NIGERIA Roadmap to Achieve RBM Targets September 2009 – December 2010

Country Summary InterventionNeed to 2010Already covered Funded and expected to be distributed before end 2010 Gap LLINs62.9m LLINs: (22.3m from Sept 2009; 40.5m in /HH with 5pers/HH +wastage) 4.4m49.378m9.2m ACTs129,194,824 doses: Sept 2009: 28,175,491; 2010: 101,019,333 (80% coverage) 8.3m94,267,43734,927,387 IRS2,540,843 HHs: 2009: 280,000; 2010: 2,260, , ,000 (2009) 560,000 (2010) 4.24m RDTs59, 202,251 tests: 2009: 29,135,153 tests (30% coverage) 2010: 30,067,098tests 034,353,875m28,848,376 IPTp 18.3m doses Sept-Dec 2009: 2,340, : 16m 18.3m0 Quinine Population at risk: (158.9m in 2010)

Country Summary -2. InterventionNeed to 2010Already covered Funded and expected to be distributed before end 2010 Gap M&E $20.4m (About 10% of Total budget) WBBP = 15.4m GF-R8 = 2.4m WHO = $354, m BCC/IEC $15,768, : 7,940,265; 2010: 7,828,713 1m WBBP: $9m GF R8: $4.8m WHO: $350,000 WBBP: $2m (NIFAA) Human Resources (Capacity Bldg) 10.5m in trainings and TAs (Excluding salaries) WB = 3.0m GF R8 = 4.1m Govt = Salaries of health workers and prog managers at all levels RBM = TAs Others: Service Delivery Population at risk: (158.9m)

LLIN resources available to achieve the 2010 targets FUNDS AVAILABLE (US $) SOURCECOMMENT Mechanism and when AvailableTotal NeedGap 140,000 LLINs 8,300,00 LLINs 3,966,786 LLINs 1,949,763 LLINs 590,000 LLINs 2,782,749 LLINs 1,259,048 LLINs 3,390,609 LLINs 629,533 LLINs FGN/MDG WB 1 WB 2 DFID USAID UNITAID / UNICEF GF R4 GF R8 USAID Campaign 2009 Mop-up ,378, ,533 22,378, , ,717,251 LLINs 17,807,958 LLINs UNITAID/UNICEF GF R8 Campaign May-Jun ,525, ,177,755 LLINsGF R8Campaign Oct-Nov ,177,75518,444,8329,177,755 53,800,775 LLINsTOTAL 53,800,775 (4.4m was distr. in Jun- Aug. 09) 62,978,5309,177,755

LLIN Ordering & Distribution to end 2010 Quantities62.8m Procurement datesVPP July 14, 2009 [WB, UNITAID/UNICEF] Expected deliveryIn country. Oct. 19, 2009 Campaign DateSept 2009; Nov. / Dec 2009; May – Dec 2010 BCCTools and materials; TV/Radio jingles/Talk shows; Drama; Community channels Community mobilizationDemand creation; LLIN hang-up campaign Distribution2 per HHs Mechanisms of distributionStand-alone campaigns Monitoring and evaluationLQAS (Sept 2009); MIS (2010); LLIN Follow-up Survey: USAID (2009, Kano) and SuNMap (2009, Anambra)

Case management (ACTs) ACTs required2009: 37,877,320 doses (30% coverage) 2010: 130,297,982 (100% coverage) Already distributed: 8.3m Procurement schedules (ACTs) Ordered: 2m (GF); 2m (WBBP 1), delivery date: August 2009 Procurement initiated already: 7m (WBBP II) Procurement to be initiated after R8 is signed : 56m Procurement to be initiated in 2010: 8m WBBP II; FGN and States 9.5m; DFID/ SuNMap = 2m; USAID 1.2m; BCC Continuously:  Improve Health seeking behaviour and informed demand for commodities  Early recognition of signs and symptoms and management by COPRs  Community sensitization  Empowerment of CORPs for prompt referral in suspected complicated cases Mechanisms of distributionHF treatments (Public and Private), Community and Home Management (PPMVs and RMMs, CBDs, etc), Drug Efficacy MonitoringSentinel Sites monitoring sites increased from 6 to 14 in : 3 Sites may commence DET in : National DET implementation, planning and training has commenced Monitoring and evaluation2009: Results of NDHS 2008 released, showed 25% and 22% IMR and U5MR reduction respectively 2009: Evaluation of WBBP performance using LQAS in selected States 2009: HF Assessment conducted for WBBP States and 2 non WBBP States 2009: Planning for MIS, Program Performance review commenced

