Photograph — REUTERS/Yara Nardi

Although COVID-19 cases dropped significantly in Nigeria within the past year, cases are beginning to rise again. Just recently, the Nigeria Centre for Disease Control (NCDC) recently reported 347 cases of COVID-19 and Lagos alone accounts for 265 (76%). This begs the question of how ready Lagos and the entire country are to quickly cub the spread of the virus or any other epidemic that may arise.

The initial outbreak of the Covid-19 pandemic and the resultant lockdown showed how unprepared and unequipped the Nigerian health sector was. Although the Nigeria Centre for Disease Control (NCDC) responded remarkably well, much more could have been better if we were prepared. At a health security policy dialogue put together by Nigerian Health Watch in Abuja recently, Peter Hawkins Country Representative of UNICEF made an impressive remark on NCDC’s response. He said, “We can affirm that Nigeria did a remarkable job to contain the COVID-19 pandemic. NCDC for instance stretched and brought on its a-game despite the challenges in the sector. Also, many initiatives like the Coalition Against COVID-19 (CACOVID) were timely interventions by the Federal Government and private institutions.  He also added, “whilst we got several things right, much more could have been done. Knowing that the pandemic is not over, and we might be at the beginning of many other, there is a need to tighten efficiency within the sector.”

According to a WHO report, the devastating human, economic, and social cost of COVID-19 has highlighted the urgent need for coordinated action to build stronger health systems and mobilize additional resources for pandemic prevention, preparedness, and response (PPR). World Bank’s Board of Executive Directors have also approved the establishment of a financial intermediary fund (FIF) that will finance critical investments to strengthen pandemic PPR capacities at national, regional, and global levels, with a focus on low- and middle-income countries. It is believed that the fund will bring additional, dedicated resources for PPR, incentivize countries to increase investments, enhance coordination among partners, and serve as a platform for advocacy. This is indeed a welcome initiative!

Whilst the rest of the world is girding up and investing in the health sector to get prepared for a possible future pandemic outbreak, Nigeria must not be left behind. Here are three key things we must consider:

Increase funding for epidemic preparedness: Ifeanyi Nsofor, a public health doctor and Senior New Voices Fellow at the Aspen Institute, Washington DC. Recently opined that indeed, it is cheaper to prevent and detect than to respond to an infectious disease outbreak. COVID-19 has shown how the impacts of pandemics go beyond the health sector. He believes that a simple way to implement this is via a budget line item called “epidemic preparedness” and then define what that covers. He stated that “For example, in local councils, it could cover the cost of provision of clean water in health facilities, setting up a good waste disposal system for communities, stipends for community health volunteers who are the first line in reporting infectious disease outbreaks. The state government’s epidemic preparedness budget could cover recruitment and deployment of different cadres of health workers to last-mile health facilities, setting up and equipping state government-owned laboratories, health communications, advocacy interventions, etc. The federal government should budget and allocate more funds to NCDC to support its efforts to prevent and detect infectious disease outbreaks.”

Invest in human resources: The level of brain drain, and the massive exodus of doctors and other medical practitioners is worrisome, especially at a time like this. The president of The Nigerian Medical Association in an interview revealed that “Over 50 percent of our doctors are outside the country, we estimate that about 80 thousand Nigerians have been trained as doctors but only about 40 thousand are at home. And these surely are not enough and adequate.”

This is a scary figure for a country looking to improve its health sector. Also at the just concluded policy dialogue by Nigeria Health Watch, many medical experts alluded to the fact that sealing the big black hole in managing human resources in the sector is a critical part to look at as Nigeria is losing its key health personnel to other nations.

Set up an accountability structure across all levels: Medical experts present at the policy dialogue by Nigeria Health Watch also made a charge for setting a proper accountability structure across the national and sub-national levels. It is believed that all hands must be on deck to get Nigeria Pandemic Prepared. For instance, Ifeanyi Nsofor said “It’s both sad and amusing when you hear Nigerians rant about the health sector. The belief that only the federal government is responsible for the workings of the health sector is a great disservice to us as a Nation. We must realize that Nigeria is a federation and all levels including states and local councils must be held accountable.”

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