The Covid-19 pandemic remains the most serious public health emergency facing our country today. Without any statistical data to help us understand the pattern of infection by age, gender or state, the discussion regarding how best to tackle the pandemic continues to be driven by geo-politics just as the vaccination plan drips of guesswork, superstition, lack of precision and an embarrassing transparency deficit. Of the 100,000 doses of Pfizer/BioNTech coronavirus vaccine we are expecting, for instance, the Executive Director of the National Primary Healthcare Development Agency (NPHCDA), Faisal Shuaib, has released a sharing formula.
The highest number of vaccines (3,557) goes to Kano while Cross River State with ‘no known case’ of infection gets 1,203—far larger than the miserable 695 doses allocated to the FCT. Others are: Lagos, 3,131; Katsina, 2,361; Kaduna, 2,074; Bauchi, 1,900; Oyo, 1,848; Rivers, 1,766; Jigawa, 1,712; Niger, 1,558; Ogun, 1,473; Sokoto, 1,468; Benue, 1,423; Borno, 1,416; Anambra, 1,379; Kebbi, 1,268; Zamfara, 1,336; Delta, 1,306; Imo, 1,267; Ondo, 1,228; and Akwa Ibom, 1,161; Adamawa, 1,129; Edo, 1,104; Plateau, 1,089; Enugu, 1,088; Osun, 1,032; Kogi, 1,030; Abia, 955; Gombe, 908; Yobe, 842; Ekiti, 830; Taraba, 830; Kwara, 815; Ebonyi, 747; Bayelsa, 589 and Nasarawa, 661.
Lagos has been the epicenter of this public health emergency and accounts for the majority of victims—including high profiles cases—so you expect that efforts would be concentrated on the city state. But that appears too much to ask from those who would always anchor public policy on base sentiment and clannish politics. Meanwhile, it seems the vaccination process has more to do with procurement than the pressing challenge of public health. In a recent interview on Channels Television, Kogi State Governor Yahaya Bello imputed that some officials have turned COVID-19 to a lucrative enterprise and are merely prescribing what he described as ‘cut and paste’ solutions from Europe and America without paying much attention to the local environment.
While I do not subscribe to the governor’s infantile insistence that COVID-19 does not touch Kogi people or his conspiracy theories on vaccines, I agree with him that the entire management of the pandemic is not anchored on any strategic thinking. How does one explain the obsession about vaccines when it is common knowledge that vaccine efficacy is a function of temperature and availability of cold chain facilities? In a country where electricity supply is at best epileptic, all we have so far been told is that vaccines are being expected, with various cost estimates touted depending on who is doing the talking. Yet, the Nigerian Institute of Medical Research (NIMR) Director-General of NIMR, Prof. Babatunde Salako has revealed that there is not enough space at the moment to store the COVID-19 Pfizer vaccines expected to arrive next week. If we have no capacity to store 100,000 doses of vaccine, where will we dump the millions the federal government wants to procure?
These are some of the obvious challenges. But perhaps more important is that the majority of Nigerians still do not believe COVID-19 is real. And there are no concerted efforts to address that challenge beyond barking orders. Indonesia began its vaccination programme last week Wednesday and in a deliberate move to counter public cynicism, authorities decided to enlist social media titans among the first group to be vaccinated. Along with President Joko Widodo, a 33-year-old television personality, Raffi Ahmad—who boasts almost 50 million followers on Instagram—was also vaccinated. “Alhamdulillah a vaccine … don’t be afraid of vaccines,” the celebrity wrote under a video of him receiving the shot. This is clear thinking. Imagine if we enlist Don Jazzy, D.J. Cuppy and other celebrities who command huge social media followings and strong voices to lead the campaign on the wearing of face masks, social distancing etc. Or people like Ali Baba, Bisi Olatilo and others who have tasted the rage of COVID-19 and can speak from experience. Not even religious leaders have been meaningfully engaged despite the fact that they hold the key to making our people comply with the COVID-19 protocols.
