Friday, August 06, 2021 /
08:46 AM / By FDC Ltd / Header Image Credit: WHO
There are speculations as to whether Nigeria is experiencing a third wave of the covid infections similar to its African peers such as South Africa who has 36.42% of total cases in Africa, Ethiopia and Morocco. In the last three weeks, Nigeria has recorded close to 4,000 new infections, which could be an indication that the country may very well be experiencing a third wave. Bear in mind that these numbers only capture the officially reported cases. So many people due to fear of stigma, being unaware that they have been infected or symptoms misdiagnosed as other illnesses do not disclose and are not captured in the official database. As at August 3, Nige-ria has 175, 264 official cases and 2,163 fatalities.
Is Nigeria ready for a third wave?
To put it bluntly, no. the economy is still reeling from the aftermath of the first lockdown and most businesses and industries are yet to fully recover. Also, reimposing restrictions at a time when the purchasing power of consumers is constrained by high prices of food, high energy costs coupled with a high rate of unemployment and poverty, the Nigerian economy could slip back to recession that would be more severe than 2020.
Does the government have the funds to provide social palliatives?
The FGN plans to release N1bn each to the 36 states by the end of July, as part of its social palliatives to curb the rising COVID-19 infections and mitigate the impact on the states. This is unlikely to make much of an impact if Nigeria in-deed faces a widespread third wave. Most states are already struggling to meet their daily obligations and are even resorting to paying the old minimum wage of N18,000 to their workers due to large fiscal deficits.
Implications of COVID-19 on the Nigerian health sector and potential lasting benefits
COVID-19 has undoubtedly burdened Nigeria's already underfunded health care system. It has contributed to the physical and mental exhaustion of health care practitioners, and further strained dilapidated hospital infrastructure, inadequate staffing levels and limited medical equipment, especially in rural communities. This, coupled with continued poor leadership, has crippled the sector's performance. According to the World Health Organization's Global Health Workforce Statistics, Nigeria has 0.4 physicians per 1000 patients, compared to advanced economies like the US which have over 2.6 physicians per 1000 patients. The low availability of physicians highlights the poor baseline for health care in Nigeria, which COVID-19 has generally made worse.
However, there have been a few instances where the pandemic has forced improvements that will have lasting positive implications for the country. These include Nigeria's increased international collaboration on epidemic control and vaccine sourcing, advancements in rapid testing, improved personal protective equipment and infection management practices in hospitals and clinics, and even increased federal funding, if only marginal.
Benefits of health financing on Nigeria's health sector
We have seen marginal improvements in federal funding of healthcare. Nigeria's 2021 health budget (recurrent) rose by N132.5 billion (ban) from N414.5bn in 2020 to N547bn in 2021. Also, the Federal Government increased the capital component of the health budget by 183.43% to N131.74bn in 2021 from N46.48bn in 2020. The increase in allocation is ostensibly aimed at improving vaccine infrastructure and reach across the country, which if sustained would support the administration of vaccines beyond COVID-19. Already, 4.6% of Nigerians have been vaccinated. The Nigerian health sector also received a total of N32bn from the Nigerian National Petroleum Company (NNPC) and the European Union as it hopes to significantly strengthen its response to COVID-19 and revitalize isolation centers. The funds should address some of the challenges confronting the healthcare system, especially with regards to the provision of more testing and isolation centers. In addition, the funds should mitigate future health crises and reduce financial barriers faced by the most vulnerable groups in society - which will support a stronger post-COVID healthcare system. The fund is also expected to strengthen the long-term objectives of the Nigerian health sector through adequate training and re-skilling of medical professionals.
Nigeria's international collaboration structure
Nigeria was able to improve its international collaboration through partnerships with China, the US and the European Union. These collab-orations have strengthened Nigeria's bilateral relationships and have improved the country's ability to curtail the spread of the virus. Anti-epidemic supplies received from the Chinese and US governments during the period include 100 medical protective suits, 12,000 face masks, 2,000 medical gloves, 2,000 infrared thermometers, 1,550 hand sanitizers and 201 ventilators.2,3 In addition, the US provided Nigeria with more than $54 million in COVID-19 assistance and technical advice. This effort was further supported by a 15-member team including 12 medical workers from China who provided medical assistance and expertise to health workers in Nigeria. These collaboration efforts with the US and China will better position Nigeria for future epidemic responses. Also, the timely provision of ventilators, specifically, will improve ongoing treatment capabilities for respiratory illnesses in Nigeria. These new formed relationships could also help address operational challenges with accessing and procuring health supplies in the near term.
How COVID-19 has improved Nigeria's vaccine sourcing & distribution
On vaccine sourcing and distribution, Nigeria partnered with organizations such as the Global Alliance for Vaccine and Immunization, the Coalition for Epidemic Preparedness Innovations, the United Nations' Children's Emergency Fund and the World Health Organization. These collaborations aim to provide adequate and equitable distribution of COVID-19 vaccines at both the state and community level. The goal is to focus on improving global access to vaccines, and the partnerships set up to facilitate these distributions will have a lasting impact on future vaccine needs. Nigeria is also adopting new ways to manage its vaccine roll out by offering online registration for persons above 18 years using the National Primary Health Care Development Agency (NPHCDA) websites. The online registration will be supported by a multi-faceted approach using the traditional vaccination campaign and house-to-house electronic registration. The adoption of these strategies is aimed at introducing the COVID-19 vaccines in phases across urban and rural communities in a more precise and equitable manner. So far, the success rate seems to be positive as 40% of the Nigerian population is expected to have been vaccinated by the end of 2021 with an additional 30% in 2022 using the various registration processes. Meanwhile, Nigeria has commenced its second dose of the Astra Zeneca vaccine and the outcome shows the number of infected persons in the country declining. The number of active cases in Nigeria as at July 8 is 1,580 with Lagos and Abuja having the most confirmed and admitted cases respectively.
The Nigerian health sector has benefitted immensely from international collaboration that will outlast COVID-19 in the areas of vaccine distribution, epidemic control and improved health protocols. However, Nigeria's capacity to tackle the COVID-19 pandemic still lags behind that of advanced economies and could also be coming at the expense of other pressing healthcare issues, eroding any progress made over the past few years. Hence, more work is required on the part of the government in terms of building capacity to ensure that the country's health sector realigns with the recommended WHO standard. This can be supported by further developing real-time scrutiny of the health sector and by building and deepening partnerships with more global pharmaceuticals and laboratories. This is expected to help cushion the impact of COVID-19 in the short-term and should outlive any future pandemic. In addition, ensuring that regular health programs remain well funded is likely to increase the efficiency of the government's response to future crises and to mitigate future economic and health-related shocks.