Nigeria's disappointing response to swine flu


It has been frustrating following the response to swine flu in Nigeria. We live in hope of the day our country will to put its act together and act with competence and confidence.

lets start from the beginning….with all the  reports from the Ministry of Health assuring Nigerians that there was “no swine flu in Nigeria“. Our Minister of Health in June 2009…assured the country that everything that needed to be done was being done.

Hear the Minister himself speaking in June…

Then on the 29th of October, a private laboratory in Lagos announced to Nigerians its “first” case of swine flu and then a few days ago the special assistant (media and communication) announced to Nigerians the“first” death. He is quoted as saying

“Nigeria has recorded 11 laboratory confirmed cases of Influenza A/H1N1 and one death from the Influenza A/H1N1”

The simple question is how do they know? What exactly is the surveillance system for influenza in Nigeria?

When most countries were confronting this new disease  months ago, they followed up their numbers with a description of the surveillance systems used to collect this data. Guidelines such as these were developed for people and health care professionals and disseminated. people were told not only what to do but also were and how. Information was updated daily on a website. In record time a new vaccine was developed and distributed….the response was managed, coordinated and effective, preventing a third wave.

Now we are told that in Nigeria, 4 months after most countries in the world had secured vaccine stock for their populations, at a time where many other countries are trying to get rid of excess stock of vaccines, that OUR  Commisioner of Health for Lagos state admits that they have NO VACCINES, not just in Lagos but in Nigeria and the state has only now placed an order that will be delivered in 4 weeks. Thisday reports that the Minister of Health says that negotiations with the UN to supply vaccines to Nigeria has reached an “advanced stage“. The Minister’s Special Assistant on Communication is quoted further as saying  deaths recorded so far were not as a result of absence of a “curative drug” but as a result of “late diagnosis” and urged Nigerians to adopt “precautionary measures”,  notably frequent hand washing, use of clean water and soap, keeping hands away from the face while sneezing or coughing as the disease gains access to the body through the eyes and nose, seeking medical attention on noticing cough, catarrh and high fever, among others. He went on to assure us that the “National Epidemic Preparedness and Response Committee was already on top of the situation” On top of the situation?!?

Then our commissioner of health went on to display an unprecedented ignorance of the transmission dynamics of influenza when he stated that 38-year-old victim of Influenza A/H1N1 (swine flu) travelled to the United States about three months ago and developed a respiratory tract infection about six weeks after the victim returned to the country“…implying that the infection was imported from the USA. Influenza has an incubation period (from time of getting the bug to becoming ill) of 1-4 days (averageof 2) and patients remain infectious for up to five days (seven days in children). Do the math! This person was infected in Nigeria! Indeed with the traffic between Nigeria and the rest of the world it is most likely that H1N1 has been circulating in Nigeria for months!

We cannot blame the commissioner. In no other country in the world is the response to infectious disease left to state and local governments. Infectious diseases, you will not be surprised to note do not respect our geopolitical boundaries! As most other countries in the world, Nigeria needs a central, well resourced centre for infectious disease prevention and control or one day we will pay the price the hard way.

Generally, while aspects of  service provision for clinical care have improved over the years (many will argue with this) our public health arrangements have not moved since independence. Our grand arsenal of responding to public health treats is a derelict Public Health Laboratory in Yaba, bureaucrats at the  Department of Public Health in the Ministry of Health,  a series of outbreak-specific task forces and a disparate group of epidemiologists in state ministries of health across the country. The lack of expertise is so glaring that it falls of the Minister’s own special assistant on media to interact with the Nigerian people on the threat of infectious diseases.

Countries that take this threat seriously consider the threat from infectious disease a matter of national security and give it deserved attention with specialised institutions. We have to believe that they are not stupid!

 In the USA its the Centres of Disease Control, in the UK the Health Protection Agency, In Germany the Robert Koch Institute, in France the l’Institut de veille sanitaire (InVS) …and South Africa National Institute of Communicable Disease (please Nigerians go at these websites to learn what you need to know). They all one thing in common – bringing together the expertise for the prevention and response to infectious diseases.

There was a collective sigh of relief around the world that the novel  2009 H1N1 influenza turned out not to be as virulent as initially feared….if it was, we would have been lost like a fish out of water. Now please go to the website of OUR Federal Ministry of Health for instructions on what to do if you are a health care professional or a patient regarding H1N1. Well, I bet you will not be surprised at what you find…

If we do not invest in protecting the Nigerian people from the threat of infectious diseases we will pay the price…its only a matter of time…and not even the high walls of the 3 Arms Zone or bullet proof 4X4s will save our politicians…. those little things have no respect!

But watch this space  – next epidemic – next task force – next media briefing. This is exactly how NOT to rebrand out country…Aluta

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.

Leave A Reply