Hundreds Of Thousands Dying In Nigeria Due To Vaccines and Immunisation Gap

By Odimegwu Onwumere

In this report, Odimegwu Onwumere writes that meningitis and other vaccine-avertable diseases have become somewhat a recurring decimal in Nigeria and in some countries of sub-Saharan Africa that include Senegal, Niger, Chad, Benin, Mali, Burkina Faso which make-up ‘Meningitis Belt’ due to poor innovative approach to delivery of vaccines

By April 17 2017, Nigeria lost about 800 lives and had 8,000 cases of Cerebro Spinal Meningitis, CSM, in six states of Katsina, Kebbi, Zamfara, Niger, Sokoto and Yobe due to embarrassing vaccine approach, informed the News Agency of Nigeria (NAN). Since 1996, there are data showing that meningitis and other vaccine-avertable diseases have killed thousands of people in Nigeria and by extension, in some sub-Saharan African countries of Senegal, Niger, Chad, Benin, Mali, Burkina Faso which make-up ‘Meningitis Belt’ due to poor delivery of vaccines.

Checks reveal that no fewer than 11,000 people were killed by meningitis alone in Nigeria in 1996 and by 2009, 600 people died. Like a recurring decimal, this dangerous disease that science says is “caused by viral or bacterial infection, and marked by intense headache and fever, sensitivity to light, and muscular rigidity and most affected age group is 5-14 years of age” impinged on approximately 10,000 people in 2015, and exterminated over 1,000 people in Nigeria.

The world is embarrassed by the outdated vaccine delivery systems in the country, because Nigeria prefers to buy vaccines from the international market instead of set up vaccines manufacturing plants for local consummations. The highlight of this is that records show that Nigeria only delivered (1.3m vaccine doses for a country that has a population of over 180m people) during the recent impasse. These vaccines, according to media reports, about 800,000 doses were mostly ordered from United Kingdom.  Yet, according to Dr. Seth Berkley, CEO of Gavi, the Vaccine Alliance, “Too many children still lack access to lifesaving vaccines because of outdated and inefficient supply chains.”

Dr. Berkley was of the belief, saying, “There is need to drive change and deliver comprehensive improvements now, countries won’t have the systems in place to protect the next generation of children, particularly the most vulnerable.”

The Nigerian Medical Association (NMA) was caught up in vaccines and immunisation ruckuses in July 2013. The then President of the association, Dr. Osahon Enabulele frowned that the Federal Government (FG) failed to curtail the sprinting of hepatitis in the country due to its overdependence on foreign delivery of vaccines. At the occasion of the 2013 World Hepatitis Day, Enabulele said, “Hepatitis virus A, B, C, D and E were accountable for the millions of death in the country, because they caused sensitive and unremitting infections and inflammation of the liver, the government did not bellyache.”

If the country had been vaccines conscious, these deaths could not have occurred. In the light of this, the World Health Organization (WHO) in one of its reports, held, “Vaccines prevent an estimated 2 to 3 million deaths every year, but an additional 1.5 million deaths could be avoided if global immunisation coverage improves.”

The international body supposed that in 2015, an estimated 19.4 million infants worldwide did not receive routine immunisations. What that suggests is that Nigeria, which includes the countries of the world, is awful in the way she sees to vaccines and how they are handled. The hullabaloo is that this oil rich country prefers to order vaccines from the Americas and Europe during outbreaks, whereas in the advanced world, such methodology of delivery of vaccines has been regarded as outdated and compromising that put the lives of people in danger.

The argument is that health and immunisation are not regarded with the attention they needed in Nigeria. According to news, “President Muhammadu Buhari submitted a budget of eight billion naira for the funding of routine immunisation and polio eradication. But the budget that came back from the National Assembly was cut by about 50 per cent. There is need for the legislature to understand the intricacies of immunisation financing and support fulfillment of the government of Nigeria’s commitment to sustainable immunisation at all levels.”

Dr. Aminu Magashi-Garba, Lead Project Director of the Routine Immunisation Sector of the Partnership for Advocacy in Child and Family, who is also Coordinator of the Africa Health Budget Network was befuddled in the above commentary on April 22 2016 in Lagos, when he succinctly declared that the budgetary allocation for routine immunisation including eradication of poliomyelitis was slashed by the National Assembly during its review and passage of the 2016 budget. This could have formed the view by Dr. Matshidiso Moeti, the WHO regional director for Africa.

Dr. Moeti said, “We must act to close the global immunisation gap. Achieving the Global Vaccine Action Plan goal of universal access to immunization by 2020 would benefit the health of millions of Africans.” This is given that pundits have said that the best ways to save lives of  children, condense cost of healthcare and give the children the prospect to live up to their aptitude is through  immunisation.

But according to Magashi-Garba, the cut in the budget meant, “We are going to have shortage of vaccine procurement this year and early next year if enough funds are not available for the vaccines to be procured completely. This also poses a problem because the funding was tied to two international commitments and it will also create a serious challenge in the sector in ensuring that all eligible children are immunised.”

