The Federal Government has announced plans to integrate Azithromycin-based intervention into its national child survival policy, as key health sector stakeholders intensify efforts to strengthen coordination, ownership and evidence-driven approaches to reducing under-five mortality.

This formed the 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 was aimed at strengthening institutional alignment, clarifying governance structures and advancing the integration of the Safety and Antimicrobial Resistance of Mass Administration of Azithromycin Among Children 1–59 Months (SARMAAN II) into Nigeria’s child survival framework.

There was a shared consensus among participants 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 and is designed to generate robust national evidence on the effectiveness of Azithromycin Mass Drug Administration (MDA) in reducing under-five mortality, while monitoring antimicrobial resistance and ensuring safety.

Azithromycin is a broad-spectrum macrolide antibiotic used in mass drug administration (MDA) programmes to reduce child mortality by preventing and treating common bacterial infections such as respiratory infections, diarrheal diseases, and some skin infections.

Chair of the SARMAAN II Steering Committee and Director/Head of the Family Health Department, John Ovuoraye, said safeguarding the lives of Nigerian children must remain a national priority, stressing that survival is the most fundamental right of every child.

He noted that the progressive inclusion of SARMAAN II into Nigeria’s Child Survival Action Plan would require stakeholders to jointly design and implement solutions, adding that discussions around the intervention must remain outcome-oriented and aligned with existing government coordination structures.

Ovuoraye 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. He emphasised that research findings alone are insufficient unless translated into policy through coordinated action by partners and technical teams.

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. She noted that no serious adverse events have been recorded so far during implementation.

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. 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.