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Why Nigeria is vulnerable to ‘Disease X’

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Medical experts have warned that the absence of a legal instrument in the fight to contain COVID-19 makes Nigeria vulnerable to another pandemic, especially ‘Disease X’ which was predicted by the World Health Organisation (WHO).

According to medical experts, with COVID-19 still ever-present as the world enters the third wave of breakouts, another threat is looming over humanity, which could become the next pandemic.

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Scientists at WHO is worried that the so-called ‘Disease X’ could cause another epidemic in the next few years.

Each year, WHO instructs a committee of experts to update its list of the most threatening infectious diseases that lack effective treatment or vaccines.

Medical experts are concerned that although there is hope that with the COVID-19 vaccine being rolled out around the world will see that type of coronavirus disappear, a ‘Disease X’ could be just around the corner, which could weaken the world’s population and economy even more than COVID-19 did.

Indeed, ‘Disease X’ is what the WHO calls the next yet unnamed disease, which could cause a new global pandemic, and after being caught cold regarding COVID-19, scientists do not want history to repeat itself.

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The medical experts are, however, unanimous that legislation specifically addressing issues of public health capacity of the state, for improved prevention, easy detection, prompt response to infectious diseases threats and improve outcomes is imperative for strategic positioning of the country to combat the incidences of pandemic diseases.

Unfortunately, the only piece of legislation on infectious disease control in Nigeria is the ‘outdated’ Quarantine Act of 1926.

However, despite several attempts by the two chambers of the National Assembly to repeal the 96-year-old Quarantine Act, they have not made much progress.

Chief Executive Officer (CEO) and Director-General, Nigeria Centre for Disease Control (NCDC), Dr. Chikwe Ihekweazu, told The Guardian that every outbreak and indeed every pandemic presents an opportunity to learn significant lessons so that we are better prepared for future outbreaks.

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Ihekweazu, who is also an epidemiologist, said: “We have learned that we need stronger legislation to guide Nigeria’s preparedness and response to pandemics. While the NCDC had the mandate to lead Nigeria’s preparedness and response to infectious disease outbreaks, the response to pandemics as we have seen with COVID-19 is multi-sectoral. Therefore, we need a legal framework that recognises this.”

Do you think that the provisions of the bills are adequate to better prepare the country to prevent and contain future pandemics? Ihekweazu said the distinguished members of the 9th House of Assembly have engaged various groups including technical agencies like NCDC, in developing the Public Health Bill. “We have contributed to its content based on our experience and expertise. The availability of a Bill is a significant step for pandemic preparedness but is not the silver bullet. Without enforcement of the regulations and adequate investment in health security, we will not be prepared for future pandemics,” he noted.

What is the global practice in terms of providing legislation for epidemics and pandemics control? The NCDC said strong laws and institutions are essential for countries to prepare for and respond to outbreaks and pandemics. He said in most countries, these are consistent with the best scientific evidence available, and importantly, respect human rights. “We also need buy-in across various levels of governments, especially in countries like Nigeria,” Ihekweazu.

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What are your recommendations in terms of global best practice? Ihekweazu said: “We need a stronger legal framework that enables a coordinated multi-sectoral response to pandemics in Nigeria. In addition, we cannot afford to wait till pandemics happen before we begin to establish laboratories, contact tracing system and other structures needed for pandemic response. Therefore, components of such a framework should enable access to resources for the Nigeria Centre for Disease Control, given our mandate for outbreak preparedness and response.”

On how relevant is the repeal of the Quarantine Act in the face of raging COVID-19, a consultant pharmacist and Chief Executive Officer of Merit HealthCare, Dr. Lolu Ojo, told The Guardian the Act would empower the NCDC to take certain actions that could prevent spread of diseases.

Ojo, who is also a Fellow of the Pharmaceutical Society of Nigeria (PSN) and the Nigerian Academy of Pharmacy (NAP), said with the fear of a potential COVID-19 resurgence in Nigeria, the Act may help the authority to react quickly and firmly to non-compliance with instructions or regulation.

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On the relevance of NCDC contributions to the workings of the Quarantine Act, Ojo said: “If we take a cue from the handling of the COVID pandemic in the United States of America (USA), the NCDC Director is actively involved in all measures deployed to contain the spread.

“We should expect (and ensure) that the same thing happens here in future. I think the Act will empower NCDC to do this and making the organisation more relevant.”

