Do we have a strategy to address these meningitis, polio and lassa fever epidemics?

By Ayo Akinfe

It has been very depressing reading about the number of Nigerians that have died from the recent outbreak of cerebro spinal meningitis (CSM) over the last few weeks. Over the last three months, 333 people have died from the disease which is sweeping across the north of the country and as far as we know, this figure may rise.

Health minister Professor Babatunde Osotimehin, has been forced to admit that 5,323 cases have been recorded in 22 of Nigeria’s 36 states this year. In Kano State alone, CSM has killed 78 people since December last year according to reports released by the state’s health ministry.

Worst affected are Nigeria’s northernmost states that border on the Sahelian savannah where CSM has traditionally been very virulent. At the moment, our people are perishing in their hundreds across Adamawa, Gombe, Jigawa, Kano, Kaduna, Katsina, Yobe, Bauchi and Bornu States.

Statistics from the Federal Ministry of Health show how static we are. This CSM epidemic usually occurs in a circle of 10 to12 years. The last major epidemic in Nigeria occurred in 1996/97 when over 108,568 cases and about 11,231 deaths were recorded. Unfortunately, we have not been able to break the cycle.

Nothing I have seen so far suggests that we will not have another epidemic in 2019. If anything, things are getting worse as the outbreak is now spreading to states that were traditionally outside the danger zone. For instance, this time around 24 people have died from it in Taraba State and there have been 53 victims in Gombe State.

Let us leave CSM to one side for a minute and look at the wider health picture. Lassa fever has claimed five lives this year and polio remains a constant threat. The World Health Organisation has Nigeria down as one of the worst afflicted countries in the world when it comes to polio.

In fact, the international community is so worried about the state of our health that the World Bank recently signed a $50m (N7.25bn) polio eradication credit agreement with the government. Onno Ruhl, the World Bank country director, said the ongoing partnership consists of the procurement of the oral polio vaccine, supplemental operations such as social mobilisation, cold chain and capacity building and effective monitoring of the programme.

Kudos to Herr Ruhl for taking the initiative and ensuring that immediate funds were made available but is this emergency approach really going to solve our problems? Today, it is polio, CSM and lassa fever but tomorrow it could be cholera, typhoid fever or whooping cough.

If we really want to prevent ourselves being wiped out by constantly occurring epidemics, we simply have to have a comprehensive health plan. Not only should there be contingency plans put in place to deal with these kind of problems but there should be emergency funding set aside to be called upon whenever there is a need to.

Never in the history of mankind have 140m people been fed, housed, catered for or had their health matters addressed by charities, international organisations or trans-national agencies. These bodies can help when it comes to emergencies but to find a permanent solution to the problem, a comprehensive and sustainable programme needs to be put in place.

Even as the United Nations Children’s Fund (Unicef) and the World Health Organisation hurriedly supply us with Oily Chloramphenicol to treat CSM, they make it clear to us that prevention is better than cure. I challenge the governments of some of the affected states, particularly Kano and Jigawa that have been most plagued, to tell us what they are doing to prevent a reoccurrence of this epidemic.

Sometimes I wonder if some of these states have health commissioners at all. If they do, what exactly is it that these officials spend their time doing? As far as I am concerned, if you are a state health commissioner and over 50 people die in your state of a preventable disease, you should be charged for murder.

That the governments of these states have not been called to answer for their inaction beggars belief. I find it hard to believe that their health commissioners are still in their jobs and it is business as usual.

At the recent Kaduna International Trade Fair, Ahmed Mahmoud, the Jigawa State deputy governor, speaking on behalf of his boss Sule Lamido, boasted that that the state is ever ready for a partnership with private sectors for mutually beneficial relationships. Someone needs to tell his excellency that no investor is interested in ploughing their money into a state where their staff run the risk of being wiped out by epidemics.

This is where our esteemed health minister Professor Osotimehin has got questions to answer. Does he have a blueprint he is working on? Is he giving states targets to meet in terms of disease eradication, water provision, death reductions, the provision of health centres, etc?

If he is not working on any of this, I question what he is doing in office. Since Professor Olikoye Ransome-Kuti departed the health ministry, we have appeared rudderless, without foresight and lacking in direction. Personally, I think Professor Dora Akunyili’s energy would be better used in this area. Something desperately needs to be done.

