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The Benefits of COVID-19 in Nigeria’s Health Sector

COVID-19 pandemic currently ravaging the global community has disrupted human existence and shattered economies, and Nigeria is not an exception. In this cover story, PharmaTimes Editor, MORGAN NWANGUMA and Senior Correspondent, CHIGBU NWAOBIA – looking beyond the contagion examine its impact on the country and how Nigeria is transforming the tragedy of Covid-19 into an advantage for the nation and especially the health sector of the economy.

As with the rest of the world, Nigeria is currently dealing with the COVID-19 pandemic under enormous challenges. Prior to the index case in the country on 27th February, Nigeria’s healthcare system has been adjudged one of the weakest in the world and that is already manifesting in the current war on COVID-19. There is the inadequacy of testing commodities which is adversely affecting efforts at containing the pandemic among a myriad of issues.

Bolstering Nigeria’s health infrastructure
For Nigeria the lessons and ‘opportunities’ that Covid-19 has brought are numerous as well as urgent. For one, the pandemic has brought to the fore the need to consolidate past gains and thus put to greater use the Polio Emergency Operations Centre model as it exists. Looking in this direction the Nigerian Ministry of Health has since activated Emergency Operations Centres (EOCs) in all of the affected states for the purpose of organising the outbreak response activities.
The EOC is a model that was first introduced to the country by the polio programme. It is organised under six functional units: Management and coordination, epidemiology and surveillance, case management, laboratory services, risk communication, and point of entry. With support of the World Health Organisation (WHO) the Nigerian government is already rolling out similar training to key health workers from around the states.

Working together and sustained vigilance
A way of transforming the disadvantages of Covid-19 into a gain for the future entails what the on-going programme is already putting in place – to intensify the actions. This includes also bringing its innovative technology to bear in the support of the response through the inclusion of disease surveillance questions on COVID-19 to the mobile application it developed for acute flaccid paralysis surveillance (AFP) which is a clinical symptom of poliomyelitis. The SMS-based application called AVADAR, short for “auto-visual AFP detection and reporting” depends on a network of health workers and community volunteers in selected hard to reach areas to support disease surveillance through filling in a simple form after receiving a notification. All this has led to the training and deployment of a total of 774 Disease Notification and Surveillance Officers spread across Nigeria working on COVID-19 contact tracing, in addition to 50,689 community informants for community sensitisation and case reporting. And so amid the numerous challenges posed by the dreaded disease it is clear that there are so many positives coming our way. The health sector is presently receiving the attention it needs from governments at federal and state levels in response to the lessons learned from the pandemic.
Thus the states governments more than ever before are at the forefront of setting up better equipped isolation centres and effective contact tracing mechanisms in addition to holding regular online conference meetings to review grounds covered and the way forward.

The federal government on its part recently approved a special hazard allowance and enrolment of frontline healthcare workers for insurance cover.
There is also rapid building of more laboratory testing infrastructure across the country. Dr Ifeanyi Casmir, national publicity secretary of Medical Laboratory Scientist Association of Nigeria, admitted that the exponential increase in the number of Laboratories with molecular testing capacities could not have been achieved without the outbreak. “From 5 molecular laboratories in the country at the onset of COVID-19 in February to 22 laboratories in May is simply exponential and NCDC approach is of international standards but the problem for getting more Nigerians tested lies in recruiting more hands,” he said.
There is no gain saying that as soon as we have these infrastructures put to use further deployment will be enhanced as we go back to solving the challenges we faced even before COVID-19 such as inadequate health manpower, low budgeting, and deplorable state of our health systems. Perhaps we will be helped by these measures to draw closer to finally achieving the ever elusive universal health coverage for the nation.

Grants for Research & Development
The recent CBN expression of commitment to extend its intervention in research initiatives particularly as it relates to funding indigenous solution to the COVID-19 challenge ought to clear any iota of doubts that the deadly disease also impacted positively in its wake on the Nigerian economy. It is common knowledge that government research institutes including the public universities are grossly under-funded and consequently depend on donations from international organisations that are hardly enough to embark on research explorations.  Emefiele had in his remarks at the commissioning of ultra-modern isolation and treatment facility in Abuja recently, announced the apex bank’s intention to develop a framework that aims at extending grants and other long term facilities to Nigerian researchers for local solutions to tackle the deadly disease. This is seen by stakeholders as a major boost to the pharma sub-sector and a challenge to pharmacists in the academia whose research works end up on glass shelves to begin to dust them up for translational purposes. The move is also being considered as a major step towards exploration into abundance of natural resources – flora and fauna the country is blessed with for medicinal benefits. Research and development remains a critical component in the pharmaceutical industry especially as it relates to drug development and it thrives on grants and other dedicated funding mechanisms.

