Nigeria: 80 Percent of Nigeria's 200 Million People Risk Contracting COVID-19 - WHO Consultant

Coronavirus
31 May 2020

Charles Obadiah Wambebe, a scientist, is a professor of pharmacology, traditional medicine expert, and a missionary. Wambebe was the pioneer Director-General of the National Institute of Pharmaceutical Research and Development (NIPRD) from 1989-2001.

He also lectured at Ahmadu Bello University, Zaria and served as President of the West African Society of Pharmacology and Drug Research, as well as Pioneer Pro-chancellor and Chairman, Bingham University Nigeria. Currently, he is a Professor Extraordinaire, Tshwane University of Technology, South Africa and, a consultant for the World Health Organisation (WHO).

He speaks on the COVID-19 pandemic, traditional herbal medicine, healthcare in Nigeria, life after public service, and combining being a man of God with science.

COVID-19 has changed human life as we know it in less than five months. What's your overview of the pandemic and how the world has responded?

It was unthinkable in December last year that a tiny virus could change every major event in the world and our lifestyles in significant ways. Indeed the world was caught unawares. Initially, details of what was really happening in Wuhan, China were not made public.

I guess even the Chinese scientists were trying to understand something about the virus and also sequence its gene. But it is amazing that within 60 days of disclosing the genetic sequence, there are over 300 clinical trials worldwide on possible treatments.

Similarly, vaccine development that normally takes 11 years took only a few months. There are now over 100 new vaccines developed specifically against coronavirus. In fact, seven of them have already entered human trials.

Although the chances of a new vaccine entering the market are about 6%, the Serum Institute (India) has started the manufacturing of vaccine developed by Oxford scientists when clinical trials only started on April 23, 2020.

Similarly, Pfizer (USA) and BioNTech (Germany) planned to manufacture a million doses of a new vaccine developed in Germany by the end of this year. On April 30, 2020, the World Health Organization (WHO) launched the Access to COVID-19 Tools Accelerator to fast track the development and manufacture of COVID-19 health technologies, including vaccines, and guarantee equitable access.

Surely, we were not prepared, but when the seriousness of COVID-19 became obvious, scientists, governments and manufacturers have responded very well.

How do you rate the Nigerian government's response to COVID-19? And how can they improve?

Definitely, Lagos and Kaduna states have responded credibly. I was personally surprised that the Federal Government relaxed the lockdown in FCT, Ogun and Lagos states while confirmed cases were still rising. Furthermore, we are not doing enough tests and tracking yet. Regarding the way forward, we do not need to reinvent the wheel. There are countries that have done very well to contain the virus. We can learn from them.

An example is South Korea. When the virus was spreading through community transmission, the country educated, empowered and engaged the whole country. The leadership of the country engaged scientists, listened to them and provided every support to implement the recommendations of the scientists.

Based on the recommendations of the scientists, an innovative diagnostic testing strategy was launched and facilities were expanded. They even engaged PhD holders in development and production.

Now South Korea supplies the world with validated diagnostic kits for coronavirus. Furthermore, they engaged in diligent contact tracing and testing of vulnerable populations.

They isolated patients and aggressively pursued public health strategy of social distancing, hygiene practice and wearing of masks. As of 5th May, only 3 new cases were registered, 10,822 total confirmed cases, 9,484 have recovered, 256 deaths, tested over 600,000 people.

To appreciate the success story of South Korea, by mid-March 2020, it had the same number of deaths from coronavirus as the US (about 90).

But as of today, South Korea has recorded only 261 deaths while the US has lost 84,763 lives. Even when you factor in the fact that the US is six times the population of South Korea, the difference is still astounding. I urge the government and states to adopt the model of South Korea.

The challenge is that the virus may be with us until about 60-80% of the population (Nigeria's estimated population is 200 million) is infected and that may take 2 years.

That is the prediction of different mathematical models. We must take this pandemic seriously and mobilise all resources to conquer it as South Korea did.

We have been informed by Lagos state government that from July-August confirmed cases of COVID-19 will significantly spike in the state. What is your advice?

Firstly as a man of God, I know God answers prayers. We should continue to pray fervently for mercy and favour of God. We should not dwell on fear but have faith in God.

Secondly, we must continue to follow the guidelines of the health authorities. Thirdly, our health authorities should take cognizance of recent developments on COVID-19.

The virus is new; therefore, scientists are still learning to know more about it. For example, on 6th May 2020, the Annals of Internal Medicine published the data of autopsies of 12 people who died from COVID-19. The study was undertaken by about 30 German pathologists.

