Each year, Nigeria confronts the same grim reality: outbreaks of preventable infectious diseases such as cholera and Lassa fever continue to claim lives, overwhelm healthcare systems, and reveal systemic weaknesses in our public health infrastructure. These recurring crises are not simply unfortunate events but preventable consequences of inadequate surveillance and delayed response.

As a physician and researcher with frontline experience in epidemic management, including leading a COVID-19 response team that achieved a 65% reduction in transmission at the Federal Medical Center Abeokuta, I have seen firsthand the critical role robust surveillance plays in protecting populations.

The Cost of Delay

Cholera outbreaks have now become seasonal in many Nigerian states, particularly during the rainy season, often due to contaminated water supplies and poor sanitation. Meanwhile, Lassa fever persists annually, especially in the dry season, exacerbated by gaps in community-level detection and delayed containment. What both diseases have in common is not just their devastating impact, but the clear warning signs they give and our collective failure to act on them.

These outbreaks reflect deeper failures in early warning systems, data collection, case tracking, and coordinated response. By the time interventions begin, communities are already in crisis. This reactive approach costs lives and places undue strain on an already fragile healthcare system.

Surveillance as Our First Line of Defense

Infectious disease surveillance is not a luxury, it is a cornerstone of national security and public health resilience. An optimized surveillance system ensures early detection, real-time reporting, rapid response, and informed policymaking. It also empowers communities and frontline workers with the tools to recognize and respond to emerging threats before they spiral into full-blown epidemics.

Nigeria must shift from an emergency-driven model to a proactive, data-driven surveillance infrastructure. This includes strengthening the Integrated Disease Surveillance and Response system at all levels; primary, secondary, and tertiary, alongside training health workers, upgrading reporting platforms, and ensuring timely data flow between states and the national coordinating centers.

Community-Level Engagement is Crucial

Effective surveillance starts at the grassroots. Community health workers must be equipped with mobile technology, standardized tools, and real-time feedback systems to flag anomalies. Health education campaigns should reinforce the role of communities not only as recipients of care but as active partners in surveillance.

We must also integrate behavioural and social data into our surveillance architecture. Mistrust, misinformation, and stigma, especially in rural and underserved communities, can severely undermine outbreak control. Therefore, community engagement must be embedded in our surveillance strategy, not treated as an afterthought.

Call to Policymakers

Now more than ever, Nigeria needs a national health security strategy that prioritizes disease surveillance. We must invest in predictive epidemiology, genomic sequencing, public health informatics, and decentralized reporting systems. Policymakers must recognize that surveillance is not only about controlling the present, but it is about securing the future. Nigeria can no longer afford to be reactive. The annual recurrence of cholera and Lassa fever should compel us to act, not only to respond, but to prevent.

Conclusion

Optimizing Nigeria’s infectious disease surveillance capability is both a moral and strategic imperative. We owe it to every Nigerian to build a system that can anticipate, detect, and contain outbreaks swiftly. With political will, adequate funding, and stakeholder collaboration, we can transform our current limitations into a model of resilience for the continent