As COVID 19, in many countries has started out as an urban disease and there is concern about how some of the megacities in the Global South will effectively address the issues, we are delighted to invite Dr. Jide Idris, previous Commissioner of Health in Lagos, who led the Ebola response in Lagos State to be a special guest writer to share his independent views.
Covid-19 appears to reflect the WHO’s prediction of Disease X since it attained a
pandemic status. Its impact has been enormous ranging from health systems
destruction, threats to national and international security, raising scientific
challenges, severe global economic damage to several industries etc. This
underscores the importance and reality of the cliché that “Health is Wealth” and
the need to look at Health as a Security issue.
Back in Nigeria, our response to this pandemic, especially between Lagos State
and the National Center for Disease Control (NCDC) teams has so far been
commendable. It shows that we learnt a few lessons from the Ebola outbreak of
2014, especially the importance of Preparedness. It would also appear that apart
from Lagos and very few other states, most states in the country are not ready
and prepared.
However, considering the mode of spread of this virus, our response needs to be
modified especially in view of the gaps we have as a country, as highlighted by
both the Joint External Evaluation (JEE) and the Global Health Security (GHS)
Index scores for Nigeria. Top amongst these is our fragile health system. A key
component of this is the severe shortage, quality and capabilities of our health
work force in some key specialty areas. A major concern is our seeming inability
to handle a surge (with complications) when it occurs. Therefore, there is a need
to increase our surge capacity by training our health workers (both public and
private) on emergency respiratory care (ventilator care), Intensive Care etc.
Also important is the large number of vulnerable groups like people with
Tuberculosis, Sickle Cell Disease, Malnutrition, Cancer, Cardiovascular diseases,the increasing number of slum areas, our communal living style, especially as it
relates to the military and police barracks etc. These represent the vulnerable
segments of our population. All these require us to review our response
strategies, more so as It would appear we already have community spread of this
virus now. Perhaps, we should consider decentralizing our detection strategy by
creating specialized centers where more rapid screening, using test kits can be
carried out.
In the same context, there is also a need to review our concept and
implementation of “social distancing” if we consider the less privileged people
living in the slum areas (the face-me-I-face-you) type of housing, people living in
the barracks etc. Furthermore, there are many communities with little or no
access to safe water supply. This also, is a reflection of our mitigation and
preparedness status. If we want to encourage the culture of hand washing,
perhaps governments should consider the provision of bore holes in those
communities.
As a country, we have many factors (e.g. the environment, population explosion,
social migration and conflicts, food, agriculture and animal industry etc.) that
render us vulnerable to biological threats. Lassa fever is currently taking its toll in
the country, in addition to the current Covid-19 pandemic. So, we must
continuously review and update our level of preparedness and response
strategies nationwide. Health must be taken as a security issue.