Their findings show that the people died from coagulopathy indicating a cardiovascular failure while we have all believed death from COVID-19 was due to respiratory failure.

Their findings were also confirmed by Italian pathologists who carried out autopsies on 30 people who died from COVID-19. Such new findings indicate that our health authorities may consider modification of standard of care to include anticoagulants and anti-inflammatory agents.

The fourth point is maintaining a DREAM Health. When over 200,000 people were tested for COVID-19 antibodies in New York, about 14% tested positive.

That is they were infected with Covid-19 and their immune system responded by producing neutralising antibodies. But these individuals were asymptomatic.

About 80% of people infected with coronavirus do not have symptoms or the symptoms are very mild that they do need to be in hospital. The major factor is the status of your immune system.

Once your immune system is functioning well, the body takes care of any infection. Beyond the immune system, you need to strive for DREAM Health because, among others, it will strengthen your immune system. D stands for Diet, make food your medicine now so that medicine will not become your food in future.

Thank God most of our vegetables and fruits are rich in micronutrients and immune-boosting agents (eg bitter leaf, ewedu, okro, moringa, bell peppers, hot pepper, green vegetables, etc). R stands for Rest; in order for your body to function well, you need rest, an average of eight hours of sleep every day.

E stands for Exercise. Even 30 minutes of walking every day is great for you. But be consistent. A stands for Alternate therapy like body massage, sauna, etc.

For those who can afford once a month is helpful. M stands for motivation. Your motivation is to enjoy quality health and avoid diseases (not only coronavirus). As a Christian, you are motivated to look after the temple of God (your body) so that you can effectively carry out His assignments.

What are your thoughts on the state of healthcare in Nigeria?

The WHO defines health as: "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." The provision of healthcare in Nigeria is the responsibility of the three tiers of government.

The primary healthcare system is managed by the 774 local government areas with support from the state ministries of health and private health facilities. The secondary healthcare system, which is the first level of speciality services, is managed by the state ministry of health and often gets patient referrals from primary healthcare.

The tertiary health care is funded by the Federal Government and includes Teaching Hospitals and Specialist Hospitals. The Teaching Hospitals also receive support from voluntary and non-governmental organizations and private medical practitioners. In the first two decades after Nigeria's independence in 1960, significant progress was made in achieving Universal Health Coverage in the healthcare sector.

Health policies have changed significantly over the past 60 years. Despite successive governments' efforts to provide increased access to health services, many Nigerians still struggle with various health challenges.

These challenges reflect in the poor health indices collated by the World Health Organization's statistics: maternal mortality is among the highest globally accounting for 19% of maternal deaths worldwide [3].

The infant mortality rate in Nigeria was 76 deaths per 1,000 births while deaths among children under-5-years are 120 per 1,000, in 2019.

The World Health Organization estimates the life expectancy of Nigerians to be 54.4 years (women at 55.4 and men at 53.7).

There is the inadequacy of health centres, healthcare personnel and medical equipment, especially in rural areas. Various healthcare reforms have been propagated by the Nigerian government but yet to be implemented at the state and local government levels.

The Nigerian healthcare system remains weak due to lack of proper coordination, inadequate resources (including drugs, consumables), inadequate and deteriorating infrastructure, unequal resource distribution and access to care and also, deplorable quality of care.

Access to healthcare is less than half of Nigeria's population which may be due to demographics, whereby about 55% of the population lives in rural areas.

About 70% of health care is provided by private health practitioners and 30% by the government. This results into significant out-of-pocket expenditure in a country where over half of the population lives below the poverty line, on less than $1 a day.

Due to little impact made on the Nigeria health sector with the introduction of the Federal Government's primary health care plan in 1987, the National Health Insurance Scheme (NHIS) was established to reduce the financial burden of medical bills on the citizens, among other objectives.

However, the NHIS has been ineffective in catering for Nigerians since the scheme represents only 40% of the entire population who work in the formal sector.

This has led to mass emigration of highly skilled healthcare personnel, compounding the already dire situation of the health sector. The collapsing health sector has also contributed to the poor health-seeking behaviour of Nigerians.

The high cost of accessing government tertiary hospitals and the bureaucratic bottlenecks involved has led to an increase in demand for private healthcare, which caters mostly for the middle-class.

The private healthcare services are not generally available to the masses due to the high cost of their services. The masses have to resort to patronizing drug peddlers and patent medicine stores as well as traditional health practitioners.

