By Bukola AFENI
SAUDANA Rashida and her family of six live in Sauka, a suburb in the Federal Capital Territory. The family had been down with a cholera outbreak a few weeks back. They were at a loss of what to do due to the fact that they do not have a hospital very close to their place of abode.
The cholera outbreak affected some families in the Federal Capital Territory, including that of Saudana.
Year in year out, several households still face epidemics and pandemics in Nigeria. There must be holistic measures to tackle the outbreak of disease.
It is quite saddening that many residents in the Federal Capital Territory still do not know about epidemics management despite the fact that they live very close to the city centre.
According to the Center for Disease Control and Prevention, epidemics is a sudden outbreak of a disease in a certain geographical area. Pandemics on the other hand is an outbreak of a disease that has spread across different countries or continents.
Cholera outbreak and Lassa Fever can be called epidemics because it usually happens in certain geographical areas, while diseases such as Ebola, and Coronavirus happened in different continents and different part of the world, and they are called pandemics.
These two remain the dominant infectious diseases that have re-emerged several times and continue to pose a significant challenge to the Nigerian health system. With the emergence of COVID-19, it has added to the problem as to if the government is prepared in tackling the epidemic properly.
COVID -19 pandemic affected the whole world last year, and brought about a change in the way things are done in terms of work and means of livelihood.
Recently, the Nigerian government announced the surge of a third wave of the deadly COVID-19 pandemic, and the country is already witnessing increasing cases of the Delta variant in several states. This surge of COVID-19 third wave traceable in some parts of Nigeria is said to be a direct result of importation from other countries tagged Red listed countries like, South Africa, India, Brazil and Turkey; where this pandemic is very active.
Dr Umaru Gidado of Bwari General Hospital said generally there has been a lack of preparedness and nonchalant attitudes of African populations towards previous epidemics in the past.
He added that stakeholders in the health sector should have learnt from previous epidemics that ravaged the country and put in place necessary measures that will make the citizen aware of a new outbreak of diseases.
“The country had witnessed different series of pandemics and epidemics ranging from Ebola virus, Lassa Fever, Yellow Fever, Monkeypox and most recently COVID-19.We should precautionary steps to inform the populace about the emergence of new diseases”.
“To improve epidemics sensitization and funding in Nigeria, all the critical stakeholders must be on deck to perform their responsibilities, without shifting blame from one agency to another. They must ensure that effective response is available in case there is a disease outbreak. The different health bodies must be prepared in terms of staffs and equipment availability”.
Speaking further he added that the knowledge and attitude of people toward COVID-19 is critical to understanding the epidemiological dynamics of the disease as well as the effectiveness, compliance and success of infection prevention control measures. Also, putting in place workable epidemic disease preparedness and response strategies is critical.
Health experts have shown concerns on the need to prepare in a bid to curtail future emergencies that may arise due to current epidemics management by highlighting different strategies that will be used to inform the citizen about epidemics preparedness.
According to Dr. Mathew Ashikeni, President of the Association of Catholic Medical Practitioners, for the country as a whole to be abreast of future epidemic reoccurrence, stakeholders in the health sector should work in close partnership by working together in surveillance to monitor these diseases conditions on a continuous basis.
“Monitoring these disease conditions on a continuous basis is the only way we are going to identify immediately when the number of cases begins to increase. Whether you are talking about measles or COVID-19, it is the same principle we must continuously apply, and place in structures that will be monitoring them both from the health intuitions, the health care facilities and personnel”.
He said proper health security and monitoring must be in place to proffer lasting solutions to future epidemics.
“We want to see our health institutions properly positioned and ensure adequate health workers are available in terms of spread. The government should also ensure that Nigerians who reside in the rural area should have access to adequate health services”.
“Proper staffing of our health institutions, as well as equipping them to serve in such disease conditions, are the lessons we have learnt from COVID. We need to adequately prepare for infectious diseases that requires isolation and also educate the people about prevention mechanism”.
Proper funding of the health sector
Dr Mathew Ashikeni also reiterated the need to properly fund the health sector, especially in terms of epidemics and pandemic management.
He added that health security cannot be achieved with poor funding. While noting that partnership with other sector will go a long way in improving the health sector.
“We cannot be talking of health security with poor funding to the health sector. However, we must fund the health sector adequately to cope with such outbreaks, and we must recognize the fact that health is not only in the hands of the health sector. Proper orientation of the populace is critical to fighting against either current or future epidemic outbreaks” he emphasized.
In addition, he said educating people on any epidemic outbreak is a critical point of concern regarding preparedness for future epidemic outbreaks or control.
“The effort should begin with community engagement to understand the beliefs and perceptions of the public about the disease, which would, in turn, inform efforts towards educating the public as necessary.
Most importantly, the public should be educated on the importance of sanitation and hygiene while laying emphasis on the need to sustain already established hygiene recommendations after the outbreak is curtailed, not to be only revisited at the start of another.”