Unlike Nigeria, most countries are “implementing changes and adopting new technologies like solar ‘direct drive’ refrigerators and redesigning delivery systems.” Against this influence, Steve Davis, president and CEO of PATH, sounded in the following comments as if he had Nigeria at heart, “There are too many places in the world where vaccines are still not reaching the people who need them most. We need to apply the same ambitious investments to vaccine delivery as we apply to vaccine development.”

In the advanced world, the innovative approaches are being put in place to help augment vaccine ease-of-use and publicity. But Nigeria is still gasping for the air on where to source for vaccines during emergencies. Hear Dr. Robin Nandy, principal advisor and chief of immunisation at UNICEF, “Expanding the use of freeze alarms and rigorous temperature monitoring is critical to ensuring that all children have access to potent, lifesaving vaccines. In the long-term, we must work toward the development of products that can better withstand temperature variations.”

However, the WHO has been concerned that 1.5 million children that include Nigerians who are yet to receive life-saving vaccines they need, do not have access. Hence, April each year is mapped out by the international body to create this attention.  But on May 25 2017, at an award ceremony on health innovation given to Alma Sana, a non-governmental organisation (NGO) at the Transcorp Hilton Hotel, Abuja, the NGO introduced a bracelet that was launched by Glaxosmithkline.

The bracelet was said to be worn on the leg or wrist of infants to remind mothers the type of vaccines they have given their children and the time they need new vaccines. While speaking at the rite, wife of the Senate President and founder of Wellbeing Foundation Africa, Toyin Saraki, believed, “We need to work towards adapting a vaccine dependable Nigeria. One of the problems faced with vaccinations is most mothers forget to take their children for immunisation and this bracelet is supposed to help tackle that issue since the bracelet will be on the child from first vaccination till the age of one.”

While the bracelet is believed to “deal with the problem of timeliness, completion of vaccine doses and that of wider coverage to know the extent immunization has been covered in a locality.” According to Dr. Jean Marie Okwo-Bele, director of WHO Department of Immunization, Vaccines, and Biologicals, in commenting on a study, “For too many countries, it is nearly impossible to collect and harness data to forecast vaccine requirements and deliver vaccines when and where they’re needed. But there are innovations such as electronic data systems that are being piloted and scaled up in developing countries that could and should be more widely adopted.”

Last year, Dr. Orin Levine, the director of vaccine delivery at the Bill & Melinda Gates Foundation suggested four innovative ways of vaccines delivery during the world vaccine week. Inter alia, Dr. Levine said that first, for vaccines to be safe and effective; they need to be kept cold, hence the invention of Sure Chill refrigerator, which is said to be using “hydro and solar power to keep vaccines cold for days without energy and are being used in more than 30 countries and have become an important tool in humanitarian response efforts when distributing vaccines for cholera or measles can be especially critical.”

In spite of this, Dr. Levine added, “Immunisation is one of our biggest public health success stories, but safe, effective vaccines don’t deliver themselves. With consistent, visible support from national and local leaders, every community can have 21st Century systems that reliably deliver lifesaving vaccines to everyone who needs them.”

Odimegwu Onwumere is an award-winning journalist based in Rivers State, Nigeria. He contributed this piece via: apoet_25@yahoo.com

Advertisements

Meningitis: Nigeria Kidding with Local Production of Vaccines

Successive government at all levels had raised the issue of opening local production of vaccines many times that never saw light of the day. However, with the outbreak of meningitis and the recent call by health workers for vaccine production in the country, the government may not turn a new leaf given its antecedents, Odimegwu Onwumere writes

What will it cost Nigeria to produce vaccines?

“This Meningitis outbreak shows that the Ministry of Health has no solid plan of action to help prevent such widespread outbreaks. It is disheartening that here in Nigeria, we wait until there is an epidemic or an outbreak before we start running helter-skelter to try to manage it,” cried out Dr. Nini Iyizoba, a contributor to national and international health discourses.

Iyizoba’s thoughts came when over 8,000 cases of Cerebro Spinal Meningitis, CSM, and about 800 deaths were reported in Nigeria by April 17 2017, amidst were 336 children. This precarious disease that was reported late 2016 with the authorities showing lackadaisical attitude, escalated this year, especially in the North-west and North-central zones, compelling the once ostensible lame-duck authorities to pronounce it as contagion in six states of Katsina, Kebbi, Zamfara, Niger, Sokoto and Yobe – informed the News Agency of Nigeria (NAN).

According to science, meningitis is a serious disease in which there is inflammation of the meninges, caused by viral or bacterial infection, and marked by intense headache and fever, sensitivity to light, and muscular rigidity; and most affected age group is 5-14 years of age. The source added that those in whose hand it’s to handle such a case were motiveless given that, “Meningitis is quite common in sub-Saharan Africa and countries like Nigeria, Senegal, Niger, Chad, Benin, Mali, Burkina Faso etc which make up the ‘Meningitis Belt’.”

