Niger: Country Profile
The republic of Niger is a West African country with a population of 25 million people. A substantial part of the rural economy concerns livestock and other agriculture. The Global Health Security Agenda (GHSA) is a multilateral effort to help countries including Niger better prevent, detect, and respond to the threats of emerging epidemics and diseases. The government of Niger, recognizing the importance of preventing zoonotic disease transmission, informally identified five priority zoonotic diseases for intervention: 1) brucellosis, 2) Rift Valley fever, 3) anthrax, 4) rabies, and 5) avian influenza. The One Health approach has made progress in recent years in Niger with the creation of the One Health Committee with a roadmap and efforts to improve multi-sectoral collaboration on risk communication.
Priority Zoonotic Diseases
Rift Valley Fever, Avian influenza, anthrax, brucellosis, and rabies were selected as priorities in 2021 by Niger’s “One Health” Committee.
Anthrax is a bacterial infection that typically affects animals and can pass from animals and animal products to humans, with limited human-to-human transmission. In endemic settings, anthrax affects primarily cattle, goats, and sheep, and the spores can remain in soil for years. It can spread to humans through open wounds on the skin, ingestion, or inhaling the spores. An outbreak in 2022 among cattle in Niger was concerning for livestock handlers.
Avian influenza is an infection by an influenza virus that can affect almost all species of birds, wild or domestic. It can be highly contagious, especially in chickens and turkeys, and can lead to extremely high mortality in large herds or factory farms. Avian influenza has resurged in Niamey and other locations in Niger in recent years.
Brucellosis is a bacterial infection with a global incidence of about 500,000 cases per year worldwide and a prevalence of more than 10 cases per 100,000 population in some countries.
Humans become infected through contact with sick animals, ingestion of fresh unpasteurized or unboiled milk, or fresh cheese. Brucellosis has a significant impact on the health and productivity of livestock, thus greatly reducing their economic value and work performance.
Rabies remains a widespread disease across the globe, responsible for tens of thousands of deaths worldwide each year. It is a viral infection transmitted by contact with saliva of infected mammals, mainly through bites and scratches and in most places, commonly through dogs. Children are particularly vulnerable to rabies. Rabies is endemic and a reportable disease in Niger.
Rift Valley Fever (RVF) is a viral infection that spreads most commonly to humans from livestock or wild animals via mosquitoes. It can also be spread through direct contact with blood or bodily fluids of animals such as sheep, goats, or camels. RVF can cause spontaneous abortion in animals, and assisting with abortions is a common exposure. Farmers, abattoir workers, and veterinary or laboratory staff are high risk groups. Mosquito control and wearing protective equipment when exposed to blood or bodily fluids of infected animals are the main prevention methods.
One Health Landscape
The stakeholders involved in the management of zoonotic diseases and the One Health platform in terms of government structures are: the Ministry of Public Health, Population and Social Affairs (MSP/P/AS), the Ministry of Livestock and the Ministry of the Environment and the Fight against Desertification. These structures are coordinated by a One Health Committee set up by order of the MSP/P/AS. It is chaired by the Secretary General of the Ministry assisted by two vice-presidents, the Secretary General of the Ministry of Livestock and the Secretary General of the Ministry of the Environment and the Fight against Desertification.
At the level of the Ministry of Health, the technical leadership of the coordination of the One Health platform is the responsibility of the Directorate of Surveillance and Response to Epidemics (DSRE) which intervenes through its response and communication divisions as well as the Health Emergency Operations Center (COUS). The DRSE is supported in this responsibility by the General Directorate of Health Protection. Within the Ministry of Health, leadership in communication and rumor management is provided by the Directorate of Archives, Information, Documentation and Public Relations. The key structures of the Ministry of Livestock involved are the General Directorate of Veterinary Services, the Directorate of Animal Health and the Central Livestock Laboratory (LABOCEL). The key structures of the Ministry of the Environment and the Fight against Desertification that act in the One Health platform include: The Directorate of Wildlife and the Directorate of Water and Forests.
In order to overcome the difficulties of coordination and operation of the One Health Committee, 3 Focal Points have been appointed by decree, one for each ministry. These focal points facilitate sectoral coordination between the 3 ministries of the One Health platform, but also collaboration with the various partners. They implement actions aimed at making the One Health platform operational with the support of the technical departments to which they report. For example, at their initiative, a governance manual for the One Health platform was validated in July 2022 with the financial and technical support of the Breakthrough ACTION and ECTAD FAO GHSA projects. In addition to government structures, there are national NGOs working in the areas of animal and human health, social organizations, the private sector and technical partners.
The key technical and financial partners that are supporting Niger in the fight against zoonoses and the strengthening of the One Health platform include:
- Breakthrough ACTION is supporting Niger through the USAID-funded GHSA project, which aims to support Niger’s progress towards improving the Joint External Assessment scores in the sub-areas of risk communication.
- ECTAD/FAO is implementing a USAID-funded GHSA project that aims to strengthen zoonotic disease control and surveillance capacity through staff training, equipping Veterinary and Laboratory Services to increase the contribution of Niger’s animal health services to the effective prevention and control of infectious diseases and zoonotic diseases.
- The World Health Organization is supporting Niger in protecting the population against emergencies through three priorities for action: (1) Preparing the country for various health emergencies; (2) Preventing epidemics and pandemics as well as other health emergencies; (3) Early detection and rapid response to all health emergencies.
- The REDISSE Project, financed by the World Bank, aims to strengthen the disease surveillance system and improve the management of epidemics and emergency situations. It also provided financial support for the realization of 9 of the 12 steps planned for the development of the risk communication plan.
- Médecins du Monde Belgium and Vétérinaires Sans Frontières Belgium support the strengthening of technical services for human and animal health but also the capacities of communities in the management of health risks related to crises and disasters.
- Davycas provides support to strengthen surveillance and improve sample transport.
- World Organization for Animal Health
Summary of existing Breakthrough ACTION research
Little research has been done in Niger on the drivers or interventions related to the country’s priority zoonotic diseases. In fall 2021, the Breakthrough ACTION team conducted formative, qualitative research to examine in depth the knowledge, perceptions, cultural practices, and other behavioral determinants of zoonotic disease risks at the community level in Niger. Findings are informing community engagement and coordination strategies to prevent and control outbreaks. Data were collected in three sites in Niger and included 183 individuals through focus group discussions, in-depth interviews, and direct observation. The interview guides explored household behaviors and determinants among the general population, professional risk factors and prevention behaviors for livestock breeders, slaughterhouse workers, and veterinarians, as well as the larger One Health environment. The study found a low level of knowledge of zoonotic diseases except for rabies and avian influenza. Economic factors drove behavior, with urgent financial needs outweighing the risk of disease exposure or transmission. Participants had difficulties accessing soap and water and other hygiene products for themselves and their animals. Animal vaccine doses were scarce and veterinary services were perceived as unaffordable. Common risk behaviors included self-medication and eating meat from sick or dead animals. Reporting during outbreaks occurred from community health workers up the administrative chain, with risk communication flowing back through radio, television, and community leaders.
Read more about the individual and sociocultural determinants of risk and prevention behaviors related to the priority zoonotic diseases in Niger in the research report.
Case study on SBC response
Breakthrough ACTION Niger used the formative research study to plan community engagement activities as part of the GHSA project’s 2023 workplan.