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COVID-19 response: Medium and long term recommendations

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Tedros Ghebreyesus


As the President Muhammadu Buhari was reading his Address to the nation on Monday 27 April, 2020 my wife was all smiles, nodding her head in my direction, feeling satisfied that what she was hearing from the President were in tandem with my analysis and recommendations which I finished earlier that morning as contained in the word document on the computer in front of her. The analysis was the outcome of hours of discussion over the phone, on our nation’s response to the Covid-19, between me and Dr. Femi Oyewole, my friend and old classmate at Christ’s School Ado-Ekiti. Dr. Oyewole had his career with the Federal Ministry of Health where he was a colleague of Dr Abdusalami Nasidi in the 80s and 90s and later went to join the World Health Organization from 2000 till his retirement in 2012. Among his postings at the WHO was Ethiopia where he worked closely with Dr. Tedros Ghebreyesus first as the Head of the Regional Health Bureau and later as the Minister of Health. Dr. Tedros Ghebreyesus is the current Director General of the WHO.

To carry out the analysis of national response to COVID-19, Dr. Oyewole and I had to take time off the Whatsapp Platform of our Old Students Association Set, where we had indulged ourselves in the habit of provoking other members to exhilarating banters as a way of killing the boredom of our executive joblessness.

Another expert that I also had to talk to in carrying out the analysis is Professor Segun Adegbulugbe, my friend from our days as students and later Lecturers at the University of Ife. Professor Adegbulugbe was the Special Adviser on Energy to President Obasanjo during his second term.

Listening to the President’s address, I was curious to see whether our analysis and recommendations as independent experts would have some semblance with and proved right by what the reports that the President had been fed from the Presidential Task Force on the Covid-19. My wife and I could not help but notice that the President’s analysis mentioned certain key points, namely:

That even though the distribution and his directed expansion of the palliatives were still on-going, he was “mindful of the seeming frustration being faced by the expectant citizens”;

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That “the lockdowns have come at a very heavy economic cost”;
That “No country can afford the full impact of sustained lockdown while waiting for the development of vaccines”;
That Analysis of Nigeria’s Response to the COVID-19 and the Medium and Long Term Recommendations : hat “Federal and State governments were jointly working on how to balance the need to protect health while also preserving livelihoods, leveraging global best practices while keeping in mind our peculiar circumstances”;

“ How our factories, markets, traders and transporters can continue to function while at the same time adhering to NCDC guidelines on hygiene and social distancing”;
“How our children can continue to learn without compromising their health”;
“How our farmers can safely plant and harvest in this rainy season and ensure our food security is not compromised”;
“How to safely transport food items from rural production areas to industrial processing zones and ultimately to the key consumption centers”; and
“That the goal was to develop implementable policies that will ensure our economy continues to function while still maintaining our aggressive response to the COVID-19 pandemic”;

The President concluded by saying that it was “based on the above and in line with the recommendations of the PTF COVID-19, the various Federal Government committees that have reviewed socio-economic matters and the Nigeria Governors Forum” that he was approving:
“a phased and gradual easing of lockdown measures in the FCT, Lagos and Ogun State effective 4th May, 2020”; that aggressive reinforcement of testing and contact tracing measures will continue; and that Government will strictly ensure mandatory use of face masks or coverings in public in addition to maintain physical distancing and personal hygiene.

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It was not only my wife that felt satisfied with the salient points in the President’s address but quite a couple of my close friends and associates that I had shared the analysis with. One after the other, they gave kudos to the President. Some even thought that the SGF-led PTF must have got hold of our own analysis, which definitely was not the case. It is just that, whenever actions are taken by Government based on critical and genuine analysis, even when the actions entail personal sacrifices, such actions will always find acceptance by the populace, knowing that the processes leading to the actions are transparent and citizens are consequently convinced that there are no hidden agenda.

The concerns raised in the President’s address and his pronouncements for immediate action were similar to mine. The only difference is that I had also gone ahead to spot the need to begin in earnest to chart the right path post COVID-19 by making medium and long term recommendations, knowing full well that the world economy will not be same again after COVID-19.

I now present hereunder, my own version of Analysis of Nigeria’s Response to the COVID-19 and the Medium and Long Term Recommendations :
Concerns on National Response to COVID-19
So far, National response to the COVID-19 in Nigeria are in four main areas, namely:
Awareness and Public Enlightenment, Testing, Contact Tracing and Isolation Support and Palliatives, and Mitigation Prescriptions and Guidelines.
The awareness and public enlightenment focus has not just been high but has achieved significant results, despite the localized skepticism and denials arising from cultural and religious biases. However, there were serious concerns in the way the three other areas are unfolding.

There were concerns for the Testing kit and Personal Protective Equipment (PPE) capacity in terms of speed of the results the turn-around time for tests, volume of tests which could be performed in relation to the population demand, access and availability;

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The encouraging general response to raking in the harvest of palliatives by Governments, the international community and multilateral agencies, the private sector, Faith based organizations (FBOs) Community Based Organizations (CBOs) and public-spirited individuals were being overshadowed by growing concerns about the disbursement and distribution of these palliatives. Inter-State rivalry in getting the support of the Federal Government had started to elicit a floating conspiracy theory that some states might be exaggerating the impact of the COVID-19 in their states in a manner reminiscent of the cholera and meningitis outbreaks figures submitted in years past by States to secure federal funding. While the principle of providing palliatives is undoubtedly laudable, there were concerns in the distribution by both the federal and state Governments of palliatives to citizens by Governments in terms of volume, expectation, penetration and receipt by the target population, within of course the overarching concern about the sustainability of such palliatives by Government.

How to ensure that Government intentions on the Palliatives are realized with Transparency and Accountability had become a nagging issue and the questions on the lips of most of our citizens were:
What is the characterization of these palliatives?

Who gets what?
Are there any standardization based on the culinary preferences across the states?
What criteria are being used to ensure equity in the distribution?

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Why do we continue to have mixed signals from government especially in the area of monetary palliative?
How do we reconcile our advocacy of cashless society and the prescription of social distancing with the distribution of bales of uncovered heavily recycled and therefore possibly contaminated currency notes to people in crowded locations?
Considering that there is hardly any household in the urban areas where we would not find someone operating a Bank Account and possibly an ATM card, shouldn’t we be bringing in such data and technology-based instruments like the BVN and National ID to the palliatives distribution matrix?

The limited effectiveness of the mitigation prescriptions and guidelines of Lockdown, Social Distancing and Hand Washing has begun to raise doubts in the minds of the populace that Government actions appear to be playing to the international gallery when indeed we should have fashioned out our own responses based on a critical assessment of our national realities, namely: Our national Demographics; Citizen Perception of the Virus; the National Economy; Food Security; Individual Survival of the over 70% of the population in the informal sector whose ability to survive to the next day is contingent upon what they are able to make today; and a large population of unemployed restive youth who are prone to excessive agitation under lockdown.

Our National Realities
Our national demographics, especially in terms of income and spatial distributions is one in which over 60% of the population live in the high density and ultra-high density urban shanties that are devoid of expected basic amenities of toilet and potable water. Such a set up makes a mockery of social distancing as a strategy.

There is a divergence of COVID-19 concerns perception among the population, as the low income earners and resource poor segment of the society do not feel a connection with the disease. They see it as a disease of the elite. They therefore see the prescription of Lockdown and Social Distancing as an unfair punishment/sacrifice that they are being made/forced to undertake to save the lives of the affluent/privileged class. Indeed, a few among them are of the rather sad extreme view that COVID-19 is God-sent to teach the elite some lessons.
Adegoroye is a retired Federal Permanent Secretary.

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