It is shameful that preventable diseases are still common enough to claim lives of Nigerians at this time. The statistics are increasingly frightening as deaths have been reported from measles, meningitis and Lassa fever in various parts of the country, this year, again.
Since the beginning of 2019, for instance, measles has killed 89 persons and infected 28,796 others nationwide. Latest statistics from the Nigeria Centre for Disease Control (NCDC) showed that during the epidemiological week, which ended on May 18, 2019; 19, 229 suspected measles infections were recorded in the 36 states with two deaths and a Case Fatality Ratio (CFR) of 0.1 per cent.
According to the Centre, Borno, Yobe and Katsina states accounted for 79.7 per cent of the outbreaks, recording 989, 372 and 301 cases during the period.
Similarly, Cerebro Spinal Meningitis (CSM) has claimed 65 lives and tainted 891 since January 2019. Again, during the week of May 18, 2019, the NCDC reported that there were 34 new cases of CSM in Cross River, Jigawa, Niger, Zamfara and Kebbi with 17, five, four, two and one respectively.
In addition, NCDC stated that since the 2019 season, there had been 128 deaths from Lassa fever and a CFR of confirmed cases put at 22.5 per cent. Ninety-two per cent of all confirmed cases were from Edo, accounting for 36 per cent, Ondo (29 per cent), Ebonyi (eight per cent), Bauchi (seven per cent), Taraba (seven per cent) and Plateau’s six per cent. While on May 23, 2019, NCDC confirmed four new outbreaks of Lassa fever in Edo and one each in Ebonyi and Taraba with no death.
The Kogi government equally said 10 incidents had been recorded alongside two fatalities in the state. According to NCDC, between January 1 and May 12, 2019, a total of 2,426 suspected incidents were reported in 21 states out of which 569 were confirmed positive, 15 probable and 1,842 negative (not a case).
These avoidable deaths are too many and show a nation with a health deficit that requires credit to nil the account! So, if the spread of measles, CSM and Lassa fever ravaging some states must be nipped in the bud, all hands must be on deck and Nigerians must act fast to avoid more deaths.
As such, the authorities at the three distinct levels of the health care delivery system – Federal, State and LGA, in collaboration with all the stakeholders in health including the private sector, development partner agencies, Civil Society Organisations (CSOs), Faith Based Organisations (FBOs) and communities should work in collaboration and scale-up preventive and curative interventions in order to prevent this yearly ritual of avoidable deaths and various disease outbreaks; and contain the nations’ health deficit.
Therefore, at the federal level, the FMoH (Health Promotion Division, Department of Family Health) should effectively coordinate, supervise and provide technical oversight through the National Health Promotion Forum platform.
The private sector should be actively involved and engaged through public-private-partnership (PPP) arrangements.
The private sector actors, institutions and bodies, whether for profit or not-for-profit, working in the health system or providing healthcare services should form an integral part of the delivery and implementation processes of healthcare services through their membership of relevant Technical Sub-Committees of Stakeholder platforms established to promote private sector participation.
At the community level, the Ward Development Committees (WDCs), Facility Health Committees (FHCs), CBOs, CSOs and other relevant platforms, have a key responsibility of ensuring that appropriate health information reaches the grassroots including holding government responsible and advocating for universal health coverage across board; and sensitising citizens on the need to seek prompt professional health care.
Also, sensitisation on disease prevention should be properly timed and coordinated by the Federal Ministry of Health and other relevant MDAs for synergy and also to avoid misinformation. Achieving this, requires joint planning by the federal and state governments and states drawing their strategies and work plans from the federal strategy.
Furthermore, religious and traditional leaders should sensitise and encourage citizens not to trivialise or resist vaccination because God wants everyone to be in good health.
Although at the moment, measles vaccine is free during routine immunisation; CSM vaccine is not: individuals have to pay for it.
Also, a reality check on response to the CSM outbreak shows that government efforts alone may not be sufficient. Against this backdrop, states must embark on massive and free immunisation. While corporate bodies should support government efforts and ensure that their workforce are immunised against CSM; and government should allow NGOs to source for CSM vaccines during outbreaks to help make the immunisation pan-Nigeria.
Similarly, the National Programme on Immunisation (NPI) should make meningitis vaccine part of the free routine immunisation for children.
In addition, government at all levels and religious leaders should embark on massive enlightenment programmes to enlighten the citizens on the prevention of CSM through the use of vaccines, and sleeping in cross-ventilated and hygienic rooms.
Also, citizens should be enlightened on the nature of the disease and symptoms; and the need to quickly visit nearby medical centres for early treatment when they notice the symptoms. While health related NGOs should also embark on massive sensitisation on the prevention and treatment of CSM, instead of hiding under health to fleece funders.
On Lassa fever, there is currently no vaccine that protects against the disease, so, containing the strange disease requires prevention. The prevention of Lassa fever relies on scientific interventions; and societal and individual behavioural change hinged on good hygiene practices that will prevent rodents from entering homes. Individuals should adopt preventive practices by storing grain and other foodstuffs in rodent-proof containers, disposing of garbage far from the home and maintaining clean households.
Health workers should maintain a high level of alert in the wake of this new outbreak and observe universal precautions in handling all suspected cases of this viral haemorrhagic fever. The scientific intervention requires a connection between town and gown.
The Federal Ministry of Health; Centre for Disease Control (CDC) in Nigeria; Nigerian Institute of Medical Research; Institute of Human Virology, Nigerian; research and development units of health related organisations such as pharmaceutical companies; and universities especially the graduate students, should reach out, collaborate and engage in a well-coordinated manner to search for solutions through research on the specie of rat that hosts the Lassa virus and how to make them de-zoonotic in order to render them impotent as carriers. They should also lead a vaccine and treatment research via a comprehensive analysis of the virus, and come up with results, which hopefully will attract investment in the development of vaccines. In addition, any institution or individual who has done any useful research should make it public.
More important, the relevant ministries, departments and agencies of government at all levels should map the pattern of the outbreak and the states that have recorded Lassa fever outbreaks, under study those that never had any outbreak. Through this mechanism, stakeholders can identify the whys and wherefores and then replicate the findings to help those that record outbreaks yearly.
Finally, leaders in the health sector must avoid fire brigade approach to managing health issues. As such, there should be early release of budgetary allocation for health programmes and emergency preparedness plan that should be activated routinely to avert disasters. Yaba vaccine production laboratory and pharmaceutical industries should be challenged and supported to produce vaccines.
After all, the country was able to produce its vaccines in 1947 to fight smallpox epidemic. As a country we must get our priorities right and human lives should be a priority at all levels of governance!
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