Deprivation arising from the lockdown imposed on Lagos and Abuja last year partly explained the maniacal (some would say animalistic) looting of food stores that followed the End SARS protest. So one can only imagine what would happen should a national lockdown be imposed, as being contemplated by the Presidential Task Force. The fact that countries in Europe are on lockdown does not mean we have to follow the same route. With millions of desperately hungry people, such a gambit in Nigeria at this period is not only bound to fail, it could ignite civil unrest that will be difficult to contain.
To compound the challenge, we have to contend with the usual issue of accountability. From selective appointment of vendors without due process to lopsided and discretionary distribution of money and food items during the lockdown, allegations abound of how middlemen and influential stakeholders have turned the pandemic into a money-spinner. Billions were spent on ‘feeding’ pupils at a period schools were not in session! Many in the private sector have also cashed in on the COVID-19 bazaar. Almost everybody is setting up their own ‘testing centres’ and I have been told one can now purchase ‘COVID-19 vaccines’ in Lagos traffic!
Shortly before his ordeal started in June last year, the suspended Economic and Financial Crimes Commission (EFCC) acting chairman, Ibrahim Magu said his operatives were on the trail of top public officials appropriating to themselves huge sums of money meant to address the Covid-19 pandemic. “At the appropriate time, we shall make public our position on the management of the Covid-19 funds and explain to Nigerians who got what, disbursed what and to who and for what purpose, in order to make Nigerians know how their money was used,” Magu promised at the time. A month earlier, the Independent Corrupt Practices and other related offences Commission (ICPC) Director of Operations, Akeem Lawal, said there were “instances of agencies involved in fraudulent purported procurement of Covid-19 palliatives, personal protective equipment (PPE) and community enlightenment activities; cases of state governments using the Covid-19 pandemic to financially exploit local governments.” When the senate probed allegations of financial malfeasance against the dissolved interim management committee of the Niger Delta Development Commission (NDDC), a sum of N1.49 billion that could not be properly accounted for was also purportedly expended on COVID-19. Yet, despite the high risks associated with being on the frontline of the fight against the pandemic, health workers in the country have neither been adequately motivated nor given essential protective gear for their work.
Science in all its aspects, according to the president of the European Council for Nuclear Research (CERN), Ursula Bassler, “is a single and essential endeavour, and covid-19 has shown the importance of putting its results at the heart of decision-making”. Politics, not science, is at the heart of decision-making on the management of the pandemic in Nigeria. A neuroscientist, Dr. Chidi Njemanze, argued last Saturday in PUNCH that spending hundreds of billions of Naira on a virus that has continued to mutate into more variants, when the national health budget is N46bn, doesn’t show strategic planning. “We are jettisoning primary things that we are supposed to do; things like getting adequate PPE and gloves for healthcare workers,” said Njemanze who counselled the federal government to be guided by our national need rather than what is going on abroad. “Decisions are being made by politicians who have no idea about what medicine is all about.”
On Monday, Health Minister, Dr Osagie Ehinare announced the release by the federal government of the sum of N10 billion to support COVID-19 vaccine production in the country. With a penchant for working from answers to questions, I don’t know how this is supposed to work. I just hope priority funding will go to the Nigerian Institute for Medical Research (NIMR) and National Institute of Pharmaceutical Research and Development (NIPRD). I understand that the NIPRD has already identified a vital ingredient that could help in treating the disease but lacks requisite resources for research and the production of pharmaceutical products.
With 10,300 confirmed cases reported from just 50,750 samples tested in one week—translating to a 20 percent infection rate—it is obvious that we have a serious problem on our hands in this second wave of the pandemic. Now that COVID-19 is claiming our promising professionals (and I know quite a few), we need to assemble experts who can come up with practical preventive solutions that we can sell to the public. Many countries in Asia rely on a mix of herbal and orthodox medicine and there is no reason why we should not do that.
While most developed countries devote between 1 to 5 percent of their Gross Domestic Product (GDP) to research and development, most of the meagre 0.04 percent we allocate to R and D in Nigeria is targeted at procurement. Yet the country boasts of reputable scientists who, if encouraged, can help us mitigate this COVID-19 pandemic, especially given the similarities of its symptoms with malaria. The seminal work on Ivermectin for prophylactic and therapeutic purposes led by the MD and Chief Consultant, Rachel Eye Center, Prof. Olufemi Babalola is a ready example. Both Prof. Babatunde Salako at the NIRM and Dr Obi Adigwe at the NIPRD are also reputed experts who, if given the needed support, can lead efforts to find local solutions for the COVID-19 pandemic. Unfortunately, our charity never begins at home.
