Global Disease Outbreaks: How Prepared is Nigeria?
The growing global interconnectedness has led to increased occurrence of emerging or re-emerging infectious diseases or disease outbreaks. These are diseases with the potential to spread rapidly and affect populations across international borders. At the beginning of the 21st century, infectious diseases remain responsible for about one-quarter of deaths worldwide, causing at least 10 million deaths per year, mainly in tropical countries.
Infectious diseases outbreak currently being reported by the Centers for Disease Control and Prevention (CDC) in 2020 includes Coronavirus disease 2019 (COVID—19), Measles Outbreak 2019, and the Ebola Outbreak. Among these diseases, the new coronavirus disease has spread from China to 120 countries and territories around the world and one international tourism ship, Diamond Princess, according to the latest data released by the Worldometer on March 11, 2020.
There are currently 121,312 confirmed cases and 4,379 deaths from coronavirus outbreak as of March 11, 2020, 12:50 GMT. Regrettably, Nigeria has also shared part of this experience. The Federal Government of Nigeria confirmed a second case of Coronavirus disease earlier this week. Given these concerns, this week edition of ENGAGE NIGERIA critically evaluates the preparedness and vulnerability of Nigeria in managing global disease outbreaks.
Factors responsible for the emergence of disease outbreaks
Several factors have been identified as responsible for the development of disease outbreaks in different parts of the world. These include microbial adaptation and change, human susceptibility to infection, climate and weather, changing ecosystems, human demographics and behaviour, economic development and land use, international travel and commerce, technology and industry, breakdown of public health measures, poverty and social inequality, war and famine, lack of political will and intent to harm.
Unfortunately, most of these factors are overrepresented in many countries in Africa. A team of researchers conducted a retrospective analysis of all infectious disease outbreaks in Africa and formally reported to the WHO in 2018. On November 11, 2019, the study found 96 new disease outbreaks, reported across 36 of the 47 African Member States. Among these diseases are HIV, Malaria, Cholera, Lassa fever, Polio, Measles, Yellow fever, Monkeypox, Ebola fever, Rift valley fever, Zika virus amongst others.
Current Disease Outbreaks in Nigeria
Nigeria, with a population of over 200 million people, has experienced many disease outbreaks both in the past, and more recently with Lassa fever and Meningitis, and Ebola, and Coronavirus. The Nigeria Centre for Disease Control (NCDC), the agency responsible for the management of disease outbreaks revealed that the death toll from an outbreak of Lassa fever has risen to 70, while 1,708 cases have been confirmed. Regrettably, a second case of the coronavirus disease, has been confirmed by the government. Another infection, such as meningitis and yellow fever have also resulted in deaths in Nigeria.
Economic Impacts of Global Disease Outbreaks
Economic experts have argued that no one knows the cost of global disease outbreaks. The world hasn’t suffered from a real pandemic since the Spanish flu in 1918 swept the globe and killed up to an estimated 100 million people. A similar conclusion was made by the World Bank in a study in 2017. The international institution said that there is no widely accepted, consistent methodology for estimating the economic impacts of global disease outbreaks.
However, the WHO lifted the public health emergency of international concern (PHEIC) status on West Africa’s Ebola situation on March 29, 2016. According to the international institution, the impact the Ebola epidemic had on the world, and particularly West Africa, was significant. A total of 28,616 cases of EVD and 11,310 deaths were reported in Guinea, Liberia, and Sierra Leone. The WHO further said that there were an additional 36 cases and 15 deaths that occurred when the outbreak spread outside of these three countries.
Nevertheless, as China struggles with the coronavirus disease, the economic damage is mounting around the world. The global demand for oil has been hit by a reduction in the demand for oil from China as the world’s biggest oil importer. China-Nigeria’s bilateral trade volume soared to $15.3 billion in 2011, 0.8% higher than the previous year.
According to data from the Nigeria Bureau of Statistics (NBS), Nigeria’s imports from China hit N1.9 trillion in the first half of 2019. These are likely to take hits as China struggles to contain the spread of the Coronavirus. Also, following the lock-down of much of the Chinese mainland (up to 150 million Chinese nationals are reported to be under mandatory movement restrictions), production of goods and services according to economic experts will continue to slow, and in some cases, shut down completely, affecting exports to Nigeria.
On the other hand, if oil demand continues to fall with no OPEC intervention in the form of production cuts, tightening supply, a country like Nigeria will negatively be impacted by the downward price trend. Economic experts argue that the situation will get worse for Nigeria as oil is the biggest revenue-generating sector of the economy. Expected revenue to be generated from the oil sector in the 2020 budget is N2.64 trillion, with the rest of the non-oil economy contributing a further N5.5 trillion.
How Prepared is Nigeria if Coronavirus arrive?
Nigeria dealt decisively with the Ebola outbreak in 2013-2014 in a short time by establishing quarantine measures in Lagos to help isolate patients with the virus. The Nigerian government has applied the same logic in a bid to manage Coronavirus. The Nigeria Centre for Disease Control (NCDC) recently set up a multi-sectorial Coronavirus Preparedness Group (CPG) that is mandated to carry out regular epidemic intelligence gathering, enhanced surveillance at the points of entry, intensive risk communications, strengthening laboratory capacity for testing, placing National First Rapid Response Team too highly pathogenic infections on alert, and scaling up of Public Health Emergency Operation Centres (PHEOC) in states amongst others (PHEOCs already established in 22 states).
The Coronavirus Preparedness Group has representatives from the Federal Ministry of Health (FMoH), Office of the National Security Adviser (ONSA), World Health Organisation (WHO), US Centers for Disease Control (US-CDC), Pro-Health International (PHI), Public Health England (PHE) and others working with the NCDC in assessing and managing the risk of importation of the disease in Nigeria, as well as making preparations for early detection and response.
Conclusion and Recommendations
The outbreak of global diseases is unavoidable; however, to effectively manage future outbreaks in Nigeria, the government needs to recognize and understand that it makes economic sense to prevent rather than control disease outbreaks. Prevention results in a significant reduction in disabilities and deaths from diseases and can be achieved through reliable and responsive disease surveillance and control mechanism. Therefore, providing adequate funding to maintain and sustain an effective national disease surveillance system backed by a reliable laboratory network service is the first step in ensuring national health security and protection of Nigerians from the ravages and deaths caused by disease outbreaks.
Secondly, there is a need for appropriate forms of global governance on critical issues to improve systems for prevention, control and treatment. National level efforts and international health cooperation, notably through the International Health Regulations (IHR), remain the cornerstones of effective infectious disease policy. However, these efforts must go beyond the state to incorporate non-state actors such as the private sectors.
Thirdly, there is a need for enhanced training on the global dimensions of infectious diseases. Medical practitioners would benefit from a greater understanding of the potentially changing profile of infectious diseases as a result of increased population mobility, intensified trade in goods and services, climate change and other factors that link globalization.
Fourthly, there is an urgent need for more considerable resources to enhance capacity in low and middle-income countries. The requirements for training are wide-ranging and include surveillance and monitoring of infectious, clinical practice, epidemiological research, and use of new ICTs. In many cases, international training exchange programmes are required to enable the sharing of experiences and ideas across national contexts.