Prof. Oladapo Ashiru
Medical experts under the aegis of Academy of Medicine Specialties, Nigeria (AMSN) have made recommendations on how to curb COVID-19 variants of concern such as Omicron and other health challenges in Nigeria.
President, AMSN, Prof. Oladapo Ashiru, told The Guardian that the country has so far been able to contain COVID-19 because the response to the pandemic was swift and the coordination went from the Presidential Task Force to the Federal and State Ministries.
“They listened to advice given by the experts such as virologists, the Rapid-Response Initiative Committee of the Academy of Medicine Specialties, and many lives were saved from the various treatment and prophylactic protocols provided. Safety preventive protocols were developed for COVID-19 and adhered to by a good population. Consequently, the pandemic casualties were very low compared to other countries. However, we have lost many people, especially those in high places. We have lost doctors, justices, engineers, Senior Advocates of Nigeria (SAN), Vice-Chancellors, and several other highly placed people. So, the impact and the import is very strong,” Ashiru said.
Ashiru, who is also the Medical Director, Medical Art Centre (MART) Maryland, Lagos, said the significant peculiar challenges confronting the health sector are loss of integrity, lack of honesty, corruption, and the absence of dignity, decency, and decorum. But for these factors, he said Nigeria would be rated highly worldwide. Ashiru said the only reason Nigeria got on the so-called red list is that government appointed some outfits to carry out mass vaccination.
He explained: “Unfortunately, in Nigeria, whenever there is a law, some people are ready to make money from it because there are willing violators. A typical example is that you can travel out of the country without being vaccinated, get the COVID-19 infection and end up with a negative COVID-19 test.
“Consequently, when they arrive at their destination and now test positive despite carrying a negative report, it lowers the integrity of our health sector. People are supposed to enter the country with a negative test report. Some manage to get in bribing their way.”
Ashiru, who is also a joint pioneer of In Vitro Fertilisation (IVF) in Nigeria and President, African Fertility Society (AFS), said that in Lagos State and Abuja, many achievements have been made by the health sector to vaccinate people with the few vaccines donated. “They have also been able to track COVID-19 travelers and ensure self-isolation through follow-up phone calls. The other states also tried to follow the monitoring protocols; hence we got the report of new cases daily from state to state. That was very efficient,” he said.
Ashiru said unless Nigeria commits itself to a cultural revolution, no amount of funding or human resources would help the health sector or any other sector. “Many are living with no conscience. They are as if there is no tomorrow. When they talk of budgetary allocation, it is always more of what is in it. Today, most decisions are made based on politics rather than merit. The location of the different institutions in the health service, effective management, and more should all be based on objective strategic planning,” he said.
The fertility expert said each geographical sub-regions of the country should be equipped with what they can handle, the staffing, the specific need of that region, and many more.
“There are stories of obsolete medical equipment, which at the time it arrived at the particular centre it was new. Sometimes we do not have the people to use them, and there is no robust maintenance infrastructure. When the computer first came, many executives bought them into their offices and covered them to gather dust until they became obsolete.
Ideally, they should have been sent for training immediately,” he said.
Ashiru said there is an urgent need for the health sector reform strategic meeting and it should be an open and apolitical strategic meeting for a complete characterisation of the various professionals within the sector. “There must be cooperation, collaboration, and mutual respect. Everyone is essential and has a role,” he said.
A Fellow of AMSN and former Deputy Vice Chancellor (DVC) University of Lagos, Prof. Sade Ogunsola, said the omicron virus represents one of the many strains “we have seen and will see.” She said there has been an overreaction by Western countries because by the time “you are identifying a strain it is too late. It was already circulating. We have no idea where the next strain will pop up but it is probably circulating already. We just need to beef up vaccination, avoid crowds and mask up in public.”
Ogunsola added: “We are already going into the 4th wave. Infections are rising. These will likely be on the basis of the Omicron virus at least we hope so because it appears to run a much milder course than the delta. If it does, then we will see less deaths.”
Ogunsola said the health sector has done well within the ambits of its funding. She said Federal Ministry of Health has been at the forefront of tracking the trends of COVID-19 virus transmission rates, tracking antimicrobial resistance rates nationally, and developing national policies on infection control.
Ogunsola said the impact of the brain drain is becoming very challenging. She said there is need to implement the National Health Act. “We need to properly delineate roles of healthcare workers. These should not be determined politically. We must depoliticise health. We must work to implement our National Health Insurance Scheme (NHIS) so that everyone is covered. Health must be better funded,” he said.
Another Fellow of AMSN and Professor of Virology, Prof. Sunday Omilabu, said Nigeria needed to overhaul the molecular laboratories handling the COVID-19 screening, with a view to checking the activities of fraudsters. “The quality management system should be improved upon,” he said.
Omilabu said there is some improvement in the health sector for the COVID 19 response but to the neglect of other endemic pathogens. “It shows the weakness of our healthcare system,” he said.
Omilabu said the main challenge is the inadequate funding. “A good number of our disease outbreaks response is still donor driven. The country is struggling to manage COVID-19. Our case search is not encouraging,” he said.
He recommended strengthening the healthcare system with adequate funding and project implementation. Omilabu said all priority endemic diseases and other health challenges should be adequately managed and not abandoned for pandemics.
He said active case search and disease surveillance should be heightened and genomic research and surveillance should be well coordinated with sufficient funding.
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