The WHO rated Nigeria as the 4th in the case of COVID-19 response which is to say in terms of our health security, we have built a lot of capacity and have filled the gaps by ensuring that a lot of capacities are in place to detect, prevent and respond to outbreak.
Dr Oyeladun Okunromade, the deputy director and head of one health division said there is need to provide sustainable funding for epidemic preparedness in the country.
“In case of any form of disease outbreak, beyond health, there is a lot of health and economy effect of an outbreak which could be severe, so we need money to put in to the domestic investment for preparing ahead of time, so that we will not be spending this amount of money responding to an outbreak”.
Steps taken in the past
Regarding epidemic outbreaks, there is a need for holistic preparedness at all levels. The deputy director and head of One Health Division of the NCDC, Dr. Oyeladun Okunromade noted that a lot of activities have been put in place by the NCDC in collaboration with relevant stakeholders using one health approach in building on the technical support from all partners to ensure that in any event of an outbreak, the mortality and mobility rate will be reduced as much as possible.
“In a bid to prevent a recurring outbreak the centre has been put in place various strategies to ensure that when there is any kind of alert or any form of notification from any state or even across the border, we carry out an inter assessment so that in the country we will assess our risk to that event”
“We would analyse the impact of risk based on the WHO standard on the country by looking at the hazard, looking at certain environmental factors among others” he noted.
She added that part of the epidemic preparedness that has been put in place at the National level by the centre includes the ‘Multi-hazard EpidemicPreparedness Plan’ which involves all stakeholders and agencies involved in emergency management, fraud, security and health sectors.
“Equally, we are planning on increasing our laboratory capacity and network across all the state to rapidly confirm any epidemic diseases within the community, as well as reliable logistics sample transportation System for delivery to the national level.
Part of the preparedness plan also is to ensure stockpile of supply and commodities across the state in terms of rehydration fluids for cholera, drugs and vaccines”.
Dr Oyeladun further added that surveillance officers are being trained at the state and Local government on how to identify any form of the outbreak and report promptly.
“We have improved on our capacity of Human Resource on training that we adopted from the Frontline field epidemiology training called the integrated training of surveillance across the country”.
Dr. Oyeladun emphasized that relevant stakeholders must invest in epidemic preparedness for the country to be abreast of the future outbreaks while noting that investing in preparedness is like buying health insurance ahead of time.
Call to Action
To a certain extent, the Nigerian experience with epidemic disease outbreaks depicts that with the right structure and resources, there is a possible chance against future epidemic outbreaks.
However, the structure must be accompanied with the appropriate personnel, sincere commitment from our leaders with foresight to plan for epidemic outbreaks, as no efforts spent towards its preparedness is a waste.
Thus, the need for increased and sustained funding for the Nigerian health sector cannot be overemphasized. Lack of funding has resulted in pervasive infrastructural decline. Without doubt, lack of standards in health service delivery, has invariably impacted negatively on outbreak preparedness and response strategies.
Integrated Disease Surveillance and Response (IDSR) should be appropriately implemented as a primary mechanism by which infectious disease outbreaks can be detected at their early stage so as to respond effectively.
It is presumed that Nigeria and other West African countries have a long history of under-reporting disease outbreaks for reasons which may be due to political, socioeconomic or health system factors. There is a need to massively engage in advocacy campaigns on epidemic outbreaks by media practitioners.
Media advocacy in epidemics prevention
Dr. Mathew Ashikeni while noting the importance of media as critical stakeholders in such endeavours, affirms that media is a very powerful tool in communicating epidemic related information to the public within a very short time particularly using online technologies that are readily accessible.
“The right information must be transmitted by the media to ensure that all information they are transmitting is coming from experts to avoid getting information from unconfirmed sources because misinformation can lead to more havoc, more deaths and more suffering”.
“It is important that partners keep working together for the health of our people, while government improves its funding for health so that all that they need to do, the technology they need to acquire, the manpower they need to work, the equipment’s and the services are adequately provided promptly because time is of the essence in controlling outbreaks, to avoid death records”.
However, the core capacities of disease outbreak preparedness are heavily reliant on solid health systems and infrastructure which comes from proper funding. To achieve this, it may be beneficial for the government to partner with other relevant stakeholders to determine ways of mobilizing the needed resources to finance preparedness and response strategies aimed at curtailing future epidemic outbreaks in Nigeria.
Dr Oyeladun Okunromade, the Head of One health division NCDC, said there is a need for the media to strengthen disease prevention capacity by providing information to the public and policymakers.
“The role of the media is very important, they are pace setters, and need to provide updates to Nigerians on a daily basis. The media are critical stakeholders and should pass information to Nigerians on disease prevention “.
The story is part of the Epidemic Preparedness and response series with support from the Global Health Advocacy Incubator. A program of the campaign for Tobacco-free kids and vital strategies.