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Halting future pandemics: A call for a strong government preparedness plan

The Nigeria Centre for Disease Control (NCDC) in partnership with the Ministry of Health has been leading the response against COVID-19 with the support of other stakeholders. As of 9th August 2020, Nigeria had recorded 46,577 confirmed cases, 33,186 discharged cases, and 945 deaths from COVID-19. Government agencies are implementing different facets of the response with the Presidential Task Force coordinating the national response.

The Federal Ministry of Health through the NCDC activated a National Emergency Operations Centre (EOC) and healthcare workers across the country were trained in various aspects of prevention, control, laboratory testing, surveillance, screening, and case management. The NCDC initiated the strengthening of laboratories across the country with the capacity to test for COVID-19 and they have been working closely with state governments through the deployment of national Rapid Response Teams to support response activities.

Other measures have also been implemented by the government to curtail the spread of the disease and protect the health of Nigerians. This includes an initial lockdown of non-essential activities in some parts of the country, an initial ban on domestic flights, and a current ban on international flights.

Halting the upsurge of future pandemics in Nigeria
The country’s response to the pandemic has received mixed reviews, with commendations and criticisms. There is plenty the country can teach but also a lot to learn from other countries.

Although some palliatives were disbursed by the government this has met criticism as the palliatives did not cover a reasonable amount of the population. Also, many Nigerians registered displeasure about the methods used in the distribution of palliatives. The federal and state governments should ensure the rights to food, shelter, and other necessities for people losing jobs or income during the COVID-19 pandemic.

There are currently 62 laboratories with the capacity to test for COVID-19 in the NCDC laboratory network. Photo source: NCDC

The inability of the government to meet people’s basic needs may be one of the reasons why Nigerians were not as willing to comply with some government advisories. The burden of testing has reduced a great deal with the current total number of laboratories with the capacity to test for COVID-19 in Nigeria at 62. Equipping NCDC to be able to mount a proactive response is in terms of preparedness and funding is important to help halt future pandemics.

The Federal Government relaxed restricted movements in Lagos, Abuja, and Ogun State – the primary focus states – in the fight against COVID 19 and ordered expanded numbers of businesses, including banks, to re-open operations at the beginning of May, but with advisories and guidelines. Ease of lockdown advisories has helped to keep awareness about the existence of COVID-19 high in the country. The government should replicate the collaborative efforts in developing guidelines to prepare for future epidemics.

There is a need to strengthen the health system, enhance the surveillance and database system, and step-up research and development. If the government is to detect, prevent, and respond to future pandemics, there are several things that it must do. These include:

Increase funding for epidemic preparedness
Nigeria was better placed than many to respond to the arrival of the coronavirus disease. Nigeria was better placed than many to respond to the arrival of the coronavirus disease. In 2014, it successfully contained a deadly Ebola virus outbreak and the country’s current JEE ReadyScore inched up from 39  in 2017 to 46 after the mid-term review in November 2019, although the Lassa fever outbreak claimed more than one hundred lives in 2020 and the aftermath of recession, insecurity, and conflict in some regions has negatively impacted the country. As at the beginning of the outbreak, Nigeria did not have enough Personal Protective Equipment for health workers, ventilators, testing centres, well-equipped staff, and an adequate and readily available budget to respond to epidemics.

Enhance our surveillance system
There is a need to enhance the surveillance and database system to help contact tracing in the future. Contact tracing is one of the critical surveillance methods for controlling the spread of transmissible diseases. It involves identifying, listing, and following up on persons that might have been exposed to someone infected with the disease. While contact tracing in Nigeria has been good, there is a need to review and further improve the surveillance system to prevent further spread of the virus. If the country can develop an electronic database that captures the Nigerian population, contact tracing and case identification would be easier and faster.

Scale-up Research and Development
Health science-related research capacity and funding are inadequate to cater for current health needs. Although estimates from 2016 showed that Nigeria, South Africa, and Egypt contribute almost two-thirds of total domestic spending on research and development in Africa, this is small when compared to the contributions of other countries outside the continent. The figures are also low when compared to research needs on the continent. Considering the numerous health needs in the country, Nigeria must increase funding for research and development to build in-country research capacity. As the most populous black country, Nigeria should set the pace in Africa in the area of research and development.

Motivate health workers
Health workers are critical in detection, prevention, and response to infectious diseases. The COVID-19 pandemic has shown how unprotected health workers can be while saving lives. This has led to health workers becoming infected with COVID-19 and some dying as a result.   Consequently, the government should improve the working conditions of health workers by ensuring they are well paid and have the necessary equipment to work safely.  Furthermore, policymakers need to equalize the distribution of medical human resources across communities and ensure proper health financing and health system strengthening in the country. The government must protect and reward health workers.

Build partnerships and support innovations
The fact that the private sector Coalition Against COVID-19 (CACOVID) rose to the occasion to pool together billions of naira to be used to support the World Health Organization (WHO), the Federal Government, and the Nigeria Centre for Disease Control in the fight against the pandemic has shown how important it is to encourage counterpart funding and support of the private sector. It would be great if CACOVID remains after COVID-19, perhaps under a different name to continue to bring to the fore private sector contribution and voice on the issue of epidemics preparedness. So far the coalition has helped to secure the purchase of testing kits, promote advocacy and public enlightenment, secure emergence of isolation centres, and buy essential equipment.
 
Effective partnerships and collaborations between the public and private sectors are increasingly critical. The private sector can support the government’s prevention, preparedness, detection, and response activities to strengthen the health system and therefore put the country in a good position to fight disease outbreaks in Nigeria.

Support should be provided for innovations that can help tackle the problem of misinformation and inadequacies in rapid detection and response to disease outbreaks. An example is the innovative tool “Covidinfo.me”, a digital diagnostic and tracking kit created to provide information about the ongoing pandemic gathered from WHO, NCDC, Medscape, and other health agencies to members of the public. Investing in technology and supporting innovative initiatives can bolster government efforts and ensure more positive health outcomes in the future.
Strengthening the health system and increasing budgetary allocations for epidemic preparedness will improve detection, prevention, and response to infectious disease outbreaks in Nigeria. 
 
What other steps do you think the Nigerian government can take to halt future epidemics? Leave a comment below or drop us a line on our social media platforms, @nighealthwatch on Twitter, and @nigeriahealthwatch on Facebook and Instagram.

2 replies on “Halting future pandemics: A call for a strong government preparedness plan”

The update is very informative and the forum is very useful for cross -fertilization of ideas and stimulate interest of the public on the way forward for building capacity for future events.
There is an urgent need to address the current skepticism of the Nigeria public to the pandemic as shown in disregard to complying the preventive measures for Covid-19. A significant proportion of our population do not yet believe in the reality of the pandemic and this calls for our attention.

Well spoken.
Quite clearly preparedness for an emergency like the COVID-19 pandemic cannot be achieved on the short-term. It requires a long period of planning and building of the reqyired systems. And this must include an on-going public enlightenment program to ensure public acceptance of measures of infection prevention and control.

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