In the next couple of days, the year 2016 will be drawn to a close and an aspect of the outgoing year which Nigerians will remember for a long time, is the harrowing set back the country recorded with regard to polio resurgence.
After more than two years without wild poliovirus in Nigeria, the Federal Government on August 11 reported that two children have been paralysed by the disease in Borno State. Both cases were detected from Gwoza and Jere Local Government Areas.
Not too long afterwards, precisely on September 5, the World Health Organisation, WHO, confirmed the outbreak of a third case in Monguno Local Government Area of Borno State.
Considered as a very big setback, the return of polio after a two year break in Nigeria is a big disaster for the country. Shortly before the outbreak the WHO, Regional Director for Africa, Dr. Matshidiso Moeti, in July had met with top-ranking government officials and stakeholders to discuss efforts aimed at certifying Nigeria polio-free but had expressed worries on the poor state of primary health care, PHC, system of the country and had alerted that this may frustrate the immunisation of children against the polio virus and the elimination of the disease in the country.
These three new polio cases, have doused hope of delisting Nigeria from polio endemic countries. Globally, the world is very close to reaching the goal of polio eradication.
Only 21 wild polio cases were reported so far in 2016, compared to 34 cases at the same point in 2015. Only two other countries are reporting polio: Pakistan and Afghanistan.
Four out of the six WHO Regions of the world have been certified poliofree and only one of the three types of wild poliovirus – type 1, is still circulating in the world. Polio is not the only disease that posed a challenge for Nigeria in 2016.
The year actually began with the outbreak of Lassa fever, a disease condition which by now should have been consigned to the dark ages. Not only did Lassa fever ravage the country, the lives of 60 per cent of those infected between 2015 and 2016 were cut short.
Despite global medical advancement of the 21st Century, poor surveillance failed the nation and Lassa fever which has afflicted over 284 Nigerians within these periods, killed about 154 people from August 2015 to September, 2016.
Other infectious diseases that held sway in 2016 include Dengue, a mosquito-borne tropical disease caused by the Dengue virus. Both Dengue and Lassa fevers are haemorrhagic in nature.
Similarly, although, the Zika virus outbreak is still prevalent in the Americas, Nigeria is still contending with the fears of its spread into Africa while the Federal Ministry of Health, FMOH, committed 2016 to increasing awareness on the prevention of Zika in Nigeria and neighbouring African countries after the WHO declared Zika a public health emergency on February 1.
Zika which is spread mostly by the bite of an infected Aedes species mosquito (Ae. aegypti and Ae, can be passed from a pregnant woman to her feotus, causing a serious birth defect called microcephaly, the sign of incomplete brain development. Also, Zika can be passed through sex from a person who has Zika to his or her sex partners.
HIV/AIDS
Nigeria has the third highest burden of HIV and AIDS in the world. The general population survey in 2013 puts the country at an HIV prevalence of 3.4 per cent, lower than 3.6 per cent reported in 2007.
About 3.5 million people are estimated to be living with HIV/AIDS in Nigeria and the estimated number of new infections and HIV/AIDS related deaths was 390,000 and 217,000 respectively in 2013.
As at 2016, this data has not changed. However, efforts to further reduce the spread of HIV is currently being threatened by stigma and poverty and fewer than half of the people in need of HIV medications, are receiving the medicines they require to survive HIV scourge in the country.
According to the Chairperson, Network of People Living with HIV/AIDS in Nigeria, NEPHWAN, Lagos Chapter, Mrs. Aminat Alli – Agboola, HIV is no longer the enemy but stigma and discrimination.
Aminat who has lived positively with HIV for 15 years, warned that except there is intervention to tackle stigma and discrimination of people living with HIV, more babies of HIV positive women will be born with the virus. In his reaction, Minister of Health, Prof. Isaac Adewole admitted that although, the Federal Government has kick-started the HIV test and treat initiative to help more Nigerians know their HIV status this year, the challenge is that while about 500,000 Nigerians would need to be put on treatment, “we do not have the resources that we need to take care of the 500,000 this year.