ACTs resources available to achieve the 2010 targets ACT dosesSOURCECOMMENT whenAvailableTotal NeedGap 3,374,509 ACTs 3,250,000 ACTs 2.400,000 ACTs FGN/MDG SFH GF R4 Distributed ,024,509 (early 2009) 37.2m for ,175,491 August ,000 ACTs 9,354,707ACTs 600,000 ACTs GF R4 WB USAID Expected ,804,707 (2009) 28,175,491 August ,370,784 for remaining m ACTs 53.3m ACTs 600,000 ACTs 9.5m 2.0m WB GF R8 USAID MDG DFID Expected ,462,730 (2010) 101,019, ,603 TOTAL103,291,946 (entire ) 94,267,437 (expected so far for Sept ) 138,219,333 ( entire ) 129,194,824 (from Sept ) 34,927,387

Case management (Parasite based diagnosis -1) MicroscopyTotal required: 1000 (2009) Acquired: 14 (Baseline=14 in Sentinel sites) Gap: 986 microscopes Cost USD450 / microscope Procurement schedule: -- Nov 09 (175 by WBBP); -- Procurement commences when R8 grant is signed, 405 in 2009 and 406 in RDTs required2009: 29,135,153 (30% coverage nationwide) NB: Discounting potential 70% coverage in 2009 in 7 WBBP States) 2010: 30,067,098 (30% nationwide) NB: Discounting 60% coverage in 7 WB States Total: 59,202,251 Cost = USD1 / strip Procurement schedules (RDTs) 2009: Procurement initiated already: 7.1m (WBBP II); Procurement to be initiated in 2010: 5.03m (GF); 20.12m WBBPII) Training Policy revised; Tools updated; Tool production is on-going Trained 14 Sentinel Sites Lab. Scientists; User-friendly training manuals are being produced ToT commences in October 2009 Support from: GF R8 and WBBP

Case management (Parasite based diagnosis -2) BCC Continuously:  Health care Worker reorientation on RDTs  Awareness creation for Health Care Seekers on RDTs Mechanisms of distribution Using morbidity data from HFs direct distribution will be to: HF treatments (Public and Private) Under GF R8: Two PRs (NMCP and SFH in 3 Northern and 3 Southern States respectively) WBBP: 4 Northern and 3 Southern States Drug Efficacy Monitoring / Quality Assurance In all Sentinel Sites monitoring sites WHO TDR certified Laboratories will quality assure Monitoring and evaluation Supportive supervision 2009: Evaluation of WBBP performance using LQAS in selected States 2009: HF Assessment conducted for WBBP States and 2 non WBBP States 2009: Planning for MIS, Program Performance review commenced

RDT resources available to achieve the 2010 targets FUNDS AVAILABLE (US $)SOURCECOMMENT

BCC resources available to achieve the 2010 targets FUNDS AVAILABLE (US $) SOURCECOMMENT whenAvailableTotal NeedGap LLINs Campaigns Routine IRS Env. Mgt Case Mgt (jingles) Printing Materials Know the Facts IPT LLINs Campaigns Routine IRS Env. Mgt Case Mgt (Jingles) WB GF R8 WHO AMFm WB (NIFFA) USAID Already covered Expected 2010 $220,400 $72,782 $34,220 $757,789 $72,782 $38,114 $72,782 $1m $4.8m $350,000 $ $2m $350,000 $1,334, (2009) $8,500,

IRS resources available to achieve the 2010 targets FUNDS AVAILABLE (US $)SOURCECOMMENT

Indoor Residual Spraying : Total HHs targeted 8% coverage of Total HHs = 2,540,843 85% of HHs/structures per targeted LGAs; Pyrethroids required Lamdacyhalothrin CS 10%: g/m2 Alphacypermethrine WP10%: g/m2 Bifenthrine 10% WP: g/m2 Carbamate Procurement schedulesProcurement of IRS logistics: Some in 2008; more in Sept Release of funds by WBBP to the IRS Contractors: Dec 2009 DistributionDistribution of IRS logistics to the target districts Implementation of IRS: Sept 2009; March 2010; Sept TrainingTraining of spray personnel – commenced already; March 2010; Sept 2010 (ToTs in collaboration with private sector partners) Implementation of IRS: Sept 2009; March 2010; Sept 2010 BCCAdvocacy and BCC/IEC campaigns: July 2009 – Dec 2010 SprayingSupervision and monitoring including quality assurance: Sept 2009; March 2010; Sept Data management and report writing: Oct 2009; July 2010 Feedback Nov 2009; August 2010; Dec 2010 Monitoring and evaluation (bioassays, insecticide resistance etc) Conduct insecticide susceptibility studies: Sept 2009; March 2010 (Sentinel sites PIs) Baseline entomological and epidemiological studies: July 2009; TA from WHO Reconnaissance and Evaluation, ANVR, etc: (Nov 2009; July 2010; Jan 2011

IPTp resources available to achieve the 2010 targets FUNDS AVAILABLE (US $)SOURCECOMMENT