The WHO has subscribed a minimum of 14% as countries' budgetary allocation for healthcare. However, with poor economic management, corrupt government officials and the competing needs of other sectors of the economy, the Nigerian government has not been able to sustain the high cost of healthcare delivery.

Another major problem in the Nigerian healthcare system is the inadequacy and poor functionality of surveillance systems to track and monitor the outbreak of communicable diseases, bioterrorism, chemical poisoning, etc.

As part of recommendations to revamp the health sector in Nigeria, the NHIS needs to expand its scope of coverage to increase accessibility to and utilization of healthcare services, thereby reducing mortality and become more sustainable. Local production of medicines will meet the basic needs of citizens especially those in the rural areas.

Government should enact policy that ensures locally produced medicines are patronized by all agencies of government while imported medicines are restricted with pricing policy in place.

The country needs to increase budgetary allocation to healthcare to the WHO's minimum of 14% and ensure proper utilization of the funds.

The facilities of hospitals and health-related research institutions need to be given priority by gvernment. The country needs a system well-grounded in routine surveillance and medical intelligence, adequate management and strong leadership.

There have been talks of turning to traditional herbal medicine for a solution to COVID-19, with Madagascar going on to officially launch COVID Organics.

Nigeria, Congo, Tanzania, Comoros have opted for the so-called cure. What are your thoughts on the efficacy of COVID Organics? And does herbal medicine have a role to play against COVID-19?

As a scientist, I cannot judge any medical product without access to scientific and clinical data. I have made serious efforts to obtain the relevant data on COVID Organics. But, so far, no success! I am also aware that some of my colleagues have made similar efforts but failed to receive anything from the authorities in Madagascar.

Maybe all the relevant data are not yet available. On a personal note, I will advise that new product without scientific and clinical evidence for safety and efficacy should not be used by anyone.

On 9th May, the WHO announced that there was no scientific evidence to support the safety and efficacy of COVID Organics. Certainly, herbal medicines and traditional health practitioners have roles in the response to COVID-19 pandemic.

The WHO has established criteria for developing new medical products which include safety, efficacy and quality.

Furthermore, the WHO has published technical tools which scientists can use to evaluate new herbal or orthodox medicines at both preclinical and clinical levels.

As long as the researcher is interested in making medical claims for his product, he has to follow the WHO pathway for research and development of medical products.

The virus may be with us until about 60-80% of the population (Nigeria's estimated population is 200 million) is infected and that may take 2 years

Of course, some of our traditional health practitioners (THPs) may have combinations of food items that can boost the immune system. I advise that such products should be developed and standardised as food supplements with the approval of NAFDAC.

On the other hand, the THPs can be appropriately trained to serve with educating their communities on public health practices, referral of patients, awareness campaigns on the severity of COVID-19 and what to do upon experiencing any of the symptoms, etc.

The THPs should use PPEs to protect themselves against infection by their patients. In the event that any THP or researcher has a recipe they believe can be useful in the prevention or treatment of COVID-19, I strongly advise they do not go to the press or press but approach NAFDAC with their products. NAFDAC will then advise them on what to do before such products can be considered for registration.

It is after NAFDAC has registered the products that the innovators can make a statement in accordance with appropriate NAFDAC regulations.

Can you bring Nigerians up to speed on what you have been up to since leaving NIPRID?

Before retiring from public service, I was released by the Federal Government to work with the WHO. After my retirement, I continued to date to work with the WHO, but now not as a staff but a consultant.

I currently serve as Honorary Professor of Pharmacology, Medical School, Makerere University, Kampala, Uganda and as Professor ExtraOrdinaire, Tshwane University of Technology, Pretoria, South Africa. In these capacities, I supervise postgraduate students, conduct research and deliver university lectures.

Interestingly, my involvement with the two universities above is based on my apostolic calling to plant churches. It was in a vision that I received the appointment as an Apostle by the Almighty God. I was already 61 years old when I received the divine calling.

Subsequently, the Lord told me to start the ministry from a village in Uganda. In April 2008, I launched Rock Church Ministries at Kiyindi village, Uganda.

By the grace of God, together with those the Lord gave me for service we have planted about 50 churches in Uganda and 15 in Kenya. It was while I was in Uganda as a missionary that the Head of Department of Pharmacology & Therapeutics, Makerere University discovered me and requested me to join and assist them.

I told him I could only serve as Honorary Professor without a salary so that I could devote quality time to the work of God. In addition to church planting, we engage in strong prison ministry and school ministry. We carry out medical outreaches to rural areas. We also disciple brethren across denominations.

