The Conversation Africa recently held its first policy dialogue session where seasoned academics in Nigeria and the country’s Minister of State, Health, Dr Adeleke Mamora, discussed the country’s handling of COVID-19 so far as well as its preparedness for the next pandemic. In this interview, Doyin Odubanjo, Folasade Ogunsola, Christian Happi and Oyewale Tomori provide their assessment and verdict on Nigeria’s chances of successfully handling another pandemic.
What has been the most frustrating aspect of managing COVID-19?
Doyin Odubanjo: It’s communication. I think we underestimated what is required. And by no means am I trying to undermine the need for vaccines, or laboratory testing, and all of that. But what you need more than anything else is behavioural change management.
You can have the testing capacity, but the people will not go to the labs; you have masks as a controlling measure, but the people will not put them on.
We were dependent more on using law enforcement, instead of understanding that we needed to communicate effectively to get people to change their behaviour and follow the directives that we gave for their benefit.
Folasade Ogunsola: The greatest problem we have is that our systems around health and education are broken. If you’re going to do research in health, it requires knowledge. It requires that you have strong educational systems. It requires that you have strong healthcare systems.
What we have seen across Africa generally is that we have a reactive approach to health rather than a proactive approach.
Oyewale Tomori: There are two things that contribute to our problems. First of all, we learn lessons and forget them as fast as we learn them. We boast about the 2014 Ebola outbreak. But what followed in 2015, what followed in 2016? We had Lassa fever. It got worse in 2016. It got worse in 2017. Lassa fever in 2018 was even worse than in previous years, that is, until 2019 came and we said we never had it as bad. This year – 2021 – it’s reducing, because every effort is on COVID-19, and reporting of other diseases is neglected.
Comparing this pandemic with others, what have been the gaps and the gains?
Oyewale Tomori: One way to measure gains is by the differences in your response between the epidemics. Your response depends on how well you prepare. And the longer the space between those epidemics, the more we (Nigeria) forget what happened during the previous outbreaks. And at the sight of each new outbreak, we prepare our ammunition at the war front, piling icing on a rotten cake.
The Minister of Health says Nigeria started to build up laboratories in response to COVID-19. We shouldn’t be building laboratories now, 60 years after independence. What we count as success is actually repairing the damage caused by past neglect. We should be ashamed instead of self back-patting.
Christian Happi: Nigeria was privileged to have some kind of skeletal infrastructure in place to respond to COVID-19. Maybe a bit better than some other African countries that had nothing. But the question is, could it have done more? Could it have been be better prepared? The answer is yes.
Were we better prepared? The answer is no.
Are we testing enough to represent what is going on in the country? I don’t believe that we’re testing enough, which means we could do more.
At the peak of the pandemic, or some time last year, we had a lot of treatment centres that were active. But after a while, when the number of cases was going down, many of them got deactivated. Now that Africa is experiencing a resurgence, can those new centres be reactivated and do we have what it takes to handle a surge like the one that is happening in India and some other African countries? The answer to that is no.
How can Nigeria catch up with the rest of the world?
Doyin Odubanjo: I think policymakers and decision makers have to engage better and more with researchers. We need to build that synergy and close that science to policy gap. We need to note that economic plans are a waste of time without the input of science.
So we have, for instance, a national economic committee in Nigeria, but we don’t have scientists on board. We don’t even have the Minister of Science and Technology there. The president of the Nigerian Academy of Science is also absent. Yet we’ll give speeches that say we know that science, technology and innovation is what drives the economy in this day and age.
We need the private sector very badly to get things running, because apart from the money, there are some efficient systems that the private sector can bring on board to help us manage our public health system.
Christian Happi: It is crucial that Nigeria invest a lot in health security. And more importantly, it is critical for Nigeria and Africa to invest in vaccine facilities. It is dangerous for a country of 230 million not to have a single facility that can help provide vaccine in case of emergency. It is dangerous for a continent of 1.3 billion people not to have production facilities that can help the continent to respond to an epidemic or pandemic.
Folasade Ogunsola: We talk about research, but we don’t fund it. There is a gap between doing the research, having the product or the prototype, and commercialisation. When we’ve done the research, you have a product. Taking it the next step requires government, requires the private sector and requires a policy framework that helps to drive that process. That’s missing in Nigeria.
How prepared is Nigeria for the next pandemic?
Doyin Odubanjo: It’s a simple phrase, “we’re not prepared”. So that’s the real takeaway. If we do all the things that have been said, and we address them, maybe we’ll be prepared, but we’re not prepared. No.
Folasade Ogunsola: Fundamentally, preparedness builds on a system that’s working – and that system is broken. So if we’re really going to prepare for the next pandemic, or we’re going to get the trust, we have to build the systems and make sure that they’re strong. We need good health systems, we need good educational systems.
Christian Happi: Nigeria would need to rally all its forces - in public health, the private sector and in academia - coming out with a framework that can prepare the country better.
There are many programmes and projects already being piloted in Nigeria like early warning systems for pandemic preemption and response. Nigeria needs to leverage such initiatives in order to strengthen the health system and prepare the country better for pandemic response.