Nigeria Situation Report, 20 November 2023

HIGHLIGHTS (20 Nov 2023)

• October Cadre Harmonisé analysis projects that nearly 4.4 million people will face severe hunger from June to August 2024 in Borno, Adamawa and Yobe states.
• Floods leave over 70 people dead, and more than 490 injured in Adamawa State.
• Diphtheria spreads across Borno, Adamawa and Yobe states killing over 200 children

BACKGROUND (20 Nov 2023)

Situation Overview

October Cadre Harmonisé analysis projects that nearly 4.4 million people will face acute hunger from June to August 2024 in Borno, Adamawa and Yobe states

The Government of Nigeria and its partners released the results of the October 2023 Cadre Harmonisé (CH) analysis on food insecurity projecting that about 3.3 million people in Borno, Adamawa and Yobe (BAY) states will face high levels of food and nutrition insecurity from October to December 2023. This is a 10 per cent increase from the 3 million people projected within the same period in 2022. The number of food-insecure people in the BAY states is expected to increase to 4.4 million during the 2024 lean season (June to August). This is slightly (2 per cent) higher than it was during the 2023 lean season when about 4.3 million people faced a severe food crisis.

Over 4 million people have needed urgent food assistance annually in the BAY states since June 2020. Trend analysis indicates consistently high or rising food insecurity levels since 2018.

Food insecurity and malnutrition are among the main drivers of humanitarian needs in the BAY states. Access to farmland is still limited in many areas because of insecurity and many of the 2.2 million displaced people do not have alternative livelihoods. They are often forced to adopt negative coping mechanisms such as survival sex and child labour to stay alive. Over the past year, dozens of farmers have lost their lives, and others have been abducted or injured trying to eke out a living by venturing outside the security perimeters of Borno’s garrison towns.

Across Nigeria, the CH analysis projects that about 26.5 million people will grapple with high levels of food insecurity in 2024. This is 6 per cent higher than the 25 million people that suffered food insecurity in 2023. Moreover, the CH analysis projects that approximately 9 million children are at risk of suffering from acute malnutrition in 2024. Of these, an alarming 2.6 million children could face severe acute malnutrition (SAM) and will require critical nutrition treatment. The CH is a food and nutrition analysis, conducted in March and October every year. It covers 26 states and the Federal Capital Territory, led by the Government and supported by the United Nations (UN) system.

The CH analysis identified continuing conflict, effects of climate change, record-high inflation and the rising cost of food, agricultural inputs and essential non-food commodities among the key drivers of Nigeria's food and nutrition crisis. In October, the National Bureau of Statistics (NBS) announced that Nigeria’s annual inflation rate rose to 26.72 per cent in September from 25.80 per cent in the previous month. The growing inflation continues to strain poor and vulnerable people’s ability to procure food.

This situation has been aggravated by the removal of petrol subsidies, leading to increased transportation costs and driving inflation. Floating the Naira has meant that over the past four months, the Naira has depreciated by over 50 per cent.

Concerned about the food crisis in the country, the Nigerian Government in July declared food insecurity a national emergency. The Government ordered the immediate release of fertilisers and grains to farmers and households to mitigate the effects of the fuel subsidy removal. It also announced steps to boost security to protect farmers from attacks.

Floods leave over 70 people dead, and more than 490 injured in Adamawa State

Over 70 people lost their lives and more than 490 others sustained injuries due to flooding in Adamawa State between May and October 2023, according to the findings of a joint multisectoral rapid needs assessment. The flooding also displaced more than 57,000 people. Heavy rainfall coupled with the release of water from Cameroon's Lagdo Dam caused the flooding that submerged some villages along the banks of the Benue River. The floods damaged schools, health centres, markets, over 19,000 hectares of farmland, and shelters. Areas affected includes Lamurde, Yola South, Mayo-Belwa, Numan, Yola North, Fufore, Demsa and Song local government areas (LGAs) of Adamawa State.

