Thought Leadership

Swine Flu – Before we embarrass ourselves

Before we embarrass ourselves like the Egyptian Government that exposed the depth of their ignorance, and Africa to ridicule yet again by ordering the slaughtering all the pigs in their county

We appeal to our Government to get its act together and give correct and coherent advice to the Nigerian people on the new H1N1 virus, that emerged from Mexico.

As we have said severally on this blog, as long as there is no central agency to organise infectious disease surveillance and outbreak control, we will have to continue fumbling through these incidents.

Our government needs to act responsibily and seek the best advice from the best possible sources and advise its citizens.

The 2 objectives have to be:

1. To mitigate the public health risk.

2. To manage public anxiety.

Both these are equally important and one will not work without the other.

Reports like these in the papers show an emerging ignorance on the key issues:

Vanguard: Nigeria swine flu-free — Minister of Health Prof. Osotimehin

How does he know this??? (assuming he was quoted directly). Nigeria does NOT have the laboratory capacity to diagnose this new virus. Thats a fact you can quote us on. Even if it did…the only reason there are no cases in Nigeria would be that there are no direct flights to Mexico, and travel between Nigeria and Mexico is minimal. Once there is significant community spread in countries with significant air travel to Nigeria, transmission in Nigeria becomes inevitable.

Thisday: FG Orders Aircraft, Ships Clean-Up On Arrival – Minister of Environment Mr. John Odey

This requires no further comment and just exposes the depth of ignorance on the problems we face.

Most of the public health workforce around the world is working flat out to mitigate the impacts of this virus, as the world faces several other problems. Governments are launching proactive programmes daily to advise their populations on what to do, how to do it and when to do it.

We might yet stop its spread. But at this point in time…we simply do not know that. Any responsible government will be at its highest possible level of preparedness.

Does anyone remember what happened after the explosion at the Ikeja Miltary Cantonement on the 27th of January 2002? 90% of the estimated 1100 Nigerians that lost their lives, died not from the explosion but from the ensuing anxiety that led to people drowning in a canal while trying to “escape”. Have lessons been learnt? Only time will tell…

Please if you have access to those that make policy, do your country a favour and bring this to their attention, and push them to act.

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

By Chikwe Ihekweazu

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.

2 replies on “Swine Flu – Before we embarrass ourselves”

I read with keen interest your analysis of the Swine Flu and the response of the Health Authorities to the sitaution.

I guess we should endeavour to give the current Minister some benefit of doubt.

I read this in Punch newspaper today and it gave me some high level of confidence:

“The Federal Government has begun the process of emergency procurement of additional doses and stockpile in case we have human cases.We are anticipating to have two million doses of the drug (Tamiflu),” Ojuolape, who answered initial enquiries by email, said. Later when our correspondent requested for further clarifications by telephone, he confirmed that government had indeed placed an order for the drug, saying, “Yes, we have placed an order for it.” He, however, did not give the cost of the drug.

He said Nigeria only had about 100,000 doses of the drug at the moment. According to him, government does not envisage that the outbreak of the disease will be massive, if it gets to Nigeria..He said, ”In countries that the disease has occurred, the total number of cases that have been recorded has not exceeded 500.”

Ojuolape said the country’s present stock of Tamiflu was procured last year for treating the bird flu, which recorded only one human victim in the country.

”The drugs are already in the states, but if there is any state requiring additional stocks, we have machinery with which we can get the drug to such a state.” According to him, Tamiflu, which is manufactured by a Swiss pharmaceutical company, Roche, has been distributed to 36 states and the Federal Capital Territory. He added that the drugs were stored at federal and states‘ ministries of health stores as well as some hospitals in all the states.

When asked how many people could be treated with 100,000 doses of the drug, the minister stated, ”We should remember that for Avian Flu, we had only one confirmed human case so far. We think from the past experience and lessons learnt from other outbreaks, we will not have a lot of cases.”

According to him, if a lot of cases are recorded, more procurement will be made within a very short time.

Meanwhile, as governments all over the world rush to equip their airports with thermal scanners, the Federal Government is yet to do so.

This situation is contrary to government‘s promise, at the beginning of the week, that scanners would be installed at all entry points to screen people coming into the country. Saturday Punch‘s findings showed that, rather than the sophisticated scanners, health officials are using unrealiable disposable thermometers.

Our correspondent, who paid a visit to the Murtala Muhammed International Airport, Lagos, on Thursday, did not see any thermal scanner at the arrival lounge of the country‘s foremost airport.

The thermal scanners are special scanners that screen passengers as they disembark from an aircraft, showing their body temperatures on screens monitored by health officials.

For example, some of the thermal scanners deployed in some Asian countries are configured in such a way that passengers with temperature above 37C are quickly identified and isolated.

Since high bodily temperature is one of the symptoms of the swine flu the thermal scanner is considered as one of the important first line preventive measures of stemming the spread of the flu.

Experts say that the non-deployment of the scanners could defeat the strenuous efforts that the Minister of Health, Professor Babatunde Osotimehin, has made in the last days to combat the flu. However, the minister tried to play down the importance of scanners insisting that government‘s efforts were adequate. ”There are no machines with which you can scan and identify viruses at the ports. If such scanners exist, the United States and Mexico would have installed them. It will take laboratory tests for us to identify and isolate viruses.

”What was meant was the fact that we are going to mount surveillance, through our officials at the airports so that we can detect as soon as possible the entry of anybody with the virus. Note that it is carried by humans and not necessarily airborne per se. Further to this, government has directed that all aircraft arriving the country be checked and cleaned up to ensure that both passengers and luggage have no trace of the influenza in them. Also, starting from today (Friday), port health authorities are to board planes arriving to try to identify anyone with flu with a view to clinically testing them in order to track down the entry of the flu by anyone.”

Officials of Port Heath Services at the Lagos airport, who refused to speak on record, confirmed to our correspondent that the equipment had not been installed but that they were presently using disposable thermometers to measure passengers‘ temperature. They also said that no case had been discovered yet. Experts have, however, said that using thermometers to measure passengers‘ temperatures may lead to a situation where impatient health staff may overlook those that ought to be checked. Our correspondent observed that due to the volume of passengers, it is difficult for PHS workers to test every passenger with the disposable thermometer.

The Port Health Services, which had issued an alert on the swine flu to airport managers and immigration, now has two stands located ahead of the immigration desk arrival hall, an arrangement that makes them passengers‘ first contact point.

Aviation and medical experts have said that Nigeria would have to be vigilant since its people travel a lot and is a country that is visited by people from different countries. The Head, Public Affairs, Murtala Muhammed International Airport , Lagos, of the Federal Airports Authority of Nigeria , Mr. Ola Ogundolapo, said that there were flights coming into the country from the various countries the flu had affected, on a daily basis. There are seven weekly flights from United Stated of America into Nigeria through Delta Airlines. There are about 60 weekly flights from various parts of Europe to Nigeria through British Airways, Air France, KLM, Turkish Airline, Lufthansa and others. However, he said that all agencies working at the airport had been put on alert by the Federal Ministry of Health through the Public Health Department‘s Port Health Services at the Lagos and Abuja airports, and that masks, gloves and thermometer had been made available to them.

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