Nigeria's Lack Of Health Security Exposed By COVID-19

By Odimegwu Oneumere

In this report, ODIMEGWU ONWUMERE centers on Nigeria's poorly coordinated reaction to pandemics and states that reinforcing the general health framework will shield the soundness, everything being equal. He likewise cautions that putting resources into general epidemic readiness is fundamentally more affordable than putting resources into the monetary effect of a pandemic. The article traces why it will be right that Nigeria shares responsibility with states in order to guarantee investment and preparedness success, adding that these methods of financing combine stronger health systems, sustainability, and affordability

"When you invest in something, you tend to pay more attention to it. Because epidemics will occur, being prepared can be challenging, but being prepared enables you to limit them. It cannot be overstated how important it is to create a strategic method for increasing funds for financing epidemic preparedness in Nigeria."

Doyin Odubanjo, a former chairman, Association of Public Health Physicians of Nigeria, Lagos Chapter, made that assertion approximately two years ago.

In contrast, prior to the COVID-19 outbreak, Nigeria's response to disease outbreaks received a poor score from both the Global Health Security Index and the Joint External Evaluation of International Health Regulation 2019 conducted by the World Health Organization.

On the other hand, the Nigeria Centre for Disease Control (NCDC) stated during one of its public tours that swift action is the only way to prevent a disease flare-up from becoming a pandemic, regardless of the circumstance, even though Nigeria has taken what are regarded as "Goliath endeavors" in the fight against COVID.

In addition, in a speech delivered at the National Case Management Training on Lassa Fever in Abuja, the Minister of Health, Dr. Osagie Ehanire, stated, "Timely decision-making is essential for these patients, who require special care."

Lame-duck approach by authorities
Although the World Health Organization declared COVID-19 a public health emergency of international concern on January 30, 2020, evidence of rapidly advancing community transmission occurred on March 28 in Lagos, Ogun, and the Federal Capital Territory, limiting the initial state lockdown to the three states. The Official Team on Coronavirus was not laid out until March 7, 2020.

The source reports that as of July 17, 2022, Nigeria had recorded over 259 thousand confirmed cases of COVID-19 and 3144 deaths after Nigeria's first COVID-19 case occurred on February 27, 2020.

This was the case
Checks revealed that juxtaposing to that, with declining healthcare system leadership in Nigeria, more and sustained investments are necessary to ensure readiness against epidemics and pandemics.

Even though a professional had previously stated that infectious disease outbreaks begin within a state before spreading, this was the case.

He glared and expressed that sub-national well-being security should be focused on. Moreover, the Federal Government has continued to support states in strengthening their health security while advocating for increased state-level investment, making this sustainable investment that is required by state governments necessary.

Just noise, not prepared
Analysts said that the Nigerian health sector was not prepared for an emergency response, especially not for a disease of the scale of COVID-19, so the majority of the pooled resources were used to build temporary structures like isolation centers and provide clinical care, despite the fact that the private sector, donors, and philanthropists contributed more than 100 percent of the Federal Government of Nigeria's anticipated budget for responding to the COVID-19 pandemic.

The overall health system has not been significantly strengthened by this expenditure, they said, adding that it is difficult to accurately estimate the number of people who had COVID-19 and the number of people who paid out-of-pocket for COVID-19 care in institutions rather than in the public and private health care centers designated by the government for COVID-19 patient care due to the low coverage of COVID-19 testing across the country.

Abysmally meager sum
Nigeria would require more than $800 million to contain future epidemics, according to observations, given that the $560.52 million raised during COVID-19 was insufficient because more than 90% of it came from the private sector and the donor community.

According to information, the Nigerian government had previously decided to allocate a meager eight naira (2.1 cents) per citizen for the prevention, diagnosis, and treatment of communicable diseases. Information shows that main amounts, N1, 673, 486, 127 were distributed to the NCDC, the country's public general health organization liable for pestilence readiness, identification, and reaction to irresistible sickness episodes and general wellbeing crises for nearly 200 million Nigerians.

Reevaluating budgeting
That called for concern among stakeholders. In the words of Odubanjo, "We simply need to reevaluate our budgeting system, which at the moment is nothing more than a con!