Intermittent Preventive Therapy : SP doses requiredDistributed 5,353,098 July 2009); Required 2009 = 50% coverage (Gap =2,340,830) Required in 2010 = 100% coverage Total = 23,081,584m; 18.3m (from Sept 2009-Dec 2010) Procurement schedulesAll doses of SPs will be procured by Governments and Partners WBBP II in & States: August 2009; Dec 2009; 2010 Government (MDG and States) in all FMCs and States: April 2010 DFID / SuNMap in selected States: Dec 2009 DistributionLogistics support through WBBP and States, LGAs Implementation through ANC clinics; DOT at public and private health facilities; on a continuous basis TrainingTraining: On-going with GF-R2 Phase II and WBBP; More trgs through in all States with support from GF-R8. It will go on till 2010 BCC  Improve ANC attendance to increase IPT uptake;  Improve Health seeking behaviour and informed demand for commodities  Early recognition of signs and symptoms Monitoring and evaluationHF Assessment done (May / June 2009) Community Survey using LQAS (2009) Program Performance Review (June ) MIS Evaluation (Sept )

Other core interventions to be delivered over the next 17 months HSS issues: –Improving utilization of ANC services –Recruiting and training community health workers –Community systems strengthening GF R8 HSS Component –Strengthen NHMIS GF R8 MAL and HSS Component –Expand HR capacity Recruitment at all levels Secondment TAs from Partners and Private-Publication Partnership –Coordination: ATM task Force, CCM, PRs’ Forum; TWGs, Partners, Bi-Annual Review and Planning ; State Support Teams; State Partners forum; etc

Summary of rate-limiting factors over the next 17 months Gap of 10m LLINs and key operational issues (costs, taxes and tariffs) to achieve SUFI including shortage in operational costs Sub-optimal capacity at sub-national levels Under utilization of commodities (Nets) Surveillance, M&E: delay and under- reporting

Summary of technical assistance needs to end 2010 NeedFrom whom Capacity building for program managers on CM, LLIN, IRS, MIP, M&E and PM WHO, UNICEF, WB, AMP, JHIPIEGO, Financial Management supportKPMG, GF, Partnership / CoordinationRBM-HWG, All Partners Program performance reviewWHO, CDC, Malaria Indicator Survey (MIS)WHO, UNICEF, MEASURES, MERG, WB, GF Drug Efficacy TrialWHO, WAMNAT, WB, GF, Consortium of RBM Experts in Research / Academia, NAFDAC, Capacity building for program managers on IRS,WHO, IRS Partners e.g. Capacity building on Pharmaco-vigillanceWHO, MSH, CF Capacity building on PSMMSH, USAID Deliver, WHO,

STATERegionJan-09Feb-09Mar-09Apr-09May-09Jun-09Jul-09Aug-09Sep-09Oct-09Nov-09Dec-09 7BenueNC 1515FCTNC 2323KogiNC 2424KwaraNC 2626NasarawaNC 2727NigerNC 1,746, PlateauNC 2AdamawaNE 1,380,718 5BauchiNE 2,067,946 8BornoNE GombeNE 1,034, TarabaNE 3636YobeNE 1818JigawaNW 1,895, KadunaNW 2020Kano NW 4,137, KatsinaNW 2KebbiNW 3434SokotoNW 1,615, ZamfaraNW 1AbiaSE 4AnambraSE 1,784,523 1EbonyiSE 1414EnuguSE 1717ImoSE 3Akwa IbomSS 1,733,527 6BayelsaSS 9Cross RiverSS 1010DeltaSS 1212EdoSS 3RiversSS 2,293, EkitiSW 1,045, LagosSW 2828OgunSW 1,643, OndoSW 3030OsunSW 3131OyoSW TotalTotal Total Nets 5,921,988 10,069,717 6,387,262 16,456,979

STATERegionJan-10Feb-10Mar-10Apr-10May-10Jun-10Jul-10Aug-10Sep-10Oct-10Nov-10Dec-10 7BenueNC 1,956,504 15FCTNC 657,956 23KogiNC 1,520,266 24KwaraNC 1,099,497 26NasarawaNC 864,019 27NigerNC 32PlateauNC 1,452,658 2AdamawaNE 5BauchiNE 8BornoNE 1,962,617 16GombeNE 35TarabaNE 1,061,704 36YobeNE 1,102,929 18JigawaNW 19KadunaNW 2,731,188 20KanoNW 21KatsinaNW 2,686,074 22KebbiNW 1,463,712 34SokotoNW 37ZamfaraNW 1,526,355 1AbiaSE 1,295,126 4AnambraSE 11EbonyiSE 998,126 14EnuguSE 1,510,440 17ImoSE 1,842,435 3Akwa IbomSS 6BayelsaSS 786,037 9Cross RiverSS 10DeltaSS 1,918,986 12EdoSS 1,470,764 33RiversSS 13EkitiSW 25LagosSW 4,220,400 28OgunSW 29OndoSW 1,595,636 30OsunSW 1,602,999 31OyoSW 2,643,613 Total 12,681,618 8,843,591 4,555,007 13,889,825 21,525,209 18,444,832