce reliance on antibiotics use • Possibility of using HMO provider audits to institute antimicrobial education and stewardship among private practice providers • Leveraging on existing health policies and surveillance systems in the tripartite sectors to build AMR surveillance system • Availability of accredited laboratories within vertical programme • Availability of World Bank supported $90m REDDISE (Regional Disease Surveillance Systems Enhancement) fund using the ‘One Health’ approach

Federal Ministries of Agriculture, Environment and Health; September 2017 27 National Action Plan for Antimicrobial Resistance, 2017-2022

TABLE 1: SWOT GRID OF AMR SITUATION ANALYSIS CONT’D OPPORTUNITIES • Establishment of more indigenous manufacturing companies for development of new antimicrobials • Review and implementation of the national drug policy • Setting up of more drug distribution centres in some States • Grazing bill could be adapted to include AMR awareness • Targeting annual conferences, national forums (NCH, NCA), CPD and committees (Livestock Development Committee) in the tripartite sector for advocacy activities • Leveraging on the existing Communication and Social Mobilisation structures at all levels for public awareness creation activities THREATS • National issues: recession, corruption, one federation account and insurgency • Health workers’ attrition in general, particularly in rural areas • Poor enforcement of regulations and policies on AMR control and prevention • Weak pharmacovigilance of antibiotics • Funding – no dedicated budget line for AMR control and surveillance • Poor coordination of research on antibiotic use • Chaotic drug distribution system in the private sector, high level of counterfeit medicines in circulation and smuggling-in unregistered medicines • Unregistered practitioners and prescription of antibiotics by unlicensed persons • Poor management of waste from pharmaceutical processes and expired drugs • Inadequate funding of indigenous pharmaceutical companies • Lack of community pharmacies in rural areas and sale of prescription medicines by PPMVs • Non-qualification of courier services used in the delivery of thermo-labile medicines and diagnostics • Non-regulation of AMR activities (awareness, training, etc.) by partners such as vertical programmes

28 National Action Plan for Antimicrobial Resistance, 2017-2022

The following priority gaps were identified; 1. Poor public awareness and weak coordination of AMR awareness activities by government and partners such as vertical disease control programmes. 2. Poor ‘One Health’ coordination of animal and human national disease surveillance systems, non-existence of a national AMR laboratory surveillance system and no dedicated funding for AMR control activities 3. Non-existence of a national Infection Prevention and Control (IPC) coordinating body or guidelines, and poor budgetary support for IPC activities in health facilities 4. Lack of antimicrobial stewardship in both private and public sectors 5. Studies on the health and economic impact of AMR in Nigeria and poor coordination of research on antibiotic use

Federal Ministries of Agriculture, Environment and Health; September 2017 29

Objectives Strategic interventions

1.1 Increase awareness of 1.1.1. Establish an evidence-based public communication AMR among Nigerians programme targeting the public and audiences in human, by 2022 animal and environmental health under the leadership of a tripartite AMR National Behaviour Change Communication Consultative Group (NBCCCG) 1.1.2. Conduct high-level advocacy visits to policy makers and relevant stakeholders to create budget lines and source for required financial and technical support for AMR awareness programmes in the 36 States, FCT and at the Federal level 1.1.3. Implement communication campaigns to increase awareness of appropriate antimicrobial use and the adoption of infection prevention measures among the public, policy makers, human, animal and environmental professionals and other relevant stakeholders in communities, schools, workplaces and health facilities

1.2 Improve knowledge of 1.2.1. Strengthen regulatory systems to promote rational AMR and related topics antimicrobial use, infection prevention and antimicrobial stewardship among human health, animal health, environment and allied professionals 1.2.2. Augment the knowledge and understanding of AMR, IPC, biosecurity and antimicrobial stewardship among human, animal, and environmental health care and allied professionals National Action Plan for Antimicrobial Resistance, 2017-2022

Focus Area 2: Building a ‘One Health’ AMR surveillance system

Collaboration across the health, animal health and environmental health sectors is largely minimal or non-existent. The focus is on setting up a national AMR surveillance system using a ‘One Health’ approach and strengthening institutional capacities (e.g. of laboratories) for early AMR detection

Objectives Strategic interventions

2.1Set up a national surveillance 2.1.1 Establish a national coordination structure for system for AMR surveillance of AMR 2.1.2 Develop a multi-sectoral surveillance implementation plan

2.2 Strengthen institutional 2.2.1 Develop sector-specific surveillance protocols to detect capacities for early AMR emerging, re-emerging and changing trends in AMR detection and trends 2.2.2 Prepare and implement a Human Resource Development monitoring in the country Plan for AMR Surveillance

2.3 Build laboratory capacity 2.3.1. Set up an NCDC National Reference Laboratory to produce high-quality 2.3.2. Standardise laboratory capacity for monitoring AMR microbiological data to (Human, Terrestrial and Aquatic Animal, Food and support surveillance activities Environment) across all sectors

2.4 Contribute to Global 2.4.1. Enroll in GLASS surveillance 2.4.2 Contribute National Surveillance data to GLASS

2.5 Build and implement a 2.5.1 Capacity Building of AMR Researchers research agenda for AMR 2.5.2. Periodically identify and articulate surveillance gaps burden assessment and AMR burden estimation needs 2.5.3. Secure funding from relevant public and private sources 2.5.4. Commission researchers and research institutions to undertake research in identified gaps

32 National Action Plan for Antimicrobial Resistance, 2017-2022

Focus Area 3: Intensifying Infection Prevention and Control in the tripartite sectors

Infection prevention and control and good hygiene practices are key to reducing antibiotic consumption and the development of resistance. This strategy focuses on strengthening the infection prevention and control programme in human health, animal health and the environment at community and all governmental levels, promoting food safety and the use of vaccines in humans and animals.

Objectives Strategic interventions 3.1 Strengthen infection 3.1.1 Establish a National Infection Prevention and Control prevention and control at all Programme governmental levels and in 3.1.2 Strengthen IPC practices health care facilities 3.1.3 Improve IPC education and training 3.2 Promote infection prevention 3.2.1 Introduce IPC programme into veterinary practice and and control in animal health aquatic and terrestrial animal husbandry 3.2.2 Improve IPC and farm biosecurity practices 3.2.3 Include hygiene and infection prevention and control as core (mandatory) content in training and education of veterinary professionals and animal health practitioners 3.2.4 Improve IPC education and training for veterinary practice and aquatic and terrestrial animal husbandry 3.3 Promote food safety 3.3.1 Support implementation of food safety guidelines at the community level 3.4 Improve infection prevention 3.4.1 Improve access to potable water in communities and and control practices at the within healthcare facilities community level 3.4.2 Ensure water quality standard 3.5 Improve environmental 3.5.1 Improve waste management practices sanitation and hygiene 3.5.2 Support safe disposal and management of sewage and fecal matter

Federal Ministries of Agriculture, Environment and Health; September 2017 33 National Action Plan for Antimicrobial Resistance, 2017-2022

Focus Area 3: Intensifying Infection Prevention and Control in the tripartite sectors cont’d

Objectives Strategic interventions

3.6 Improve hygienic practices at 3.6.1 Promote hand hygiene at the community level and in the community level schools

3.7 Increase the use of vaccines 3.7.1 Scale up immunisation coverage in human and animal to prevent new infections in health sectors humans and animals 3.7.2 Increase range of available vaccines in–country for both human and animal health 3.7.3 Support surveillance of vaccination programmes in human and animal health to enable appropriate vaccination

34 National Action Plan for Antimicrobial Resistance, 2017-2022

Focus Area 4: Promoting Rational Access to Antibiotics and Antimicrobial Stewardship

In Nigeria, antibiotic sale and use is poorly regulated and monitored. The strategy is to improve access to quality antimicrobial agents for infections, promote antimicrobial stewardship and strengthen regulatory agencies across all sectors (humans, animals and environment).

Objectives Strategic interventions

4.1 Improve access to quality 4.1.1 Promote optimal procurement and distribution of quality antimicrobial agents for antimicrobials and diagnostics for human and animal infections in humans and use animals 4.1.2. Enhance local production of quality antimicrobial agents and diagnostics for human and animal use 4.1.3. Expand NHIS coverage to include more enrollees

4.2 Promote antimicrobial 4.2.1 Promote the use of up to date treatment guidelines and stewardship in human and ensure prudent use in humans and animals animals 4.2.2 Promote optimal prescribing and dispensing of antimicrobials in humans and animals

4.3 Strengthen regulatory 4.3.1 Strengthen the capacity of regulatory agencies across agencies across all sectors ‘One Health’ sectors (i.e. human, animals, food products (humans, animals and and environment) environment) to enable them 4.3.2 Enhance inter-sectoral coordination and collaboration perform their mandate with between/amongst regulatory agencies regards to antimicrobials

Federal Ministries of Agriculture, Environment and Health; September 2017 35 National Action Plan for Antimicrobial Resistance, 2017-2022

Focus Area 5: Investing in AMR Research and Development

This strategy is focused on driving investment in the conduct of AMR research, promoting the use of innovative investment channels for research and investing in the development of antibiotic alternatives and advanced diagnostic techniques for impact on human and animal health.

Objectives Strategic interventions

5.1 Map current funding and 5.1.1. Assess available AMR funding mechanisms promote the use of innovative 5.1.2. Conduct needs assessment and develop a priority investment channels for AMR framework for AMR funding research 5.1.3. Promote the use of innovative investment channels for AMR research funding

5.2 Incorporate AMR research 5.2.1. Support AMR researches in universities and relevant at advanced education research institutes institutions

5.3 Encourage research and 5.3.1. Encourage research in and the development of development of technical alternatives to antibiotics expertise on antibiotic alternatives

5.4 Invest in advanced diagnostic 5.4.1. Invest in advanced diagnostic and pharmaceutical and pharmaceutical techniques for AMR research and development techniques for AMR research and development

36 4 Operational Plan

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 1.1.1 Establish an evidence-based public communication programme targeting the public and audiences in human, animal and environmental health under the leadership of a tripartite AMR National Behaviour Change Communication Consultative Group (NBCCCG) Activity 1.1.1.1 Constitute, inaugurate and orientate the AMR National Behaviour Change Communication Consultative Group (NBCCCG) at the Federal Level 1.1.1.1.1: AMR TWG 3 Short Abuja FMARD, FMEnv, FMoH, FMARD, NBCCCG Hold meetings FMoH, term FMoEd, FMoI FMoEd, constituted, to identify NCDC, FMoH/HPD NCDC Donor Terms of relevant FMARD, NCDC agencies and Reference organisation FMEnv, development developed and request FMoEd, FMoI partners and NBCCCG for nominees Inaugurated to serve on the NBCCCG, develop Terms of Reference and Inaugurate NBCCCG 1.1.1.1.2: AMR TWG, 1 Short Abuja AMR TWG FMoH, NCDC, NBCCCG Hold an FMoH, term FMoH/HPD FMARD, empowered orientation for NCDC, NCDC, FMARD, FMoEd Donor on roles and NBCCCG FMARD, FMEnv, FMoEd, agencies and responsibility FMEnv. FMoI development FMoEd, FMoI partners 1.1.1.1.3: NBCCCG 35 Long Nation NBCCCG, FMoH, NCDC, Number of Hold series of members term wide FMoH/HPD, FMARD, FMEnv engagement Planning and FMoEd, FMoI NCDC FMARD, and Donor meetings held implementation FMEnv, FMoEd, agencies and per year Reports meetings by FMoI development of meetings NBCCCG partners containing Key resolutions Working documents developed at the meetings Federal Ministries of Agriculture, Environment and Health; September 2017 37 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding

STRATEGIC INTERVENTION 1.1.1 cont’d

Activity 1.1.1.2 The AMR NBCCCG to Coordinate and strengthen the capacity of the existing State Communication and Social Mobilisation Committee (CSMC) and LGA CSMC to carry out an effective AMR Communication campaigns at the community, schools, workplaces and health facilities

1.1.1.2.1: Two NBCCCG, 6 Short Abuja NBCCCG FMoH, NCDC, Number days Zonal NCDC, term NCDC, FMoH/ FMARD, of CSMC sensitisation FMoH/ HPD, FMARD, FMEnv representatives meeting on HPD, CSMC FMEnv and Donor sensitised burden of AMR representatives agencies and on AMR and national from tripartite development communication communication partners campaigns sectors (36 campaign activities States and for CSMC representatives FCT) from tripartite sectors (36 States and FCT)

1.1.1.2.2: TOT NBCCCG, 1 Short Abuja NBCCCG FMoH, NCDC, Crop of master on burden NCDC, term FMARD, Donor trainers who are of AMR and FMoH/HPD, agencies and skilled in AMR national State CSMC development communication communication partners campaigns campaign activities

