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How governments, private sector can collaborate to strengthen epidemic preparedness in Nigeria

The current experience from the COVID-19 pandemic should provide a solid ground for the Nigerian government to change its attitude to the funding of epidemic preparedness in the country.

The government and indeed the citizens have felt the devastation that COVID-19 visited on the economy and the response to it presents an opportunity for the country to improve on the funding of its healthcare and epidemic preparedness.

Thankfully, the governor of Lagos State, Babajide Sanwo-Olu, has emphasised the need for strategic preparedness against pathogens of high consequence and infectious disease as key in strengthening Africa’s resilience in tackling emerging bio-security threats.

Epidemic preparedness is funding, especially funding to help the health sector prepare before any outbreaks occur. The important thing that funding epidemic preparedness helps countries do is that with proper research and analysis of trends, it can help them predict, prepare for and even prevent the next epidemic.

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Over the years, Nigeria has experienced annual and often concurrent and increasing frequency of disease outbreaks such as Lassa fever, cholera Monkeypox, yellow fever, and others pose a rising threat to the country.

In spite of the health security challenges, the 2019 global health security index ranked Nigeria 67 out of 195 countries in the world. In terms of emergency preparedness and response planning, the country is ranked 171 for its public health vulnerabilities, which is not quite encouraging.

Some state governments and some financiers are investing substantially in new molecular centers and delivery methods, spurring private-sector engagement and innovation. However, governments at the three tiers must take these opportunities to leverage current investments beyond COVID-19.
Following these experiences, it is quite clear now that funding should not just be used to combat COVID-19, but also to prepare the health system for future epidemics.

“Lagos is still taking lessons from the COVID19 pandemic. There are gaps in the State response to the infection that will be bridged to strengthen the State’s resilience in effectively tackling COVID19 and other infectious diseases that may occur,” said Sanwo-Olu.

According to the governor, COVID19 is still around us but it is the learning we need to have post-COVID19 that is very critical. “In Lagos state, we commit to building infrastructure that will adequately prepare the state for future health crises,” the governor said while noting that quality and equitable health services remain paramount.

The Federal government’s budget for 2021 proposes N547 billion for healthcare, which is just about seven percent of the N13.08 trillion budget.

The amount comprises N380.21 billion for recurrent expenditure and N132 billion for capital projects. There is also N35.03 billion Basic Health Provision Fund, which includes funds for managing emergencies and infectious diseases such as the COVID-19.

Now that the country has experienced COVID-19, this should change. The government should appreciate the importance of epidemic preparedness because the lack of it can actually cripple the country. It should be taken at all levels just as seriously as the government has taken national security and human capital development.

Nigeria has continued to battle with diseases that threaten public health security. These include diseases such as cholera, meningitis, yellow fever, and hemorrhagic fevers, especially Lassa fever for which Nigeria reports considerable morbidity and mortality annually.

Governments at all levels have responded to and contained these outbreaks, but further steps must be taken to detect them earlier to prevent illnesses and death. Preparedness for epidemics and health emergencies has a high return on investment, estimated at $2 -7 for every $1 committed.

Meanwhile, innovations at all government levels in healthcare support by governors, practitioners, and the broader community stakeholders will address and build new forms of resilience and preparedness at all levels.

However, the industry’s response has intensely revealed its resilience and ability to bring innovations to play in handling issues. The innovative application of converging technologies such as mobile computing, mobile communications, and broadband internet to the management of epidemic outbreaks will build forms of resilience and preparedness.

Although technology had been used to assist in the fight against epidemics in the past, the Ebola outbreak led to a step-change in the level of focus from the technology sector. This means that technology is likely to provide a significant impact on future outbreaks.

While technology cannot stop the spread of an epidemic, it can educate, warn and empower those on the ground and those that need to be aware of the situation to significantly reduce the impact at all levels.

Experts say improved epidemic preparedness in government at all levels in Nigeria cannot be achieved in isolation as R&D remains a benchmark for growth.

Babatunde Salako, director-general, NIMR, said challenges facing the development of research in Nigeria include donor-driven research. Nigeria’s health research fund stands at 0.08 percent as against the two percent recommended by the World Health Organisation, clearly of the challenges beleaguering the development of research in Nigeria.

“Research is the greatest engine for national development, through which a developing nation and poor nation can attain economic prosperity, social engineering, patent and innovations, drug discovery, job creation, human longevity, and health system impact,” he said.

“There is a shortage of faculty and research leaders as well as inadequate facilities and few career opportunities for building researchers. However, there should be increased funding on the part of the government, training in new technologies, acquiring new skills, and extensive collaboration.

“Also, there is a need for increased advocacy for policy and decision-makers to address the challenges of building health research innovations to practice more quickly, helping to bridge the service to science gap,” said Salako.

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Doyin Odunbanjo, a public health expert, said that scientists and academia have criticised the federal government over the gradual decline of research in Nigeria, noting that states can learn from each other in strengthening their research by addressing economic challenges, bridging knowledge and skill gaps while building solutions and preparing for future outbreaks.

Odubanjo said that Nigeria continues to experience a continuing decline in the quantity and quality of its research output.

According to him, the government at all levels must be committed to R&D and innovation funding, developing strong institutions, enhancing the academia-industrial linkage as well as implementing a workable science, technology, and innovation policy in order to bolster and diversify the economy.

“Government should also provide various fiscal incentives for the health sector and other industrial firms in their various clusters so as to encourage them to engage in R&D and innovation activities, either through reverse engineering or inventing new ones, as this will not only lead to economic growth but also raise the global competitiveness of Nigeria,” said Odubanjo.

Collaboration

Nigeria is now experiencing significant public-private healthcare partnerships and collaborations but there needs to be more accurate evaluation to inform future scaling up of epidemic preparedness generally, experts say.

They add that collaboration between the government and the private sector in epidemic preparedness is critical, as it has emerged as a possible vehicle to enable the prevention of future outbreaks.

In line with the International Health Regulations (2005), the Africa CDC’s mandate includes disease surveillance, prevention, and response measures intended to shift the focus from quarantine and embargoes at borders to containment at the source. It aims to increase the emphasis on preparedness by supporting countries to establish the necessary core capacities in surveillance and response.

“It is a big factor when you are thinking about the response to an epidemic, where a national response is necessary for Nigerians for correlation. There are a lot of lessons that we can learn on how little tiny microscopic organisms can cause a global pandemic and bring nations to an economic halt,” said Chikwe Ihekweazu, Chief Executive Officer, NCDC while speaking recently at the Omnia Health.

According to Ihekweazu, Epidemiology is essential to the fight against any disease. it is important for all states having a State Epidemiology Unit as part of the State Ministry of Health.

“Before an outbreak begins, we have to ensure the capacity is in place to detect the outbreak and then respond. We continue to encourage State Governments to invest strongly in their State Epidemiology Units so that they have adequate resources for outbreak preparedness, prevention, detection, and response,” he said.

Odubanjo added that the only certain thing is that when this epidemic is brought under control, another will eventually take its place.

“Epidemic threats are inevitable. To better prepare for the next crisis, and future epidemics, the government at all levels will need to devote considerable political capital and economic resources to reducing the domestic and global vulnerabilities that jeopardize individual, national, and global health security,” he said.

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