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Getting prepared to tackle future pandemics

By Chukwuma Muanya and Adaku Onyenucheya
11 February 2021   |   4:25 am
Experts in the health sector have blamed the leadership of the country for the continuous threat of infectious diseases ravaging the country.

Director General, Nigeria Centre for Disease Control Chikwe Ihekweazu PHOTO:Twitter

*How climate change drove emergence of more strains of coronavirus
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Experts in the health sector have blamed the leadership of the country for the continuous threat of infectious diseases ravaging the country.

They stressed that the inability of the country to tackle the infectious diseases, ranging from cholera, Lassa fever, Ebola and the COVID-19, among other epidemics, rests on the lack of commitment on the part of the leadership to address issues affecting its containment by building institutions, development of vaccines, training of capacities, putting confidence in the country’s scientists and products.

Speaking at the Pat Utomi’s CVL series via a webinar, the Director General, Nigeria Centre for Disease Control (NCDC), Dr. Chikwe Ihekweazu, said the country’s challenge is a result of leadership’s lack of investment in epidemic preparedness and response, as they rather concentrate on big infrastructure projects in other sectors that produce big visible political capital to leaders in government.

He said they were of the impression that the epidemic would come and go and then the whole country will go back to business as usual.

“There is a very high level of policy inconsistency at the leadership. We understand the challenges of our political structure. We have always tried to educate our leaders on the threat of infectious diseases and it always seems like a very hypothetical threat. It is very difficult to use our work for political capital because when you succeed by preventing events, it is very difficult to show success. We all try to pay for insurance policy, but it is always like a painful expense we try to put off and hope doesn’t come to us,” he said.

Ihekweazu lamented that Nigeria, for the past 60 years, has not invested in building the type of institutions needed to tackle infectious diseases, with no private sector incentive given to the health sector just like the oil sector and other business capital-making sector.

He said with the pandemic ravaging the world, Nigeria is years away from science and vaccine manufacturing, as it is an extremely complex process.

“If you look at the big countries of the world, they all have big science institutions that work quietly in the background, producing the research and human resources that are deployed to emergency when they are needed, but we simply don’t have that in Nigeria, although we have started building on that at the NCDC from a very low base,” Ihekweazu said.

He said Nigerians don’t celebrate her scientists and scientific institutions and at the end, they are expected to perform miracles when epidemic arises.

“If people don’t understand how treatment of vaccine is defined or accepted to be effective, then you find people coming up with all insinuations on why we are not using the cure from Madagascar, chloroquine, which worked for some and didn’t work for others,” he said.

Professor of Virology and pioneer Vice Chancellor of Redeemer’s University, Oyewale Tomori, said Nigeria has abandoned good governance, which plays a critical role in the severity of the infectious diseases.

He said the government only focuses on the oil sector, leaving other sectors to survive on their own, adding that the health and education sector should be given utmost priority if we must overcome the pandemic and other infectious disease outbreaks.

“We have not made vaccine for other diseases in the country like LASSA Fever, which is over 50 years now, because the effect on the economy has not been that important, just like the COVID-19. This is a consistent and persistent disruption to the economy and the government needs to act now,” he said.

Tomori also emphasised the need for capacity building, adding that Nigerian scientists do not have the capacity and right language to inform people of the relevance of tackling infectious disease critically.

“It is for us as scientists to prove that it is not what we are bringing back to the table, but what we will take away if the disease comes. All of the things you have built up in years, it requires one disease to wipe all those things out,” he said.

Speaking on the challenges of containing Lassa fever for over 50 years, Prof. Sylvanus Okegbeni said the disease had been prevalent in the human environment with many deaths recorded, including the health workers whose deaths were recorded yearly as of 2006.

He said until the country acts swiftly and strongly against Lassa fever by setting up institutions on infectious diseases, as well as work with local and international partners, the disease will continue to take the lives of not only the people in communities, but also the health worker, which he said could be disastrous.

Okegbeni said while the institutions are working with the World Health Organisation (WHO) to address the development of Lassa fever vaccines, the issue of politics was limiting all efforts at addressing the infectious disease control, adding that the vaccine production would take many years before it could be developed.

