Nigeria: Lessons From Nigeria in Responding to Coronavirus

Nigeria COVID-19 cases rise.
20 March 2020

Abuja — Coronavirus is now a pandemic and the World Health Organization considers Europe as its new epicenter. Italy, Spain and France are on lockdown and several nations are banning travelers from countries where cases are on the rise.

But it's a problem beyond Europe too, and governments in 61 countries have closed schools to slow the spread of the virus. In the U.S., President Trump recently declared a national emergency after the virus had spread to nearly every U.S. state, and he urged state governments to set up emergency operation centers immediately.

Most of these measures occurred after a significant number of cases were documented. In contrast, Nigeria, where I am based, has shown a remarkable level of preparedness and response to the Coronavirus pandemic even with just 12 cases diagnosed.

These efforts are led by the Nigeria Centre for Disease Control (NCDC). Nigeria's past experiences of quickly responding to the 2014 Ebola outbreak and continuously responding to other infectious diseases such as Lassa fever, have strengthened its health security capacity. Consequently, there are lessons that other countries can learn from Nigeria's response to Coronavirus.

Nigeria's past experiences of quickly responding to the 2014 Ebola outbreak and continuously responding to other infectious diseases such as Lassa fever, have strengthened its health security capacity. Consequently, there are lessons that other countries can learn from Nigeria's response to Coronavirus

First, invest in epidemic preparedness before an outbreak occurs. The Director-General of NCDC, Chikwe Ihekweazu believes that nations should build systems in 'peace time' that can be used during outbreaks. Working with subnational governments and partners, the NCDC since 2017 have been supporting Nigerian States to set up Public Health Emergency Operations Centre (PHEOCs).

At the last count, 23 States in Nigeria have set up PHEOCs. The PHEOCs serve as an epidemic intelligent hub for effective communication and efficient resource management during any outbreak. Therefore, the U.S. should have set up PHEOCs long before this Coronavirus pandemic.

Second, be open and transparent about Coronavirus cases. The index Coronavirus case recorded in Nigeria was reported within 48 hours of the Italian arriving Nigeria. The federal minister of health, NCDC and the Lagos state commissioner of health did not waste time informing Nigerians.

They have also continuously followed that with regular updates. The NCDC now has a microsite to provide regular updates to Nigerians and the international community. Other information available on the microsite are videos on risk reduction and summaries of the global Coronavirus situation report.

Third, invest in laboratory diagnoses of Coronavirus. Within weeks after the Coronavirus outbreak began, NCDC, with the support of partners, upgraded four of its reference laboratories to diagnose Coronavirus.

This led to quick diagnosis of the Italian despite his falling ill in a neighboring state to Lagos. These reference laboratories are located strategically around the country, so that delays in moving samples are reduced.

Fourth, the highest political will is imperative for epidemic preparedness. In 2018, after 7 years of operating without a legal backing, the NCDC was legalized through a bill signed into law by President Buhari.

This action puts NCDC in its rightful place as the national public health institute, with the mandate to lead the preparedness, detection and response to infectious disease outbreaks and public health emergencies. President Buhari backed the legal mandate with an approval for NCDC to receive 2.5% of the Basic Health Care Provision Fund - a funding mechanism designed to improve primary health care in Nigeria. This is unprecedented in the history of health security in Nigeria.

Likewise, some Nigerian legislators are advocating for increased funding for epidemic preparedness. For instance, the chairpersons of Nigeria's senate committees on health and primary health care/communicable diseases have been advocating for increased budgetary allocation to NCDC.

Without a doubt, health security is an area that Nigeria's executive and legislature agree. With hindsight, the U.S. should not have cut its Centres for Disease Control's budget by 20% in 2018.

Fifth, pay attention to what is happening outside of one's own country. Infectious diseases do not respect borders. Perhaps the most important lesson we should learn from Nigeria's response to the Coronavirus is what Chikwe Ihekweazu said when he was interviewed by an international media outlet; "The concept of every country trying to look only within its own borders is completely, mindbogglingly, a waste of everybody's time".

To be sure, Nigeria is currently dealing with its largest Lassa fever outbreak, attempting to rebuild its health system and still requires more funds to prepare for the next epidemic. However, NCDC has shown what is possible in reducing the impact of a virus with accountable leadership, use of science for decision-making and ensuring value for money in epidemic preparedness.

Chikwe Ihekweazu's admonition on borderless approach in responding to infectious disease outbreaks is very important because as far as global health security is concerned, the world is as prepared as its weakest link.

Other countries do not have to reinvent the wheel in managing this Coronavirus pandemic. Nigeria has succeeded in containing Coronavirus and is willing to share lessons learnt.

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