COVID-19: Key takeaways why epidemic preparedness is non-negotiable as Nigeria re-opens its economy

By Chidindu Mmadu-Okoli

The novel coronavirus is likely ascribed as the newly employed, intelligent, and most-hated class instructor, teaching the world a lesson it should have already learnt – health security is serious business!

As a result of the pandemic, we have seen businesses, schools, and religious places shut down. People have lost their means of livelihood, businesses have lost money and the Nigerian economy has taken a massive hit. Quite fortuitously, most Nigerians have realised  in these unprecedented times that “God forbid” is not an action plan for health security, neither is “It is not my portion” an accurate compass in epidemic preparedness.

COVID-19-positive cases have been on the rise since the Nigeria Centre for Disease Control ramped-up her tracing and testing activities. It could be argued that Nigeria having almost 40% of recoveries out of 12,801 laboratory confirmed cases as of 9 June, is proof that its disease prevention and management protocol has improved but there are still fundamental gaps that must be addressed. Drawing from different discussions on Nigeria’s response to the pandemic, these few takeaways are worth highlighting as Nigeria prepares to reopen its economy.

Examining the Status Quo: How Did We Get Here?

Prior to the  pandemic, Nigeria had been dealing with other infectious disease outbreaks such as, Lassa fever, measles, cholera, monkeypox, cerebrospinal meningitis, etc. These are still diseases of national concern and they speak volume of the current state of Nigeria’s healthcare system.

Sharing her thoughts at a media dialogue series organized by Nigeria Health Watch on COVID-19 and sustaining funding for health security, cancer-advocate and First Lady, Kebbi State, Dr. Zainab Shinkafi-Bagudu, opined that Nigeria’s situation is tantamount to sitting on a knife edge. “It is not all good, but it is not all bad”

She said: “The global outbreak is surprising. We have had ill-prepared budgets for epidemics and there is a grossly inadequate amount for epidemic preparedness. There is no reason we cannot have a proper health system. We are just not focused on it.”

To create sustainable plans for health security, the government at all administrative levels in Nigeria needs to be deliberate about fixing the health systems. Diseases can change lives forever and the current times have revealed the core need for epidemic preparedness.

A Joint-Sector Collaboration at all levels is essential for achieving a healthy nation. Speaking on  efforts made by his organisation towards responding to COVID-19, MD/CEO of the Aliko Dangote Foundation (ADF),Dr. Zouera Youssoufou, said it was already prepared from the time of Ebola Virus Disease (EVD). We received an intervention plan immediately after the first (COVID-19) case was recorded on the 27^th of February. We took charge of the port of entries and called private sector collaboration to fight COVID-19, known as CACOVID.”

Together, the Coalition against COVID-19 (CACOVID) raised N30 billion, with the Dangote Group of Companies contributing N2 billion to increase testing, ensure there are more isolation centres, and provide palliatives to select 10 million Nigerians living across the country. With the support of the Nigerian Governors’ Forum (GSF), more health workers from underutilized health facilities were trained and subsequently deployed to areas  where their services are urgently needed. “These joint public-private partnerships, they work!” Dr. Zouera emphasized.

Increase Tracing and Testing

As Nigeria relaxes its lockdown, priority should be given to vulnerable populations who are at most risk for and/or complications from contacting COVID-19. To do this, more funds will have to be channeled towards contact tracing, identity management, testing more people and managing COVID-19 positive patients. Also, other vulnerable populations such as newborns, pregnant mothers, people living with other infectious diseases or pre-existing medical conditions such as cancer, hypertension, diabetes, anaemia, or obesity, among others, need not be abandoned.

Set a budget line for public health emergencies

As with natural or man-made disasters, one disease outbreak can lead to loss of financial resources. To prevent and cushion these effects, the government needs to approve a budget-line dedicated to addressing public health emergencies in Nigeria. This is the core of financing epidemic preparedness, as it caters to all efforts geared towards preventing, managing and controlling disease outbreaks.

“We have a budget line for the National Emergency Management Service (NEMA). We can also have the same type of funding health emergencies in Nigeria,” Dr. Shinkafi-Bagudu recommends.

Currently, the approved National Action Plan for Health Security (NAHPS), a 5-year strategy document that highlights current financing gaps and critical capacities that Nigeria must continue to develop to protect its citizens, still awaits funding for implementation. The NAPHS document also shows the need for advocacy, resource mobilization, and coordination between relevant stakeholders in order to keep Nigerians safe and make health security a way of life.

Amplifying the Need for Universal Safety Precautions.

Our current epidemic preparedness level is proof of the need to ramp-up efforts towards adhering to universal safety precautions. There is a need to mainstream Water, Sanitation and Hygiene (WASH) into the national COVID-19 response framework and ultimately in our epidemic preparedness response strategy. More handwashing points with good hand hygiene materials should be made available in markets, schools, offices and other public places, as we go about our activities to reduce spread. The need for increased production of personal protective equipment (PPEs) like face masks and hand gloves and continuous monitoring for social distancing are non-negotiable as citizens press forward in their day-to-day life.

Health Insurance, Financing or Universal Coverage are pistons that drive the engine of health security. The last two outbreaks of global concern, EVD holds firm lessons for Nigeria to increase her citizens’ access to quality, affordable and skilled care, since diseases spread without regard for  people’s status or location. Nigeria may have been lucky that these outbreaks did not originate from remote villages with porous land borders, foot-crossings and ill-equipped primary health centres without adequate resources for detecting and handling outbreaks. However, there are rules to luck. Luck is a dividend of consistent commitment and health security should not be left to chance. Funding epidemic preparedness through health insurance is cost-effective and reduces delays that lead to the spread of infectious diseases in the long run.