Nigeria has capacity to diagnose, contain coronavirus

Prof. Babatunde Lawal Salako is the Director General of the Nigerian Institute of Medical Research (NIMR) Yaba, Lagos. Salako in this exclusive interview with The Guardian said NIMR has capacity to diagnose, sequence and contain coronavirus. He, however, said the country needs dedicated funds for research and must secure the future of research. Salako said the Institute is currently conducting several clinical trials including that of Human Immuno-deficiency Virus (HIV) cure claims of Dr. Maduike Ezeibe. The professor of medicine among other things said as part of efforts to reduce maternal and child deaths in the country, the institute has developed a genome extraction kit and a genotype machine. CHUKWUMA MUANYA writes.

Are you concerned about the new virus that is spreading across the world, which has affected and killed so many people?
Certainly as an institute for medical research we should be concerned about such outbreaks. And for the fact that recently quite a number of foreigners have been visiting Nigeria especially from China. So it calls for surveillance on those people really and other people who travelled to China when they are coming back to Nigeria. Our institute apart from joining the Nigeria Centre for Disease Control (NCDC) in looking at surveillance and helping to do laboratory tests on samples that are sent to us, we also need to provide information on the symptoms of the disease, the people who have the disease how do they present and things like that. That will mean that when we see people who have the infection, we interview them and document the findings in as many people as possible because that may provide opportunity for clinical diagnosis and the lab can then later confirm. In the past two years we have been building a tissue culture lab, which is a lab where we can grow viruses especially arboviruses. About two days ago somebody sent me an email saying some Chinese will be arriving at their company in the next few weeks and wanted to know if we could assist in screening them for the virus. I contacted our lab and it is exactly this morning that I got a feedback that we would be able to screen patients for coronavirus. We do have some state-of-the-art equipment that we can use to prepare the diagnosis and the last bit of it, which may have to do with the sequencing of the virus may have to be sent out for now. We have a sequencer that can actually do that but we need a modern one that is called next generation sequencer, which is something that we hope to acquire in the course of this year. Last year we sent three of our researchers to China CDC for three months to learn the art and skills and research of pathogen identification especially viruses. So this knowledge is with them. We also have about two of them who went for another two weeks course. Two people also went to Institute Pasteur in Senegal, a World Health Organisation (WHO) Regional lab, which is where Nigeria often send samples to during outbreaks and they spent about two weeks. All of these are to prepare the capacity of the institute to assist public health institution in making detection of pathogens during outbreak of any area of interest of researchers.

So you are saying that NIMR is ready and capable to diagnose the coronavirus?
Yes! We are ready.

Have you seen such virus in NIMR before?
Not really but coronaviruses are known. It is just that this one is a new strain that broke out in China. I believe the Chinese people have sequenced the virus and made the diagnosis. So it makes things easy.

It has been shown that the virus can move from human to human. So what should be the precautionary measures that Nigerians should take?
I think basically it is a zoonotic infection- something that comes from animals to man. Currently it is believed it can move from human to human. So the basic things are if you have people you suspect that have that kind of infection, they have to be treated with a little bit of isolation such that people who walk around will not have contact with them. Of course the usual aseptic cleaning methods that people use- washing of hands, using antiseptics and things like that. These are the things that people can do for now because we cannot talk about immunization yet because it is a new thing. So vaccines cannot be used for now, perhaps in the future.
Your are almost four years on the job, what have ben the challenges in meeting the mandate of NIMR in terms of research considering that there is technically zero budget of research in Nigeria? Correct me if I am wrong, I never heard of NIMR making and discovery?
The common challenges, which I have decided to stop talking about is inadequate funding. It seems that one cam never get adequate funding. So one really has to work within the little that is available and also think outside the box to see how you can attract fund to the institute. While I have said that, I also believe that is important for the country to have dedicated funds for research because research and development go together. And when the country does not fund research, it affects the country’s development. It is part challenges but we want to down play it a little. What we have done is to see how we can bring the public, private partners to be interested in research. We decided to establish a NIMR Research Foundation, which will be a public-private outfit. It will be run as a private outfit and it will engage and provide opportunity for private practitioners and public companies to contribute to research priorities in Nigeria. That will be an opportunity for Nigeria to train younger people because what we intend to do is to use fund from the foundation to support people who are doing PhD of MDs in the universities particularly those whose projects resonate with research agenda of Nigeria. We intend to support them for three to four years through, which they will finish their PhD. Two things to gain: one they gain their PhD; we get some of our research questions answered and that can translate to clinical use or policy briefs that the ministries can use. We also hope that foundation will establish a mentorship and grant writing training that can run twice a year. Where we can also get fund for our researchers to have the ability to write award-winning grants that they can submit to funders all over the world. And if we have a training workshop regularly that young researchers, that is those that just started lecturing in the universities or who have just started working as researchers in institutes in and around Nigeria, can come and sharpen their skills on how to put grants together and also mentor them and that will increase their ability to win grants. It will also increase the money that is coming to the institute or to the universities and the research and development in Nigeria. So these two functions is what we intend to give to this foundation. I say that we are lucky that the current Minister of works has agreed to chair the board of trustees. The stage which we are now is to register the foundation, which we hope to get the certificate in the next one or two weeks because we have been at it for the past one year. Once we get the certificate we constitute the board of trustees and have the first meeting and then put all these plans on their table and we hope that with the calibre of people we have in the board of trustees they might be able to get us links who will be interested in funding research and training through that foundation. Those are the things we believe we can do to assist government in improving research funding in Nigeria as a national institute.

