Nigeria

In the early 1990s, The Carter Center helped launch Nigeria’s national program to eliminate river blindness (onchocerciasis), a parasitic disease transmitted by the bites of infected black flies.

Our Work and Methods

With our partners, we support mass drug administration of Mectizan^® (donated by Merck & Co. Inc.), along with health education.

Impacts

• By 2021, three states (Plateau, Nasarawa, and Delta) met the criteria for interrupting transmission, meaning nearly 5 million people no longer required Mectizan^® treatment.
• In December 2022, Nigeria’s National Onchocerciasis Elimination Committee announced that four states supported by The Carter Center (Abia, Anambra, Enugu, and Imo) had interrupted transmission of river blindness and no longer required Mectizan^® treatment. Those states are home to 18.9 million people, making this the largest stop-treatment decision in river blindness history.

The Carter Center works with Nigeria’s Ministry of Health to eliminate the debilitating parasitic disease lymphatic filariasis, a leading cause of permanent and long-term disability.

Our Work and Methods

• Community-selected volunteers are mobilized to educate their neighbors and annually distribute a combination of free medications: Mectizan and albendazole.
• In two states where lymphatic filariasis transmission has been eliminated (Plateau and Nasarawa), the Center’s work has shifted to caring for individuals suffering from the lingering effects of the disease. We work to strengthen primary care support and referral networks as well as to address mental health needs in “Hope Club” support groups.
• After five years of good treatment coverage, we conduct assessments to determine whether transmission of lymphatic filariasis has been interrupted.
• We also have distributed long-lasting insecticidal nets to protect pregnant women and children who cannot take drug treatments.

Impacts

• Millions of Nigerians are no longer at risk of lymphatic filariasis since the Ministry of Health-Carter Center partnership succeeded in 2017 in eliminating the disease as a public health problem in Plateau and Nasarawa.
• Case numbers in 137 of the 141 endemic districts in which we work have dropped so low that mass drug administration is no longer required.
• Bed nets we’ve distributed also help protect against other mosquito-borne diseases, such as malaria.

In partnership with Nigerian health authorities, The Carter Center works to help control schistosomiasis in nine states.

Our Work and Methods

• We exclusively treat children, distributing doses of with praziquantel (donated by Merck KGaA), most often in school settings.

Impacts

• A recent impact survey revealed reductions of schistosomiasis in Plateau and Nasarawa states, but mass drug administration is still needed.

Current Status: Transmission stopped, November 2008
Certification of Dracunculiasis Elimination: 2013

In 1988, the government of Nigeria invited The Carter Center to begin Guinea worm eradication programming in the nation.  

Our Work and Methods 

In collaboration with Nigeria’s Federal Ministry of Health, the strategy for elimination consisted of several components, driven by health education. The goal was to change behavior and mobilize communities to improve the safety of their local water sources. 

Approaches included: 

• Conducting health education and distributing nylon filters 
• Treating stagnant ponds monthly with ABATE^® larvicide (donated by BASF) 
• Caring for patients in case containment centers to prevent disease spread 
• Directly advocating with water organizations 
• Increasing efforts to build safer hand-dug wells 
• Training and supervising village volunteers to carry out monthly surveillance and interventions

Impacts 

• By November 2008, incidence of Guinea worm disease had been reduced by more than 99. In December 2009, with 13 consecutive months of zero cases, Nigeria was provisionally determined to have broken Guinea worm transmission. 
• In 2013, Nigeria was certified by the World Health Organization as having eliminated Guinea worm disease. 

Because Plateau and Nasarawa already supported Guinea worm eradication, lymphatic filariasis elimination, and control efforts for river blindness and schistosomiasis, the integration of trachoma control in these two states was a logical next step, and that effort began in 2003.

Our Work and Methods

• The program in Plateau and Nasarawa focused on:
  • Health education, targeting those at highest risk of infection, primarily children and women in rural communities
  • Promotion of household latrines to eliminate the breeding ground of eye-seeking flies
  • Mass distribution of antibiotics to treat active infections
• In 2010, in partnership with the Ministry of Health and Sightsavers, the first mass distribution of azithromycin (Zithromax^®, donated by Pfizer Inc.) was conducted in 10 local government areas in five states, including Plateau and Nasarawa.

Impacts

• After three rounds of mass drug administration in Plateau and Nasarawa states, impact surveys in 2014 showed significant decreases in active cases. Because of this success, we were able to end our assistance in both states in May 2015.
• The states of Plateau and Nasarawa eliminated trachoma as a public health problem in 2018.

This project ended in 2015.

The Carter Center along with the Nigeria Federal Ministry of Health launched the Nigeria Public Health Training Initiative in 2017 to improve the training of health professionals who work directly with women and children.