1.1.1.2.3: Hold NBCCCG, 37 Short Nation NBCCCG FMoH, NCDC, Increased Orientation NCDC, FMoH/ term wide FMoH/HPD FMARD, percentage meetings of HPD, State FMARD FMEnv FMoEd of functional existing State CSMC Partners and Donor CSMC and CSMC on agencies and improved AMR burden of AMR development community and expected partners campaign skills roles

38 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 1.1.1 cont’d

Activity 1.1.1.2 cont’d

1.1.1.2.4: State CSMC, 774 Short Nation State CSMC, SMoH, Increased Hold LGA CSMC, term wide FMoH/HPD SMARD, percentage Orientation NBCCCG, (36 Partners SMoEnv of functional meetings of FMoH/HPD States, and Donor CSMC and LGA CSMC team FCT, agencies and improved AMR for effective 774 development community Community LGAs) partners campaign skills Mobilisation activities at LGA level Activity 1.1.1.3. Conduct a nationwide baseline behavioural study on AMR awareness, knowledge, attitudes, practices and perceptions in different social and professional groups 1.1.1.3.1: Meeting, 2 Short Abuja NBCCCG FMoH, Developed Hold meeting to NBCCCG, term FMARD, appropriate develop survey FMoH/ FMEnv, and Survey tools tool HPD, FMoH, Partners FMARD, FMoEd survey tool 1.1.1.3.2: Training, 1 Short Abuja NBCCCG, FMoH, Trained data Two days NBCCCG, term Partners FMARD, collectors at training of data FMoH/ FMEnv, National level collector (s) HPD, FMoH, and Donor FMARD, agencies and FMoEd survey development partners tool 1.1.1.3.3: Training, Data 37 Short Abuja State CSMC, SMoH, Trained data One day collectors term Partners SMARD, collectors at training of data survey tool SMoEnv, State level collector (s) at and Donor State level agencies and development partners

Federal Ministries of Agriculture, Environment and Health; September 2017 39 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding

STRATEGIC INTERVENTION 1.1.1 cont’d

Activity 1.1.1.3. Cont’d

1.1.1.3.4: Carry Survey 37 Short Nation NBCCCG FMoH, Report of out baseline term wide FMARD, baseline survey survey on AMR (36 FMEnv, on AMR awareness, States, and Donor awareness knowledge, FCT, agencies and amongst public perception 774 development and private and practice LGAs) partners sectors in among the Nigeria public and in human, animal and tripartite professionals in both public and private sectors in States and FCT

1.1.1.3.5: Meeting, 1 Short Abuja NBCCCG FMoH, Baseline report Debriefing term FMARD, on awareness, meeting to FMoEd, knowledge, collate findings and Donor attitude, agencies and perceptions development and practice in partners Nigeria

40 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 1.1.1 cont’d

Activity 1.1.1.4 Use baseline findings to develop and disseminate an AMR communication message that will ensure the adoption of behaviours that promotes appropriate antimicrobial use and practices among the public, policy makers, human, animal and environment professionals and relevant stakeholders.

1.1.1.4.1: Hold Meeting, 3 Medium To be NBCCCG, NCDC FMoH, AMR Stakeholders NBCCCG, term decded FMoH/HPD FMARD, communication consensus Stake FMARD FMEnv FMEnv, strategy building holders and Donor document meeting to agencies and develop and development finalise AMR partners Communication Strategy

1.1.1.4.2: Type Print ready 5,000 Medium Abuja NBCCCG FMoH, Printed copies setting, editing, AMR copies term FMARD, of AMR printing and communi FMoEd, communication distribution -cation and Donor strategy of AMR strategy agencies and Distribution list Communication development Strategy partners

1.1.1.4.3: National 38 Short Nation NBCCCG, NCDC FMoH, Pre-Launch National and Launch term wide FMoH/HPD, FMARD, Ministerial Press State levels Printed (36 FMARD FMEnv FMEnv, Briefings, Report dissemination Communi States, and Donor of National of the AMR -cation FCT, agencies and launch communication strategy 774 development strategy LGAs) partners

Federal Ministries of Agriculture, Environment and Health; September 2017 41 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 1.1.1 cont’d

Activity 1.1.1.4 cont’d

1.1.1.4.4: Meetings, 10 Short Locations NBCCCG, FMoH, Training Stakeholders NBCCCG, term within the FMoH/HPD FMARD, materials meeting to develop State Rep 6 geo FMARD, FMEnv, FMEnv, and job aids training guidelines -resentative -political and Donor developed. and job aids zones agencies and Copies of on AMR use by development the training different audiences partners module per (human/animal/ group Content environmental of the training professionals, module for Media, Community each group mobilisers and other relevant stakeholders.

42 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 1.1.1 cont’d Activity 1.1.1.5. In line with baseline findings, adapt and produce existing audience specific Social and Behaviour Change Communication (SBCC) materials (advocacy kits and key messages for print and electronic) on AMR prevention and containment in English, Pidgin and three local languages (Hausa, Igbo and Yoruba)

1.1.1.5.1: Factsheets, 10 Short Geo NBCCCG, FMoH, Number of Hold posters, flex/ term -political NCDC, FMoH/ FMARD, stakeholder stakeholders roll up/draw zones HPD FMARD, FMEnv, meetings held meeting back banners, FMEnv, FMoEd, and Donor to develop to adapt stickers, handbills, FMoI agencies and advocacy kits, audience development target specific FAQs, danglers, specific partners key messages. wrist band, key- AMR SBCC Types of AMR holders, radio materials SBCC materials in English, sound bites, adapted, Pidgin and radio/TV jingles Contents of 3 local and spots, text each SBCC languages messages, design materials per –Hausa, for bus branding, group. Yoruba and billboard, outdoor Igbo umbrella, wall painting, murals, neo-sign boards, reflective jackets, flash, face caps, T-shirt, badges/ lapels, memo pads and media kits) including Invitation cards, letter head, envelopes and certificate of appreciation for CORPs

Federal Ministries of Agriculture, Environment and Health; September 2017 43 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 1.1.1 cont’d Activity 1.1.1.5. cont’d 1.1.1.5.2: 8 locations To be Short 8 NBCCCG, FMoH, Pretested SBCC Pretest of Draft AMR decided term locations FMoH/HPD FMARD, materials List audience SBCC FMARD, FMEnv, FMEnv, of pretest specific materials FMoI and Donor locations AMR SBCC in English agencies and Collated inputs materials and 4 local development from the field in English, partners languages Pidgin and local languages (Hausa, Yoruba and Igbo) in selected locations 1.1.1.5.3: Pretested 2 Short Lagos NBCCCG, FMoH, Finalised SBCC Finalisation SBCC term Kaduna FMoH/HPD FMARD, materials of audience materials FMARD, FMEnv FMEnv, specific in English and Donor AMR SBCC and 4 local agencies and materials languages development in English, partners Pidgin and local languages (Hausa, Yoruba and Igbo) 1.1.1.5.4: Finalised To be Short Abuja NBCCCG, FMoH, Quantity of Production audience decided term FMoH/HPD FMARD, audience of audience specific FMARD, FMEnv FMEnv, specific specific AMR SBCC and Donor AMR SBCC AMR SBCC materials agencies and materials materials in English, development produced per in English, Pidgin and partners language per Pidgin and three local group. three local languages languages

44 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 1.1.1 cont’d

Activity 1.1.1.5. cont’d

1.1.1.5.5: Printed To be Short Nation NBCCCG, FMoH, List of AMR Distribution audience decided to Long -wide FMoH/HPD FMARD, SBCC materials of AMR (36 FMARD, FMEnv FMEnv, distribution per specific term audience AMR SBCC States, UNICEF, target group. specific materials in FCT, 774 Donor The forum of LGAs) agencies and dissemination AMR SBCC English and materials to development of SBCC four local LGAs partners materials languages STRATEGIC INTERVENTION 1.1.2. High level advocacy to policy makers and relevant stakeholders to create budget line and source for required financial and technical support for AMR awareness programme in the States, FCT and Federal level Activity 1.1.2.1. Audience specific advocacy visits and group meetings using appropriate channels of communication and SBCC materials (advocacy kits and key messages) to decision makers in MDAs, regulatory bodies, academia, industry, media, religious structures, traditional structures, development/ implementation partners, telecommunication organisations, financial institutions, law enforcement agencies, artisan associations, youth organisations 1.1.2.1.1: Meetings, To be Medium Nation NBCCCG, FMoH, Increased Conduct Advocacy deter to Long - wide NCDC, FMoH/ FMARD, budget line evidence (36 kits: -mined term HPD FMARD, FMEnv, for AMR based Advocacy kit States, FMEnv, State SMoH, activities at the advocacy to will include FCT, 774 CSMC, LGA/ SMARD, National, State legislators materials LGAs) CSMC, SMoEnv, and LGA levels and decision that will and Donor makers at address Federal, agencies and States, FCT Resource development and LGA mobilisation, partners to allocate Legal, resources for Research AMR activities and M&E needs for AMR, IPC and AMS

Federal Ministries of Agriculture, Environment and Health; September 2017 45 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 1.1.2. Cont’d

Activity 1.1.2.1. cont’d

1.1.2.1.2: Advocacy To be Medium Nation NBCCCG, FMARD, Number Investiture kits Meetings deter to Long - wide NCDC, FMoH/ FMEnv, of AMR of prominent (36 HPD FMARD, SMoH, champions Identified -mined term personalities champions States, FMEnv, State SMARD, instituted as AMR FCT, CSMC, LGA/ SMoEnv, to increase Champions 774 CSMC, and Donor budget lines at (including LGAs) agencies and the National, Wives of development State and LGA Governors/ partners levels Chairmen/ Traditional/ Religious leaders) 1.1.2.1.3: Advocacy To be Medium Nation NBCCCG, FMoH Number of Advocacy/ kits deter to Long - wide NCDC, FMoH/ FMARD, advocacy sensitisation Meetings, -mined term (36 HPD FMARD, FMEnv, MoH, meetings held States, FMEnv, State SMARD, per group. meeting/ Media owners FCT, CSMC, LGA/ SMoEnv, Report of visit with and workers, 774 CSMC, and Donor meetings stakeholders PMAN LGAs) agencies and such as media Nollywood, development institutions NGO, FBOs partners entertainment and CSOs industry, NGO, FBOs and CSOs 1.1.2.1.4: Multinationals, To be Medium Nation NBCCCG, FMoH, Number of Conduct Banks, Telecom deter to Long - wide NCDC, FMoH/ FMARD, round table Annual SMEs, Wealthy -mined term (36 HPD FMARD, FMoEd meetings held Roundtable Individuals States, FMEnv, State SMoH, advocacy Private sector FCT, CSMC, LGA/ SMARD, meeting for 774 CSMC, SMoE, private sector LGAs) and Donor organisations agencies and for funding development of AMR partners programmes

46 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding

STRATEGIC INTERVENTION 1.1.3. Implementation of communication campaigns to increase awareness on appropriate antimicrobial use and adoption of infection prevention measures among the public, policy makers, tripartite professionals and other relevant stakeholders in community, schools, workplaces and health facilities Activity 1.1.3.1. Engagement of stakeholders to increase public awareness on AMR and related topics in communities, schools, workplaces and markets using existing communication approaches such as for community mobilisation, fixed post, outreach and interpersonal communication activities, town announcers, community dialogue, public gatherings, mass media, annual events (World Antibiotic Awareness Week, World Health Day, Hand Washing) 1.1.3.1.1: Meetings To be Short Nation LGA SMC, FMoH/HPD 1. Number Sensitisation Participants deter- to -wide State CSMC, FMARD, of persons meetings for (36 NBCCCG, FMoEd, sensitised from mined Long various groups social and States, FMoH/HPD SMoH, per group term to build skills professional FCT and FMARD, FMEnv, SMARD, per sector/ on AMR and 774 State CSMC, SMoE, meeting/ State/ sectors: related topics in LGAs) LGA/CSMC, UNICEF, LGA Community states, FCT and Donor 2. Proportion LGA (human/ leaders & agencies and of sector/ animal/ groups NGOs, development stakeholders environmental CSOs/FBOs partners that has skill on professionals, Heads of implementing NGOs, Educational communication CSOs, FBOs, institutions, campaign professional Teachers, that promote bodies, PTA, Artisan antimicrobials academia, associations, use and IPC. industry, Law 3. Increased Media, enforcement mobilisers – awareness on agencies. CORPs, NOA, antimicrobial COMOS, Peer use and IPC educators measures (Students, out among the of school youth, general women groups, population and male groups), professionals CSO, NGOs)

Federal Ministries of Agriculture, Environment and Health; September 2017 47 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 1.1.3. Cont’d Activity 1.1.3.1. cont’d

