On FG’s assurance of containing meningitis

It is a shame that the death toll from cerebrospinal meningitis (CSM) outbreak has hit about half a thousand while 3,959 suspected cases have been reported as at April 5! The government has stepped up plan to put an end to this calamity. The figures are frightening as the deaths have been reported from 106 local council areas in 19 states of the federation. The current outbreak that started in Zamfara State in November 2016, affecting mostly states in the upper parts of the country, which fall within the African Meningitis Belt, is also at the moment, affecting other countries such as Niger, Chad, Cameroun, Togo, and Burkina Faso, as they are facing similar outbreaks at the moment. Meanwhile, wild poliovirus has been detected at gully erosion sites in Gombe State.

Currently, the government has secured 500,000 doses of the meningococcal vaccines from the World Health Organisation (WHO), which will be used in Zamfara and Katsina states, while additional 800,000 units are being expected from the British government. The government has also constituted a CSM outbreak control team whose membership include FMOH, NCDC, NPHCDA, WHO and other partners (MSF, UNICEF, CDC and EHealth Africa) to coordinate all responses aimed at controlling the outbreak. However, the team is facing the challenges of low collection rates of samples versus reported cases, weak logistics for sample transportation for prompt laboratory diagnosis and a weak coordination between SMOH surveillance officers and treatment centres, delayed reporting of suspected cases to national level and low availability of supplies at the national level, among others. These are indicators of slow response; and medical doctors under the aegis of the Nigerian Medical Association (NMA) have condemned the Federal Government’s handling of the CSM outbreak. They condemned in strong terms the reactive measures by the government on the epidemic, arguing that “the delayed immunization of citizens against an infection that is already established is ineffective based on the epidemiology of the disease. For immunisation to be effective, it must be administered around three months before the period of clinical manifestation due to latent period.”

Against the backdrop that in 1996, Nigeria recorded the worst CSM epidemic with about 109,580 cases and 11,717 deaths and since then, it has become an annual ritual. Nigeria stands accused of having no forward planning to procure vaccines and immunise citizens against CSM. So, it is obvious that the current outbreak has been aggravated by leadership ineptitude. Again, the current outbreak of CSM started since November 2016 and government only recently secured 500,000 doses of the meningococcal vaccines; and ordered 800,000 units, which have not arrived. The doses of CSM vaccines secured and ordered might just be a drop in the ocean given the country’s large population and the spread of the disease.

Furthermore, media reports indicate that the cost of the vaccine doses alone for a total population of 22 million in just five affected states will be $11billion; and the doses being sourced are from an Indian firm. So, what will be the cost for procuring vaccines now that CSM has spread to 19 states?Given the fact that vaccines are part of practical and medically certified efforts to stem this ugly reality, why can’t Nigeria, a country with a huge population of about 180 million people, develop vaccines to respond to situations? These issues and the fact that the government is not proactive, show how much value is placed on the lives of Nigerians. Besides the government not being proactive, the issues of health and vaccines are complicated by religion, culture and attitude of citizens. While some citizens resist, some reject vaccination; and whenever anyone dies as a result of avoidable disease, it is explained away in spiritual terms. Life is indeed cheap in Nigeria!

Against the backdrop of these challenges, can government practically contain the current CSM outbreak? Containing any disease requires both practical and strategic interventions. So, if Nigeria must nip the spread of CSM ravaging some states in the bud, all hands must be on deck and Nigerians must act fast to avoid more deaths! What is the best time to go for CSM vaccination? What is the term of each dose before revaccination? Where can citizens go for CSM immunisation? So, sensitisation on CSM should be properly timed and coordinated by the Federal Ministry of Health and other relevant MDAs to address these issues. Also, a reality check on response to the CSM outbreak shows that government efforts alone may not be sufficient. So, religious and traditional leaders should sensitise and encourage citizens not to trivialise or resist CSM vaccination because God wants everyone to be in good health. All states must embark on massive and free immunisation. While corporate bodies should support government’s efforts and ensure that their workers are immunised against CSM. Government should allow NGOs to procure CSM vaccines to help make the immunisation pan-Nigeria. In addition, Nigeria must be strategic in the handling of human lives by being proactive; and must avoid fire brigade approach to managing health issues. As such, there should be early release of budgetary allocation for health programmes. The Yaba vaccine production laboratory and all pharmaceutical companies should be challenged to produce vaccines just as the country was able to produce its vaccines in 1947 to fight smallpox epidemic.