Advocates call for domestic control of SARMAAN initiative to reduce infant mortality rates in Nigeria

Nigeria's key health sector stakeholders are urging for a more robust national ownership and coordination of the Safety and Antimicrobial Resistance of Mass Administration of Azithromycin Among Children, or SARMAAN, project, as a means to accelerate child survival interventions in the country.

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This call to action was made during a high-level stakeholder roundtable, which was convened following recommendations from the National Child Health Technical Working Group and the Family Health Department of the Federal Ministry of Health.

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Participants at the meeting underscored the importance of Nigeria taking full leadership of the project to ensure its sustainability and strengthen the country's strategy to reduce preventable child deaths.

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According to Dr. John Ovuoraye, Chair of the SARMAAN II Steering Committee and Director/Head of the Family Health Department at the Federal Ministry of Health, protecting the lives of Nigerian children must remain a national priority.

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Ovuoraye emphasized that "Survival is the most fundamental right of Nigerian children" and stressed the need for collaborative solutions, saying "For the progressive inclusion of SARMAAN II into Nigeria’s Child Survival Action Plan, we must co-create and implement solutions together".

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He also highlighted the importance of focusing discussions on practical outcomes and aligning them with existing government coordination structures, noting that "Research alone cannot translate into policy".

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Ovuoraye further emphasized the need for collective effort, stating "All partners and technical teams must work together, and everyone in this room must ensure we succeed as a country".

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Stakeholders at the meeting agreed that Nigeria must increasingly lead the narrative and drive informed government decision-making on child survival interventions.

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The SARMAAN II project, which is Nigeria's contribution to the regional Resiliency through Azithromycin for Children Network, aims to generate strong national evidence on the effectiveness of Azithromycin Mass Drug Administration in reducing deaths among children aged one to 59 months.

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Prof. Babatunde Salako, Principal Investigator of the project and Director-General of the Nigerian Institute of Medical Research, explained that the initiative is part of a wider African effort to combat high child mortality through evidence-based interventions.

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Salako noted that the programme builds on successful trials in Niger, Tanzania, and Malawi, where similar azithromycin interventions recorded up to a 13.5 percent reduction in child mortality.

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Senior Project Manager Solina Ijeoma Mmirikwe provided an overview of the project's implementation progress, disclosing that the intervention has already reached millions of Nigerian children.

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According to Mmirikwe, more than 13 million unique children have been reached between 2022 and 2024, with 19 rounds of Mass Drug Administration successfully implemented across 10 states.

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The states where the intervention has been implemented include Adamawa, Gombe, Yobe, Bauchi, Kaduna, Kano, Jigawa, Katsina, Kebbi, and Sokoto.

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Mmirikwe also reported that over 1.5 million bottles of azithromycin have been distributed across the participating states, with no serious adverse events recorded so far during implementation.

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Project Lead of the SARMAAN Advocacy Project, Ikechukwu Ofuani, said the advocacy initiative is focused on ensuring government ownership of the intervention and integrating the programme into Nigeria’s Child Survival Action Plan.

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Ofuani added that the advocacy strategy also aims to secure sustainable domestic financing, strengthen policy engagement, and improve public awareness around child survival interventions.

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The advocacy consortium supporting the initiative is led by Policy Vault Africa, with communications support from Saldrey Communications Limited and Big Cabal Media.

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Health experts at the meeting emphasized that strengthening coordination, policy integration, and stakeholder collaboration will be crucial for scaling up interventions capable of significantly reducing preventable child deaths in Nigeria.

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They noted that collective ownership of the SARMAAN project will help ensure that the programme not only generates scientific evidence but also translates into long-term national policy and sustainable child survival strategies.