Nigeria still on our minds: even in Iceland


I hear you asking “Iceland?…Yes!

The same thought crossed my mind when I saw that this year’s International Symposium on Pneumococci and Pneumococccal Diseases was holding in Reykjavik. It was definitely not top of my list of “must-visit” destinations…and I must confess that their national hobby; whale watching, will not exactly send my adrenaline pumping…but anyways…we deh for Iceland!
I hoped I would at least be too far from Nigeria to encounter any further frustration at our collective abdication of the health of our people.

Wetin concern us and pneumococcal disease you might ask. Well look at this graph.

Yes, HIV, TB and malaria get all the attention these days…and yes kids are dieing from those too. But not just these!

Serious pneumococcal diseases caused by Streptococcus pneumoniae – primarily pneumonia and meningitis – are the #1 vaccine-preventable cause of death in children under 5. A new conjugate vaccine recently became available and has been introduced in most western countries. In 2007, WHO issued a recommendation for the introduction of pneumococal vaccines into immunization programs in developing countries that will potentially save millions of lives. Good news!

So…1st day of conference…Nigeria is on the agenda:

Kathy O’Brein – of Johns Hopkins –“More children die from pneumococcal disease in India and Nigeria than any other country in the world”

“The 2 countries with significant U5 populations …where it is most difficult to get any data from are Indonesia and Nigeria”

No…this is not what I hoped to hear!

As usual I meet several Nigerians working all over the world. We share our frustrating experiences of engaging with Nigeria. A colleague tells of his recent experience during an advocacy meeting with our most senior colleagues in Abuja working at the National Primary Health Care Development Agency (Into which the National Programme for Immunisation was subsumed). Stories of incompetence too alarming to be reported in detail.

Historically 15-20 years would pass before new vaccines reached children in developing countries. A new organisation: PneumoADIP, part of the GAVI alliance is working to develop effective public-private partnerships in order to accelerate the introduction of pneumococcal vaccines into developing coutries routine vaccination programmes, potentially saving millions of lives. Good news for Nigeria?

In late March 2007, GAVI issued a brief letter to all 72 eligible countries asking if they would be interested in introducing the new pneumococcal conjugate vaccine. 31 countries indicated an interest in introducing pneumococcal vaccines by 2010. The most responses came from Africa, the region of the world with the highest incidence of pneumococcal disease….and NO! Nigeria was not one of them. We do not care for our children enough….sadly.

The other disease discussed at the conference was Hib. Haemophilus influenzae type b (Hib) is a bacterium which causes serious disease often life-threatening, illnesses in young children. Hib can cause meningitis and severe pneumonia, leading to an estimated 3 million cases of serious illness and 400,000 deaths each year in children under 5 years of age. On average, 20% of children in developing countries with Hib meningitis will die. Hib bacteria normally establish themselves in the nose or upper throat. It is spread through sneezing, coughing, or speaking closely with an infected person.

Fortunately, Hib is now preventable. There is a highly safe and effective vaccine routinely used in the industrialized world for over 15 years. More than 100 countries now routinely use Hib vaccines in childhood immunization programmes and have documented virtual elimination of disease. This month, Uganda announced that it has nearly eliminated deadly Hib meningitis in young children. This comes just five years after that vaccine was first introduced into the country’s immunization programme. As a result, Uganda prevented an estimated 28,000 cases of pneumonia and meningitis and 5000 deaths, each year. Precious Ugandan children. Nigeria is one of the few countries that has not made any move to introduce this vaccine despite the support available from GAVI. We do not care for our children enough….sadly.

Well ….we cannot all blame “some one else”. There were at least 6 Nigerians at the conference….and as usual we moaned..and moaned. The lone soldier that actually came from Nigeria was Dr Falade from the University College Ibadan. Ibadan, Nigeria. The rest of us are in the so called “Diaspora”. Dr Falade has been the leading the research and advocacy for pneumococcal disease in Nigeria. he recently wrote an emotional Op-ed published in many Nigerian newspapers titled Vaccine Proves Successful in Eliminating Deadly Disease in Uganda: A Wake up Call to Nigeria.”

Also at the conference was a revered senior colleague, Dr Richard Adegbola by any estimate, one of the foremost scientists in this area. He works out of the Medical Research Council in The Gambia. Read a recent interview. How our country can ignore this man beats me. Yet…where is there for him to come back to? We marveled at the huge team from the Kenyan Medical Research Institute (KEMRI)…and the work they presented….researching, engaging and thinking about Kenyan children.

Again I came across another reason to be saddened at the sacking of Prof Grange, our erstwhile Minister of Health. A pediatrician and president of paediatric association wrote an Op-ed in Washington post asking the same questions I am….why are we doing so little to save her children from diseases no one else is dying from? Still…it is not clear why so little has changed with our National Primary Health Care Development Agency during her short tenure. Time, maybe will tell.

Meanwhile…our children continue to die …me sef …I tire

Back to my conference…back to Iceland.

But ….Nigeria remains…always on our minds…

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (, which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.

Discussion1 Comment

  1. So much for thinking Nigeria was far away from Iceland…..

    What are the solutions? Maybe I haven’t looked deeper but instead of rehashing the problems, what can be done.

    Your blog is an eye opener,not to say that living in Nigeria doesn not open your eyes daily to the problems, methinks we all need to do some thinking and acting….

    Like telling your colleagues with the superspeed computers to actually use them for a more noble cause…last post I read before this

    I could go on and on….Solutions!!!!!!!

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