Do you agree with the insinuation that there is zero budget for research?
There is really no zero budget. We can say inadequate.

But there is no budget line for research?
For us there is a budget line for research. I think institutions really have to put research budget line in their budgets. Because if they don’t put it they are not likely to get it even though what we get in the budget line is very pittance but then we cannot say that. For example the federal government through Tertiary Education Trust Fund (TETFund) fund research in the universities. The problem we have with TETFund is that TETFund serves only tertiary institutions. We are quaternary institutions and we are research institute but we cannot access that fund and we think that is a weakness in the TETFUND Act and we feel that should be extended to research institutes so that we can also access fund from them. What we have been doing is to collaborate with universities and see if we can put proposals together for people in the institutes to be able to access TETFUND funds for research. So we have in the last two years created adjunct research professors or adjunct researchers. So we attract from the universities some of their researchers and lecturers to be adjunct researchers with us. We also approach some of the universities to employ some of our own top researchers as adjunct lecturers and that creates a milieu where they can have cross fertilization of ideas and put things together and ask for funding either from local funders or international funders.

As a research institute, have you made any discoveries?
Well we have made and we will continue to make. We really have in the last four years have made not may be discoveries but from some of our research findings really can be translated to use. The first one I can talk about is what we call a DNA Extraction Kit. Deoxy ribonucleic Acid (DNA)/genetic material is the real thing that represents the genome of the person and these days we talk about personalized medicine or precision medicine and this precision medicine cannot be done without the extraction of DNA and determining the genome of either the plant, the animal or whatever. We have recently produced 100 per cent made Nigerian kits that helps to extract DNA from the blood, from tissues, from plants and so on. We can use it to extract DNA, which can then be used for other things in research. Hitherto, DNA extraction kits are imported and they are very costly. But with the ones we have produced in NIMR, we did not have to import anything.

Do you sell them or just for internal use?
We have been using it for our own research and other people have been coming in to use it. We are in the process of patenting it but we want to let people prove what we have said and that will give it more power so that we can then try to roll it out for public use.

Can it also be used for paternity determination?
Well for anything you have to first extract the DNA and so that kit is very useful and that was done by some of our researchers here. We also recently produced a machine for haemoglobin genotype. Again 100 per cent Nigerian made to make diagnosis of sickle cell disease and this is a disease that is very common among blacks and especially in Nigeria. It is one of the things causing morbidity, mortality, killing people and causing sickness among Nigerian population. We think that one of the ways we can contribute is to make easy access to diagnosis. To be cheap so that people can get screened easily even a primary care centre. We have produced this genotype machine, two of them, model one and two, and we have tested them against the one s from abroad and it works very well to it and we also produced our reagents for it within NIMR. So these ate two things that we have done that we feel that will contribute to the Nigerian health system and helps to improve the status of the health system in Nigeria. Our plan is to make sure that we get other people to use them and confirm our proof and claim and then we can get the report to the honourable minister.

How about herbal medicine?
Yes! We are also looking at herbal medicine use in Nigeria. We have created a centre for traditional, complimentary and alternative medicine. What we do is to work with herbal practitioners, to look at their claims and beyond that to assess the safety of their drugs and then help to assess efficacy so that we can guide the public and say, ‘this you can use, this one we don’t think you should use and this is working and this is not working’. And we can also provide the same information to the herbal people themselves so that they can refine their methods.

How about the HIV cure claims? Are you working on any?
Yes we are assessing Dr. Maduike Ezeibe’s claim. He was sent to us through the Federal Ministry of Health by the Office of the Secretary to Government of the Federation (SGF). He in fact has approached the ministry before and we have looked at his process and we advised that he would do a proper trial to determine his claim. I think he wrote a petition to the SGF and that was sent to us. We have had about two to three meetings with him and we have looked at the drug toxicity of rats and we think it is safe to a large extent and so we are now looking at the effects in humans and we are now working with a small number of patients.

Is it herbal medicine?
Yes it is herbal. So we will in the next few months be done with his claim and we will be able to tell whether it works or it doesn’t.

I heard you are partnering with some hospitals?
As a research institute, we should have a hospital where our research patients attend, where we will do our clinical trials on drugs, on diagnostic devices. We should have a hospital. But we don’t have. We have a clinic. We think that for us to be able to perform our duties appropriately we needed a hospital. So we approached the management of Federal Medical Centre (FMC) Ebute Meta, Lagos and asked them to go into a Memorandum of Understanding (MoU) with us to be our research hospital, which we have done. Although it is still at its teething stage but we are already working together. Last year from our budget we created a clinical trial field in Ijede and we have done their census demography for them. We know the number of houses, we know the people living there, and we know their ages. We are doing malaria surveillance there now. But it is a field where we can do vaccine trial and do some other clinical trails if we want. So we have bought an ambulance, which we can use if we detect any thing on the field and we needed to bring the patient from the field for observation. So we bought an ambulance that we transferred to FMC and that sealed our collaboration and now if we work on the field the ambulance will be moving to and fro.