In my column, ‘Nigeria in A Zoom New World’ on 21 May last year, I counselled on the necessity to create an environment for research activities, especially in the health sector. “COVID-19 is a virus and malaria is a parasite, but there have been many tales to suggest that both preventive and curative drugs for the virus could be found in Africa” I wrote before adding, “At the risk of sounding pessimistic, something tells me that, as with Lassa fever that has become a yearly epidemic killing hundreds of our citizens, Nigeria could still be dealing with COVID-19 years after the rest of the world has moved on.” We should do everything to avoid such a tragic outcome.
I have been speaking with respected medical practitioners across the country and what stands out clearly is that government is not engaging the right stakeholders on how to fight this pandemic. For a low income country like ours, repurposing drugs ought to be on the front burner. Since most respiratory viruses, according to medical experts, are self-limiting, educating Nigerians on how to boost their immunity using locally available food and medications gives them a better chance in fighting the virus and other diseases. We must begin to sensitise people along that direction while making PPEs available at affordable prices. Frontline workers, especially in hospitals and primary health centres not certified to treat COVID-19 as well as in ‘drug stores’ within local communities remain the first port of call for people nursing ‘Malaria’. These health workers are even more prone to COVID-19 infection than those in certified treatment centres.
On the whole, I have no problem with vaccines. However, the federal government should look inward and think beyond purchasing vaccines for one virus to revamping the entire health sector in Nigeria. The same goes for authorities in the 36 states and I am delighted that governors are already discussing possibilities. Since every crisis comes with its opportunities, we should leverage the pandemic to strengthen the primary healthcare system in the country by rallying people at the grassroots not only in risk communication but also in identifying local remedies. This way, it will be easier to mobilise communities for compliance with COVID-19 guidelines and help to contain its spread in Nigeria.
In his interview with Chris Cuomo on CNN last month, Director of the American National Institute of Allergy and Infectious Diseases (NIAID), Dr Anthony Fauci said that even after taking vaccines, Americans cannot dispense with face masks, social distancing, hand washing etc. until the “overwhelming majority of the country must have had COVID immunity either through vaccination or herd immunity.” Fauci added that people who get the vaccine could still be infected and that has been proved to be true. Since the January 6 invasion of the Capitol, no fewer than six members of Congress have tested positive for COVID-19 despite receiving one or two doses of the vaccine last month.
What this means in effect is that for COVID-19, the surest antidote still remains prevention. In an environment like ours where we have neither the resources to purchase, nor the capacity to store these expensive vaccines, that is the ‘gospel’ those in authority at all levels should be preaching to Nigerians!
America after Trump!
One of the most controversial eras in American history ended yesterday with the inauguration of Mr Joseph Robinette Biden Jr. as the 46th President of the United States. He succeeds Mr. Donald Trump whom he defeated in the 3rd November 2020 election. While the history of every country is defined in phases and epochs, it is safe to conclude that in many decades (and perhaps centuries) to come, the discussion of American presidential contests and conduct will most certainly be dichotomized as ‘Before Trump’ and ‘After Trump’. “Politics doesn’t have to be a raging fire, destroying everything in its path,” Biden said in his inaugural address yesterday. “Every disagreement doesn’t have to be a cause for total war. And we must reject the culture in which facts themselves are manipulated and even manufactured.”
It is a testimony to the resilience of American democracy that it survived Trump as I pointed out last week in my column, https://www.thisdaylive.com/index.php/2021/01/14/lessons-from-trumps-foiled-coup. But the real work lies ahead for Biden and his team. Trumpism, as an idea is now a global phenomenon and the (now former) American President who unleashed the demon of hate and intolerance has pledged that we have not heard the last of him. “Unlike most inaugurals suffused with joy and a sense of fresh beginning”, as a New York Times report pointed out yesterday, “the festivities on the nation’s 59th Inauguration Day served to illustrate America’s troubles.”
President Biden certainly has his job cut out for him!