Local Drug Manufacturing
The journey to the nation’s quest for self-sufficiency in medicine needs stakeholders say must necessarily begin with provision of access to favourable credits for manufacturers. That is the reason why the N100 billion intervention fund approved for pharmaceutical manufacturers by the CBN recently is considered a major dividend accruing to the pharmaceutical industry from COVID-19 outbreak. Pharmaceutical manufacturers say that the loan came as succour for expansion of their operations and upgrade of their capacities. After all said and done, Nigeria should begin to reverse the ugly trend of being continuously import dependent for her pharmaceutical supplies including active pharmaceutical ingredients (API) meant for local drug manufacturing. The experiences we are going through with China and India during this pandemic is an eye opener for future development.

Recognition of Community Pharmacists
As the community transmission of COVID-19 surges, community pharmacists are being recognised as frontline health workers that would be engaged in ramping up testing across the 36 states of the country.

Regulatory Intervention
In alluding to COVID-19 outbreak in the country as playing a positive role, commentators say that nothing else could have convinced the Prof. Moji Adeyeye-led NAFDAC to shift grounds in pursuit of standard operating procedure dotting the landscape of the agency’s operations. But a regulatory review was undertaken by the agency to mitigate challenges posed by COVID-19 to the pharmaceutical sector. NAFDAC had reportedly said it would limit “Good Manufacturing Practice (GMP) inspections for local facilities at this period, to encourage local production of the critical items.” Similarly, NAFDAC said its conduct of GMP of foreign facilities, which is a major pre-requisite for pharmaceutical products import cannot be undertaken due to the pandemic and the current travel restriction on international travel for public officers, hence application for registration of products deemed to have urgent public health impact would be processed and given conditional approvals. The action of NAFDAC led to a surge in the number of local manufacturers for products vital to the control of Coronavirus such as hand sanitizers and masks, to make up for the current deficit in supply. Besides, the leadership of NAFDAC met with major players in the herbal and alternative medicine recently as part of efforts to find a treatment to the COVID-19 pandemic.

The virtual meeting, which was convened by the Director-General of agency, had in attendance over 35 players in the herbal medicine sector including two professors from the field of Pharmacognosy, Maurice Iwu and Anthony Elujoba, who was once an acting Vice-Chancellor of the Obafemi Awolowo University, Ile Ife. Some others at the meeting were Prof. Martins Emeje of the National Institute for Pharmaceutical Research and Development; the Managing Director, Neimeth International Pharmaceuticals Plc, Matthew Azoji; and Prof. McDonald Edu of the Department of Plant Biology and Biotechnology, University of Benin.

Others are Executive Director, Yemkem International Group, Mr. Akinyemi Ayeni; and Dr. Oluwatobi Abiola, Managing Director of Ablat Nigeria Limited, manufacturers of Yoyo Bitters. The meeting also had in attendance representatives of the Ministry of Trade and Investment as well as the Department of Traditional and Complementary and Alternative Medicine at the Ministry of Health according to Punch report. Similarly, the Presidential Task Force on COVID-19 indicated that Nigeria was making headway in getting local cures for COVID-19. The PTF Chairman and Secretary to the Government of the Federation, Boss Mustapha, gave this indication at the task force press conference in Abuja recently. He said the Complementary and Alternative Medicine Department of the Federal Ministry of Health had forwarded some of the claims for COVID-19 cure to the National Agency for Food and Drugs Administration and Control. According to the SGF, some of the claims for COVID-19 cures have met preliminary requirements, but the NAFDAC will evaluate them for listing. All these urgent efforts arose for the first time as a result of the pandemic.

Finally if promises from the federal government can be anything to go by, the Covid-19 experience holds a future of hope – redirecting the way we would normally carry on. “We will act quickly to enable faster recovery of the economy by targeted measures towards particular sectors that are able to support mass employment and wealth creation in the country. We will do so by focusing on four main areas, namely, light manufacturing, affordable housing, renewable energy, and cutting-edge research,” Emefiele stated. Thus the coronavirus pandemic has reinforced the popular saying that ‘there is something good in everything bad.’

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