Event of the year: A better health outlook possible in 2023

Health event of the year

By Kennedy Nnamani

WITH the lifting of travel restrictions, social gathering and wearing of face masks among others in Nigeria and globally in 2022, there is every hope that the coming year, 2023 will witness global economic recovery from the devastating effects of COVID 19.

According to Nigerian health officials, the country’s health sector fared well in the outgoing year.

Evidently, the Federal Government’s approval of immediate relaxation of the COVID-19 safety measures and travel advisory, including the suspension of all pre-departure, pre-boarding, and post-arrival PCR test requirements in December 2022 clearly manifests this claim.

Boss Mustapha, the SGF noted that President Muhammadu Buhari’s approval follows the recommendations based on clinical and laboratory evidence of a constant reduction in COVID-19 infection and transmission and the steady increase in vaccination coverage across the country.

The National Primary Healthcare Development Agency, NPHDA, through Faisal Shuaib, its Executive Director, said that so far, not less than 54 million Nigerians have been fully vaccinated against COVID-19, while over 60 million have taken the first dose of the vaccine.

However, Dr Ifedayo Adetifa, Director-General of the Nigerian Centre for Disease Control, NCDC, has advised the public to continue to maintain a positive health attitude.

Meanwhile, the activities of saboteurs surfaced to truncate the achievement of the health workers with the importation of counterfeit COVID-19 test kits.

Early in December 2022, the National Agency for Food and Drug Administration and Control, NAFDAC, notified Nigerians of the counterfeit BTNX Incorporated COVID-19 rapid antigen test kits in circulation.

Describing the kits, NAFDAC stated the counterfeit kits and the authentic BTNX Inc. look alike in packaging, colour and typeface, however, the device identifier has “COV-19C25” and also several key differences, but labelled as manufactured by “Health Advance Inc.” instead of BTNX Inc.

Despite the achievements of medical officers in the country and the world at large, there seems to be some other health threatening factors that have attracted little but significant attention of the government, stakeholders and the public for immediate actions.

Although most of them are not new discoveries, their recent outbreak, endurance, and mutation have also posed a huge threat to public health, which made the government take serious measures to either eradicate or abate them.

One of these is another outbreak of Lassa Fever in January 2022.

The efforts of health workers in the preceding year abated the spread of the virus such that the cases recorded were beginning to run in single digits, but resurfacing in January 2022, although still in lower percentage, it calls for more efforts.

Meanwhile, the Coalition for Epidemic Preparedness Innovations, CEPI, through Dr Gabrielle Breugelmans, its Director of Epidemiology, in Abuja, at a workshop, co-hosted with the NCDC, Africa CDC and CEPI expressed optimism that vaccines for the virus could be available in Nigeria by 2030.

The NCDC report revealed that not less than 1038 confirmed cases of Lassa Fever were recorded with at least 183 deaths as at December 18, 2022, which shows a fatality rate of 18 per cent, which is less than the 21.1 per cent recorded for the same period the previous year.

Still battling to contain the spread of Lassa Fever, there came the surge of Monkeypox in May 2022.

The World Health Organisation, WHO, reported that within a very short time of its surge, the pox hit over 48 countries of the world with over 3,200 cases recorded.

The NCDC, in December 2022, reported that Nigeria registered not less than 49 confirmed cases of the Monkeypox.

It added that cumulatively, the case in the country stands at 753 confirmed and seven deaths.

The WHO also reported through Tedros Ghebreyesus, its Director General that “In Nigeria, the proportion of women affected is much higher than elsewhere.

While the Nigerian Institute of Medical Research, NIMR, claimed to have unveiled Monkeypox Diagnostic Kits in a bid to increase case detection, a report from Daily Trust revealed that scientists and U.S researchers fear they’ve found the next big pandemic threat — a virus that lives in African monkeys.

Called Simian hemorrhagic fever virus, SHFV, the virus is capable of causing devastating Ebola-like symptoms, including internal bleeding and kills virtually every primate it infects.

The group added that the virus operated by hijacking the immune system, disabling key defense mechanisms and breaking the body down cell by cell.

Although the researchers said that no cases have been detected yet, they warned that it is ‘poised for a spillover’.

