Federal Government Moves to Integrate Azithromycin into National Child Survival Policy
The Federal Government has announced a strategic initiative to incorporate Azithromycin-based interventions into its national child survival policy. This decision comes as key health sector stakeholders intensify efforts to enhance coordination, ownership, and evidence-driven approaches aimed at significantly reducing under-five mortality rates across Nigeria.
High-Level Stakeholder Roundtable Drives Policy Integration
The initiative was the central focus of a high-level stakeholder roundtable, convened following recommendations from the National Child Health Technical Working Group (NCH TWG) and the Director of the Family Health Department at the Federal Ministry of Health. The meeting aimed to strengthen institutional alignment, clarify governance structures, and advance the integration of the Safety and Antimicrobial Resistance of Mass Administration of Azithromycin Among Children 1–59 Months (SARMAAN II) project into Nigeria's child survival framework.
Participants reached a shared consensus that Nigeria must take greater ownership of the child survival agenda by leading the narrative and driving informed government decision-making on interventions such as Azithromycin mass drug administration. The SARMAAN II project represents Nigeria's contribution to the regional Resiliency through Azithromycin for Children (REACH) Network. It is designed to generate robust national evidence on the effectiveness of Azithromycin Mass Drug Administration (MDA) in reducing under-five mortality, while simultaneously monitoring antimicrobial resistance and ensuring safety protocols are upheld.
Azithromycin's Role in Child Health
Azithromycin is a broad-spectrum macrolide antibiotic used in mass drug administration programmes to reduce child mortality by preventing and treating common bacterial infections. These include respiratory infections, diarrheal diseases, and some skin infections, which are prevalent causes of death among young children in high-mortality settings.
Key Stakeholders Emphasize Collaboration and Ownership
Chair of the SARMAAN II Steering Committee and Director/Head of the Family Health Department, John Ovuoraye, emphasized that safeguarding the lives of Nigerian children must remain a national priority. He stressed that survival is the most fundamental right of every child, noting that the progressive inclusion of SARMAAN II into Nigeria's Child Survival Action Plan requires stakeholders to jointly design and implement solutions. Ovuoraye added that discussions around the intervention must remain outcome-oriented and aligned with existing government coordination structures.
He also pointed to the need for adjustments within the project's governance framework to ensure inclusive engagement and strengthen collective institutional ownership among national stakeholders. Ovuoraye emphasized that research findings alone are insufficient unless translated into policy through coordinated action by partners and technical teams.
Project Progress and Implementation Details
The Principal Investigator of the SARMAAN project, Oliver Ezechi of the Nigerian Institute of Medical Research (NIMR), explained that the initiative is part of an African-led effort involving Ministries of Health and international partners to reduce child mortality through evidence-based Azithromycin MDA in high-mortality settings.
Providing a progress update, Senior Project Manager at Solina Centre for International Development and Research, Ijeoma Mmirikwe, disclosed that over 13 million unique children were reached between 2024 and 2026. She added that 19 rounds of mass drug administration had been successfully conducted across Adamawa, Gombe, Yobe, Bauchi, Kaduna, Kano, Jigawa, Katsina, Kebbi, and Sokoto states, with more than 5.7 million bottles of Azithromycin distributed. Notably, no serious adverse events have been recorded so far during implementation.
Advocacy and Sustainable Financing Efforts
Also speaking, Project Lead of the SARMAAN Advocacy Project Team, Ikechukwu Ofuani, introduced the advocacy consortium supporting national ownership, policy integration, communications, and knowledge management for the initiative. According to him, the advocacy effort is focused on ensuring government ownership of the intervention, integrating SARMAAN into Nigeria's Child Survival Action Plan, securing sustainable domestic financing, and strengthening public awareness and policy engagement. He added that the consortium is led by Policy Vault Africa, with communications support from Saldrey Communications Limited and Big Cabal Media.
Building on International Evidence
The SARMAAN programme builds on international evidence from Niger, Tanzania, and Malawi, where similar Azithromycin interventions have demonstrated up to a 13.8 per cent reduction in child mortality. Stakeholders noted that Nigeria's implementation adapts this approach to the local context while generating country-specific evidence and strengthening ownership at the state and community levels.