He lamented that the laboratory diagnosis and case management, which are important pillars for infectious disease control, need to be strong, adding that the government had neglected setting up institutions to address the issue.

“Lessons must be learnt now so that we can fundamentally build up structures to ensure infectious diseases do not catch us grappling. The most important is the human capacity development. Once we develop the human capacity and provide structures and resources, then we can do well like any other country of the world,” he said.

Former Commissioner for Health, Lagos State, Dr. Jide Idris, said looking at the lessons from the case of Ebola, it has been discovered that the issue of leadership is key and is one of the problems the country is facing, adding that lack of support from the government has put Nigeria in the situation it is facing right now.

He said as a country with a high population, the government needs to be ready for emergencies and plan against such by setting up institutions and structures to contain any form of infectious disease.

Idris also emphasised on the need to develop capacity and competence. “Why can’t we support local capacities in structures to aid testing? You must protect your citizens from infectious diseases. We need to start looking at the gaps we have now and start building on the capabilities for solutions to happen,” he said.

The Director General, National Agency for Food and Drug Administration and Control (NAFDAC), Prof. Mojisola Adeyeye, lamented that not involving the right stakeholders in developing solutions to address the issues of infectious diseases is one of the reasons Nigeria is facing challenges in combating these epidemic/pandemic.

“Our food preservation processes is very poor and that is part of the reasons we have these infectious diseases ravaging our society and until we bring everybody together to play their part, we will not address the issue.

“We also have a leadership problem, if the government does not see that it is supposed to be a round table of the concerned and not the politicians, we will have a lot of problems to solve,” she said.

President, African Organisation for Research and Training in Cancer, (AORTC), Dr. Bello Abubakar Mohammed, said it is crucial to look back at history and trace the value of leadership and where the country got it all wrong, noting that if this is not done, there is no way the country can move forward and ever be able to achieve positive results in containing infectious diseases.

He said pandemic could consume anybody at any place, adding that when governments put policies in place, which are not, adhered to, with no sanctions enforced, the laws become a caricature.

Meanwhile, a new study claims climate change may have driven the emergence of SARS-CoV-2, the virus that causes Covid-19.

United Kingdom (U.K.) researchers say global greenhouse gas emissions over the last century have driven growth of forest habitat favoured by bats.

This has made southern China, in particular the Chinese Yunnan province, a ‘global hotspot’ for bat-borne coronaviruses like Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2) that causes COVID-19.

Bats act as reservoirs of numerous zoonotic viruses, including SARS-CoV, Middle East Respiratory Syndrome Coronavirus (MERS CoV) and the Ebola virus.

It was believed the SARS-CoV-2 virus originated from bats, although scientists are still debating the origins of the disease, which may not ever be officially confirmed.

World Health Organisation (WHO) investigators admitted last week that their research mission in Wuhan will not reach its goal of revealing how coronavirus jumped from animals to humans.

It is likely to have its ancestral origins in a bat species but may have reached humans through an intermediary species, such as pangolins – a scaly mammal often confused for a reptile.

Despite this, the study authors claim the first evidence of a mechanism by which climate change could have played a direct role in the development of the current pandemic.

“Climate change over the last century has made the habitat in the southern Chinese Yunnan province suitable for more bat species,” said study author Dr. Robert Beyer from the University of Cambridge’s Department of Zoology.

“Understanding how the global distribution of bat species has shifted as a result of climate change may be an important step in reconstructing the origin of the Covid-19 outbreak.”

In the southern Chinese Yunnan province, and adjacent regions in Myanmar and Laos, there have been ‘large-scale changes’ in vegetation in the last century, the study found.

Climate changes including increases in temperature, sunlight, and atmospheric carbon dioxide – which stimulates plant and tree growth – have changed natural habitats from tropical shrubland to tropical savannah and deciduous woodland.

This has created a suitable environment for many coronavirus-carrying bat species that predominantly live in forests to thrive.

The study found that an additional 40 bat species have moved into the southern Chinese Yunnan province in the past century, harbouring around 100 more types of bat-borne coronavirus.

This ‘global hotspot’ is the region where genetic data suggests SARS-CoV-2 may have arisen, and been borne by bats to the city of Wuhan in Hubei province, where it was transmitted to humans just over a year ago.