“We have to start with what we have and divide it up according to priority. The Abuja Declaration's 15% target may not always be attainable.”

This implies that the Nigerian government will spend eight naira per person annually, or 66 kobo per month, the source cried out loud, with the underprivileged budget.

In the meantime, investigation showed that the Centers for Disease Control and Prevention (CDC), NCDC's American counterpart, spent approximately N2.34 trillion in 2020 on epidemic preparedness, exceeding Nigeria's entire five-year allocation from the Federal Ministry of Health.

Odubanjo added, “Even if you only allocate 15% of your budget, this does not guarantee that it will be well-spent or have the desired effect. We really want to understand what our needs truly are and apply what is accessible to them as best as could be expected. We absolutely need to strengthen the health system by properly utilizing evidence for policymaking."

Locking citizens without reprieve
Since many Nigerians became economically impoverished as a result of the COVID-19 pandemic, the enormous expenses and the inability of the majority of Nigerians to earn money as a result of the measures taken to contain the pandemic would not be a pleasant experience in the future.

According to the findings, the NCDC had to respond to an outbreak after it was first discovered on average six days later, with one outbreak in five (20%) requiring a longer response time.

For instance, the NCDC was unable to respond to a meningitis outbreak in Zamfara for 108 days due to a complicated chain of events, data revealed.

According to a study, the severity of the outbreak, the total number of cases, and the number of disease-related deaths all increased as a result of the delay.

Ill-equipped healthcare
It is believed that the health care system is ill-equipped to meet the demands of an epidemic like COVID-19 as a result of years of the government's nonchalant investment in health care.

Opinions have it that as a result, even the substantial funds collected for the emergency response are insufficient and cannot be invested long-term in the country's health care because they were used for temporary infrastructure.

In any case, Nigeria's 2018 health spending plan was N340.46 billion, or 3.96 percent of its proposed N8.6 trillion. A breakdown of the health budget reveals that approximately N1,832.62 was allocated for each citizen of Nigeria, which at the time was estimated to have 186 million people.

Analysts said that of the total budget of N9.45 trillion for 2020, the Federal Government allocated N427.3 billion, or 4.5%, to health. In the budget for 2021, healthcare accounted for N547 billion, or approximately 7%, of the total budget of N13.08 trillion.

"The sum is split between N132 billion for recurring expenses and N380.21 billion for capital projects. Additionally, there is a N35.03 billion Essential Wellbeing Arrangement Asset that contains resources for managing crises and infectious diseases," said the source.

Health apparati not scaled up
According to examinations, research institutes, pharmaceutical manufacturing industries, coordinated rapid epidemic response forces, integrated surveillance, and reserved manufacturing capacity for medical security measures like vaccine production are not scaled up, which results in an ongoing mismanagement of health threats.

Donations and fundraising during epidemic outbreaks, according to a person whose identity was withheld, are insufficient to raise the necessary funds for such endeavors.

"COVID-19 has shown how weak the health security is and its challenges of how it affects the populations; there are still, several needs to be met in strengthening Nigeria's public health laboratory system and capacity," Chikwe Ihekweazu, director-general of the NCDC, stated.

Funding as a necessity
"Citizens also play a significant role." Oyewale Tomori, a professor of virology, stated, "They must request accountability from their governments for health emergency preparedness, which requires leaders to empower their citizens and strengthen civil society."

Due to the reemergence of disease outbreaks like COVID-19, Lassa fever, cholera, yellow fever, measles, monkey-pox, and meningitis, funding epidemic preparedness by the Nigerian government is no longer an option but a necessity, said the source.

"We must not overlook the other aspects of epidemic preparedness, including those that are not directly under the control of the health sector. This will require not only substantial funding but also stable funding that meets the evolving need to invest in diagnostics," he concluded.

In response, Ihekweazu offered advice, stating that the Nigerian government's inadequate funding for citizen health extends beyond the budget for epidemic preparedness. A decision that has had an impact on the country's health indices has also caused the entire health sector to struggle with inadequate government funding.

Onwumere writes from Rivers state via: [email protected]

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