Ayodeji Ake write on the thoughts of a United States’ Epidemic Expert, Dr. Tom Frieden, who recently visited Nigeria to share his ideologies on epidemics prevention
The incidents following the 2014 Ebola outbreaks in Nigeria showed that the country was not ready for disease outbreaks. Hence, according to report, Nigeria relies heavily on foreign sources to keep the citizens safe from diseases.
One of which is the World Bank’s Regional Disease Surveillance Systems Enhancement (REDISE) project, which for instance is currently funneling 90 million dollars into efforts to strengthen Nigeria’s epidemic preparedness. Which automatically signaled that the country’s epidemic funding is poor.
Despite the financial and technical support from multilateral institutions, governments and philanthropies, major parts of the National Action Plan for Health Security will remain unfunded without significant investment.
Yet, this year, Nigeria has had death records from disease outbreaks like Lassa fever. Other diseases at the fore are; Meningitis, Monkeypox, Yellow fever and Measles.
Although President Buhari’s administration, with the aim of preventing disease outbreaks in Nigeria passed the Nigeria Centre for Disease Control (NCDC) bill in November 2018, giving the agencies full legal mandate to continue protecting the health of Nigerians; in December, the first costed National Action Plan on Health Security (NAPHS) was launched; and the NCDC with its collaborating partners is building a network of Public Health Laboratories and establishing Public Health Emergency Operational Centres (PHEOCs), but more need to be done.
According to www.preventepidemics.org, with a Ready Score of 39 per cent, Nigeria is not prepared for the next epidemic. This implies that if an outbreak of an infectious disease happens today in Nigeria, it could lead to many deaths and could spread across international borders. As the Ebola outbreak has shown, the global health system is as strong as its weakest link.
On recent visit to Nigeria, President and Chief Executive Officer, Resolve to Save Lives, Dr. Tom Frieden, a physician trained in internal medicine, infection diseases, public health, and epidemiology, during the Roundtable Discussion organised by Nigerian Health Watch (NHW), held in Abuja, recently to discuss the nation’s preparedness level, stressed on adequate funding and corporation of the three tiers of government and the NCDC.
As Director of the Centers for Disease Control and Prevention, he oversaw the work that helped end the 2014 West Africa Ebola epidemic. Frieden noted the three major scope to epidemic preparedness were; budget, coverage, and effective spending.
In his words: “Nigeria has made an excellence start reducing epidemics risk which has a long way to go. I am encouraged by the progress of Nigeria’s NCDC. What we need to see is steady investment, support for states and Local Government Areas (LGAs), effective expenditure of national and international resources that are allocated.
“For people who are running local and health departments, it is very important to defend their budget, get grade A staff, defend the staffs, to prioritise and to look at the core things that will keep your population safe by having tracking or surveillance systems for the key diseases, effective laboratories with effective laboratory networks that can respond rapidly to outbreaks, do you have people in place, cultural data ? It’s important to have data so to use the data to improve performance”.
He mentioned the implementation of a disease tracking device which will enable for rapid response for disease outbreak.
“The disease tracking system is fundamentally important. It is seen as a system within the society to detect problems so response can be rapidly made. One of the things we are looking at in Nigeria and globally is tracking the time frame for response. How long does it take between the emergence of the disease and starting control measures,” he said.
Frieden commended NCDC for epidemic interventions and urged for laboratories development, building rapid response teams for swift epidemic detection.
“The NCDC is growing. Recently they are increasing the number of staffs. The cultural data needs to grow and the laboratories should be well develop for rapid response, and their support for States as partners is crucially important because an institution like NCDC should be effective at the states and LGAs.
“The issue of appropriate materials, using radio and other means of communication is very important. What we found in the 2014/2016 Ebola outbreak was that we need to engage the leaders within the community to make sure that communities should have concerns for outbreaks” he said.
He also said creating awareness at the grassroot is key. He added that communicating through the media and community leaders at all level of government to educate them on epidemics; causes and prevention will go a long way.
He concluded by emphasising that budget was very key to epidemic prevention.
“We encourage the people to check the epidemic website to get information with what is happening with outbreaks and countries performances in terms of how ready they are. We encourage stories on outbreaks to be apparent not only to the public but also the decision makers. Everyday children and adults are at risk for preventable illness and death.
“To better protect people within the society, its increasingly important that we focus on few things; how much money is been spent on public health, show me your budget and I will show you your priorities; secondly, is that money going to the front lines of the budget of the states and LGAs for effective response of outbreaks?, and thirdly, are you doing what you need to do get the money spent effectively and well?” he said.
In a nutshell, to be prepare for disease outbreaks, Nigeria need to adequately increase budgetary allocation for epidemics, training health workers in early detection and response, educating communities about epidemics and prevention, fascinating health workers in high risk areas, equipping health facilities, and conducting stimulation exercises to maintain a high level of readiness.
Dr. Tom Frieden now leads Resolve to Save Lives, a 225 million dollars, five-year initiative housed at Vital Strategies, which aims to save millions of lives from cardiovascular disease and make the world safer from epidemics.