Ayo Akinfe

aakinfe@aol.com

Robot  # 1 | 05.04.2009 20:40

Do we have a strategy to address these meningitis, polio and lassa fever epidemics? By Ayo Akinfe It has been very depressing reading about the number of Nigerians that have died from the recent outbreak of cerebro spinal meningitis (CSM) over the last few weeks. Over the last three months, 333 people have died from the disease which is sweeping across the north of the country and as far as we know, this figure may rise. Health minister Professor Babatunde Osotimehin, has been forced to admit that 5,323 cases have been recorded in 22 of Nigeria’s 36 states this year. In Kano State alone, CSM has killed 78 people since December last year according to reports released by the state’s health ministry. Worst affected are Nigeria’s northernmost states that border on the Sahelian savannah where CSM has traditionally been very virulent. At the moment, our people are perishing in their hundreds across Adamawa, Gombe, Jigawa, Kano, Kaduna, Katsina, Yobe, Bauc...Read the full article.

eire  # 2 | 06.04.2009 11:47

to be honest the living habits of northerners is a contribution factor for these diseases. I mean how many kuturu and almajaris does an area have to have? Their filthy way of life and their reliance of 13th century religion has turned them into primitive and backward disease infested things. to be honest I don't care, maybe its natures way of reducing their population after what they constantly do to Christians.

hap  # 3 | 06.04.2009 12:05

Again- yes we have, yes we can and yes we will. The bane of the problem with nigeria as whole is reasonable environmental provision; provision of portable water, clean air, safe food and unpolluted soil. Teaching student to watch thier hands without water in school or to be hygienic without provision of hygienic basic does not make sense. So, adequate education and reasonable infrastructure will make a difference if not prevent all these preventable diseases. Blaming the people is not the solution but adequate education.

infoabdlanz4u  # 4 | 09.04.2009 07:23

The Minister has a blue print, I read that in some newspapers. The Minister has spent about four months in office, and issues like Lassa fever, Polio and Meningitis, they have been in existence. You would recall that about a week ago WHO gave report that Polio has reduced in Nigeria, Guardian Monday, March 30, 2009 Polio spread drops by 80 per cent in 2009, says WHO THE number of children in the high risk states in Nigeria who have been paralysed by the wild polio virus in 2009 has declined by over 80 per cent as compared to the same period in 2008, according to the World Health Organisation's (WHO) Country Representative in Nigeria, Dr. Peter Eriki. I don’t know if you have been following the news on health, things are really looking up for the country, I watched the Minister on NTA Periscope on Monday, talking about some issues they are working on, some I can recollect are: • Training of midwives nationally to serve primary health care levels. • The NHIS free under five medical services which covers pregnant women as well. • Encouraging stakeholder outside the health sector to invest in health i.e. Aliko Dangote and Bill Gates • Emphasis on successful activities carried out while at NACA. • National Health Frame Work Plan • Strengthen coordination of partners in health from other countries. • Upgrading of 14 Hospitals Don’t forget that the Minister wrote a letter to the Commissioners last week, tasking them on Primary Health Care which is their primary responsibility. I can still recall that last week the Minister said the Federal Government is working on getting more Lassa fever Diagnostic centers in the country. This I believe is a positive development. What I suspect is Prof Osotimehin is a man of few words who does not believe in making too much noise in the pages of newspapers. Going by what he did while at NACA, I have confidence in him.

dmelekwe  # 5 | 09.04.2009 08:08

There has never been an administration this responsive to health issues in Nigeria. It’s with great pleasure I wish to commend the Minister of Health for his strides in fighting against disease. I for one will call him a chief strategist as he has developed a strategy that will revitalize health institutions in Nigeria and resuscitate the health sector that was once in slumber. His identification of Primary health care as the Key to solving health issues in Nigeria is laudable. Providing healthcare at the grassroots level is a strong indication that he has the interest of all Nigerians at heart. With primary health care in place, basic health issues will be well taken care of, issues like maternal mortality, infant death, polio, and other diseases will be reduced to the barest minimum. As the country is being rebranded, this is an indication that the government is being sensitive to health needs of the people, and is also rebranding through the 2009 health Agenda giving life to the once decaying health sector. With this, Nigerians can be guaranteed a higher life Expectancy. For the first time we have a Health minister that understands the health needs of the people, and is passionately implementing his Agenda which is the road map to sustainable health development.