1.1.3.1.2: Media Public To be Medium Nation LGA SMC, FMoH/HPD Frequency of engagement Media deter to Long - wide State CSMC, FMARD, airing of jingles for awareness (36 NBCCCG, FMEnv, and publication plan, -mined term creation in media States, FMoH/HPD SMoH, of editorials. English, Pidgin Placements FCT, FMARD, FMEnv SMARD, Frequency of and local 774 SMoEnv, call-In on Radio and Key languages LGAs) UNICEF, & Television message using multiple Donor Chat Shows on platform (print on ARM agencies and major TV and and electronic appropriate development Radio. Frequency channels) to use and partners of bi-monthly disseminate practices. publication on AMR key Functional AMR Feature messages on Hotline Articles in major selected major newspapers radio and TV Organize stations and Quarterly Media newspapers Coverage and Reportage by Journalists for AMR Campaign Activities 1.1.3.1.3: Public Key To be Medium Nation LGA SMC, FMoH Community Community message decided to Long - wide State CSMC, FMARD, dialogues dialogues on AMR term (36 NBCCCG, FMEnv, and town hall and town hall appropriate States, NCDC, FMoH/ SMoH, meetings, meetings, use and FCT, HPD FMARD, SMARD, Outcomes of the ensuring practices 774 FMEnv SMoEnv, meetings that resource LGAs) and Donor mobilisation, agencies and legal, research development and M&E needs partners for AMR, IPC, biosecurity and antimicrobial stewardship are also covered

48 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 1.1.3. Cont’d Activity 1.1.3.2. Effective mechanism for coordination of AMR awareness activities

1.1.3.2.1: FMoH, To be Short Nation LGA SMC, FMoH Number of Inter-sectoral FMEnv, deter to Long - wide State CSMC, FMARD, reporting collaboration FMARD, (36 NBCCCG, FMEnv, channels -mined term between FMoEd, States, NCDC, FMoH/ SMoH, established. the relevant FMoI SMoH, FCT, 774 HPD FMARD, SMARD, Report of Ministries SMoEnv, LGAs) FMEnv SMoEnv, activities (health, SMARD SMoI, and Donor carried out per agriculture, SMoE, NOA agencies and communi- environment, Development development cation etc.), Partners, Law partners channels (Toll telecommuni enforcement free lines, Bulk -cation agencies, SMS, website) companies and Telecommuni at the Federal, the community -cation State and LGA to establish companies, levels reporting NGOs, CSOs, mechanisms for CBOs, FBOs AMR awareness etc. activities 1.1.3.2.2: FMoH, FMEnv, To be Medium Nation LGA SMC, FMoH Number of Periodic FMARD, deter to Long - wide State CSMC, FMARD, monitoring monitoring of SMoH, -mined term (774 NBCCCG, FMoEd, exercises the implemen SMoEnv, LGAs) FMoH, FMARD, SMoH, carried out. -tation of AMR SMARD FMEnv SMARD, Report of awareness FMoI, NOA SMoEnv, monitoring programmes Development and Donor exercise (three times Partners, agencies and yearly) development partners 1.1.3.2.3: FMoH, FMEnv, 10 Short Geo LGA CSMC, FMoH, Number Conduct FMARD, to Long -political State CSMC, FMEnv, of Review biannual SMoH, term zones NBCCCG, FMARD meetings Review SMoEnv, NCDC, FMoH, and Donor carried out, Meetings and SMARD, FMARD, FMEnv agencies and Reports of incorporate FMoI, NOA development meetings review of AMR Development partners awareness, Partners training and and relevant education Stakeholders Federal Ministries of Agriculture, Environment and Health; September 2017 49 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding

STRATEGIC INTERVENTION 1.2.1 Regulatory systems to promote rational antimicrobial use, infection prevention and antimicrobial stewardship among human, animal and environment and allied professionals

Activity 1.2.1.1 Review of school curricula (primary, secondary and tertiary) and training guidelines for teachers and health professionals in human, animal and environment to ensure appropriate inclusion of AMR, IPC, biosecurity and antimicrobial stewardship

1.2.1.1.1: Meeting Ministry of 8 Medium To be NBCCCG, FMoH Reviewed to review and Education. term deter NCDC, FMoH/ FMARD, Primary and expand curriculum Curriculum -mined HPD FMARD, FMEnv, Secondary and teachers of schools FMEnv SMARD, Schools training guidelines AMR SMoE, curricula for primary and experts and Donor Report of secondary school agencies and meetings on AMR, IPC and development AMS for students partners

1.2.1.1.2: TOT for Ministry of 2 Medium To be NBCCCG, FMoH Number of teachers on the Education term deter NCDC, FMoH/ FMARD, master trainers revised primary Tripartite -mined HPD FMARD, FMEnv, trained per and secondary Ministries FMEnv, and, Donor session. Report school curriculum Master agencies and of training and training trainers development sessions guidelines using Donor existing structures agencies and development partners 1.2.1.1.3: Meeting Regulatory 20 Medium To be NBCCCG, FMoH Number of to review and bodies and term deter FMoH/HPD FMARD, curricula expand curriculum training -mined FMARD, FMEnv FMEnv, reviewed for of undergraduate, institutions and, Donor professionals residency and post in the agencies and in human, graduate training tripartite development animal and programmes sectors partners environment on AMR, IPC, AMR sectors biosecurity and experts Number and antimicrobial report of stewardship for meetings tripartite and allied professionals

50 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding

STRATEGIC INTERVENTION 1.2.1 Cont’d

Activity 1.2.1.1 Cont’d

1.2.1.1.4: Meeting Regulatory 20 Medium To be NBCCCG, FMoH Number of to train tutors bodies and term deter FMoH/HPD FMARD, training session on the revised training -mined FMARD, FMoEd FMEnv, held, Number undergraduate, institutions and, Donor of tutors residency and in the agencies and trained per post graduate tripartite development institution per curriculum Donor professional sectors agencies and group AMR development experts partners Activity 1.2.1.2 Encourage regulatory bodies to include AMR related training in the requirements for qualification and renewal of license 1.2.1.2.1: Regulatory 20 Long Abuja NBCCCG, FMoH, Number of Sensitisation bodies, term NCDC, FMoH/ FMARD, regulatory and meeting for professional HPD FMARD, FMEnv, professional regulatory bodies bodies and FMEnv and Donor bodies and professional training agencies and sensitised per associations for institutions development sector Report human, animal in the partners of meetings and environment tripartite and reports providers to include sectors ARM AMR and related experts topics in trainings, renewal of license and facilities accreditation checklists

Federal Ministries of Agriculture, Environment and Health; September 2017 51 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding

STRATEGIC INTERVENTION 1.2.1 Cont’d

Activity 1.2.1.3 Implement educational activities such as seminars, conferences, and short courses on AMR and relevant topics as appropriate for human, animal and environment professionals and relevant groups

1.2.1.3.1: AMR experts, TBD Long Abuja NBCCCG, FMoH, Number of Organise seminars Human, term FMoH/HPD FMARD, training sessions and training animal and FMARD, FMEnv FMEnv, held per group for relevant environment and Donor per year stakeholders professionals, agencies and Number of such as PPMV, and relevant development trained service animal health partners providers per groups inspectors, clinical group veterinarians, livestock producers, aquaculture farmers, toll milers, feed manufacturers, etc. 1.2.1.3.2: NBCCCG 20 Short Abuja NBCCCG, FMoH, Number Train media AMR experts to FMoH/HPD FMARD, of health correspondence NUJ Long FMARD, FMEnv FMEnv, Donor correspondence on appropriate term agencies and from print and reporting and development electronic media investigative partners trained on AMR journalism on reporting. AMR awareness, education and training activities

52 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding

STRATEGIC INTERVENTION 1.2.2 Augment the knowledge and understanding of AMR, IPC, biosecurity and antimicrobial stewardship among human, animal, and environment care and allied professionals

Activity 1.2.2.1 Develop training programmes related to AMR prevention and containment in continuing education for human, animal and environment professionals

1.2.2.1.1: AMR experts To be Medium Nation LGA SMC, FMoH, Assessment of Organise In-service deter to Long -wide State CSMC, FMARD, knowledge and in-service NBCCCG, FMEnv, understanding Training -mined term training on institutions FMoH/HPD and Donor of professionals AMR, IPC Tripartite FMARD, FMEnv agencies and on AMR, IPC, and AMS development biosecurity and Professionals appropriate partners antimicrobial use and stewardship practices for Human, animal and environmental professionals Activity 1.2.2.2 Put in place mechanisms to monitor onsite practices by human, animal and environment professionals 1.2.2.2.1: M&E officers 4 Medium To be LGA SMC, FMoH, 1. Antimicrobial Organize of tripartite term deter State CSMC, FMARD, use and practice meeting to ministries, -mined NBCCCG, FMEnv behavior change define/identify NGOs/ FMoH/HPD and Donor Indicators antimicrobial CSOs and FMARD, FMEnv agencies and identified use and Development development practice Partners, partners 2..Appropriate indicators FMoH tools developed and develop NHMIS unit 3.Antimicrobial appropriate behaviour data collection change data and audit tools elements reflected in appropriate data collection platforms in the tripartite sector

Federal Ministries of Agriculture, Environment and Health; September 2017 53 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding

STRATEGIC INTERVENTION 1.2.2 Cont’d

Activity 1.2.1.2 Cont’d

1.2.2.2.2: RRegulatory To be Medium Abuja NBCCCG, FFMoH, Number of Strengthen bodies, deter to Long FMoH, FMARD, FMARD, regulatory regulatory NBCCCG, -mined term FMEnv FMEnv, bodies authorities Mechanism and Donor strengthened to monitor for agencies and to monitoring AMR, IPC, monitoring development AMR biosecurity and AMR partners practices such antimicrobial practice in as penalties, stewardship the tripartite Monitoring practices sectors report in tripartite sectors Activity 1.2.2.3. Improve access to information on appropriate use of antimicrobials by the human, animal and environmental professionals 1.2.2.3.1: Tripartite To be Short Nation LGA SMC, FMoH, Functional Create/Update sectors deter term -wide State CSMC, FMARD, web site web based website, -mined to Long NBCCCG, FMEnv on AMR information FMoI, term FMoH/HPD and Donor activities, system General FMARD, FMEnv agencies and Trend of visits (publication, Population development to the website, reports, partners Publications, research, research intervention) findings for AMR in report etc. Nigeria uploaded 1.2.2.3.2: Tripartite To be Short Nation LGA SMC, FMoH, Number of Update sectors deter term -wide State CSMC, FMARD, social media existing website, -mined to Long NBCCCG, FMEnv engagement social media FMoI, term FMoH/HPD and Donor and analysis platforms in General FMARD, FMEnv agencies and the tripartite Population development sectors partners for online dissemination of information on AMR

54 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding

STRATEGIC INTERVENTION 1.2.2 Cont’d

Activity 1.2.2.4 Monitoring of change in AMR awareness, knowledge, attitudes, practice and perception among the public

1.2.2.4.1: Annual To be Short Nation LGA SMC, FMoH, Number Conduct relevant Survey deter to Long -wide State CSMC, FMARD, and report studies on impact -mined term NBCCCG, FMEnv of studies of the AMR NCDC, FMoH/ and Donor conducted, communication HPD FMARD, agencies and Data on campaigns FMEnv development change in to track partners behavior and perceptions and rational use of understanding antimicrobials of the messages disseminated, and track behavior levels STRATEGIC INTERVENTION 2.1.1 To establish a national coordination structure for surveillance of AMR Activity 2.1.1.1 Set up a National Steering Committee and National Coordinating Centre

2.1.1.1.1: Write Terms of 1 Done Abuja, CEO, NCDC NCDC, Approved TOR and approve Reference Abuja FMoH, Donor ready Terms of agencies and Reference (TOR) development for NCDC as partners the National Coordinating Centre for AMR Surveillance in Nigeria 2.1.1.1.2: Appoint Individual 12 Short Abuja, CEO, NCDC NCDC, NSC individuals into a Members term Abuja FMoH, Donor Inaugurated National Steering agencies and Committee development (NSC) for AMR partners surveillance in Nigeria

Federal Ministries of Agriculture, Environment and Health; September 2017 55 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 2.1.1 cont’d Activity 2.1.1.1 cont’d

2.1.1.1.3: Write Terms of 1 Short Abuja, FMoH, CEO NCDC, TOR and approve Reference term Abuja (NCDC) FMoH, Donor terms of agencies and reference for development a National partners Steering Committee for AMR surveillance 2.1.1.1.4: Meetings 14 Short Variable NCDC NCDC, Improved Establish term FMoH, Donor surveillance Statutory agencies and system across Meetings for development different AMR the NSC sectors

