EXPLAINER: How health advisories work in Nigeria

A health advisory is an official communication from authorities during a disease outbreak that threatens public health.

“Health advisories increase public awareness and detail preventive measures to be taken to ensure safety among members of the public,” Tanimola Akande, a professor of public health at the University of Ilorin, told Africa Check.

Advisories also guide healthcare workers on how to detect, manage and treat diseases, while supporting policy decisions with expert advice.

Examples of advisories:

• During Covid-19, global advisories from the World Health Organization (WHO) promoted mask-wearing, social distancing and vaccination.
• During the most recent Ebola outbreak, NCDC advisories explained symptoms and how to avoid infection, including through safe burial practices.
• In 2023, the NCDC also issued anthrax advisories warning against handling suspicious mail, sick or dead animals or undercooked meat. They also encouraged the reporting of unusual animal deaths.

Akande listed other public health threats in Nigeria, such as substance abuse, malnutrition, heart disease, HIV and tuberculosis.

“The early advisory on Ebola helped to contain the outbreak. The same also happened with Mpox,” Akande said.

Mpox, formerly called monkeypox, is a contagious disease that can cause a painful rash, swollen lymph nodes, fever, headache, body aches, back pain and fatigue.

Making an advisory starts with monitoring and data collection from hospitals and labs. Agencies like the NCDC work with global partners, such as the WHO and the US Centers for Disease Control and Prevention (CDC), to track health threats.

Next, experts do a risk assessment to judge how serious and widespread a disease is. For example, on 6 January 2025, the NCDC classified HMPV as a moderate threat after a joint assessment with the federal ministry of health and other partners.

Once the risk is determined, experts create clear messages with preventive tips for the public and guidelines for healthcare workers on diagnosing, reporting and managing cases.

The NCDC told Africa Check that its process involved stakeholder groups, including regional and international organisations. 

Every health advisory is developed through brainstorming sessions. It then undergoes internal review before reaching the NCDC director general.

“The DG and his experts look at the advisory and make sure it aligns with the protocols,” NCDC spokesperson Sani Datti said. 

The resulting advisories are shared via government websites, media briefings and statements and social media. 

According to Akande, factors like how fast a disease spread, available preventive measures and the health system’s capacity also determined if an advisory was needed. 

Government partnerships, especially with the WHO, also played a role.

Health advisories are issued by health authorities at the local, national and global levels.

In Nigeria, the NCDC handles advisories, focusing on local diseases like Lassa fever and HMPV. In the US, the CDC also issues alerts, including travel-related and global disease risks.

At the global level, WHO leads in issuing advisories on major health threats like pandemics. 

These national and global agencies work together to ensure a coordinated response to health threats around the world.

Health advisories play key roles in helping countries prevent and respond to disease outbreaks through shared surveillance systems:

• Early warning and risk communication: Health advisories are early warning systems for possible outbreaks that could become international public health emergencies, especially of infectious diseases.  
• Information sharing: Countries share updates with the WHO and others to monitor and assess outbreaks.
• Enhancing public awareness and compliance: Advisories educate travellers, health workers and the public on disease risks and how to stay safe.

When there's a disease outbreak, health agencies share important information for travellers. In Nigeria, this is handled by the NCDC. There are various types.

Health declaration form: Travellers entering Nigeria must fill out a health declaration form, either online or on paper. 

“There are healthcare workers at the airport who ask questions and ask travellers to fill forms,” the NCDC’s Datti said.

The form asks for personal details and symptoms that may indicate illness, especially infectious ones.

Vaccination cards: Governments tend to warn their citizens about new outbreaks in a destination country. For example, the US CDC advises its citizens to get vaccinated for yellow fever, polio, diphtheria and measles before visiting Nigeria.

Some countries require proof of vaccination before travel. The “yellow card”, or international certificate of vaccination or prophylaxis, is proof of yellow fever vaccination and is accepted worldwide.

Time-sensitive and country-specific: During the Covid-19 pandemic, many countries required certain vaccines for entry. Even though many restrictions have been lifted, it’s still important to check what vaccines or health forms are needed before visiting any country with an outbreak.

Social media connects millions, but it also spreads misinformation – especially during health crises. 

In 2020, false claims about Covid vaccines hurt uptake in parts of Nigeria, despite government efforts.

In 2014, viral WhatsApp messages advised people to drink salt water to prevent Ebola, causing hospitalisations and even deaths.

The media plays a key role in spreading accurate health info, Dr Theresa Amobi, a senior lecturer in the department of mass communication at the University of Lagos, told Africa Check.

“Health advisories are tools to guide people against certain diseases and mitigate dangers. It’s simple to deduce that the media must be at the forefront of putting out the correct information,” she said.

She noted that while the media helped raise awareness about advisories, it was less effective at changing behaviour.

Amobi also said that defamation law was the closest Nigeria had to tackling health misinformation, and a proposed 2019 bill to address online falsehoods – the Protection from Internet Falsehood and Manipulations Bill – was never passed.

Datti said the NCDC's risk communication team worked to tackle misinformation and ensure accurate health info reached the media.

Africa Check is part of the NCDC’s infodemic risk pillar, which tracks and debunks false health claims linked to disease outbreaks in Nigeria.

“In our advisories, it is stated to always refer to our website for more information,” Datti said.