Nigeria not prepared for another Ebola outbreak

• World Bank Forum proposes regional lab, re-training of medical personnel others
• More eulogies for the late Dr. Ameyo Stella Adadevoh as Health Trust takes off
• Liberia to be declared Ebola free on May 10

NIGERIA is not fully prepared to withstand future outbreak of the deadly Ebola Virus Disease (EVD) because of poor diagnostic capacity and weak health system.

That was the verdict of experts, yesterday, at a roundtable discussion on Nigeria’s recent experience with the Ebola epidemic and lessons learned for future national and regional public-private action.

To prevent future outbreak of Ebola in West Africa and to be better prepared for possible epidemics, the medical and economic experts at the roundtable organized by the World Bank Group (WBG) and the World Economic Forum in collaboration with the Boston Consulting Group (BCG) recommended among other things:

the development of diagnostic capacities in individual countries and establishment of a regional laboratory; continued training and re-training of medical personnel; institutionalizing clinical practice governance in hospitals; setting up legal frameworks to address the challenges; incorporate a wider scope of partnerships, innovations, particularly within the business community and through unprecedented forms of public-private cooperation; and establishment of new platforms of public-private cooperation to manage future outbreaks more effectively and to manage the risk of their occurrence.

The experts also eulogized late Dr. Ameyo Stella Adadevoh of First Consultant Clinic Obalende, Lagos, who diagnosed the incidence case of EVD and the first Nigerian to die of the virus.

They also promised to support the Dr. Ameyo Stella Adadevoh Health Trust, a non-profit organization set up to foster connections and partnerships between key stakeholders to achieve its core objectives in the areas of public awareness, medical education and simulation training, health policy, and medical research.

The experts include: Commissioner for Health Lagos State, Dr. Jide Idris; a public health consultant and former Chief Medical Director of Lagos University Teaching Hospital (LUTH) Idi Araba; Prof. Akin Osibogun; Chair, Adadevoh Trust and younger sister of the late Dr. Ameyo Adadevoh, Dr. Ama Adadevoh; Chief Executive Officer of Heirs Holdings, Tony Elumelu; Managing Director, GSK, Lekan Asuni. Others include: Programme Leader WBG, Ayodeji Odutolu; Mayor, Paynesville City, Liberia, Cyvette Gibson; Director PharmAccess, Pieter Walhof; Chief Medical Director of First Consultant Clinic, Dr. Benjamin Ohiaeri. Idris said:

“Are we prepared to handle another Ebola outbreak? My answer is that we are better off compared to where we were before the first situation. Are we fully prepared? No.

We have started testing at the point of entry and other measures we have introduced at state and national levels. But we are not there, yet. Our diagnostic capabilities are not there. Apart from Lagos , we do not have laboratories that can diagnose Ebola in other states. We need to build those capabilities.”

On how Lagos was able to contain the Ebola outbreak, Idris said: “The main thing was leadership. We have a governor that has a vision and did not hesitate to do what he had to do. Six years ago we sat down to look at possible emergency situations…

We had established the disease surveillance unit and a unit that was picking up dead bodies on Lagos streets, which we employed for contact tracing during Ebola outbreak. We now call it incidence management structure.”

Osibogun said training of the medical personnel and the quick diagnosis of the incident case were key to the containment of the EVD. He explained: “Training was very important.

The people at the First Consultant Clinic were able to contain the virus because they were trained. You cannot contain what you do not know. We had equipment for avian influenza containment that is PCR to characterize the virus. So the training to be able to diagnose the case was there. We are fortunate that the virus came through Lagos.

We got all the support from the Governor of Lagos State. The Lagos State government did not have to wait for anybody and was able to enforce leadership. “So leadership is very critical as well as development of diagnostic capacity.

These diseases will come in the near future. These are mutants that will come. We need to develop a public health system to be able to respond on time. It is not yet over.” Osibogun added: “It is very important for us to make diagnosis.

We need a regional laboratory that is capable of making EVD diagnosis. Shortly before the incidence case of Ebola we got some support from Chevron to be able to set up Molecular Laboratory.

If you have genomic laboratory you will be able to go to Deoxy ribonucleic Acid (DNA)/genetic material level to identify the strain of the virus. “It is good for us to have one or two countries in the region with capability to make that diagnosis.

Other laboratories should be able to have PCR. We should be able to go into the level of gene banking. “Although technology is necessary, it is not the solution. You could have all the resources and if your training is not good enough , technology will fail.

We should organize the private sector to buy into this, set up chairs in universities and sponsor researches. I think it is a question of value system. I look into the National Honours and I don’t see any scientist.

We need to change our value system, maybe give tax reprieve to companies that support research.” Ama Adadevoh said: “I believe that the Nigerian government and private sector were not prepared for the Ebola outbreak.

We were not prepared. We did not have functional isolation centre. Going forward we need to improve in training and preparedness. There should be emphasis on training at all levels of health care.

Why Nigeria was successful was the identification of the index case.” Ohiaeri said all medical institutions must put in place, clinical practice governance.

He said it was during such meeting with late Adadevoh that the team made the prognosis that the index case, Mr. Patrick Sawyer, had EVD. Gibson, who narrated Liberia’s experience in tackling the virus, said the country “would be declared Ebola free by the World Health Organisation (WHO) in six days.”

Odutolu said the Forum, with the support of the Boston Consulting Group, will consult stakeholders from both the private and public sectors, including the United Nations, the World Bank Group, the African Development Bank and the Centers for Disease Control and Prevention.

The private-sector stakeholders include a wide range of companies and industries such as mining, healthcare and consumer goods. He said the effort will culminate with a short report and recommendations presented at the World Economic Forum on Africa on June 3 to 5 in Cape Town, South Africa, to support a high-level session on managing future epidemics through public-private cooperation.