After 10 years of missionary service in Uganda, the Lord chose to direct us to South Africa to continue the service. We obeyed.

Thus, for the past two years, my wife and I have been in South Africa as missionaries. Interestingly, we just got a new plot of land at one of the slums in Pretoria to plant our church during this lockdown.

Just like Uganda, we are actively engaged in discipleship programmes at some churches in Johannesburg and Pretoria as well as my university.

In view of your wealth of experience on health matters based on your work in the US, Nigeria and the WHO, has the Nigerian government contacted you for your expertise?

Not yet. I believe that the authorities have found suitably qualified experts to serve them. However, when I have any observations and suggestions, I pass them to some of my contacts in government.

Are you currently involved with any COVID-19 related research at the moment?

Yes, I am deeply involved in relevant activities in response to COVID-19. I am basically a Research & Development Pharmacologist which means my expertise is drug development. I have one recipe to subject to scientific evaluation for the management of COVID-19.

Since we are still on lockdown, the universities here are closed and no access to the lab.

I have to wait until after the lockdown before commencing the lab studies. Since the recipe is derived from food items, the evaluation process should be fast. Secondly, I serve as Chairman of Health & Human Wellbeing Africa-wide Consortium under the International Science Council African Regional Office.

In that capacity, I have developed a Concept Note for research and development of medical products based on Africa's neglected and underutilized species.

Thirdly, as consultant to the WHO Regional Office for Africa, I am involved in developing guidelines on African Traditional Medicine and COVID-19 which will be disseminated to all Member-States of the WHO.

How have you combined being a man of science and faith? And can you share a little background into your missionary journey?

I received Jesus Christ as my Lord and Savior on 30th January 1970 when I was a first-year pharmacy student at then-University of Ife (UNIFE; THE GREAT). Before then, my fiancée was already born again and used to share the gospel with me. I used to confuse her with science. She would only tell me that she would be praying for me.

Unfortunately, she was already deeply in love with me and could not sack me. Thank God, her prayers were answered when I gave my life to God. Unfortunately, she passed on to glory in June 1970. It was a painful loss for me. Now I believe one of her missions on earth was to lead me to Christ.

Actually, it was the tract she sent to me that God used to convict me. The tract was entitled, 'Suppose it is true, Suppose the Bible is the word of God,

Suppose Jesus Christ is the Way, the Truth and the Life, Suppose there is hell and heaven, Suppose you can only enter heaven by giving your life to God through Jesus Christ'. In my room at UNIFE, I knelt down and invited Jesus Christ into my life on 30th January 1970.

To me, it was an experiment. I decided to experiment with the God of my fiancée to see if He is really God. If I found Him not to be faithful to His word, then I would return to my old life without Jesus Christ.

Surely, the experiment has been very successful. That is why at my age, I am serving as a missionary in a foreign land. I made one request when I received the apostolic calling.

I asked God to give me excellent health and strength just like Caleb who had the same strength at 85 years of age compared to when he was 40. Certainly, God answered my prayer.

Interestingly, I had asked God twice to relieve me of the medical research work so that I could devote 100% of my time to the mission work.

On both occasions, He did not answer the usual way. But what God did was to open doors for mission among my scientific community. For example, on one occasion, after praying to be freed of research, an invitation came from South Africa to serve as a consultant.

When I registered at the hotel, I informed them that I was a pastor. I told them my room number. Then I asked them to inform any staff that needed prayers to meet me in my room after my meetings. By the end of two weeks of staying in that hotel, 33 souls (managers, supervisors, and others) were harvested into the Kingdom of God. Now I totally depend on the Holy Spirit to guide me on wise use of time.

In most cases, God gives me opportunities to share His love during my academic endeavours. Every day I claim divine wisdom and the exceedingly abundant grace of God by faith. After my salvation, I quickly discovered that there is no conflict between science and my faith. Science only tries to find out how the things God created work and to harness them for useful technologies.

What would you be your expectations for a post-COVID-19 world, public-health wise?

I believe the infrastructure established to combat COVID-19 will be a useful asset. Furthermore, we shall be more prepared. The human capacity trained will be available to serve.

The global response will be more coordinated, not only at the level of the US and the developed countries. The WHO is doing an excellent job of providing guidance.

They will continue to do so. I believe Africa would have learnt the lesson of looking inwards, identifying talents, mentoring them, and supporting them to develop their innovations into appropriate technologies.

Vanguard News Nigeria.

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