Activity 2.1.1.2 Set up Technical Working Groups (TWG) at national and state levels

2.1.1.2.1: Individual Short Abuja NCDC NCDC, TWG Appoint Members term FMoH, Donor Inaugurated National agencies and Technical development Working Group partners (TWG) Establish 20 Short MOH MOH NCDC, statutory term FMoH, Donor meeting for the agencies and national development 2.1.1.2.2: Individual Short SMoH SMoH SMoH, Donor 1. STWG Appoint State Members term agencies and Inaugurated Technical development Working Group partners 2. NTWG (STWG) notified

2.1.1.2.3: Meetings 20 SMoH SMoH SMoH, Donor SMoH, Donor Establish agencies and agencies and Statutory development development Meetings for partners the STWGs

56 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 2.1.2 Write a multi-sectoral surveillance implementation plan Activity 2.1.2.1 Determine surveillance priorities

2.1.2.2: Type of Short Abuja NTWG NCDC, FMoH, List of priority Identify AMR specimen term FMARD, specimens surveillance FMEnv Donor priorities for agencies and Nigeria development partners

2.1.2.2.2: Type of Short Abuja NTWG NCDC, FMoH, List of priority Identify priority organism term FMARD, organisms organisms FMEnv Donor from humans, agencies and animals, and development environment partners 2.1.2.2.3: Type of Short Abuja NTWG NCDC, FMoH, List of Identify priority Medicine term FMARD, priority medicines for FMEnv Donor medicines use and quality agencies and monitoring development partners Activity 2.1.2.2 Write the surveillance implementation plan viz-a-viz existing policies in all sectors 2.1.2.2.1: The draft 1 Short Abuja NTWG NCDC, FMoH, Draft copy Draft the plan term FMARD, multi-sectoral FMEnv Donor Surveillance agencies and Implementation development Plan partners 2.1.2.2.2: The Variable Short Abuja NSC NCDC, FMoH, Reviewers' Stakeholder Review term FMARD, comments Review of the FMEnv Donor Draft agencies and development partners

Federal Ministries of Agriculture, Environment and Health; September 2017 57 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 2.1.2 Cont’d Activity 2.1.2.2 Cont’d 2.1.2.2.3: The Plan 1 Short Abuja NTWG NCDC, Improved Finalisation term FMoH, multi-sectorial and adoption FMARD, surveillance of the FMEnv Donor implementation Surveillance agencies and plan Implementation development Plan partners 2.1.2.2.4: Printed and Short Abuja NTWG NCDC, Percentage Produce and electronic term FMoH, of sector with Disseminate copy FMARD, Surveillance the Surveillance FMEnv Donor Implementation Implementation agencies and plan printed and Plan in print development disseminated and online partners formats STRATEGIC INTERVENTION 2.2.1 Write sector-specific surveillance protocols to detect emerging, re-emerging and changing trends in AMR Activity 2.2.1.1 Identify surveillance focal points in clinical settings, food chain, terrestrial and aquatic animal production value chains and the environment 2.2.1.1.1: Baseline Short Abuja NCDC NCDC, Number of Perform assessment term FMoH, Donor institutions baseline agencies and that have assessment of development competence to laboratory and partners detect emerging, other capacities reemerging trends in AMR using standardised protocols 2.2.1.1.2: Select Sites and Short Abuja NCDC NCDC, List of selected initial and laboratories term FMoH, Donor surveillance and subsequent agencies and sentinel sites surveillance development sites and partners sentinel laboratories

58 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 2.2.1 Cont’d Activity 2.2.1.1 Cont’d

2.2.1.1.3: Eligible sites Medium Abuja NCDC NCDC, Increased Support term FMoH, Donor competence of eligible sites agencies and emerging, re- with technical development emerging and assistance partners trend among to meet surveillance sites minimum and lab standards for surveillance 2.2.1.1.4: Surveillance Short Abuja NCDC NCDC, Improved detection To set up system term FMoH, Donor and reporting of a national agencies and diseases using surveillance development WHONET system for partners AMR Activity 2.2.1.2 Adopt or adapt standardized protocols for the surveillance system

2.2.1.2.1: Review or Short Abuja NTWG NCDC, FMoH, Compiled report Review or pre-test term FMARD, Pre-test FMEnv Donor existing agencies and protocols development partners 2.2.1.2.1: Adopted Short Abuja NTWG NCDC, FMoH, Relevant manuals Select and protocol term FMARD, and SOPs available adopt FMEnv Donor appropriate agencies and protocols development partners 2.2.1.2.2: Addressed Short Abuja NCDC NCDC, Acknowledgement Disseminate copy term FMoH, Donor of receipt of the adopted agencies and manuals and SOPs protocols development partners

Federal Ministries of Agriculture, Environment and Health; September 2017 59 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 2.2.1 Cont’d Activity 2.2.1.2 Cont’d 2.2.1.2.3: Training Short Abuja NCDC NCDC, Proficiency Training to module term FMoH, Donor testing ensure capacity agencies and and adherence development to protocols partners

2.2.1.2.4: Scheduled Medium Abuja NTWG NCDC, Compiled reports Schedule review term FMoH, reviews of FMARD, protocols FMEnv Donor in line with agencies and the adopted development standardized partners protocols Activity 2.2.1.3 Implement WHONET Tools for data management 2.2.1.3.1: Platform Short Abuja NCDC NCDC, Platform up and Deploy a for data term FMoH, Donor running unifying manage agencies and platform -ment development for multi- partners sectoral data management collaboration at the NCDC 2.2.1.3.2: Software Short All NCDC NCDC, Download report Install WHONET copies term surveillance FMoH, Donor from WHONET and AMU at sites and agencies and Secretariat selected and Abuja development potential partners surveillance sites 2.2.1.3.3: Training Short All NCDC NCDC, Improved Training of modules term surveillance FMoH, Donor detection and personnel to sites and agencies and reporting of use WHONET Abuja development resistances and partners diseases using WHONET

60 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 2.2.1 Cont’d Activity 2.2.1.3 Cont’d 2.2.1.3.4: M&E Plan Short Abuja NTWG NCDC, Written plan Devise a term FMoH, monitoring FMARD, and evaluation FMEnv Donor plan for use of agencies and WHONET development partners STRATEGIC INTERVENTION 2.2.2 Prepare and implement a Human Resource Development plan for AMR Surveillance Activity 2.2.2.1 Implement a Human Resource Development plan for AMR surveillance 2.2.2.1.1: Carry Needs Short Abuja NTWG NCDC, Needs out Human assessment term FMoH, Assessment Resource Needs FMARD, report Assessment for FMEnv Donor the Surveillance agencies and System development partners

2.2.2.1.2: Draft, Draft plan 1 Short Abuja NTWG NCDC, Adopted plan Review and term FMoH, Adopt a plan FMARD, for Human FMEnv Donor Resource agencies and Development development partners 2.2.2.1.3: Training Short Variable NCDC NCDC, Proficiency Conduct modules term FMoH, Donor testing training and and agencies and retraining Long development to address term partners relevant gaps identified in the Needs Assessment

Federal Ministries of Agriculture, Environment and Health; September 2017 61 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 2.2.2 Cont’d Activity 2.2.2.1 Cont’d 2.2.2.1.4: Scheduled Short Abuja NCDC NCDC, Schedule Schedule periodic audit and FMoH, Donor Human Resource long agencies and Audit at all levels term development partners

STRATEGIC INTERVENTION 2.3.1 Set up an NCDC National reference laboratory Activity 2.3.1.1 Set up a national reference laboratory 2.3.1.1.1: Write TOR 1 Short Abuja NCDC NCDC, TOR and approve term FMoH, Donor terms of reference agencies and for a national development reference partners laboratory with expertise in methods for confirming and characterizing specific pathogens 2.3.1.1.2: Laboratory 1 Short Abuja NCDC NCDC, National Designate term FMoH, Donor Reference an existing agencies and Laboratory laboratory to development serve as an partners interim National Reference laboratory 2.3.1.1.3: Laboratory 1 Long Abuja NCDC NCDC, Percentage Upgrade the term FMoH, Donor capacity NCDC Laboratory agencies and of NCDC in Gaduwa development reference (Abuja) to serve partners Laboratory to as the permanent support AMR National surveillance Reference across sectors. laboratory

62 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 2.3.1 Cont’d Activity 2.3.1.1 Cont’d 2.3.1.1.3.4. Enrolment Long Abuja NCDC NCDC, Readiness for Enroll NCDC term FMoH, Donor accreditation Lab in the step- agencies and assessed wise Laboratory development improvement partners process towards accreditation (SLIPTA) STRATEGIC INTERVENTION 2.3.2 Standardize laboratory capacity for monitoring AMR (Human, Terrestrial and Aquatic Animal, Food and Environment) ACTIVITY 2.3.2.1 Institutionalize laboratory capacity for monitoring AMR (Human, Terrestrial and Aquatic Animal, Food and Environment) 2.3.2.1.1: Assess Laboratory 3 Medium Abuja NCDC NCDC, Increased data capacities & Long FMoH, Donor demand and of identified term agencies and use laboratories for development AMR surveillance partners 2.3.2.1.2: Adopt The system 1 Short Abuja NCDC NCDC, Adopted a system for term FMoH, Donor system certification and agencies and standardization development of laboratories partners 2.3.2.1.3: Laboratories Medium Laboratories NCDC NCDC, Readiness for Mentoring the & Long FMoH, Donor accreditation identified public term agencies and assessed laboratories development towards partners accreditation or (SLIPTA) 2.3.2.1.4: The system 1 Short Abuja NCDC NCDC, Adopted Establish a term FMoH, Donor system unified system agencies and for Total Quality development Management of partners laboratories

Federal Ministries of Agriculture, Environment and Health; September 2017 63 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 2.3.2 Cont’d ACTIVITY 2.3.2.2 Establish a mechanism for information sharing among stakeholders 2.3.2.2.1: Local Short Abuja NCDC NCDC, FMoH, Compiled Use WHONET Surveillance to Long Donor agencies reports to analyse reports term and development and produce partners reports at the laboratories and surveillance sites

2.3.2.2.2: WER on 1 Short Abuja NCDC NCDC, FMoH, Inaugural Create the One AMR term Donor agencies issue Health Weekly and development Epidemiology partners Report (WER) on AMR 2.3.2.2.3: Set Desk office 1 Short Abuja NCDC NCDC, FMoH, Desk office up up a desk office for WER term Donor agencies and running for collation of and development research outputs partners to enrich the surveillance data and Weekly Epidemiology Reports 2.3.2.2.4: Addressed 234 Short Abuja NCDC NCDC, FMoH, Disseminated Disseminate copy to Long Donor agencies WER the WER via term and development available partners platforms STRATEGIC INTERVENTION 2.4.1 Enroll in GLASS

Activity 2.4.1.1 Enroll in GLASS 2.4.1.1.1: Enrolment 1 Short Abuja NCDC NCDC, FMoH, Enrolled in Complete term Donor agencies GLASS relevant strategic and development activities for partners enrolment in GLASS

64 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 2.4.2 Contribute National Surveillance data to GLASS Activity 2.4.1.2 Contribute National Surveillance data to GLASS 2.4.1.2.1: Data 1 Short to Abuja and NCDC NCDC, Baseline data Measure baseline medium Surveillance FMoH, Donor surveillance term sites agencies and baselines development partners 2.4.1.2.2: Data Medium Abuja NCDC NCDC, Included in Submit curated submission to Long FMoH, Donor GLASS Reports data to WHO term agencies and GLASS development partners STRATEGIC INTERVENTION 2.5.1 Capacity Building for AMR Researchers 2.5.1.1: AMR Grantsmanship training 2.5.1.1.1: Workshops 10 Short variable NTWG variable Attendance Develop and and to Long and successful administer modules term awards targeted grantsmanship workshop and modules STRATEGIC INTERVENTION 2.5.2. Periodically identify and articulate surveillance gaps and AMR burden estimation needs Activities 2.5.2.1: Identify surveillance gaps and AMR burden estimation needs

2.5.2.1.2: Meetings 5 Short Abuja NTWG NCDC, Minutes of Periodic to Long FMoH, Donor meetings meetings term agencies and to identify development research partners needs and expert panel membership