Meanwhile, the WHO has decided to rename the virus “Mpox” instead of the “Monkeypox” noting that the new name was chosen because it is easy to pronounce and can be used in many languages.

Recall that the disease was called monkeypox because it was first discovered in monkeys in 1958.

The organisation noted that Monkeys had nothing to do with the outbreaks this year, however, Monkeys were recorded to have been attacked this year in a country like Brazil because humans held them responsible for the outbreaks.

Meanwhile, according to the WHO, the two names will be used simultaneously for another year before only Mpox will be used exclusively.

In addition, the reappearance of cholera heavily influenced by the incessant flood in most parts of the country also marked major health events in the 2022.

In a report from Premium Times, a total of 233 Cholera deaths and 2,187 confirmed cases have been recorded between 1 January 1 and September 25, 2022.

According to the report, the NCDC explained that the rise in Cholera cases in Nigeria “exacerbated by limited access to clean water and sanitation facilities, open defecation and poor hygiene practices”

The waterborne disease has equally ravaged a lot of countries across the world with over 29 countries being hit.

Countries like Lebanon, Malawi, Congo, Cameroon as well as Nigeria received serious blow from the disease

In October, Manaouda Malachie, Cameroon Minister of Public Health, disclosed that no less than 12,952 people were known to have been infected by the disease.

Firass Abiad, Lebanese caretaker Health Minister, in October, raised the alarm that the disease could become “endemic” if the country fails to curb the spread.

While Khumbize Chiponda, Malawi’s health minister disclosed that the infection, which started in March 2022, has infected 9,447 people, alarming that the country may witness a devastating outbreak during the rainy season, a report from News Agency of Nigeria, noted that Dr. Bishikwabo Irenge, director of the new cholera treatment center run by Medecins Sans Frontieres, MSF, alarmed that the infection is threatening the Eastern Congo camp of displaced persons.

In Nigeria, a report on the NCDC website shows that as of November 27, 2022, a total of 23,550 suspected cases, including 583 deaths, being summary from epi week 1 to 47.

Meanwhile the WHO said it would temporarily suspend the standard of two-dose vaccination regimen for cholera and replace it with a single dose due to vaccine shortages and rising outbreaks worldwide

The International Coordinating Group, ICG, explained that “The pivot in strategy will allow for the doses to be used in more countries, at a time of unprecedented rise in cholera outbreaks worldwide.

Furthermore, the persistent effect of malaria continued to be felt in 2022.

According to reports, medicines for Malaria Venture and the Africa Centres for Disease Control and Prevention (Africa CDC), in Kigali, Rwanda, have signed an MoU, focusing on strengthening African manufacturing of malaria medicines.

Dr. Nicaise Ndembi, Africa CDC’s Senior Science Advisor stated that “Africa is capable of manufacturing its own medicines.”

Dr. Ndembi that “The partnership between Africa CDC and MMV will increase local medicine manufacturing and focus on establishing several regional hubs to manufacture Active Pharmaceutical Ingredients, API, and Finished Pharmaceutical Products, FPP.”

There was a sigh of relief in Nigeria following the announcement of the world’s first malaria vaccine which was promised to Nigeria and sub-saharan Africa sequel to its success in Ghana, Kenya and Malawi.

Consequently, Nigeria planned to roll out the vaccination by the first quarter of 2023, but this dream was distorted following the withdrawal of financial support from Bill and Melinda Gate Foundation, for the initial batch of donation to African countries.

Philip Welkhoff, the Gates Foundation’s director of malaria programmes, in a statement, explained that the foundation, which is the biggest financier of the project took the decision due to concerns that the efficacy rate of the vaccine is lower, expensive and tougher to handle the logistics to deliver.

In the same vein, mental health also played its role in making headway in the country’s health topic in 2022.

As common as mental health seemed, the topic caught the attention of some stakeholders as well as media houses.

For example, the Vanguard 2nd Mental Health Summit, 2022 with the theme: “Mental Health In A Distressed Economy”, where Prof. Taiwo Sheikh, former President, Association of Psychiatrists of Nigeria, APN, enjoined the Federal Government to pay more attention to mental healthcare and increase investments to the subsector.

