Recent outbreaks of Lassa fever in Nigeria and Ebola in the Democratic Republic of Congo have highlighted the importance of strong surveillance systems that can support public health decision-making during periods of uncertainty The Guardian Nigeria, March 2026. While outbreak preparedness is often associated with emergency treatment, vaccines, diagnostics and disease containment, these are underpinned by part of the response happening more quietly in the background: the collection and interpretation of reliable health surveillance data to support the assessment of the safety and effectiveness of new vaccines. Across Africa, the CEPI-supported BRAVE project looks to strengthen health surveillance infrastructure, capability and capacity for reliable vaccine safety assessment during future vaccine introductions and public health activities. By generating background rates of naturally occurring health outcomes that may be reported following vaccination, BRAVE provides critical context for interpreting potential vaccine safety signals.
In Nigeria, BRAVE partners with the International Foundation Against Infectious Disease in Nigeria (IFAIN) working with healthcare facilities including the Abubakar Tafawa Balewa University Teaching Hospital in Bauchi, Federal Medical Centre in Owo, University of Benin Teaching Hospital in Benin and Irrua Specialist Teaching Hospital in Irrua, also regions affected by recurrent Lassa Fever activity and broader infectious disease pressures. These recent outbreaks in Nigeria have reinforced the importance of surveillance systems that can function across multiple disease contexts, a challenge shared by health networks across the continent. Rather than building isolated responses around individual disease outbreaks, BRAVE is working to ensure Nigerian research institutions and health facilities can continuously generate reliable safety and effectiveness evidence, whatever the public health emergency.
As of 27 May 2026, the BRAVE project had screened more than 10,000 patients across these four healthcare facilities, with monthly screening activity stabilising at between 2,000-3,000 patients. These activities are embedded within routine clinical care and demonstrate how vaccine safety surveillance can be integrated into day-to-day clinical workflows.
BRAVE’s work in Nigeria reflects the importance of locally led research partnerships. Effective vaccine safety surveillance depends not only on local data systems and technology, but also on the people responsible for collecting, managing, and interpreting data within real-world healthcare settings. Field teams, clinicians, data officers, and researchers all play a critical role in generating reliable evidence and building a clearer picture of population health during periods of increased public health pressure.
On the country team approach to health systems strengthening, Bernard Ebruke, IFANI’s National Principal Investigator says, “Our approach to building capacity in the local healthcare workforce that will be prepared to respond to future threats is illustrated by the African proverb, ‘if you make friends with the boatman in the dry season, you will be the first to cross when the rains come and the tide is high.’”
Across the network, collaboration of the BRAVE network sites provides opportunities for building a broader understanding of how surveillance systems function across different healthcare settings and offers cross country and cultural exchange of ideas and experiences on health systems strengthening. Regional and cultural experiences from countries managing Lassa fever (Nigeria), Ebola (DRC), and other infectious disease threats continue to shape how data systems, clinical workflows and field activities are built and strengthened over time.
Building reliable vaccine safety surveillance systems takes time. It depends on consistent data collection, strong local partnerships and sustained investment in people, processes and infrastructure. As the BRAVE network continues to expand, Nigeria’s contribution demonstrates the long-term value of strengthening surveillance systems before they are needed in a public health emergency. The expertise, partnership, and data generated through BRAVE will help support evidence-based vaccine safety assessment and public health decision-making for years to come.