femtop  # 6 | 09.04.2009 09:19

As a closer watcher of the activities in the health sector over the past three months, I have no doubt that the present leadership in the Federal Ministry of Health is prepared to set a record in the healthcare delivery system in Nigeria. Notwithstanding the rot that dotted the entire health system, particularly the Primary Health Care System, the minister has at different fora, mention the readiness of the present leadership in the ministry to tackle headlong the decay and turn around the system within the shortest possible time. Towards this, he said that a new health development agenda is being prepared which will holistically tackle the decay in the healthcare system with emphasis on Primary Healthcare (PHC). The minister has met severally with the various stakeholders in the health sector and even the media where he intimated them with the proposed Health Development Initiative being put together to revive the Primary Health Care system, which is the fulcrum of the healthcare system in Nigeria. He has emphasized that success of the new initiative requires collaboration all relevant stakeholders. He has made promises to tackle the perceived neglect of the key failure factors in the sector, like poor funding, obsolete and inadequate infrastructure, poor motivation of health workers, poor attitude of health workers to patients, adequate and regular healthcare education and awareness to enable Nigerians know about how to prevent the common diseases like CSM and Lassa Fever and even Malaria fever that is killing people in hundreds today. Other agencies of government too need to complement the effort of the ministry of Health in the provision of potable water, electricity etc. Nigerians too have a part to play in the healthcare system by maintaining good personal hygiene. Worthy of note is the way the minister participated in combating the recent outbreak of CSM and Lassa fever in country. He showed that he was a man who has the mind to serve his people. He visited virtually all the epidemic areas and supervised the administration of vaccine to curtail its spread. Such leadership style is what we have lacked all this while in the ministry. There can’t be a better time for the expected breakthrough in the health sector than now when we have a core Health Specialist to handle the ministry having made his mark at NACA. One of the salient points in the development of the PHC which he has been preaching is the collaboration between the various tiers of government particularly the Federal and State governments with local government working together to ensure that adequate healthcare is accessible to Nigerians. Recently at the just concluded 52nd National Council of Health which involves meeting of all State Health Commissioners and the various stakeholders in the health sector, he emphasized that the State commissioners need to do more by waking up to their responsibilities of funding the Primary Healthcare system as enshrined in the constitution. This is the time to give him all the support and encouragement he needs to succeed in this dispensation rather than castigating him for the errors or mistake of past leadership of the ministry. If he could do it at NACA then he can also do it in the Ministry of health. Let’s support him and drop all sentiments.

Public Sweetheart  # 7 | 09.04.2009 10:17

In as much as I respect the opinions of the writer of “Do We Have A Strategy To Address These Meningitis, Polio And Lassa Fever Epidemics?” I go by the philosophy of objectivity in reacting to issues that affect the lives and image of this great nation. The writer, having put together various statistics generated from disease outbreaks across the country, still demonstrated gross pretence concerning the activities the current Minister for Health, Professor Babatunde Osotimehin, is putting in place to salvage health situation in the country. I mean how could a person take an extra effort in quoting facts and figures about the precarious situation of the health sector and still failed to see solutions and activities already in place to salvage it? This is a cheer demonstration of a deliberate attempt to malign the image and office of the honourable minister for health. Sometime in January or February, there came out a publication that explained the minister’s agenda for the health sector, he also has a bill that would take care of activities to be achieved by his ministry. The problem this sort of write-up can generate is a bad image for the outside world to see, and it generally can jeopardize the “Re-branding Nigeria” project of the honourable Minister for Information, Professor Dora Akunyili, as the campaign is a patriotic endeavour. Professor Akunyili has appreciated the position she found herself, and she has promised to do her best in managing the country’s information. Thus, portraying her as the best for the health sector detracts from her endeavour in re-branding Nigeria; it is tantamount to saying she can’t do well as minister for information, and this is a statement she would not appreciate. Thus, we should be mindful of how we portray the activities of our representatives. The achievements of Prof Osotimehin as NACA DG are there for all to see, his activities toward primary health care in the country have been properly articulated, the bill to generate the tools he needs to achieve his intentions and agenda has been properly explained through various media. Henceforth, let all know that Nigerians shall no longer be misled by acts shielded with deliberate ignorance or by a calculated misrepresentation of available information. Everyone should do their jobs accordingly and we should stop underestimating the abilities of the health minister; we’ve seen him act in different capacities successfully.

ozoodoo  # 8 | 09.04.2009 12:21

Chei....so many JJCs with just one post on this thread. It is also interesting that "Prof Osotimehin is a man of few words who does not believe in making too much noise in the pages of newspapers". Maybe we need to see his works on the ground rather than him getting some jobbers to tell tory on his behalf on the internet.

Auspicious  # 9 | 09.04.2009 12:29

=ozoodoo;344611>Chei....so many JJCs with just one post on this thread.. Hehe! That was observant of you - I didn't even notice it! :biggrin: Are you tryna say the Good Prof has agents swarming this thread? :eek: Auspicious.