Also, Realnews Magazine rightly pegged its 2022 annual lecture on the effect of drug which is one of the major effects of mental health.

During the event, Brig-Gen Buba Marwa, Chairman National Drug Law Enforcement Agency, NDLEA, who was the guest speaker, warned that Nigeria cannot afford to ignore drug abuse among youths in the country.

Gen. Marwa said: drug abuse “cannot be ignored in today’s world because it is a growing concern for all countries and a problem area for humanity”.

He disclosed that the past two decades “have seen a dramatic rise in drug abuse around the world and more than ever before, the situation is becoming complicated and dire”.

Consequently, the Association of Psychiatrists in Nigeria, through Prof. Taiwo Obindo, its President, called on President Muhammadu Buhari to assent to the National Mental Health Bill 2021 on or before Feb. 26, 2023.

Apart from the various diseases, viruses and infections that preoccupied the lists of the Nigerian health sector, other human factors also exerted pressure to the heavy load of making Nigeria a healthy nation.

Some of these other factors included incessant brain drain, strike actions, poor health facilities, poor remuneration of health workers as well as poor conducive operational environment for health workers in addition to poor security of lives of health workers.

Controversies have continued to trail this concept. The Nigerian Medical Association, NMA, reported that Nigeria is currently battling with its worst situation of brain drain in history, noting that no fewer than 10,296 Nigerian-trained doctors are currently practicing in the United Kingdom

Dr. Uche Ojinmah, the National President of the association, lamented that Lassa Viral Hemorrhagic fever, Malaria, COVID, Ebola, Marburg are still very much available in the face of worsening health incidences while the country is losing its human resources to health.

“Let me inform you all that Nigerian doctors are poorly paid, overworked, lack necessary work tools and have become a target for kidnapping,” he said.

According to a report, ”the UK’s Higher Education Statistics Agency said earlier in 2022, that the number of Nigerian students in the country rose by 69 per cent. The rate of international air passenger movement in Nigeria has risen by 91 per cent.

In the same development, in a report from NAN, PROF. Abiodun Otegbayo, the Chief Medical Director, University College Hospital, UCH, Ibadan, called for removal of the bottlenecks in replacing the workforce due to mass exodus of health workers.

Speaking at a news conference marking the 65th Founder’s Day celebration of the foremost tertiary health institution in Ibadan, Prof. Otegbayo said: “every week, I signed resignation letters of 15 health workers at the institution, who are mostly clinicians, that is, Nurses, Doctors and Pharmacists, among others.

He added that from 2020 to Oct. 15, 2022, no fewer than 600 clinical staff had left the hospital, noting that bureaucracy bottlenecks had been hindering their replacement.

Also, Dr Adekunle Ashimi, the Chairman of the Ogun chapter of the NMA called on the state government to declare a state of emergency on the health sector to address the issue of brain drain among medical doctors

Speaking during the flag off of the 2022 Physicians’ Week, Dr Ashimi said that no fewer than 10,296 doctors who obtained their degrees in Nigeria were currently practising in the United Kingdom.

However, some believe that the government has chosen to play politics with the situation.

Despite the challenges faced by the health sector in 2022, efforts are being made to improve the state of health facilities in the country. Recently. President Buhari inaugurated a state-of-the-art speciality eye hospital in Abuja.

Inaugurating the health facility, President Buhari said that the hospital, which is of international standard with outfits in other countries of the world, has successfully carried out 1,500 cataract surgeries; 4,500 glaucoma surgeries; 2,000 retina surgeries and other eye related surgeries in Nigeria.

He said: “With the commissioning of Skipper Eye-Q Super Speciality Hospital, the frequency with which Nigerians travel abroad to seek medical attention, including eye treatment with the attendant financial drain on the country, would be reduced.”

It may therefore be argued that the health sector of the country made a tremendous achievement in terms of taming outbreaks and maintaining decorum in the health space, but there is an urgent need to make necessary improvements in the sector to attract foreign investments and maintain a convivial environment.

There is no doubt that if these challenges are taken care of, the constant brain drain will become a brain gain for the country.