How COVID-19 Has Slowed Nigeria’s Access to MedicineNigeria, a country with both bustling cities and green plains stretching for miles, has earned the nickname “Giant of Africa.” Although Nigeria isn’t the largest country in Africa, it has the largest population with 206 million people calling it home. Even though the population in Nigeria has grown in 2020 by 2.58%, the country still has a high mortality rate and life expectancy of 54 years. Nigeria has one of the biggest HIV pandemics as well as a high risk for malaria. Access to medicine and vaccines have always been limited in Nigeria; however, COVID-19 has exacerbated the issues facing Nigeria’s healthcare system. The COVID-19 pandemic has increased restrictions on international trade, which has greatly impacted Nigeria’s pharmaceutical needs for people with pre-existing conditions, particularly those with HIV/AIDS or malaria. As 70% of Nigeria’s medical products are shipped from China and India, COVID-19 has interrupted an important part of Nigeria’s basic health needs.

Healthcare in Nigeria

Nigeria has always had trouble accessing medication as the country has a great dependency on imported products. According to Medrxiv, a server for health sciences, in 2013, only 25% of kids under the age of 2 had been vaccinated. In an attempt to secure a more efficient healthcare system, Nigeria began to manufacture its own pharmaceuticals but lately, production has been on a decline due to high prices, poor quality and a shortfall in access to medicine. Nigeria has 115 pharmaceutical manufacturers but they mainly rely on large imports from neighboring countries.

Before the virus swept across Nigeria, the country only had 350 ventilators and beds for the entire population. In April 2020, Nigeria obtained 100 more ventilators. But, what has actually been done to improve Nigeria’s basic health needs?

Changing Nigeria’s Healthcare

In 2018, four policy documents were presented to Nigeria by the Federal Minister of Health. The four policies acknowledge Nigerians need for access to medication and control of narcotics.

  1. The National Policy for Controlled Medicines — This policy, with support from the United Nations Office on Drugs and Crime (UNODC) and the European Union (EU), aims to improve healthcare services in Nigeria. By properly training healthcare professionals, narcotics can be safely monitored for medical and scientific use while avoiding abuse. The policy ensures that Nigeria will have better access to medication so citizens do not have to silently suffer. In 2012, as reported by The Global Access to Pain Relief Initiative, Nigeria only used 0.01% of narcotics to manage pain. The UNODC states, “This was largely attributed to limited or poor quantification of annual estimates, inadequate and irregular release of funds for procurement, limited knowledge and poor attitude, or issues of fear and stigma among many healthcare workers and the general populace.”
  2. National Guidelines for Quantification of Narcotic Medicines — This policy is continuous of Nigeria’s efforts to have access to “narcotic medicines.” It is a way to know how much medicine is required to fulfill Nigeria’s basic health needs. By creating a standardized system, Nigeria can estimate which and how many narcotics are needed for the country.
  3. National Guidelines for the Estimation of Psychotropic Substances and Precursors — This policy regulates “psychotropic substances,” such as alcohol, caffeine and marijuana. These drugs, according to the UNODC, can be used for “pain management including treatment of neuropathic pain and in the management of obstetric emergencies including hemorrhage, thus critical in reducing maternal deaths.” The policy verifies that these substances are and will be used for legal use only.
  4. National Minimum Standards of Drug Dependence — In the past, Nigeria treated addiction as a psychiatric condition or mental illness. Although Nigeria does not have the data to see how many people in the country have a drug dependency, treatments of addiction are changing. The policy’s goal is to have adequate care such as “counseling, vocational and occupational rehabilitation” available across Nigeria.

According to a 2020 Statista analysis, the budget for Nigeria’s healthcare is expected to increase, eventually reaching 1477 billion Nigerian naira by 2021. This can create more opportunities for Nigeria’s healthcare system, increase access to medicine and fulfill Nigeria’s basic health needs.

– Jessica LaVopa
Photo: Flickr

Healthcare in Nigeria
Healthcare in Nigeria leaves a lot for people to desire. The system is inefficient and inequitable, although there are some stories of success. Here are eight facts about healthcare in Nigeria.

