Posted on: Fri 10-07-2020

Mr Charles Mensah is the Managing Director and Chief Operating Officer of the Institute of Human Virology, Nigeria. He speaks to DAYO  OJERINDE on how COVID-19 has affected health financing and research in the country

What are the likely long-term effects of COVID-19 on health financing and administration of NGOs like yours?

Non-governmental organisations survive mainly on grants, contracts, Cooperative agreements and very few, if any at all, get any kind of subvention from the government. For us at the Institute of Human Virology, Nigeria, we do not get a single kobo from the government; so, our funding is 100 per cent donor-dependent. When we have an issue like COVID-19, resources from donor countries dwindle, because even the donor countries are struggling to maintain their local economies. 

For instance, in the United States of America, the unemployment rate has gone up to almost about 15 per cent now, so you expect that they will like to push a lot of money to their citizens before they even think about donating money to any other country. That kind of operating environment poses a unique challenge to the operation of an NGO, but the good thing with ours is that we are much diversified; our source of funding is not from a single country or a single donor. We deal with numerous organisations and numerous countries.

But beyond that, we also try as much as possible to work with local private organisations that we think can fund some of the things that we do, and that is why our collaboration with the banks and other financial institutions in the country is very germane. We try as much as possible to align ourselves with health sector institutions like the Nigeria Centre for Disease Control, the Nigerian Institute of Medical Research and the National Agency for the Control of Aids. It will take continuous re-strategising efforts to be able to self-sustain, especially during this period.

How sustainable is the dependence on international donor funding for the implementation of health programmes in the country and what areas should the country prioritise in meeting funding needs to address infectious and non-infectious diseases?

What I have come to know working with my colleagues, who are the experts in this area, is that when it comes to health services implementation, health care financing and health research, those who are funding it are not funding it entirely out of pity, they also have something to gain. For every programme that we implement, donors have what we call open targets and, sometimes derived targets. I think over the years, our governments have not been asleep also; they have been contributing substantially to health programmes in the country.

Do we want more? Yes. Every implementer will tell you that they want more government support and more funding so that these programmes can be somewhat self-sustaining.

Investment in equipping our existing health institutions is important. I always get worried when I hear that a new hospital is going to be established or a new specialist centre, do we really need that? We have a lot of active and massive institutions across the country. We can properly equip them, train those who are to use the equipment, establish a very good supply chain and maintenance systems for this infrastructure.

I think we will do very well in health research. We will attract a lot of talents, not only in the country. We may even be able to get a lot of our people in the Diaspora to come back home.

We believe that if we have very well-equipped infrastructure in our teaching hospitals and research centres, we will have well-trained people, a very good training system and send people for PhDs, Master’s and have a very good post-doctoral for them to be able to come back into, which we have done very well at the IHVN.

How has COVID-19 affected the administration and management of human resources in health organisations?

The psychological impact on health workers when there is restriction is enormous; when they need to get a special permit to move around, they become apprehensive too and some of them, sometimes, become panicky and feel unsafe, even when they are on the road.

For us at the IHVN, we think we have done very well. For instance, because of the limit of the number of people, who can be in a vehicle at any point in time, we have deployed some of our official vehicles to go around and pick people from home to work and drop them. Because apart from the community work that we are doing, trying to get medication to patients, we have a substantial number of our staff involved in the running of the laboratories that are conducting the COVID-19 test, particularly in Abuja, Jos and Port Harcourt.

How has the IHVN been able to maintain laboratories like the Biosafety Level 3 Laboratory in Zaria?

We have developed strategies right from the time these laboratories were set up. For instance, the Zaria laboratory, when it was installed, we had a five-year prepaid maintenance agreement with the company that fabricated it. They are based in Florida in the US and fortunately, they extended it by two years. They gave us two years of free maintenance, so we had seven years of prepaid. Every year, we pre-pay them but we don’t rely on them alone, we also have local maintenance teams within our system that keep an eye on the laboratory and that is the same thing that we have done with all the laboratories that we have.

Most of our pieces of equipment are on a maintenance agreement with manufacturers of the equipment. We don’t just buy equipment and look for some local people to be maintaining them. We establish a maintenance agreement with the manufacturers and make sure that the engineers come in from time to time to check the equipment.

We do what we call preventive maintenance. We don’t wait till the equipment breaks down. The engineers come periodically, sometimes quarterly, sometimes biannually and sometimes annually, depending on the complications and the kind of equipment that we are dealing with. They come in to maintain the equipment and to make sure that the equipment is in good operating condition.

We have a very robust power support system for all our laboratories. Each of those laboratories, including the repositories, has not less than two back-up power supplies apart from the main power. We have generators and battery-powered inverters that back them up.

The repositories have at least two back-up generators that support each laboratory. That means we have four power back-up systems in each repository and the same thing we have done with the tuberculosis laboratory in Zaria too. At any point in time, 24 hours, seven days a week, they have power supply, because that is the most critical infrastructure that any laboratory needs – continuous power and water supply.

The laboratories, particularly the repositories, are also equipped with alarm systems and these are alarm systems that are online and the way they are structured is that if something, perhaps, if the temperature drops below acceptable levels in a particular refrigerator in any of the laboratories, the alarm system sends an alarm to the manager of that laboratory and the maintenance people. If there are fumes coming from fire or something else, the same thing is done. So, there is a rapid response team within the organisation that responds immediately and takes care of the problem.

How significant is private sector collaboration in the establishment of the soon-to-be-unveiled International Research Centre of Excellence?

Without the involvement of the private sector, we would not have got to where we are. For us, this is a huge milestone that we achieved and we are building on that to make sure that when the place is completed, we have very high-level private sector involvement in terms of sustaining it and also expanding its reach in terms of the actual implementation of our research agenda.

Source: punch

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