Federal Ministries of Agriculture, Environment and Health; September 2017 65 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 2.5.3. Secure funding from relevant public and private sources 2.5.3.1: Fund raising and resource mobilisation 2.5.3.1.1: Potential 5 Short Abuja NSC NCDC, FMoH, Annual list of Identify funding to long FMARD, FMEnv target funding funding sources list term Donor agencies agencies sources and development partners 2.5.3.1.2: Secured Variable Short Variable NTWG NCDC, FMoH, Available Fundraising funds to long FMARD, FMEnv funds (cultivating term Donor agencies and closing) and development partners STRATEGIC INTERVENTION 2.5.4. Commissioning researchers and research institutions to undertake identified research gaps 2.5.4.1: Competitive grant programme management 2.5.4.1.1: Call for 5 Short Abuja NTWG and NCDC, FMoH, Call for Expert proposals to long expert panel FMARD, FMEnv proposals panels draw term Donor agencies up calls for and development proposals partners 2.5.4.1.2: Published 5 Short Abuja NCDC NCDC, FMoH, Proposals Advertise call for to long Donor agencies received calls for proposals term and development proposal partners

2.5.4.1.3: Research Variable Short Abuja NTWG and NCDC, FMoH, Awards made Selection awards to long expert panel FMARD, FMEnv and award term Donor agencies process and development partners

2.5.4.1.4: Research Variable Short Abuja NTWG NCDC, FMoH, Reports, Award awards to long FMARD, FMEnv publications monitoring term Donor agencies and other and and development research evaluation partners outputs

66 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 3.1.1: Establish a National Infection Prevention and Control Programme Activity 3.1.1.1: Set up a National coordination for IPC in providing oversight for Healthcare facilities across the nation 3.1.1.1.1: Inaugural 1 Short Term Abuja, National Report of Prepare terms meeting Abuja AMR steering FMoH inaugural of reference committee and FMARD meeting and have working group. FMEnv inaugural Nigeria Donor agencies meeting of Infection Control a National Association infection (NICA), prevention Nigeria and control Infectious coordinating Disease Society AMR sub- (NIDS) technical working group 3.1.1.1.2: Biannual 10 Continuous Zonal IPC TWG FMoH Number of Establish meetings FMARD Meetings statutory FMEnv meetings for Donor agencies the IPC-AMR Technical working group Activity 3.1.1.2: Review the existing National IPC policy and develop IPC guidelines which captures practices to prevent the spread of multidrug resistant organisms 3.1.1.2.1: IPC Policy 4 Short Term Abuja IPC TWG FMoH Revised policy Review the NICA FMARD available existing FMEnv national IPC Donor agencies policy 3.1.1.2.2: IPC 4 Short Term Abuja IPC TWG FMoH IPC guidelines Write national guidelines NICA FMARD available IPC guidelines Academia FMEnv Donor agencies

Federal Ministries of Agriculture, Environment and Health; September 2017 67 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 3.1.1: Cont’d Activity 3.1.1.3: Develop a monitoring and evaluation component of the IPC programme including surveillance for HAI 3.1.1.3.1: Setup Implementa 10 Continuous Nation IPC TWG FMoH Number of a national -tion of -wide FMARD M&E activities M&E unit for M&E plan FMEnv carried out implementation for IPC and Donor ensure agencies IPC M&E implement -tion plan ready for use 3.1.1.3.2: HAI 20 Continuous Abuja NCDC FMoH HAI quarterly Coordinate surveillance IPC TWG FMARD report national system and NICA FMEnv surveillance for Quarterly AFENET Donor HAIs surveillance NIDS agencies meeting 3.1.1.3.3: Hold HAI review 5 Continuous Abuja, NCDC FMoH Annual HAI HAI annual Abuja IPC TWG FMARD review report review meeting NICA FMEnv Rep of sentinel Donor sites IPC TWG agencies

STRATEGIC INTERVENTION 3.1.2: Strengthening IPC practices

Activity 3.1.2.1: Develop an IPC curriculum for training of certified IPC professionals

3.1.2.1.1: Develop IPC 4 Short term Abuja IPC TWG FMoH Number of an IPC curriculum curriculum NICA FMARD IPC certified for training of FMEnv practitioners certified IPC trained practitioners

68 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 3.1.2: Cont’d Activity 3.1.2.1: cont’d 3.1.2.2.2: Advocacy 5 Continuous Abuja NCDC FMoH Advocacy Advocacy meetings NICA FMARD meeting meetings for Society for FMEnv reports adoption as Quality in Donor significant part Healthcare agencies of healthcare (SQHN) facilities accreditation by the Government Activity 3.1.2.3: Establish and or strengthen IPC committee across all health facilities in the nation 3.1.2.3.1: Advocacy 2 Short term Abuja NCDC FMoH Advocacy Advocacy meeting meeting IPC TWG FMARD meeting report with the Health FMEnv Minister and Donor permanent agencies secretary on the need for all healthcare facilities to form IPC committees 3.1.2.3.2: Assessment 2 Continuous Nation IPC TWG FMoH Assessment Assessment of Survey -wide NICA FMARD Survey report IPC programmes AFENET FMEnv within healthcare Donor facilities across agencies the country 3.1.2.3.3: Training Training 2 Continuous Abuja IPC TWG FMoH Number of of representatives NICA FMARD health facilities of IPC committees FMEnv represented at on identified gaps Donor the training agencies

Federal Ministries of Agriculture, Environment and Health; September 2017 69 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 3.1.3: Improve IPC education and training Activity 3.1.3.1: improve IPC Education and Training 3.1.3.1.1: Training 3 Medium Abuja IPC TWG FMoH Training Development curriculum TErm NICA FMARD curriculum of a generic AFENET FMEnv available basic IPC Donor curriculum agencies for training of frontline healthcare workers at various levels 3.1.3.1.2: Advocacy 5 Medium Abuja NCDC FMoH Advocacy Advocacy meetings term IPC TWG FMARD meeting report for use of FMEnv curriculum Donor by relevant agencies institutions Activity 3.1.3.2: Promote hand hygiene and other safe behavioral practices that limit the spread of infection

3.1.3.2.1: BCC 3 Short term Abuja NCDC MoH BCC materials Adaptation of materials IPC TWG FMARD on IPC Hand hygiene NICA FMEnv and other IPC Academia Donor BCC materials agencies to local and culturally acceptable content and language 3.1.3.2.2: Printing 200,000 Continuous Abuja NCDC FMoH No of States Printing and Distribution IPC TWG FMARD reached with distribution of FMEnv BCC materials BCC materials

70 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 3.1.3: Improve IPC education and training Activity 3.1.3.1: improve IPC Education and Training 3.1.3.2.3: Awareness 10 Continuous Nation NCDC FMoH Number of Sensitisation campaigns -wide NICA FMARD campaigns and Awareness IPC TWG FMEnv campaigns on NOA Donor Hand hygiene CBOs agencies & other IPC FBOs practices 3.1.3.2.4: Distribution of 10 Continuous Nation NCDC FMoH No of BCC Commemoration BCC materials -wide NICA FMARD Materials of the 5th May as support IPC TWG FMEnv distributed International to institutions NOA Donor Number of hand hygiene and CBOs agencies campaigns day organisations FBOs supported Campaign promotion – media, organisations Activity 3.1.3.3 Promote biosafety as a standard of practice in all medical laboratories and relevant research centres

3.1.3.3.1: Biosafety & 2 Short term Abuja IPC TWG FMoH Laboratory Develop Biosecurity NCDC LAB FMARD Biosafety and Biosafety and criteria TWG FMEnv Biosecurity Biosecurity Donor performance criteria as agencies indicators performance indicators for Medical Laboratories and relevant research centres

Federal Ministries of Agriculture, Environment and Health; September 2017 71 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 3.1.3:Cont’d Activity 3.1.3.3 Cont’d 3.1.3.3.2: Training 10 Continuous Abuja IPC TWG FMoH Number of Institutional AMR TWG FMARD Trainings capacity NCDC LAB FMEnv development TWG Donor of Laboratories Academia agencies within the GLASS network on Biosafety and Biosecurity STRATEGIC INTERVENTION 3.2.1: Introduce IPC programme in veterinary practice and aquatic and terrestrial animal husbandry Activity 3.2.1.1 Increase awareness on IPC in Veterinary practice and aquatic and terrestrial animal husbandry

3.2.1.1.1: Sensitisation 12 Continuous Zonal NCDC FMoH Number of Sensitisation meetings IPC TWG FMARD sensitisation meetings Academia FMEnv meetings to relevant Donor conducted stakeholders on agencies the relevance of IPC in aquatic and terrestrial animal husbandry and veterinary practice

Activity 3.2.1.2 Conduct high level advocacy to relevant stakeholders on introduction of IPC for veterinary practice and aquatic and terrestrial husbandry 3.2.1.2.1: Advocacy 12 Continuous Zonal NCDC FMoH Meeting & Advocacy meetings IPC TWG FMARD visit reports meetings with Academia FMEnv stakeholders Donor on need to agencies incorporate IPC in aquatic and terrestrial health

72 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 3.2.2 Improve IPC and farm biosecurity practices Activity 3.2.2.1 Support the development of IPC policies and guidelines for veterinary practice and aquatic and terrestrial animal husbandry 3.2.2.1.1: IPC/ 4 Short term Abuja NVMA FMoH IPC Development Biosecurity IPC TWG FMARD biosecurity/ of specific IPC Guidelines Academia FMEnv Guideline and biosecurity NSA Donor ready for use guidelines for Agricultural agencies common farm association types and in veterinary practice Activity 3.2.2.2 Monitor for adherence to IPC guidelines in animal health

3.2.2.2.1: Set Coordination 10 Continuous Abuja FMARD FMoH Coordination up coordination Meetings IPC TWG FMARD meeting mechanism Academia FMEnv reports for IPC and Donor biosecurity agencies compliance among farm types

STRATEGIC INTERVENTION 3.2.3: Include hygiene and infection prevention and control as core (mandatory) content in training and education of veterinary professionals and animal health practitioners Activity 3.2.3.1 Advocate for the development and inclusion of IPC curriculum in undergraduate curricula for animal health professionals 3.2.3.1.1: Advocacy 5 Continuous Abuja NCDC FMoH Advocacy Advocacy meeting Abuja IPC TWG FMARD meeting meetings of VCN FMEnv report animal health Agricultural Donor and veterinary association agencies professional NSA bodies and NVMA groups

Federal Ministries of Agriculture, Environment and Health; September 2017 73 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 3.2.4 Improve IPC education and training for veterinary practice and aquatic and terrestrial animal husbandry Activity 3.2.4.1 Inclusion of IPC as continuing professional education/development trainings in veterinary practice and aquatic and terrestrial animal husbandry 3.2.4.1.1: Develop IPC 4 Short Abuja IPG TWG FMoH IPC training IPC training Training Term Academia FMARD materials materials for NVMA FMEnv available animal health NSA Donor agencies 3.2.4.1.2: Advocate Advocacy 1 Short Abuja NCDC FMoH Number for inclusion of IPC meeting Term IPC TWG FMARD of annual trainings in annual NVMA FMEnv professional professional NSA Donor meetings that meetings Agricultural agencies included IPC association trainings STRATEGIC INTERVENTION 3.3.1 Support implementation of food safety guidelines at the community level Activity 3.3.1.1 Provide information on hand hygiene and safe food handling at the community level 3.3.1.1.1: Support Awareness 5 Medium Nation NCDC FMoH No of sensitisation campaigns term -wide NICA FMARD campaigns and Awareness IPC TWG FMEnv supported campaigns on NOA Donor Hand hygiene & CBOs agencies safe food handling FBOs practices 3.3.1.1.2: ACSM 200,000 Short Abuja FMoH FMEnv ACSM Adaptation materials Term FMARD FMARD materials of Advocacy printing FMEnv FMoH distributed Communication and IPC TWG and social distribution NOA mobilisation (ACSM) materials related to hand hygiene and food safety to culturally acceptable contents

74 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 3.3.1 Cont’d Activity 3.3.1.2. Support monitoring and inspection of food producers and handlers 3.3.1.2.1: Develop IPC 2 Short term Abuja IPC TWG FMoH IPC criteria for relevant IPC criteria criteria for FMARD Inspection tool to be included in inspection FMEnv available inspection tools at tool Donor abattoirs and food agencies production facilities 3.3.1.2.2: Advocacy Advocacy 2 Short term Abuja NCDC FMoH Advocacy for use of criteria meeting IPC TWG FMARD meeting as part of licensing FMEnv reports requirements Donor agencies STRATEGIC INTERVENTION 3.4.1 Improve access to potable water in communities and within healthcare facilities Activity 3.4.1.1 Conduct advocacy to relevant stakeholders on provision of potable water at all healthcare facilities and communities 3.4.1.1.1: Advocacy Advocacy 2 Continuous Abuja NCDC FMoH Advocacy meeting of relevant meeting IPC TWG FMARD meeting stakeholders to FMEnv reports improve access to Donor potable water at agencies healthcare facilities and communities STRATEGIC INTERVENTION 3.4.2 Ensure water quality standard Activity 3.4.2.1 Conduct sensitisation and education of the community on making their water safe 3.4.2.1.1: Advocacy Advocacy Medium Abuja NCDC FMoH Advocacy to relevant meeting term IPC TWG FMARD materials for stakeholders for FMEnv use Advocacy regular monitoring Donor meeting of water supplies, agencies reports especially to health facilities