Meanwhile, the latest Bill by the Senate seeks to help Nigeria deal with any impending outbreak of infectious and contagious diseases in the future.

The National Health Emergency Bill recently scaled second reading at the Senate.

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The bill, which seeks to repeal the 96-year-old Quarantine Act, was considered after a brief deliberation on February 16, 2021. The bill was sponsored by Chukwuka Utazi (PDP, Enugu North).

Introduced in May 2020, the legislation seeks to help Nigeria deal with any impending outbreak of infectious and contagious diseases in the future.

If signed into law, it would establish a legal and administrative framework for handling outbreaks of infectious and contagious diseases that portend major threats to public health safety within Nigeria or are likely to be transmitted into Nigeria or outside Nigerian borders.

The bill is considered, by many, as the Senate version of the controversial Control of Infectious Disease Bill, which was introduced in the House of Representatives, last year.

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The House bill had triggered outrage among Nigerians majorly because of the provisions of the bill and the speedy consideration and passage by members of the House.

One major aspect of the House bill that caused controversy is the power it gives a Health Officer, to carry out vaccination on a person leaving or coming into the country, “if he thinks fit”.

Utazi, however, said his bill does not demand such. He said the bill “is devoid of any controversial clauses and no individual will be subjected to forced immunisation under the proposed legislation.”

In his lead debate, he said the bill provides the legal and institutional framework for imposition and implementation of mandatory seIf-isolation and quarantine of infected persons, the introduction of movement restrictions, and adoption of appropriate safety and welfare measures at or during the outbreak of dangerous contagious diseases.

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The bill also provides statutory recognition for the power of the President, and in appropriate circumstances, the Governor, to declare any place or area “an infected area” and accordingly issue appropriate regulations or directives to prevent the spread of such infections in Nigeria, and the transmission from Nigeria to any other part of the world.

“It also provides for funding, accountability mechanisms for containment measures introduced at the outbreak or during disease epidemics and pandemics and prescribes offences and appropriate punishments for violations and contraventions associated with the control and management of dangerous contagious disease epidemics or pandemics.”

Made up of 72 clauses, which are subdivided into eight parts, the legislation seeks to repeal the archaic Quarantine Act of 1926 and under schedules, l and II, expands the scope and interpretation of dangerous infectious diseases beyond what is contained in the Quarantine Act.

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“Indeed, most of the ailments like cholera, plague, yellow fever, smallpox and typhoid that warranted the enactment of the Quarantine Act of 1926 do not require the same quarantine measures like today’s complex and deadly epidemics such as Ebola and COVID-19.

“The passage of this Bill will effectively address these shortcomings and put in place a legislation that is up to date with modern realities regarding disease epidemics or pandemics,” he added.

Meanwhile, the Ministry of Health and NCDC have faulted some of the provisions of the Quarantine Act 2004 (Amendment) Bill, being considered by the Senate Committee on Primary Health and Communicable Diseases over the duplicity of function between the task force and NCDC.

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Alleged infractions on extant laws by some provisions of the bill came to the fore at the one-day public hearing held on it by the Senate Committee on Primary Health and Communicable Diseases at the National Assembly in Abuja.

Specifically, the Minister of Health, Dr. Emmanuel Ehanire, in his submission at the hearing session said though the Amendment bill was a welcome development as far as Public Health Emergency Laws are concerned, some provisions overlapping with functions already being performed by NCDC must be removed.

“It is important to draw the attention of this Committee to the fact that the provision for the proposed Public Health Emergency bill, are already contained in other enactments of this National Assembly such as the Nigeria Center For Disease Control Act of 2018.

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“To be specific, sections 1 and 3 of the proposed Amendment bill, portend potential conflict with existing Act the NCDC as far as a task force for formulation and implementation of emergency measures are concerned.

“The powers being sought for the Task Force in the Amendment bill is already saddled with the NCDC and may therefore be deleted,” he said.

Ihekweazu, in his presentation, said “what constitutes public health emergency must be clearly defined in avoiding operational clashes between the proposed task force and NCDC or delete the provisions, proposing the Task Force.

“The powers vested on the task force as stated are similar to those vested in NCDC it may amount to the duplicity of functions, so we recommend a careful review of the functions of those of NCDC as stated in the current mandate signed into law by the President.”

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