8 Facts About Healthcare in Nigeria

  1. Prior to the European colonization of Nigeria, the healthcare system consisted entirely of herbal medicine treatments. This system relied on the knowledge of practitioners and a strict apprenticeship program. Understanding the background of Nigerian healthcare is an important prerequisite for assessing the modern system.
  2. After Nigeria gained independence in 1960, the country put a radical new healthcare system in place. Primarily a welfare-based system, it was progressive for its time. The government offered free or heavily subsidized treatments and medicines. However, the subsequent downturn in oil prices destroyed this system. Augmented by political corruption, the government could not afford to continue subsidizing healthcare.
  3. Currently, Nigeria’s healthcare system ranks among the lowest in the world. A study from 2018 in the Lancet of Global Health Care Access and Quality looked at 195 countries around the world; Nigeria ranked 142nd.
  4. One of the biggest problems facing Nigeria is the lack of qualified workers in the healthcare sector. The densities of nurses, midwives and doctors are ineffective for a country the size of Nigeria. There are only 1.95 qualified healthcare workers per 1,000 citizens in Nigeria.
  5. The healthcare statistics in Nigeria are abysmal. Maternal mortality in Nigeria is among the worst in the world with a whopping 19% of global maternal deaths occurring in the country. Additionally, the infant mortality rate is far too high at 19 deaths per 1,000 births. In addition, the mortality rate of children under 5 is 128 per 1,000. Moreover, life expectancy in Nigeria is an incredibly low 54.4.
  6. Healthcare expenditures accounted for 3.7% of Nigeria’s GDP in 2016. Of total healthcare expenditures, 71.7% is from out-of-pocket spending – expenses that do not receive coverage from insurance or government subsidies.
  7. One of the biggest problems plaguing healthcare in Nigeria is inequality. For example, most of the healthcare workforce works in urban areas, specifically in the southern parts of the country. As a result, rural healthcare lags behind with fewer healthcare workers. Fortunately, Nigeria has identified this problem and is working to mitigate it. A successful approach that Nigeria initiated was the Midwifery Service Scheme. This program, started in 2009, took unemployed, retired and recently graduated midwives and placed them in rural areas for a year of community service. Simply getting more qualified healthcare workers in rural areas is proving to be a huge success.
  8. Healthcare in Nigeria is not all bad. Recent infrastructure improvements are helping end polio and fight diseases, such as Ebola and COVID-19. For example, Nigeria has implemented a decentralized disease control network and better vaccine storage methods.

Today, Nigeria faces an uphill battle. The country needs to address healthcare inequality and a lack of a qualified healthcare workforce to continue developing on a global scale. The country has taken some measures to modernize its healthcare infrastructure and more are on the way.

– Evan Kuo
Photo: Flickr

History of Ebola in Nigeria
The Ebola virus is a very rare, but very deadly, disease that occurs in humans and other primates. It originates from sub-Saharan Africa where the viruses causing the disease are found. People contract it after contact with an infected person or animal, whether alive or dead. So far, there is no approved vaccine or treatment for the virus as yet, and it is currently treated by dealing with the symptoms.

The History of Ebola in Nigeria

The history of Ebola in Nigeria is, fortunately, a short one. The deadly virus found its way onto Nigerian soil on July 20, 2014, by airplane after a Liberian man infected by the virus had flown into Lagos from Monrovia. He collapsed shortly after landing and was rushed to a hospital where he was tested for malaria as well as HIV before the doctors checked for Ebola, which yielded a positive result. The man died on July 25, 2014.

Upon discovery, The Nigerian Port Health Services began performing tests and trying to trace those possibly infected. An announcement was made notifying the public of the virus’ presence and its dangers. Precautions were taken to ensure that patients of the virus be isolated and treatment facilities, also standing as quarantines, were set up in Lagos and, eventually, in Port Harcourt.

The infected man exposed 72 people to the virus at the airport and in the hospital. After his death, it was confirmed that 19 people were infected, but only seven of those people died, making the total fatality of the situation close to 40 percent.

Response to the Threat

There was a grave threat posed to the country’s well being and its population by the arrival of the virus in Lagos, the largest city in Africa and a central hub of activity, particularly because of its crowded nature. The over-population alone, without the lack of equipment and facilities, posed a major threat that the Ebola virus could spread like wildfire, wiping out millions of people in a short period of time.

Another threat posed to the country was the lack of supplies and equipment because it put the healthcare professionals at risk of contracting and even transmitting the disease while treating infected patients. However, the Nigeria Center for Disease Control (NCDC) reacted quite quickly to the situation, and the rapid response played a big part in the speed and precision with which the disease was contained.

The World Health Organisation (WHO), along with The United States Center for Disease Control and Prevention (CDC), Doctors Without Borders, UNICEF and other organizations came together to assist Nigeria in their time of crisis and provided experts who led efforts in tracing the disease as well as in assessing the risks and providing adequate medical care.

The country was officially declared Ebola-free in October of 2014 after twice the maximum incubation period of the disease had passed. Ebola takes 21 days to rear its head in victims, so WHO waited 42 days before finally declaring the country free of the disease. However, the government and health experts in WHO offices in Nigeria still remain alert since the risk of the country being hit by another outbreak through imported cases will always remain high.