Federal Ministries of Agriculture, Environment and Health; September 2017 75 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 3.3.1 Cont’d Activity 3.4.2.1Cont’d 3.4.2.1.2: Support Awareness 10 Medium Nation NCDC FMoH Number of sensitisation campaigns term -wide NICA FMARD campaigns and awareness IPC TWG FMEnv supported campaigns to NOA Donor community on FBOs agencies ways of making CBOs water safe STRATEGIC INTERVENTION 3.5.1 Improve waste management practices Activity 3.5.1.1 Conduct advocacy to relevant stakeholders to provide logistic support for safe healthcare waste management 3.5.1.1.1: Advocacy Advocacy 2 Short term Abuja NCDC FMoH Advocacy to relevant meeting IPC TWG FMARD meeting stakeholders FMEnv report for support on Donor healthcare waste agencies management

Activity 3.5.1.2 Conduct advocacy to relevant stakeholders to Increase coverage and support to local government areas on disposal of communal waste 3.5.1.2.1: Advocacy Advocacy 12 Continuous Abuja NCDC FMoH Advocacy to increase meetings IPC TWG FMARD meeting coverage and FMEnv reports support to Local Donor Government Areas agencies on communal waste disposal STRATEGIC INTERVENTION 3.5.2 Support safe disposal and management of sewage and fecal matter Activity 3.5.2.1 Support awareness and provide information on proper disposal of sewage and faeces 3.5.2.1.1: Awareness 5 Continuous Abuja IPC TWG FMoH Number of Awareness and campaigns NCDC FMARD campaigns sensitisation on NOA FMEnv held proper disposal of Donor sewage and faeces agencies

76 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 3.6.1 Promote hand hygiene at the community level and schools Activity 3.6.1.1 Promotion of hand hygiene at the community and in schools 3.6.1.1.1: Support Distribution 10 Continuous Nation NCDC FMoH No of ACSM commemoration of of ACSM -wide NICA FMARD Materials the 15th October materials as IPC TWG FMEnv distributed Global hand support to NOA Donor Number of washing day institutions CBOs agencies campaigns and FBOs supported organisations Campaign promotion – media, organisations 3.6.1.1.2: School hand 4 Medium Survey IPC TWG FMoH Training Adaptation of hygeine term report NICA FMARD material hand hygiene training Educationists FMEnv available training materials materials Donor for primary and agencies secondary schools local use

3.6.1.1.3: Advocacy Advocacy 2 Medium Abuja IPC TWG FMoH Advocacy for adoption of meeting term FMARD meeting training material in FMEnv reports to school curricula Donor agencies STRATEGIC INTERVENTION 3.7.1 Scale up immunization coverage in human and animal health sectors Activity 3.7.1.1 Improve immunization coverage 3.7.1.1.1: Assessment 2 Continuous Survey IPC TWG FMoH Survey report Assessments survey report NCDC FMARD of current NICA FMEnv immunization AFENET Donor coverage for Agricultural agencies bacterial and key associations viral diseases in NVMA both humans and NSA animals

Federal Ministries of Agriculture, Environment and Health; September 2017 77 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 3.7.1 Cont’d Activity 3.7.1.1 Cont’d 3.7.1.1.2: Dissemination 2 Continuous Nation NCDCNICA FMoH Dissemination Dissemination of meeting -wide IPC TWG FMARD meeting survey report FMEnv report Donor agencies 3.7.1.1.3: Support Awareness 6 Medium Nation NCDC FMoH Number of sensitisation at campaigns term -wide NICA FMARD campaigns the community IPC TWG FMEnv supported level for NOA Donor vaccinations agencies STRATEGIC INTERVENTION 3.7.2 Increase range of available vaccines in – country for both human and animal Activity 3.7.2.1: Increasing bacterial vaccines range available for immunization in both humans and animals 3.7.2.1.1: Survey report 2 Medium & Nation IPC TWG FMoH Survey report Assessment of Long term -wide NCDC FMARD types of current AFENET FMEnv vaccines being Donor used for both agencies human and animals 3.7.2.1.2: Survey Survey report 2 Medium & Nation IPC TWG FMoH Survey report on prevalence Long term -wide NCDC FMARD of vaccine AFENET FMEnv preventable Donor bacterial diseases agencies

78 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 3.7.2 Cont’d Activity 3.7.2.1 Cont’d 3.7.2.1.3: Dissemination 4 Long Nation NCDC FMoH Meeting Survey report and advocacy term -wide FMARD reports dissemination meeting FMEnv and advocacy Advocacy Donor for inclusion of meetings agencies vaccines against with FMoH, those diseases NPHCDA and that contribute to FMARD burden of disease to be included in Immunisation programmes in both humans and STRATEGIC INTERVENTION 3.7.3 Support surveillance for vaccination programmes in human and animal health to enable appropriate vaccination Activity 3.7.3.1 Surveillance of prevalent serotypes to support targeted vaccination programmes 3.7.3.1.1: National 10 Long Abuja IPC TWG FMoH Surveillance Surveillance surveillance Term NCDC FMARD reports on circulating AFENET FMEnv serotypes of Donor high burden agencies bacterial diseases in both human and animal populations STRATEGIC INTERVENTION 4.1.1 Promote optimal procurement and distribution of quality antimicrobials and diagnostics for human and animal use Activity 4.1.1.1 Update existing documents (Essential Medicines List, Standard Treatment Guidelines and Veterinary formulary to guide procurements 4.1.1.1.1: Prepare Updated 1 Short Abuja FMoH, FMoH, Updated EDL an up to date documents term PCN, donor produced version of EDL MDCN agencies/ partners

Federal Ministries of Agriculture, Environment and Health; September 2017 79 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 4.1.1 Cont’d Activity 4.1.1.1 Cont’d 4.1.1.1.2: Prepare Updated 1 Short Abuja FMoH, PCN, FMoH, Meeting an up to date documents term MDCN FMARD/ reports version of STGs donor agencies/ partners 4.2.1.1.3: Adapt Animal 1 Medium Abuja FMARD, VCN. FMARD Updated STG treatment treatment term NCDC produced guidelines for guideline animals in accordance with OIE terrestrial and aquatic code 4.1.1.1.4: Updated 1 Short Abuja PCN, VCN, FMARD Increased Prepare an up documents term FMARD, rational to date version NAFDAC prescribing of Veterinary among formulary prescribers. STRATEGIC INTERVENTION 4.1.2 Enhance local production of Antimicrobial agents and diagnostics for human and animal use Activity 4.1.2.1 Government enforcement of import prohibition list to encourage local manufacturers 4.1.2.1.1: Advocacy Advocacy 2 Short Nation FMoH, FMoF FMoH, Donor Number of to government on visits term -wide development advocacy visits enforcement agencies and partners 4.1.2.1.2: Advocacy Advocacy 4 Short Nation FMoH, FMoF, FMoH Number of to government on visits term -wide MOTI, MOEBP Donor advocacy visits patronizing locally development manufactured agencies and antimicrobial partners agents

80 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 4.1.1 Cont’d Activity 4.1.2.2 Implement favourable tax regime for human and animal pharmaceutical raw, materials, active pharmaceutical ingredients and machineries 4.1.2.2.1: Advocacy Advocacy Short Nation FMoH FMoH, Donor Number of to government visits term -wide FMARD FMoF development advocacy on favourable agencies and visits tax regimen to partners manufacturers Activity 4.1.2.3 Creating interventionist fund for pharmaceutical industries

4.1.2.3.1: Advocacy Advocacy Short Nation FMoH, FMoF, FMoH Number of to government visits term -wide MOTI Donor advocacy on Creating development visits. interventionist fund agencies and for pharmaceutical partners industries STRATEGIC INTERVENTION 4.1.3 Expand NHIS coverage to include more enrollees Activity 4.1.3.1 Advocacy to NHIS and state governments to expand NHIS coverage

4.1.3.1.1: Advocacy 2 Short Nation FMoH, SMoH FMoH Increase in Advocacy to state visits term -wide Percentage of governments enrolled state to enroll their employees employees 4.1.3.1.2: Advocacy 2 Short Nation FMoH, NCDC FMoH, NCDC Number of Advocacy to state visits term -wide advocacy governments visits done to establish community-based insurance schemes

Federal Ministries of Agriculture, Environment and Health; September 2017 81 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 4.2.1 Update and promote use of treatment guidelines and ensure prudent use in humans and animals Activity 4.2.1.1 Update and disseminate of STGs for treatment of animals to human and animal health workers 4.2.1.1.1: Update Disseminated 1 Mediun Nation FMARD, NCDC FMARD, Donor Updated and disseminate Animal term -wide agencies and Animal guidelines for treatment development treatment treatment of guidelines partners guidelines animals to animal available at health workers at facility levels facility level 4.2.1.1.2 Update Disseminated 1 Short Nation FMoH, NCDC FMoH STGs available and disseminate STG term -wide Donor at facility guidelines for document agencies and levels treatment of development humans to health partners workers at facility level STRATEGIC INTERVENTION 4.2.2 Promote optimal prescribing and dispensing of antimicrobials in humans and animals Activity 4.2.2.1 Promote evidence based prescription of antimicrobials by health workers after appropriate laboratory investigations 4.2.2.1.1: Training Training 2 Medium Nation FMoH, FMARD, FMoH Trained health and retraining Term -wide NCDC and animal of human and workers animal HCW on RDU Activity 4.2.2.2 Restrict non-therapeutic use of antimicrobials in animals (as growth promoters or as feed additives) according to OIE, FAO/CODEX guidelines 4.2.2.2.1: Compliance 2 Medium Natio FMARD, NCDC FMARD Proportion of Enforcement term -wide animal feed OIE, FAO/CODEX producers in guidelines on compliance non-therapeutic use of antimicrobials in animals

82 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 4.2.2.2 Cont’d Activity 4.2.2.3 monitoring and supervision of drug dispensers to encourage compliance with restriction on OTC sale of antimicrobials 4.2.2.3.1: Support Supervisory Medium Nation PCN, VCN, FMoH, FMARD Number of PCN, VCN and visits term -wide NAFDAC supervisory NAFDAC to carry visits monitoring and supervisory visits to drug dispensing outlets Activity 4.2.2.4 Institutionalize antimicrobial stewardship in human and animals sector

4.2.2.4.1: define TOR 1 Short Nation AMR Secretariat FMoH, Donor TOR available terms of reference term -wide (TWG) agencies and for the committee development partners 4.2.2.4.2: Working 1 Short Nation AMR Secretariat FMoH Manual Develop and manual term -wide developed disseminate and antimicrobial disseminated stewardship working manuals/ guidelines for hospitals and community AMS 4.2.2.4.3: Advocacy 3 Federal- Nation FMoH, NCDC FMoH Number of Advocate for visits short -wide advocacy creation of term visits hospital and community committees at different levels 4.2.2.4.4: Begin Meeting of Medium Nation wide FMARD Meeting a National Veterinary term Reports discussion on Professions Veterinary AMS and relevant government agencies

Federal Ministries of Agriculture, Environment and Health; September 2017 83 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 4.3.1 Strengthen the capacity of regulatory agencies across one health sectors Activity 4.3.1.1 Support registration of all antimicrobial agents 4.3.1.1.1: Training Training 1 Medium Lagos NAFDAC FMoH, Decrease in regulators on and tool term NAFDAC number of evaluation of development donor and unregistered dossier development antimicrobial partners medicines in circulation 4.3.1.1.2: Facilitate Electronic 1 Medium Lagos NAFDAC FMoH, Availability of electronic drug registration term NAFDAC e-registration registration process process donor and on system development partners Activity 4.3.1.2. Conduct post-marketing surveillance on antimicrobials

4.3.1.2.1 Advocate PVCs 1 Short Nation FMoH FMoH Number of for creation of term -wide advocacy Pharmacovigillance visits committees (PVCs) where they don’t exist and support proper functioning of existing ones 4.3.1.2.2: Training 1 Short Nation FMoH FMARD Meeting Training HCPs on term -wide Reports reporting of ADRs, medication errors, lack of efficacy etc 4.3.1.2.3: Training Training 1 Medium Nation NAFDAC FMoH, Number on risk based term -wide NAFDAC of people surveillance trained

4.3.1.2.4; Develop Surveillance 1 Medium Nation NAFDAC FMoH, Number of surveillance term -wide NAFDAC surveillance protocols and activities conduct periodic carried out surveillance

