The Bill & Melinda Gates Foundation has highlighted critical challenges in Nigeria's flagship REACH program aimed at reducing child mortality, citing delays in drug authorization and concerns about antimicrobial resistance.
The Acting Director of the Foundation’s National Office in Nigeria, Uche Amaonwu, disclosed this on Tuesday at the REACH 2024 Network Annual Regional Meeting in Abuja, Federal Capital Territory (FCT) of Nigeria.
The REACH (Resilience through Azithromycin in Children) initiative is a major public health intervention across sub-Saharan Africa, leveraging biannual doses of azithromycin to reduce infant and under-five mortality in high-risk areas.
However, the Foundation said logistical obstacles threaten to hamper the program's effectiveness.
“Logistics issues, such as delays in the supply and authorization of medicines, have presented obstacles along the way. But each challenge has also been an opportunity to innovate and improve. We would appreciate the coordinating minister prioritizing obtaining the necessary approvals to authorize donated azithromycin for the duration of the programme,” Amaonwu said.
He urged Nigeria's Coordinating Minister for Health and Welfare, Muhammad Pate, to expedite the necessary approvals to authorize donated azithromycin shipments.
In addition to logistical setbacks, the Gates Foundation highlighted the critical need for ongoing monitoring of antimicrobial resistance (AMR).
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As the use of azithromycin increases, there is concern about potential resistance that could compromise the long-term benefits of mass drug administration (MDA).
“Antimicrobial resistance surveillance is integrated into the SARMAAN project and remains a top priority,” said Mr. Amaonwu, referring to the Antimicrobial Safety and Resistance initiative of mass administration of azithromycin in Nigeria, which aims It is balancing life-saving interventions with public health risks.
Achievements amidst challenges
Despite these challenges, he said the REACH program has marked notable progress.
Since its inception, Nigeria has administered more than 1.3 million doses of azithromycin to children between one and 11 months of age in six states (Abia, Akwa Ibom, Jigawa, Kano, Kebbi and Sokoto), achieving a coverage rate of 97 percent.
This success, he said, highlights the viability of large-scale MDA efforts in Nigeria's complex health landscape, and Amaonwu attributed this achievement to local partnerships and integration with existing health programs such as polio eradication. and seasonal malaria chemoprevention.
According to him, the second phase of the programme, SARMAAN II, which started in April, has reached almost 1.2 million children in other states including Adamawa, Gombe, Kaduna and Katsina.
The project is expected to run until 2027, further strengthening Nigeria's efforts to reduce child mortality.
Support calls
Amaonwu emphasized the need for continued collaboration and government support to maintain the momentum.
“While we have made significant progress, sustaining these efforts is paramount,” he said, calling on Nigerian health authorities to prioritize the rapid authorization of donated medicines and commit to further research on antimicrobial resistance to address potential threats of resistance.
As sub-Saharan Africa continues to face high rates of child mortality, the Gates Foundation reiterated its commitment to the REACH initiative, urging stakeholders to collaborate to overcome challenges and ensure every child has the opportunity for a healthy life.