To get their results, the researchers created a map of the world’s vegetation as it was a century ago, using records of temperature, precipitation and cloud cover.

Then they used information on the vegetation requirements of the world’s bat species to work out the global distribution of each species in the early 1900s.

Comparing this to current distributions allowed them to see how bat ‘species richness’ – the number of different species – has changed across the globe over the last century due to climate change.

Researchers say the number of coronaviruses in an area is closely linked to the number of different bat species present.
The world’s bat population carries around 3,000 different types of coronavirus, with each bat species harbouring an average of 2.7 coronaviruses – most without showing symptoms.

Over the last century, climate change has also driven increases in the number of bat species in regions around Central Africa, and scattered patches in Central and South America, the study also found.

An increase in the number of bat species in a particular region, driven by climate change, may increase the likelihood that a coronavirus harmful to humans is present, transmitted, or evolves there.

Most coronaviruses carried by bats cannot jump into humans, but several coronaviruses known to infect humans are ‘very likely’ to have originated in bats.

This includes three than can cause human fatalities – Middle East respiratory syndrome (MERS) CoV, and severe acute respiratory syndrome (SARS) CoV-1 and CoV-2.

The SARS outbreak of 2002 to 2004 was caused by the SARS-CoV-1 virus strain which was first identified in Guangdong, China in 2002.

Since the emergence of SARS-CoV-2 in Wuhan, China, late last year there’s been much uncertainty surrounding the virus’s origin.

A previous report from scientists said the virus is 96 per cent identical to one found in bats, although this is yet to be officially confirmed as the source.

While it was initially assumed that the virus passed to humans in a Wuhan wet market, other studies have pointed to an anteater-like animal called a pangolin being the intermediary animal.

Pangolins are mammals but are often confused for reptiles due to their scaly appearance. They’re consumed as food in China and are also used in traditional medicine.

Yunnan, the region identified by the new study as a hotspot for a climate-driven increase in bat species richness, is also home to pangolins, however.

Also, according to a new study by an international team of economists, the onset of the COVID-19 pandemic caused a sharp decline in living standards and rising food insecurity in developing countries across the globe.

The study, published February 5 in the journal Science Advances, provides an in-depth view of the health crisis’s initial socioeconomic effects in low- and middle-income countries, using detailed micro data collected from tens of thousands of households across nine countries. The phone surveys were conducted from April through July 2020 of nationally and sub-nationally representative samples in Bangladesh, Burkina Faso, Colombia, Ghana, Kenya, Nepal, Philippines, Rwanda, and Sierra Leone. Across the board, study participants reported drops in employment, income, and access to markets and services, translating into high levels of food insecurity. Many households reported being unable to meet basic nutritional needs.

“COVID-19 and its economic shock present a stark threat to residents of low- and middle-income countries — where most of the world’s population resides — which lack the social safety nets that exist in rich countries,” said economist Susan Athey, of Stanford University’s Graduate School of Business. “The evidence we’ve collected show dire economic consequences, including rising food insecurity and falling income, which, if left unchecked, could thrust millions of vulnerable households into poverty.”

In most countries, a large share of respondents reported reduced access to markets, consistent with lockdowns and other restrictions on mobility implemented between March and June 2020 to contain the spread of the virus. The amount of social support available to respondents from governments or non-governmental organizations varied widely across the surveys, but the high rates of food insecurity reported suggest that support was insufficient even when present, the researchers state.

The study shows that in addition to increasing food insecurity, the pandemic and accompanying containment measures have undermined several other aspects of household wellbeing. Schools in all sample countries were closed during most or all of the survey period. Respondents also reported reduced access to health services, including prenatal care and vaccinations. Combined, these factors could be particularly damaging to children in the long run, the researchers note.

Current circumstances may call for social protection programs that prioritize addressing immediate poverty and under-nutrition before tackling deeper underlying causes, the researchers state. They suggest policymakers consider identifying poor households using mobile phones and satellite data and then provide them mobile cash transfers. The researchers also recommend providing support for basic utilities, such as water and electricity, through subsidies and by removing penalties for unpaid bills. They note a fundamental link between containing COVID-19 and providing economic relief as households facing acute shortages may be less willing than others to follow social distancing rules so that they can find opportunities to meet basic needs.