- Government support strengthens prospects for sustainability of mass azithromycin initiative
The Bauchi State Government has signalled its commitment to taking greater ownership of the SARMAAN project, with the state Commissioner for Health, Dr. Sani Mohammed Dambam, pledging to support the programme’s inclusion in the state’s Annual Operational Plan (AOP).
The commitment came during a high-level engagement between the SARMAAN team and the Bauchi State Ministry of Health involving the Commissioner, the Permanent Secretary and the Director of Planning, Research and Statistics (DPRS), Dr. Yakubu Dauda.
The meeting focused on a question that often determines whether public-health interventions survive beyond their initial funding and implementation period: how can a successful project become part of the health system itself?
The SARMAAN team presented an overview of the three rounds of implementation conducted so far in Bauchi State and outlined plans for integrating the programme into the state’s routine health planning and budgeting processes.
The Commissioner expressed support for the proposal, saying the Bauchi State Government had consistently supported health initiatives introduced in the state and that SARMAAN would be no exception.
He pledged to personally champion the inclusion of the programme among priority initiatives in the state’s AOP, describing the move as evidence of the government’s commitment to improving health outcomes for children.
From project to state-owned programme
The Commissioner also commended SARMAAN for considering sustainability from an early stage, noting that interventions designed with an exit and ownership strategy are more likely to leave lasting benefits.
He directed the DPRS to become actively involved in the discussions with the SARMAAN team, given the department’s responsibility for health-sector planning, coordination and the use of data in decision-making.
He also indicated that further discussions would be necessary with the Executive Chairman of the Bauchi State Primary Health Care Development Agency, pointing to the need for wider alignment among institutions responsible for primary healthcare delivery.
For SARMAAN, the development represents an important shift from implementation largely driven by project structures towards greater integration into the state’s own health system.
SARMAAN — Safety and Antimicrobial Resistance of Mass Administration of Azithromycin in Children — is a major child-survival and public-health initiative being implemented in Nigeria.
The programme involves the mass administration of azithromycin to eligible young children at scheduled intervals, with the broader objective of reducing childhood mortality while generating evidence on the safety, effectiveness and antimicrobial-resistance implications of the intervention.
The initiative is led by the Nigerian Institute of Medical Research (NIMR), in collaboration with the Federal Ministry of Health and Social Welfare, and involves a range of national and international partners.
Among the organisations supporting or collaborating with the programme are the Bill & Melinda Gates Foundation, AFENET Nigeria, Malaria Consortium, Sightsavers, eHealth Africa, SCIDaR and Mitosath.
The first phase, SARMAAN I, focused on infants aged 1–11 months in selected pilot states, including Jigawa, Kebbi, Kano, Sokoto, Akwa Ibom and Abia.
The second phase, SARMAAN II, running from 2024 to 2027, has expanded the target population to children aged 1–59 months across 11 northern states: Sokoto, Kano, Katsina, Kebbi, Kaduna, Jigawa, Bauchi, Adamawa, Gombe, Yobe and Zamfara.
The scale-up means that the programme is potentially reaching millions of Nigerian children, while simultaneously providing an opportunity to strengthen the country’s evidence base on mass azithromycin administration and antimicrobial resistance.
Why state ownership matters
Public-health programmes can achieve impressive results while external funding and technical support are available. The more difficult test is whether governments can incorporate successful interventions into their own systems and continue them when a project eventually winds down.
That is why the Bauchi engagement is significant.
By seeking inclusion in the AOP, SARMAAN is moving beyond the question of implementation to the more fundamental issue of institutionalisation — ensuring that the programme is recognised within the state’s formal health priorities and planning processes.
The proposed involvement of the DPRS and the Primary Health Care Development Agency could further strengthen that transition by linking the initiative to planning, budgeting, primary healthcare delivery and routine government structures.
For children and families in Bauchi State, the ultimate measure of success will not simply be the number of project rounds completed, but whether the gains from the intervention can be sustained over time.
The latest commitment from the state government suggests that the conversation is moving in that direction.