84 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 4.3.1 Cont’d Activity 4.3.1.3 Conduct OIE PVS follow up mission 4.3.1.3.1: Conduct Conduct 1 Medium Nation FMARD FMARD Report of the OIE PVS follow up follow up term -wide follow up mission mission mission

Activity 4.3.1.4 Implement recommendations from PVS follow up mission about AMR in veterinary services 4.3.1.4.1: Circulation 1 Medium Nation FMARD FMARD Report Circulation of of reports Term -wide circulated report to relevant stakeholders

4.3.1.4.2: Convene Convene 1 Long Nation FMARD FMARD Meeting round table meeting Term -wide convened meetings of partners

4.3.1.4.3 Advocacy Advocacy 1 Long Nation FMARD FMARD Advocacy for implementation Term -wide carried out

Activity 4.3.1.5 Develop regulations for AMR from the animal disease control and veterinary surgeon acts 4.3.1.5.1: Produce Regulatory 1 Medium Nation FMARD FMARD Regulations and circulate document Term -wide produced and document on circulated regulation STRATEGIC INTERVENTION 4.3.2 Enhance inter-sectoral coordination and collaboration between/amongst regulatory agencies Activity 4.3.2.1 Establish a one-health committee among regulators 4.3.2.1.1: Develop TOR and 2 Short Abuja FMoH, FMARD, FMoH TOR developed TOR and constitute committee term FMEnv and committee committee constituted

Federal Ministries of Agriculture, Environment and Health; September 2017 85 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 5.1.1. Assess available AMR funding mechanisms Activity 5.1.1.1 To assess available AMR funding mechanisms and create a database for storing information 5.1.1.1.1: Conduct Desk 1 July- Abuja NCDC FMoH NCDC FMoH Database an assessment reviews September FMARD FMEnv FMARD on possible on current and Interviews 2017 FMEnv funding sources potential AMR research funding within Nigeria, international, and various institutions 5.1.1.1.2: Create Purchase 1 October AMR NCDC FMoH NCDC FMoH Website a database/ and or -December Secretariat FMARD FMEnv FMARD established network of build 2017 FMEnv with database information on servers access AMR funding STRATEGIC INTERVENTION 5.1.2. Conduct needs assessment and priority framework for AMR funding Activity 5.1.2.1 Develop a priority framework for assessing AMR project funding. 5.1.2.1.1: Needs High level 2 Every 2 Abuja NCDC NCDC Priority assessment for experts years Partners, framework/ AMR funding meeting MDAs, Road map Development developed agencies, academia, research agencies

86 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 5.1.3. Promote the use of innovative investment channels for AMR research funding Activity 5.1.3.1 To promote the use of innovative investment channels for AMR research funding 5.1.3.1.1: Advocacy Several Ongoing Abuja NCDC FMARD NCDC Government Promote the use to the FMEnv FMARD commitment of government government FMEnv obtained incentives such as tax holidays, patent extension, custom waiver for companies importing raw materials for development of drugs and vaccines 5.1.3.1.2: Explore AMR 2 Medium Lagos, NCDC, Ministry NCDC, Potential the use of private Investment term Abuja of Trade and FMoH, investors equity firms to forum Investment FMARD, identified fund research and FMoEdnv, development in Donor AMR agencies and development partners 5.1.3.1.3: Look Advocacy Several Ongoing Nation NCDC FMARD NCDC FMoH Support in to possible visits, letters -wide FMEnv FMARD obtained contributions and FMEnv cost sharing from telecommunication companies, financial institutions, pharmaceuticals, media, vertical programmes

Federal Ministries of Agriculture, Environment and Health; September 2017 87 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 5.1.3. Cont’d Activity 5.1.3.1 Cont’d 5.1.3.1.4: Call for 1 Medium Abuja NCDC NCDC, Fund Involve private interest to term FMoH, managers organisations manage FMARD, identified and institutions pooled AMR FMoEd, in managing funds Donor government agencies and AMR research development funds partners STRATEGIC INTERVENTION 5.2.1 Support AMR researches at universities and relevant research institutes Activity 5.2.1.1. Inform and or provide grant opportunities to students and researchers

5.2.1.1.1: Advertise Several Medium Abuja NCDC Association, Publications Promote funding term NGOs, and products information opportunities, private sharing call for organisations on AMR research research to proposals, students and innovation researchers challenges in human, animal and environmental health departments 5.2.1.1.2: Encourage Ongoing Ongoing Nation NCDC NUC NCDC Inter Encourage institutions to -wide FMoEd Donor -disciplinary collaboration collaborate agencies and research between on AMR development institutions research partners and across researchers within the one health system

88 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 5.3.1 Encourage research on and development of alternatives to antibiotics Activity 5.3.1.1 Promote the production and use of alternatives that will reduce the use of antimicrobial in humans, aquatic and terrestrial animals

5.3.1.1.1: Create Several Ongoing Nation NCDC, FMARD NCDC New alternatives Encourage awareness -wide Donor adopted funding and agencies and of basic advocacy development research on on the partners the use of implication alternative to antimicrobials 5.3.1.1.2: Advocacy Ongoing Nation NCDC NOTAP, Commercial Partner with to identified Several -wide Ministry of patented relevant organisations Trade and diagnostics and organisations Investment, pharmaceuticals to support Bank of patenting and Industry, commerciali PMGMAN, -zation Donor agencies and development partners

Federal Ministries of Agriculture, Environment and Health; September 2017 89 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source Indicator activity line -tion entity of Funding STRATEGIC INTERVENTION 5.3.1 Cont’d Activity 5.3.1.2. Promote the research and production of vaccines for diseases in humans, aquatic and terrestrial animals

5.3.1.2.1: Identify and ‘twin’ Continuous Long NCDC NCDC, Vaccine Promote local laboratories term FMoH, production in the with foreign Donor Nigeria production laboratories to agencies and of vaccines support local development for production of partners diseases in human vaccines humans Support the development of existing physical infrastructure and Partner with institutions to train scientists in Federal vaccine production lab Yaba and/ or NIMR on vaccine production, use exchange programmes 5.3.1.2.2: Support the Continuous Long Jos NCDC FMARD FMARD, Vaccine Expand expansion of term FMEnv Donor production in capacity existing physical agencies and Nigeria for local infrastructure development vaccine Partner with partners production institutions to in animals train scientists in NVRI on vaccine production, use exchange programmes

90 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding STRATEGIC INTERVENTION 5.4.1. To invest in advanced diagnostic and pharmaceutical techniques for AMR research and development Activity 5.4.1.1. Invest in antibiotic supply chain innovations 5.4.1.1.1: Solicit Short to Abuja NCDC FMoH Donor agencies Funding Develop funding for medium FMARD FMEnv and development obtained, the use of innovative term partners innovation technology tracking prototypes/ in tracking solutions models antibiotic sales to end users in the drug distribution system 5.3.1.2.2: Support the Continuous Long Jos NCDC FMARD FMARD, Donor Vaccine Expand expansion term FMEnv agencies and production in capacity for of existing development Nigeria local vaccine physical partners production in infrastructure animals Partner with institutions to train scientists in NVRI on vaccine production, use exchange programmes Activity 5.4.1.2. Support the development of novel antibiotics and innovative diagnostics 5.4.1.2.1: Partner with Continuous Long Abuja NCDC Pharmaceuticals, New drugs Encourage pharma term Donor agencies produced the -ceuticals, and development and approved development seek partners for human of antibiotics collaboration consumption with novel with mechanisms agencies of action focused on drug development

Federal Ministries of Agriculture, Environment and Health; September 2017 91 National Action Plan for Antimicrobial Resistance, 2017-2022

Sub- Unit QTY Time Loca Responsible Source of Indicator activity line -tion entity Funding Activity 5.4.1.3. Invest in genome sequencing of bacterial isolates 5.4.1.3.1: Identify and Several Medium Abuja NCDC FMARD Donor Increased Encourage partner with to Long FMEnv agencies and utilization the use organisations term development of genome of gene (e.g APIN, partners sequencing sequencing IHVN) with techniques in existing identifying genome AMR sequencing mechanisms infrastructure, acquire machines, build capacity and store genomes in world gene bank 5.4.1.3.2: Solicit for 1 Long term Abuja NCDC Lab NCDC Donor Gene bank Invest in funding and agencies and established establishing technical development an expertise from partners integrated partners/ national experts in gene bank gene banking for storage

92 5 Monitoring and Evaluation

The AMR status of the population must be monitored regularly to enable a better understanding of the scope of the problem throughout the country as well as to measure any progress made in addressing it. Such monitoring requires the collection, collation, analysis and management of data from the Human and Animal Health, as well as Food, Agriculture and Environment sectors. Programmes and projects with strong Monitoring and Evaluation (M&E) components tend to stay on track. The role of M&E will be to provide a strategic link with the relevant stakeholders to ensure that strategies are dynamic and more effective in responding to the antimicrobial resistance challenges in the country. Additionally, it enables problems to be detected earlier, thereby reducing the likelihood of major cost overruns or time delays.

A Monitoring and Evaluation system therefore needs to be in place pre- implementation, to ensure that results are reported in a timely and efficient manner. In addition, such a system supports the establishment of transparent feedback loops with implementing agencies, stakeholders and the public. Monitoring and evaluation helps in extracting relevant information from ongoing activities to be used for programmematic fine-tuning, reorientation and future planning. Without an effective M&E structure, it would be impossible to evaluate if activities are executed as planned and outcomes achieved as anticipated, as well as derive learning on how to improve future activities.

Federal Ministries of Agriculture, Environment and Health; September 2017 93

Objectives Indicators Baseline Short term Mid term Long term Data Value Year 2017-2018 2019-2020 2021-2022 Source and frequency Objective 1: Functional NBCCCG NA YES Meeting Increase established at the reports awareness, National level knowledge and behavioral Baseline survey NA 2018 YES change on AMR conducted in 36 States and related and FCT topics among AMR communication - YES Nigerian advocacy kit developed

Proportion of school NA 2018 50% curricula (primary, secondary and tertiary) that are reviewed to include AMR

Proportion of health- NA 2018 70% related national professional bodies that included AMR as part of CME in Nigeria

Objective 2: Functional national 0 2017 YES Set up a Committee for AMR AMR national surveillance across surveillance human and animal system, health established strengthen institutional Number of laboratories 0 2017 8 22-40 45-50 capacities for participating in EQA early AMR and reporting regularly detection and to GLASS surveillance Number of veterinary 0 2017 1 2 3 activities across public health laboratories sectors conduct antimicrobial susceptibility testing for key isolates National Action Plan for Antimicrobial Resistance, 2017-2022

Monitoring and Evaluation Framework cont’d

Objectives Indicators Baseline Short term Mid term Long term Data Value Year 2017-2018 2019-2020 2021-2022 Source and frequency Objective 3: IPC Baseline survey - 2018 Strengthen conducted, and report infection submitted to the Public prevention Health department in and control Federal Ministry of programme in Health human, animal health and National policy on IPC is - YES - environment and reviewed and approved promote the use by NCH of vaccines Number of IPC policy NA 2018 70% printed and disseminated to 36 states MOH

Proportion of health - 70% facility with functional IPC committees in 36 states

Objective 4: Proportion of states - 80% Improve access meeting 80% to quality immunization and antimicrobial reactive vaccination agents for coverage infections, promote National standard - YES antimicrobial treatment guideline stewardship and National drug and strengthen policy reviewed and regulatory disseminated agencies across Proportion of animal - 50% all sectors feed producers in compliance with OIE, FAO/CODEX guidelines on non-therapeutic use of antimicrobials in animals in 36 states

96 National Action Plan for Antimicrobial Resistance, 2017-2022

Monitoring and Evaluation Framework cont’d

Objectives Indicators Baseline Short term Mid term Long term Data Value Year 2017-2018 2019-2020 2021-2022 Source and frequency Objective 4: List of registered NA 2018 YES YES cont’d antimicrobials approved for use in the country are reviewed every two years Objective 5: Number and types of 1 4 Invest in vaccines manufactured advanced AMR for humans techniques and promote the use Percentage of 25% 50% of innovative grant opportunities investment disseminated to channels institutions Percentage of students 50% or grantees with access to AMR research opportunities

Federal Ministries of Agriculture, Environment and Health; September 2017 97 R References

1. World Bank: Nigeria: Population [Internet]. Databank. 2016 [cited 2017 Jan 31]. Available from: http://data.worldbank.org/indicator/SP.POP. TOTL?locations=NG&view=chart

2. Kombe G, Fleisher L, Kariisa E, Arur A, Sanjana P, Paina L, et al.: Nigeria Health System Assessment 2008. In 2009. p. 1–135.