Our Work and Methods

The initiative focused on improving the learning environment of adult students and midcareer professionals such as nurses and midwives in select institutions across six states (Akwa Ibom, Gombe, Imo, Ogun, Plateau and Sokoto).

Impacts

• Provided teaching skills training to over 180 faculty members.
• Donated more than 14,000 items, including furniture, laboratory equipment, classroom accessories, information and communication technology equipment, and books and reference materials to health training institutions.
• Updated training curricula for nurses, midwives, community health extension workers and junior community health extension workers and adapted them for the health needs of local communities.
• Successfully transitioned the Nigeria Public Health Training Initiative to state ownership in 2020.

This project ended in 2020.

How It Started

Working hand in hand with Nigeria’s Federal Ministry of Agriculture, The Carter Center, in partnership with the Sasakawa Africa Association, assisted Nigerian farmers in nine states with agricultural production starting in 1993. The program was part of a larger partnership led by Nobel Peace Prize winner Dr. Norman Borlaug that helped over 8 million small-scale sub-Saharan African farmers in countries where malnutrition is a constant threat.

Our Work and Methods

The program provided farmers with credit for fertilizers and enhanced seeds to grow test plots, often yielding 200% to 400% more crops. Participating farmers went on to teach others, creating a ripple effect to stimulate self-sufficiency.

The Carter Center ended its agricultural activities in Nigeria in 2011.

Through its groundbreaking Inform Women, Transform Lives campaign, The Carter Center partners with city leaders worldwide to raise awareness about women’s right to access information and to help cities reach women with valuable information and essential municipal services. 

Access to this information empowers women with a stronger voice, enabling them to participate in public life, utilize public services, and make more informed decisions for themselves, their families, and their communities. In Nigeria, this project has partnered with the cities of Lagos, and Abuja.

In February 1999, following the death of dictator Gen. Sani Abacha, The Carter Center and its partner, the National Democratic Institute for International Affairs (NDI), observed National Assembly and presidential elections.

President Carter led these efforts, and observers reported serious irregularities nationwide, including ballot stuffing, inflation of results, and voter intimidation.

President Carter then sent a letter to the election commission asserting the Center could not verify the outcome of the vote because of the seriousness of the flaws. Nevertheless, former Gen. Olusegun Obasanjo was sworn in as president.

The Center and NDI called for significant changes in electoral preparations for the 2003 presidential election and conducted a preelection mission in March 2003 but ultimately did not observe the 2003 election.

This project ended in 2003.

To promote peace and democracy, The Carter Center often speaks out against human rights violations. In November 1995, President Carter wrote to Nigeria Head of State Gen. Sani Abacha to express his “profound dismay and shock” at the execution of nine environmental and minority rights advocates, including Ken Saro-Wiwa.

President Carter called on Abacha to “release all other prisoners detained or convicted on the basis of the peaceful expression of their beliefs, to commute the sentences of other detainees facing capital punishment on politically inspired grounds, and to give full effect to the rule of law in Nigeria.”

A letter also was sent to the secretary-general of the Commonwealth of Nations stating that the executions raised “serious questions as to Nigeria’s continued good standing with the international community.”

Impacts

• President Carter’s high-profile advocacy brought worldwide attention to the human rights violations.

This project ended in 1995.

In the early 2010s, under the banner of the Mobilizing Faith for Women and Girls Initiative, the Carter Center partnered with Christian and Muslim networks in Nigeria and trained religious and traditional leaders on human rights-based approaches, tools and strategies to advance gender equality.

In February 1999, President Carter visited the Niger River Delta to meet with activists, who had grown increasingly confrontational in protesting policies and practices of the government and major oil companies operating in the area.
He met with members of the Ijaw Youth Council and elders from the Ijaw, Urhobo, Isoko, Ogoni, and Itsekiri peoples and recommended more peaceful options for their activism.

President Carter suggested initiating a dialogue with representatives chosen by the Delta people themselves and establishing a clearer federal oil revenue-sharing formula to allow local and state officials in the Delta region to administer oil revenues for new roads and other projects.

He also recommended that a social development trust fund be administered privately with local participation to support more such projects.

This project ended in 1999.

Because a free press is vital to a strong democracy, The Carter Center arranged professional training workshops in 1999 for print and broadcast reporters in Nigeria covering the elections and political issues.

The project was a collaborative effort with the U.S. Information Service’s Democracy and Governance Program, the Nigerian nongovernmental organization Media Rights Agenda, and the DeWitt Wallace Center at Duke University.

Workshops focused on topics including the media’s role in free and fair elections, and how to deal with censorship and government interference.

Impacts

• Print and broadcast reporters became better equipped to report fairly and hold the government accountable.

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