By Iyemah David
In October, the scientific journal, “Nature,” called health systems to prepare for future pandemics with improved surveillance, information sharing and training.
Also, a recent article in the Bulletin of the Atomic Scientists also called for investment in pandemic preparation and prevention.
These are self-evident positions that should, ordinarily, not be debated. But in their present state, national and global health systems are unlikely to create or sustain such measures.
Some Nigerians are appraising how the country has fared in its test on preparedness and response to the COVID-19 pandemic. It remains to be determined whether the country will do better next time because it is inevitable that there will be another pandemic.
According to public health experts, progress will require more and sustained funding from governments, better technical capacity and improved operational excellence in Nigeria’s public health system.
But the proposed 2023 budget has failed to do this, with funding cuts to National Action Plan for@ Health Security.
Strengthening the country’s health security will require commitment from the 36 states of the federation and the FCT.
It will also require effective governance, effective use of financing and other resources, strong and accountable leadership, robust technical support, substantial new funding with efficient financial mechanisms, and rigorous accountability.
The experts said that success will also require a stronger commitment to collaboration and new ways of working together that recognise the reality of mutual dependency and the need for mutual accountability, as illustrated by Covid-19.
Meanwhile, countries across the globe have continued to witness emerging and re-emerging disease outbreaks spread at alarming rates.
Some stakeholders in the health sector alleged that funding for preparedness has been difficult to establish and maintain in the country, because government has focused on immediate and visible problems rather than prevention of future harms.
They said that the primary healthcare facilities in the country do not have the political support needed to establish the funding required to provide essential care and prevent the spread of disease through vaccination or other means.
According to Dr Solomon Chollom, a Virologist, each state of the federation, Nigeria Centre for Disease Control and Prevention (NCDC), as well as other relevant agencies, need effective mechanisms to ensure that resources are invested in remote sensing and outbreak gate keeping efforts.
Chollom said that actionable public health information must be articulated and shared transparently and with verification mechanisms; and robust mutual accountability mechanisms that incentivise states to report on progress made with invested funds.
He said that in all public health efforts, it takes trained staff to transform financial resources into functional capacities.
“Practical, mentored training of public health experts needs to be scaled up and sustained across the country.
“Field epidemiology training programmes will further improve quality so that those graduates can operate with upgraded skills and be at par with counterparts in other climes, given the globalisation of recent disease outbreaks.”
The expert said that in most states, the public health workforce needs to be more prominent in terms of structure and function.
“It should be larger, better trained, better able to design, implement, analyse and evaluate health risks and public health programmes and better supported by the NCDC, WHO and other relevant agencies.
“This is where the call for establishing state Centres for Disease Controls becomes louder. What we have at the moment is basically, help desks,” he said.
He said that COVID-19 demonstrated that even robust public health institutions were not immune from inappropriate political interference.
“The NCDC is the essential anchor of our public health architecture in the country and must be reinforced by human resource policy improvements, increased resources, and functional partnerships with international donors and other organisations.
“Yet the scope of financial, technical and operational support required to respond effectively to the next pandemic is likely to remain beyond the reach of any single institution.
“Further improvements in NCDC are necessary but not sufficient to greatly improve the country’s readiness,” he said.
Dr Samuel Eleojo, a public health practitioner said that the most important task for all states is to strengthen their capacity to identify and respond to outbreaks where and when they occur.
Eleojo said that this included genetic sequencing of pathogens and sharing of sequence data in the country’s databases.
According to him, to ensure the best possible health security for the country’s population, industrialised states should support lower- and middle-income states as they strengthen their public health capacity.
Mrs Jennifer Shoshan, a Medical Laboratory Scientist with Innovative Biotech Limited, said that the COVID-19 pandemic exposed weaknesses in laboratory capacity in many parts of the country.
“A major effort by the Medical Laboratory Science Council of Nigeria (MLSCN), and partners should help strengthen that capacity, essential for detecting the spread of future pathogens.
“To do that requires more than a one-size-fits-all approach.
“Laboratories can only be sustained if they are adapted to suit the environments and societies hosting them,” Shoshan said.
She explained that another major factor in monitoring is the need to shift the emphasis from detecting pathogens in humans to detecting them in animal populations early and preventing them from becoming established long before they spread to humans.