Minor Improvement Needed in Nigeria’s Response to Ebola

The Nigerian government was commended for coordinating an effective response to the outbreak as the government immediately began repurposing funds and resources to the many organizations involved at the onset of the outbreak, which paved the way for the quarantine and treatment of Ebola patients.

While the government’s response was quite adept, a few issues were noted at the time that deterred the speed of elimination of the deadly virus. First, there was a delay in the arrival of resources at The Emergency Operations Center (EOC) and the delay in arrival meant a delay in treatment. The political leaders did not grasp the extent to which even a small outbreak of Ebola would threaten the entire country if it were exposed to the people, especially in public spaces like hospitals and airports.

Additionally, the general public, while made aware of the outbreak, did not know the specifics of the disease and as a result, the broadcasting of the existence in Ebola in the areas caused a panic even in people who were too far away from the location to be affected by it. In their ignorance, people resorted to useless and somewhat harmful methods in order to prevent the virus, such as drinking large amounts of salt water.

There was also a delay in the establishment of a working isolation ward due to the Nigerian health workers refusing to help with the Ebola patients for fear of contracting the virus. This showed a lack of information about how Ebola is transmitted and a lack of training against the virus, a problem which the country would have to fix.

Despite all the issues pointed out, the Nigerian government responded quickly and well enough to ensure that the outbreak was contained and the country was free of the disease. Their decision to use EOCs to respond to the virus ensured that the history of Ebola in Nigeria was a success story, and Nigeria stands as an example of how to deal with emergency outbreaks in the future.

– Aquillina Panashe Ngowera
Photo: Flickr

poverty in LagosLagos, Nigeria is the fastest-growing city in the world, set to become a megacity by 2020. However, with its booming growth comes an underlying pang: millions suffer in poverty. Just how many, what caused so many to go hungry, and what is being done about it? Here are ten facts about poverty in Lagos.

10 Facts About Poverty in Lagos

  1. Nigerian statistics report that 8.5 percent of the near 21 million people living in Lagos, Nigeria live in poverty — about 1.7 million people.
  2. Overpopulation is a major factor in the growing number living below the poverty line. Also referred to as the city that won’t stop growing, Lagos does not have sufficient economic opportunities for the thousands of people who relocate there weekly. There is a shortage of jobs and housing.
  3. Government corruption and greed add to poverty concerns in Lagos. In 2017, it was reported that police officers raided the town of Otodo-Gbame, leaving thousands of poor Nigerians homeless. The raid was part of deals made with wealthy investors who desire more waterfront land. Instead of lifting the poor from slums in Lagos, wealthy investors are bulldozing waterfront slums to build high-rises and luxury hotels.
  4. The growing homeless population continues to fuel poverty in Lagos. Some 300,000-plus Nigerians are homeless in the growing city, mostly due to state-ordered demolitions and lack of space.
  5. According to Justice and Empowerment Initiatives Nigeria, 65 percent of the people living in Lagos are urban poor who live in slums and settlements.
  6. Thousands of poor residents in Lagos lack access to clean water. CNN reported a water crisis in Lagos which highlighted demand outweighing supply, some of the water never reaching households due to terrible water infrastructure.
  7. Millions lack access to roads, electricity and waste disposal, a result of being forced to live in slums and lagoons near locations that may hire them to work as domestic staff workers.
  8. Poverty leads to sickness and disease, both of which are common amongst those living in poverty in Lagos. According to the World Health Organization, from Jan. 1 to Apr. 15, 2018, 1,849 cases of Lassa fever were found in 21 states in Nigeria, with Lagos among them. This is a viral disease usually acquired from infected rat, and most sufferers live in areas where they don’t have access to hospitals or healthcare.
  9. Lack of education sparks poverty. Many families who live in slums and settlements cannot afford to send their children to school. As well, school facilities that offer quality education are not available for children who live in slum environments. If they are lucky enough to go to school, it’s a nearby meeting place, a small school building on the water where 100 pupils cram in to be taught by one teacher.
  10. Economic inequality has been an ongoing battle in Lagos for years. In an article concerning economic inequality in Lagos, it was reported that one could be looking at a mansion in close proximity to a slum. The Lagos government made claims it is fighting to create wealth in the midst poverty.

These facts skim the surface of the issues that are causing millions of Lagosians to live in poverty. However, they do shed light on issues that can be tackled with the right policies and aid.

In the meantime, the Lagos government is developing strategies to uplift all in Lagos. Governor Akinwunmi, through the N25 Billion Employment Trust Fund, plans to make more Lagosians self-employed, creating 300,000 direct and 600,000 indirect jobs by 2019.

As surety, the Lagos Ministry of Wealth Creation and Employment was created to encourage entrepreneurship by using strategies that create wealth. Lagosians are expecting to see a turnaround on poverty in years to come.

– Naomi C. Kellogg

Photo: Flickr