The flood water contaminated water points in several communities causing water-borne and vector-borne diseases like cholera, diarrhoea, malaria and dengue fever. Disease surveillance and notification officers in Yola South LGA reported that 38 cases of cholera have been confirmed and referred from the Wauro Jabbe community to the Modibbo Adama University Teaching Hospital, Yola. Moreover, an outbreak of scabies, a parasitic skin infestation, was reported in riverine communities like Bawaranji. The risk of infection is higher for vulnerable groups, such as malnourished children whose immune systems are already compromised. Disease outbreaks are putting pressure on the already threadbare healthcare system in Adamawa State.

The Adamawa State Emergency Management Agency (ADSEMA) is coordinating the assessment and response to the flooding. According to the agency, over 5,000 households in remote communities have lost their homes and urgently need shelter. Thousands of farmers have lost their farms and crops while herders have lost their livestock. Farmers urgently need input to begin dry-season farming, while the herders need support to replenish their livestock.

Humanitarian actors are complementing the Government’s efforts through the implementation of the flood preparedness and response plan in the BAY states. Activities in the plan includes the prepositioning shelter kits for an estimated 23,600 households in 22 flood-prone LGAs in the BAY States and providing non-food items like mosquito nets, blankets, water storage items, hygiene kits, and soap for at least 24,000 people in 4,000 households in high-risk areas. Other activities include desilting drainages. A shortfall in funding is however constraining the implementation of the flood response plan. The camp coordination and camp management and shelter/non-food items (NFI) sectors that are pivotal in the flood preparedness and response are only 6.4 per cent and 51.2 per cent funded, respectively.

Diphtheria spreads across Borno, Adamawa and Yobe States killing over 200 children

The World Health Organization (WHO) reports that more than 200 children have lost their lives in Borno (65) and Yobe (141) states following a resurgence of diphtheria since November 2022. As of 30 October 2023, an estimated 3,359 children have been infected by the disease in Borno (742), Adamawa (34) and Yobe (2,672) states. The outbreak has been particularly severe among children under 15, with three-quarters of cases in this age group. Cumulatively from May 2022 to October 2023, there have been about 15, 569 suspected and 9,772 confirmed diphtheria cases across Nigeria, and more than 540 children have died from the disease. Confirmed cases have been recorded in 19 states, with the Federal Capital Territory, Kano, Yobe and Bauchi States the worst affected.

Diphtheria is a highly contagious and potentially life-threatening bacterial disease which affects the respiratory tract and skin. Without treatment, it can kill half of those infected and is still fatal in 5 per cent of patients who receive treatment.

Aid organisations in the BAY states, including WHO, Médecins Sans Frontières (MSF) and the UN Children’s Fund (UNICEF) are working with relevant Government agencies to strengthen the outbreak response. WHO disbursed US$1.3 million to enhance outbreak control measures, including disease surveillance, laboratory testing, contract tracing, case investigation and treatment, training, as well as collaboration with communities to support the response efforts. The BAY states governments set up surveillance working groups for active case searches, contract tracing and referral of cases to health facilities for treatment.

Despite diphtheria being a vaccine-preventable disease, more than 2.2 million children in Nigeria are yet to be vaccinated, according to UNICEF. Data from the Nigeria Centre for Disease Control and Prevention shows that 64 per cent of the confirmed cases occurred among unvaccinated or partially vaccinated children, while 11 per cent of the cases were among children of unknown vaccination status. MSF has warned that a shortage in vaccine funding is an obstacle to ending the outbreak and called on the international community to offer support. The organization has so far donated 7,000 diphtheria vaccines, while UNICEF donated 1.2 million doses to respond to the outbreak. The available vaccines are inadequate to cover the high-burden states with MSF noting that Kano alone requires 31 million doses of the vaccine.

Although the spread of the disease has gradually dropped across Nigeria, aid organisations are concerned that the coming harmattan season may increase respiratory tract infections. Also, the relatively small number of cases in Adamawa State means that an outbreak can still be prevented there.