Amid the COVID-19 pandemic that has plunged the world into an existential crisis, the dreaded Ebola Virus Disease has reared its ugly head again, first in Congo and now in Guinea. According to the Nigeria Centre for Disease Control, given the proximity of Guinea to Nigeria and other West African countries as well as other indicators, Nigeria is at a moderate risk of an Ebola outbreak. Therefore, measures must be put in place to ensure that the current COVID-19 pandemic, which has led to over 155,076 infections and 1,902 deaths, is not exacerbated.
According to the World Health Organisation, a delivery of 11,000 Ebola vaccines has arrived in Guinea, while 225 high-risk contacts and frontline health workers have been vaccinated. This is certainly the way to go. But Nigeria must also play its part by strengthening vigilance through the port health services and ensuring that symptomatic persons are not allowed in through the various borders.
Mechanisms for contact tracing, which were strong at the onset of the COVID-19 pandemic, but have since weakened, must be revived. While vigilance at airports has been sustained, the same cannot be said of the porous land borders. The reopening of the land borders should also not be an excuse to let people in without subjecting them to temperature checks. Health experts have argued that Nigeria was fortunate that the index Ebola case in 2014, Patrick Sawyer, came in through the Murtala Muhammed International Airport, Lagos and ended up in a private clinic. The story may have been different if he had come in by land and ended up in a remote public hospital. This therefore underscores the importance of safeguarding the land borders.
The fact is that outbreaks of diseases are preventable if advisories and guidelines are strictly adhered to. And while the citizens must play their part, the government must ensure that it leads the way by example and strict enforcement. For instance, the government says gatherings of any kind should be discouraged and this message ought to be clearly spelt out. Unfortunately, the Federal Government has failed to lead by example by allowing people to gather in large numbers to beat the deadline to register for National Identity Numbers. The ruling All Progressives Congress is also holding a registration and revalidation exercise nationwide in the middle of the pandemic. Surely, there ought to be smarter and more effective ways to do things.
According to the NCDC, the recent report of cases of Ebola is a reminder that outbreaks will continue to emerge and this emphasises the need for continued investment in health security at national and state level. Billionaire philanthropist and Microsoft Co-Founder, Bill Gates, had similarly in January voiced the need for Nigeria and the world at large to prepare for the next pandemic.
But how can Nigeria properly prepare for the next pandemic when it has continued to make poor budgetary provisions for health? The woeful budgetary allocation to health by the three tiers of government calls for a complete rethink of health-care financing. The health budget, which stands at seven per cent in the 2021 budget, is in clear violation of the African Union Abuja Accord of 2001 that mandates all signatories to set aside 15 per cent of federal budgets for healthcare. As the WHO has advised, government at all levels should give higher priority to health in their budget allocations, collecting taxes more efficiently, including compulsory insurance contributions, and raising additional funds through various innovative funding mechanisms.
Without mincing words, the poor funding of the health sector and the current universal health coverage, which stands at five per cent, is a symptom of the poor leadership Nigerians have continued to endure. The country has had to depend largely on foreign governments and donors like the Bill and Melinda Gates Foundation and GAVI, the Vaccine Alliance. This is an unsustainable model for the development of the health sector of any country. The failure of the government is why Nigeria has continued to witness periodic outbreaks of cholera, hepatitis, monkeypox, Lassa fever, meningitis and yellow fever which are preventable.
It must be said that given Nigeria’s poor health indices, it cannot withstand an Ebola outbreak in the middle of the COVID-19 pandemic. Already, the country is finding it difficult to effect testing for COVID-19, with thousands complaining of having to wait for weeks on end to get their test results, while oxygen demand is difficult to meet. Besides, the incessant strikes by doctors and health workers due to the failure of the government to pay salaries and allowances could cripple the sector if Ebola is added into the mix.
The NCDC says it has put in place several measures to prevent and mitigate the impact of a potential outbreak. It says a National Emergency Operations Centre operating from its Incident Coordination Centre is on alert mode along with a team of first responders on standby, ready to be deployed within 24 hours in the event of an outbreak. It has also established testing capacity for Ebola at the NCDC National Reference Laboratory.
The states must also play their part by ensuring that isolation centres are upgraded to handle Ebola cases. Efforts must be put in place to ensure that state laboratories can test for Ebola. Currently, 16 states have just one molecular laboratory, most of which are owned by the Federal Government. This should not be so. States must avoid the temptation of relying exclusively on the Federal Government.
It must not be forgotten that Ebola is a severe disease with a possible case fatality rate of 90 per cent unlike COVID-19, which kills mainly persons with pre-existing conditions and the elderly. This is certainly not the time to drop the ball.