3. Nigeria National Population Commission, ICF International: Nigeria Demographic and Health Survey. 2013.

4. United Nations: World Population, Ageing [Internet]. 2015. Available from: http://www.un.org/en/development/desa/population/publications/ pdf/ageing/WPA2015_Report.pdf%5Cnwww.un.org/.../population/.../ WPA2009/WPA2009

5. World Bank: Nigeria: Adult Literacy Rate [Internet]. Databank. 2016. Available from: http://data.worldbank.org/indicator/SE.ADT.LITR. ZS?locations=NG

6. National Bureau of Statistics: Statistical Report on Women and Men in Nigeria. 2014.

7. World Bank: Nigeria: Gross Domestic Product [Internet]. Databank. 2016 [cited 2017 Feb 14]. Available from: http://data.worldbank.org/indicator/ NY.GDP.MKTP.CD?locations=NG

8. National Bureau of Statistics: Nigerian Gross Domestic Product Report: Quarter One [Internet]. 2016. Available from: http://www.nigerianstat.gov. ng/nanapages/download/329

9. World Bank: Nigeria: Poverty Gap At National Poverty Lines [Internet]. Databank. 2016 [cited 2017 Feb 14]. Available from: http://data. worldbank.org/indicator/SI.POV.NAGP?locations=NG 98 National Action Plan for Antimicrobial Resistance, 2017-2022

10. Federal Ministry of Health. National Strategic Health Development Plan (NSHDP) 2010-2015. 2010.

11. Labiran A, Mafe M, Onajole B, Lambo E.: Health Workforce Country Profile for Nigeria [Internet]. First. Africa Health Workforce Observatory. 2008. Available from: http://scholar.google.com/scholar?hl=en&btnG=Search&q =intitle:HEALTH+WORKFORCE+COUNTRY+PROFILE+FOR+NIGERIA#0

12. Nigeria Centre for Disease Control: Situation Analysis and Reccommendations: Antimicrobial Use and Resistance in Nigeria. 2017.

13. Hogerzeil HV, Bimo, Ross-Degnan D, Laing RO, Ofori-Adjei D, Santoso B, et al.: Field Tests For Rational Drug Use In Twelve Developing Countries. Lancet. 1993;342(8884):1408–10

Federal Ministries of Agriculture, Environment and Health; September 2017 99 C Contributors

Name DESIGNATION/Organisation Chikwe Ihekweazu CEO, Nigeria Centre for Disease Control, Abuja Coordinators Aaron Oladipo Aboderin Department of Medical Microbiology and Parasitology, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Osun Adebola Tolulope Department of Medical Microbiology, Ahmadu Bello University Teaching Olayinka Hospital, Zaria, Kaduna/AFENET Nigeria, Haile Selassie, Asokoro, Abuja Iruka N. Okeke Global Antibiotic Resistance Partnership (GARP) Nigeria Co-chair and Professor and MRC/DfID African Research Leader Department of Pharmaceutical Microbiology Faculty of Pharmacy University of Ibadan, Ibadan, Oyo State Obasanya Joshua Director Prevention and Programmes Coordination, Nigeria Centre for Disease Control, Abuja Contributors Abiodun Egwuenu Epidemiologist, Nigeria Centre for Disease Control, Abuja Adedeji Adebayo Director Laboratory Services, Nigeria Centre for Disease Control, Abuja Aderinola Olaolu Moses Assistant Director/PMOII, Nigeria Centre for Disease Control, Abuja Adeyemi Temitayo Department of Medical Microbiology and Parasitology, Obafemi Awolowo Adeyemo University Teaching Hospitals Complex, Ile Ife, Osun State, Nigeria Ahmad T. Aliyu Institute of Human Virology, Nigeria (IHVN) Director/Head, Monitoring and Evaluation Aizobu Mojisola Pharmacists Council of Nigeria (PCN) Akinbiyi Olugbenga Head/ HIV Drug Resistance Monitoring National HIV AIDS Control Akinyemi Programme, Federal Ministry of Health Alexander Ray Jambalang Principal Veterinary Research Officer, National Veterinary Research Institute Vom Aghogho Gbetsere Federal Ministry of Environment, Abuja Aliyu Suleiman World Health Organisation, Nigeria

100 National Action Plan for Antimicrobial Resistance, 2017-2022

Name DESIGNATION/Organisation Aremu Abdullahi Agaka National Environmental Standards and Regulatory Enforcement Agency (NESREA) Aroyewun Eunice Severe Typhoid in Africa (Medical Microbiology Department, College of Medicine, University College Hospital, Ibadan Babalola Jacob Olalekan Federal Department of Fisheries, Federal Ministry of Agriculture and Rural Development, Area 11, Garki, Abuja Babatunde Salako DG/ Chief Executive Officer, Nigerian Institute of Medical Research (NIMR) ‘Biodun Ogunniyi Consultant Epidemiologist, Nigeria Centre for Disease Control, Abuja Celestine O. Okanya Chief Executive Officer, Nigeria National Accreditation Service (NiNAS) Charles Emejuru AFENET Nigeria, Haile Selassie, Asokoro, Abuja Chibuzor Eneh Assistant Director, Emergency Preparedness and Response, Nigeria Centre for Disease Control Chinazo Eddie Brown Medical Officer, National Tuberculosis and Leprosy Control Programme (NTBLCP) Chinelo Egwu, MBBS University of Maryland Maryland Global Initiative Cooperation, Nigeria Comfort Kunak Ogar Assistant Director. Pharmacovigilance and Post Marketing Surveillance (PV/ PMS) Directorate, National Agency for Food and Drug Administration and Control (NAFDAC) David Olusoga Ogbolu Department of Biomedical Science, College of Health Sciences, Ladoke Akintola University of Technology, Ogbomoso (Medical Laboratory Science Council of Nigeria) Diane Ashiru Oredope, Lead Pharmacist, AMR Programme Public Health England Adviser, FFRPS PhD Commonwealth Pharmacists Association, Honorary Lecturer UCL School of Pharmacy Dooshima Kwange Disease Surveillance and Reporting, Epidemiology Division, Federal Department of Veterinary and Pest Control Services, Federal Ministry of Agriculture and Rural Development, Nigeria Dorothy Nkiruka Oreh Nursing and Midwifery Council of Nigeria Easter G. Nwokah Lecturer and Medical Microbiologist, Rivers State University (Medical Laboratory Science Council of Nigeria) Ekpo Stella Effiong Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan Fatima Abba Pharmacist, Nigeria Centre for Disease Control Abuja Federal Ministries of Agriculture, Environment and Health; September 2017 101 National Action Plan for Antimicrobial Resistance, 2017-2022

Name DESIGNATION/Organisation Fayemiwo, Samuel Senior Lecturer / Consultant Clinical Microbiologist, University of Ibadan / Adetona University College Hospital, Ibadan Folasade Olufunke Lawal, Immediate Past Chairman, Drug Information Center, Association of FPSN, ARPharmS Community Pharmacists of Nigeria (ACPN) Frank S. Kudla Federal Ministry of Environment, Abuja G.A.T Ogundipe Veterinary Council of Nigeria Gbolahanmi Akinola Fish Medicine Unit, Department of Veterinary Medicine, University of Oladosu Ibadan, Ibadan, Nigeria Hamzat Omotayo World Health Organisation, Nigeria Helen Adamu, DVM MPH Center for Clinical Care and Clinical Research Nigeria Hellen Gelband Associate Director, Centre for Disease Dynamics Economics & Policy, (CDDEP) Washington DC, USA Idowu Abeni Oduh Federal Ministry of Agriculture and Rural Development, Abuja Irek Emmanuel O. Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Osun State Isiramen Olajide, MPH Center for Clinical Care and Clinical Research Nigeria Iwakun Mosunmola Institute of Human Virology, Abuja J. A. Onaolapo Pharmaceutical Microbiology Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Kaduna Joseph Gbenga Chief Pharmacist, Nigeria Centre for Disease Control, Abuja Josiah T. Kantiyok Ag. Registrar, Veterinary Council of Nigeria Junaidu Kabir Department of Veterinary Public Health and Preventive Medicine, Ahmadu Bello University, Zaria, Kaduna State, Nigeria Kenneth C. Iregbu Chief Consultant/ Head of Medical Microbiology & Parasitology Department, National Hospital Abuja Kola Jinadu Consultant Public Health Physician/Epidemiologist, Nigeria Centre for Disease Control, Abuja Ladidi K. Bako Aiyegbusi Deputy Director, Health Promotion Division, Federal Ministry of Health, Abuja Mabel Aworh Ajumobi Assistant Director (Veterinary Drugs Monitoring), Department of Veterinary & Pest Control Services, Federal Ministry of Agriculture & Rural Development, Area 11, Garki, Abuja 102 National Action Plan for Antimicrobial Resistance, 2017-2022

Name DESIGNATION/Organisation Mercy Niyang, MPH Maryland Global Initiative Cooperation, Nigeria University of Maryland M.S. Salifu Principal Medical Officer II, Federal Ministry of Health, Abuja Mohammed Yahaya Lecturer/Honorary Consultant Clinical Microbiologist, Department of Medical Microbiology, College of Health Sciences, Usmanu Danfodiyo University/Usmanu Danfodiyo University Teaching Hospital, Sokoto Molly Miller Petrie Research Associate, Centre for Disease Dynamics Economics & Policy, Washington DC (CDDEP) Obadare Temitope Department of Medical Microbiology and Parasitology, Obafemi Awolowo Oyewole University Teaching Hospitals Complex, Ile Ife, Nigeria Obi Peter Adigwe Executive Secretary, Pharmaceutical Manufacturers Group of Manufacturers association of Nigeria (PMG MAN) Ogunleye V. O. Deputy Director, Medical laboratory scientist, Dept of Medical Microbiology and Parasitology, UCH, Ibadan Ogunnoiki G.A. Assistant Director/ Principal Veterinary Office, Federal Department of Modupeola Fisheries FMAR&D, Lagos Ojewuyi Abiodun Ronke Department of Medical Microbiology and Parasitology, Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Osun Okwuokenye Henry Medical and Dental Council of Nigeria (MDCN) Oladosu Gbolahan University of Ibadan, Oyo State Olawale Olufemi Adelowo Department of Microbiology, University of Ibadan, Ibadan, Nigeria Olayinka Habib Raji, Research Associate, Severe Typhoid in Africa (SETA Nigeria) Department of B. Ed, MPh Medical Microbiology and Parasitology, College of Medicine, University of Ibadan. Olufemi I. Olatoye Senior Lecturer, Food Safety Unit, Department of Veterinary Public Health and Preventive Medicine Oluwatoyin B. Karimu Chief Pharmacist, Food and Drugs Services Department, Federal Ministry of Health, Abuja Omoniyei Tarelayefa Love Global Antibiotics Resistance Partnership (GARP) Country Assistant, Ducit Blue Solutions, Abuja Onyekachi Estelle Global Antibiotic Resistance Partnership (GARP) Country Coordinator and Mbadiwe Business Director, Ducit Blue Solutions, Abuja Oyama Enang Enang World Health Organisation, Nigeria

Federal Ministries of Agriculture, Environment and Health; September 2017 103 National Action Plan for Antimicrobial Resistance, 2017-2022

Name DESIGNATION/Organisation Oyekola Victor Abiri Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Osun Oyeniyi Stephen Bejide Severe Typhoid in Africa (SETA) Nigeria, University College Hospital, Ibadan Peters O. Oladosu National Institute for Pharmaceutical Research and Development, Abuja Philippe Chebu APIN Public Health Initiatives Sambo Bello Zailani University of Maiduguri, Department of Medical Microbiology, Maiduguri, Borno Samuel E. O. Peters Director, Clinical Laboratory Services, Institute of Human Virology, Nigeria Shamsudin Aliyu Department of Medical Microbiology, Ahmadu Bello University, Zaria Shittu Adebayo Osagie Associate Professor, Department of Microbiology, Obafemi Awolowo University, Ile Ife, Osun Steve Felix Uduh National Primary Healthcare Development Agency (NPHCDA) Global Health Fellow, eHealth Africa Tochi Joy Okwor Consultant Public/Occupational Health Physician and IPC Specialist, NICA Ukpoju Sam Adam Federal Ministry of Agriculture and Rural Development, Abuja Vivian Maduekeh Food Health Systems Advisory Limited Editor Sola Aruna Regional Centres for Disease Control, Nigeria

104 NOTES NOTES

NIGERIA CENTRE FOR DISEASE CONTROL

Nigeria’s National AMR Coordinating Body: Nigeria Centre for Disease Control (NCDC) Plot 801 Ebitu Ukiwe Street, Jabi Abuja,Nigeria 0800-970000-10 (Toll Free Call Centre) [email protected] c www.facebook.com/nigeria.ncdcgov d @ncdcgov www https://www.ncdc.gov.ng