BusinessDay

2020: The year of health systems failed COVID-19 litmus test

When 2020 began, Nigeria had 832 cases of Lassa fever across 23 states. Yellow fever had been nipped in the bud to just 2 cases by week 52, giving impression that outbreaks were under control.

But it turned out to be the year of pandemic, heralded by the rapid spread of COVID-19 across the country, like most parts of the world.

2020 was the year the health infrastructure in Nigeria were tested by the Coronavirus pandemic which experts and the federal government admit exposed the deplorable state of Nigeria’s health system.

Nigeria confirmed the first case of COVID-19 on the 27th of February 2020 in Lagos State and recorded the first death on the 22nd of March, 2020.

As the virus ravaged America and Europe, Nigeria, however, began to witness a decline in the number of covid_19 cases in August and all lockdown measures were lifted, but started recording an increase in cases termed the second wave in December.

The federal government during the first heat of the pandemic and the lockdown it imposed vowed to draw lessons from the pandemic and strengthen its health care system, but have come under criticism for failing to do so.

On 28th July, the Nigeria Centre for Disease Control (NCDC) failed its own target to test two million Nigerians within three months, with a little over 200,000 tests done. The target was set on April, 28th, 2020.

Private sector to the rescue

In March, Nigerian private sector leaders announced Creation of the Coalition Against COVID-19 (CACOVID) is a Private Sector task force in partnership with the Federal Government, the Nigeria Centre for Disease Control (NCDC) and the World Health Organisation (WHO) with the sole aim of combating Coronavirus (COVID-19) in Nigeria.

This task force pulled resources across industries to provide technical and operational support while providing funding and building advocacy through aggressive awareness drives.

This task force is tasked with pulling resources across industries to provide technical and operational support while providing funding and building advocacy through aggressive awareness drives.

The Coalition provided and equipped medical facilities in the six geopolitical zones in Nigeria. This will involve the creation of testing, isolation and treatment centers, and include the provision of Intensive Care Units (ICUs) and molecular testing labs. With Lagos (1,000 beds), Kano (500 beds), Rivers (210 beds), Abuja (200 beds), Enugu (200 beds) and Borno (200 beds), also set up facilities in Katsina, Ogun, Bayelsa, Anambra, Bauchi and Plateau.

Strike Action by Health Workers

As the country continued to battle the pandemic, strike actions by health care professionals rocked the sector over issues bordering on welfare and the deplorable state of infrastructure in public health facilities. It is practically an unwritten law in the health sector structure that either doctors or other health workers must go on strike each year in Nigeria as part of an expanded ritual to assert their power over each other or to make their demands heard by the government.

This year wasn’t any different. For every time this ritual occurs, the country loses patients. As the country has been witnessing COVID-19 pandemic and as a second wave ravages, a spike in infections has been seen in Africa’s most populous nation, leaving at least 20 Nigerian doctors die in one week from COVID-19 and also more than 1,000 health workers reportedly tested positive for coronavirus

Many doctors do not have access to Personal Protective Equipment (PPE) before attending to patients, according to the report.

As of June 2, 812 health workers in Nigeria tested positive for COVID-19, according to Health Minister Osagie Ehanire, according to the website.

On 14th September, the nation’s health sector suffered more paralysis, when the Joint Health Sector Unions and Assembly of Health Care Professionals (JOHESU) began a strike over the failure to reach an agreement with the Federal Government over the demands of the workers.

On Monday June 15, 2020, The National Association of Resident Doctors (NARD) commenced on an indefinite nationwide strike. On 4th September, the Nigerian Association of Resident Doctors (NARD) again began a nationwide strike over the federal government’s failure to honour demands including the implementation of residency funding, COVID-19 allowance, payment of hazard allowance and the outstanding salary shortfall of 2014, 2015, and 2016.

Certified wild polio free

Another major activity that shaped the sector is the certification of Nigeria free of the Wild Polio Virus after over a decade of battle. Nigeria and Africa were on Tuesday, 25th August certified polio-free by WHO, but experts have warned that Nigeria may record a resurgence long as the poliovirus is still active in the Asian region and the menace of the circulating vaccine-derived poliovirus remains in the continent.

Other outbreaks robbed of attention

Covid-19 distracted to aids programmes including the provision of tuberculosis drugs, HIV drugs, malaria bed nets, measles campaign and other routine immunization efforts.

In June, for instance, Nigeria recorded an outbreak of measles in 13 local government areas of Niger during the lockdown as routine immunisation stopped and mothers shunned health facilities on fear of contracting the virus

Despite being certified polio-free, millions of children in Nigeria were at risk of fresh exposure to polio, measles, diphtheria and other diseases.

Also, on April 28. 2020, the Nigeria Centre for Disease Control (NCDC) declared an end to the emergency phase of the 2020 Lassa fever outbreak after the country recorded at least 188 deaths and over 4,400 cases across 27 states. However, Nigeria confirmed cases of yellow fever from seven LGAs across four states early October.

The yellow fever outbreaks recorded this year were a total of 3,097 suspected cases and 108 confirmed cases reported from 488 local government areas (LGAs) across all states and FCT

Universal Health Coverage (UHC)

On the issue of Universal Health Coverage (UHC), the Nigerian government made moves towards the attainment of same by 2030.

The National Health Insurance Scheme (NHIS) in November launched a new health insurance programme known as Group, Individual and Family Social Health Insurance Programme (GIFSHIP) for Nigerians who are currently not insured by their employers and to rapidly expand the scope of healthcare coverage in Nigeria and urgently attain UHC.

The federal government also in November inaugurated a Ministerial committee to drive the provision of health insurance for retirees and elderly Nigerians and also attain the much desired Universal Health Coverage (UHC) by 2030.

Further, the National Primary Health Care Development Agency (NPHCDA), has rolled out a 10-year roadmap to significantly reduce out-of-pocket expenses and drive the attainment of Universal health coverage in Nigeria by 2030.

As the global community intensifies efforts towards the procurement of vaccines to defeat covid-19, the Federal Government in November announced plans to set up a vaccine production company in Nigeria and work towards licensed indigenous production of Covid-19 vaccines.

Subsequently, the federal government on Thursday signed a Memorandum Of Understanding (MoU) with Biovaccine Nigeria Ltd (BVNL) to begin local production of vaccines and enable Nigeria achieve self-reliance in vaccine production.

In July, Nigeria received the sum of $890 million as a grant from the Global Fund to fight HIV/AIDS, tuberculosis (TB), malaria, and support Health Systems Strengthening Programmes over an implementation period of three years, beginning from 2021 to 2023.

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