FG response to rising Lassa fever epidemic condemned

The federal governmentand health ministry officials are under stinging criticism over its un-coordinated response to the deadly Lassa Fever disease outbreak currently sweeping through the country, as death toll and reported cases mount.

So far the disease, which is named after Lassa village in Bornu state,the village in which it was first discovered in 1969, has been reported in 10 states in the past 6 weeks. There are now over 40confirmed deathsand over 93 reported cases. Lagos, Abuja and Ondo States were the three latest states to confirm deaths (3 in Lagos, 1 in Abuja and 2 in Ondo). The Lagos State teaching Hospital has since been put under red alert.

Federal health officials say it’s not yet an endemic case to declare an emergency. “Given the current level of the disease, it would be too hasty to declare a national emergency as was done with the case of Ebola,” according to Project director, National Centre for Disease Control, NCDC, Prof. AbdulrahmanNasidi, in recent media chat.

Critics and medical practitioners quickly dismissed Nasidi’s comments as “irresponsible” and have seized on what they view as uncoordinatedand slow response by the authorities to highlight the consequences of not declaring a swift quarantine of the disease hotbed nationwide as well as putting in place known systems and resources in the hands of appropriate agencies in this emergency.

“The response so far is very unprofessional and not enough,” says Sylvan Ebigwei, MON, consultant dental surgeon, who also recalled his experience at the Lagos University Teaching Hospital, Lagos,following the first major outbreak in 1969, which left many medical doctors and nurses dead in its wake.

“We need to put a trace on everyone that have had contact with known fatal cases or suspected cases, isolate them, observe them and quarantine them immediately,” he told BDSUNDAY in a telephone interview. “Many of the suspected cases must have had contacts with others either as they travel or in their various communities. So, your first response is not to raise a committee who will spend days traveling while more people are dying.”

The health minister in a press briefing on the onset of the out break told news men he was setting up a committee after widespread reports of fatalities started emerging. The committee chaired by Prof. Michael Asus, is to visit Kano, Niger and Bauchi, the three most endemic state, for fact finding, assess the current situation, document response experiences, identify gaps and proffer recommendations on how to prevent future occurrences.

A consultant in one of the nation’s leading teaching hospitals was visibly disturbed by the approach of the health ministry on the issue as well as on funding and documenting disease control in the country.

“Yes, we can not fully prepare for this type of outbreak, but what I can say is that Nigeria’s preparedness and ability is much below expectations. We don’t have facilities, for instance, to mine patterns of illness that herald the next deadly outbreak,” he said. “So, it is not just enough to set up a committee at every outbreak. We must have a long term, sustainable approach to dealing with them. The Ebola scare would have acted as a wake up call for Nigeria.”

A number of other medical experts BDSUNDAY spoke to were not sure there is even adequate and strategic means to study the genetics of the disease or whether there is a link to other advanced economies where details of the strain of the disease can be shared for study and recommendation on how future occurrences can be avoided.

Others where particular about information dissemination pattern on the current outbreak and subsequent outbreak.

“What I think government should focus more is on the creation of awareness. This could be done through the media by the National Orientation Agency (NOA). People must be told to put their waste bins away from the reach of rats and food items must be properly covered, especially by those who live in places where the species of rats that cause the virus is prevalent,” Dr. Prudence Oledingwa, medical director of Elfry Family Clinic and general secretary, Association of Generaland PrivateMedical Practitioners of Nigeria(AGPMPN), Surulere Zone 2 Branch, said,in response to the issue of information dissemination. “There’s the need for strategic information dissemination,” he added.

Explaining the reason for the committee established by the Federal Government on the Lassa fever, Oledingwa said: “The committee is working in collaboration with the ministry of health. It is not working blindly. What it is set to do is to check the spread of the virus by way of distributing relevant medicines to control the symptoms as it doesn’t have any known cure. If the immune system is high, the victim can overcome it.

It’s not clear why they were no early warnings and why until now there is still no national mobilization and a consistent communication strategy against the disease with potential to erode national gross domestic product, GDP. Experts say that is a ‘very serious gap’ amid the rising nationwide panic in hospitals and communities across the country.

“We don’t have a clear future road for scaled-up response to outbreaks like this. This is what we have been calling for since the Ebola outbreak,” a federal health ministry source told BDSUNDAY. “By now, what we should be doing is sharing samples of recent outbreak with laboratories around the world for studying and preparation of vaccine and inviting the World Health Organisation, WHO, to provide support.”

Some observers pointed to the current level of health care funding as the major handicap to proactive thinking when issues like this occur. Currently, according to federal statistics, less than 5 percent of GDP is spent on health care annually, this equivalent toper capital expenditure of $94 which issignificantly below BRICS average of $600. About 68 percentof total health expenditure is from private out-of-pocket. Experts say this essentially prohibits access to quality health care for most of the population, while Physician/population ratio is 0.4/1000. Besides, over the years, there has been insufficient capital investment to improve quality of healthcare from the supply side also, according to expert reckoning.

Many failings of the health sectoris highlighted in a document by Transition Committee of the current administration exclusively obtained by BDSUNDAY. The report noted the ineffective leadership of the Health system by the Federal Ministry of Health, lack of clarity in the division of responsibilities across different levels of government and poor operational coordination between each tier of government and lack of transparency and accountability within the health care system.

Nevertheless, health watchers say what is happening now should serve as a lesson, which has potentially presented the country with the opportunity to move forward, while working towards improving its preparedness and ability to tackle complex disease cases.

 

CHARLES IKE-OKOH