Hence, in our 2017 budget,we are looking at how we would take care of about 100,000 out of the 500,000. “We are looking at donor support including Global Fund and other donors to join us so that we can scale up treatment for the other people,” he added. Furthermore, the global community has called health systems strengthening, saying it is needed to ensure that countries can realise the benefits of new policies and technologies for HIV treatment.
WHO recommends that all persons living with HIV should be put on anteretrovirals, ARV. Standard antiretroviral therapy (ART) consists of the combination of antiretroviral (ARV) drugs to maximally suppress the HIV virus and stop the progression of HIV disease.
PHCs
The rehabilitation of 110 Primary Health Care, PHCs is still ongoing while the World Bank is supporting each state of the federation with $1.5m U.S dollars to focus on maternal and child health programs.
Fake drugs
In Nigeria, part of the factors encouraging drug counterfeiting In Nigeria include being a developing country, the large population estimated to be 167 million, availability of good market size, low local production capacity, good buying power as an oil producer and the vast and porous borders covering 924,000km.
The Pharmaceutical Security Institutes data estimates that drug counterfeiting is a $75 billion business while the World Customs Service puts it at $200 billion business annually.
Drugs that counterfeiters targeted in the country during the year in review include antimalarials, antibiotics, antihypertensives, anti-diabetic agents, and life style drugs.
Throughout 2016, the National Agency for Food and Drug Administration and Control, NAFDAC, operated without a director general. Stakeholders especially pharmacists have therefore, urged President Muhammadu Buhari to appoint a substantive head for the Agency to enable the incoming director general strategise on reducing facke drugs in the system.
Impending scarcity of essential medicines
A major factor that dominated 2016 is the predicted impending scarcity of essential medicines occasioned by the shortage of foreign exchange in the country.
Going by the trend, which has resulted in the high cost of medicines, pharmaceutical industries have alerted the public about the situation, saying the scarcity of essential medicines may lead to high disease burden.
Both the Chairman of the Pharmaceutical Manufacturing Group of the Manufacturers Association of Nigeria, PMGMAN, Mr. Okey Akpa and the President of the Pharmaceutical Society of Nigeria, PSN, Dr. Ahmed Yakasai, agreed that local pharmaceutical manufacturers were producing below 30 per cent capacity utilisation, lamenting that it would result in the scarcity of essential medicines.
While assessing activities in the health sector in 2016, the immediate past Chairman of the Association of General Private Medical Practitioners of Nigeria, AGPMPN, Dr. Adeyeye Arigbabuwo said the 2016 Health Budget of about 3.6 per cent, makes it very difficult to achieve the Universal Health Coverage, UHC that is being clamored for Nigerians. Part of the initiative of the United Nations Sustainable Development Goals, SDGs, is that all UN members should achieve UHC BY 2030.
This includes financial risk protection, access to quality essential health care services and access to safe effective quality and affordable essential medicines and vaccines for all. In his views, the immediate past President of PSN, Olumide Akintayo lamented that the minister of Health continues to demonstrate zeal to perform, but “in terms of concrete achievement, we cannot really see what has been done and it is not really the fault of the health minister.”
Akintayo, lamented that the Federal Ministry of Health, FMOH, does not seem to be in a hurry to implement the National Health Act, NHA, 2014, which allocates one per cent of consolidated federal revenue to the health sector.
“This type of fund under the NHA could be used to boost primary health care, PHC, to improve social health insurance and could make health care accessible for many more people but government is not implementing it.
“It is becoming clearer by the day that the Federal Government has not factored this one per cent consolidated revenue into what can be achieved from the NHA. “Hence, it looks like we are gravitating towards zero level and sub-optimal level.
It is not good that government has become the biggest law breaker by not implementing the NHA.” Giving an assessment of the performance of the health sector in 2016, the President of Healthcare Providers’ Association of Nigeria (HCPAN), Dr. Umar Oluwole Sanda Dr. said, “the performance is very poor.
We still have a lot to do”, adding, “The 2016 Budget is not helpful at all.” Sanda urged the Federal Government to do something about it, predicting that with the recession, “we are still going to get bad figures.”
By: APPOLONIA ADEYEMI
The Newtelegraph News
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