Apart from the 2016-2017 presence of the disease, health establishments educated that this is not the first time that the country was experiencing meningitis. “In 1996 alone, Meningitis killed more than 11,000 people in Nigeria. In 2009, almost 600 people died. In fact, just two years ago, a meningitis epidemic affected almost 10,000 people and killed over 1,000 people in Nigeria.  And now, again, in 2017, it’s happening all over again,” enthused Iyizoba, adding, “How can we not be prepared? Why should we be caught unawares? It is occurrences like these that make people theorise about the lack of empathy for the poor or average Nigerian life.”

Failed promises on vaccines

Experts have judged that if there were local vaccine production plants in the country, it is apparent that the number of the affected would not have risen as drugs would be at doorsteps to help in the outbreak. But over the years the authorities have deafened people’s ears that they would be building drug plants and manufacture vaccines in Nigeria that never come to be. Hence, Nigerians have taken the government’s overtures on production of vaccines in the country aftermath of the epidemic as a tale by moonlight.

Many believed that what the authorities have always preferred was what it did recently: Buy and share drugs. In the voice of Iyizoba, “About 500,000 doses of Meningitis C vaccine have been distributed to affected areas in the North for immediate vaccination. Approximately, another 800,000 doses are being expected from United Kingdom to help support the ongoing vaccination programmes. That brings the total to about 1.3m vaccine doses for a country that has a population of over 180m people.”

In several occasions, individuals and organisations such as the Association of Medical Laboratory Scientists of Nigeria (AMLSN) have pleaded with the federal government to redirect its focus on local production of vaccines. But the government wouldn’t do this given the many years it had been clamouring for erecting vaccines and drug production plants in the country.

The government would always prefer to import vaccines even when there were suggestions that the Federal Vaccine Laboratory, Yagba, can help Nigeria vaccines-wise go a long way if reinvested in. Before its comatose condition, this outfit produced vaccines that were sent to foreign countries.

Many failed calls on local vaccines

In July 2013, the Nigerian Medical Association (NMA), had called on the federal government to gear up in producing domestic vaccines, but that call seemed unattended to.

NMA’s call was in order to curtail the sprinting of hepatitis in the country, which was viral. It was the then President of the association, Dr. Osahon Enabulele who made the call on the occurrence of the 2013 World Hepatitis Day. It is evident that the call died immediately it was made.

Even when Dr. Enabulele made it known at the occasion that hepatitis virus A, B, C, D and E were accountable for the millions of death in the country, because they caused sensitive and unremitting infections and inflammation of the liver, the government did not bellyache.

Failed attempts to produce vaccines

In June 2012, ex-President Goodluck Jonathan had approved the local production of vaccines with an aim tailored towards everyday accessibility of routine vaccines in the country. While Jonathan might have meant well for the health sector with his government taking-off with Biovaccines Nigeria Limited, which was a joint project company between Federal Government and May and Baker Nigeria Plc, that project did not meet the direction it was intended to reach. If it had reached, the health sector and the government wouldn’t be gasping for air on where to get vaccines for the control of outbreak of meningitis in the country as they are doing today.

At the opening of the Health Canada-NAFDAC Mentorship Launch aimed at building the Agency’s capacity in the area of vaccine regulation on March 26, 2013, the then Director General of National Agency for Food and Drug Administration and Control (NAFDAC), Dr. Paul Orhii said that the country was ready to start local production of routine immunisation vaccines for tuberculosis, hepatitis B, diphtheria, tetanus and pertussis/whooping cough (DPT), polio, measles and yellow fever. With these words by Orhii – “We want to start manufacturing vaccines. We are starting on a right footing of vaccine production in Nigeria by beginning with capacity building of NAFDAC officers” – up till now, there is nothing on ground to show for the mouthing.

From the month of June 2012, there was expectancy that Nigeria would have a world-class vaccine plant where the production of Yellow Fever vaccines would be fad in 18 months, but this expectation also bit the dust.

Lying on vaccines

Opinions were that the government has been toying with the hope of Nigerians of benefitting from a well designed local vaccines production, given the statement by the MD/CEO, May and Baker Plc, Mr. Nnamdi Okaforthat could not have come to pass till date.

“Our job is to revive that entity using our knowledge, expertise and resources to produce and distribute vaccines in Nigeria once again and consequently end the era of 100 per cent dependence on foreign vaccine producers to immunise our citizens against vaccine preventable diseases that ravage our society.”

Okafor made it known that the requisite industrial capability had been attained. But Nigerians have been wondering why they still gasp for local vaccines today, if that target has been met. Hear Okafor again, “Our major priority now is to commence local vaccines production as soon as possible. The Biovaccines business plan is being reviewed and will be presented to the Board as soon the latter is constituted. We plan to commence construction of a new vaccine plant at the new site in Ota, Ogun State with a view to starting production of Yellow Fever vaccines within 18 months.”

Millions of money that never produced vaccines

The initial plan for the vaccines plant in Ota was to give hope in Nigeria that there would be enough and quality vaccines that are also secure and inexpensive, and create job opportunities for Nigerians.

Okafor even captured it thus: “By going into local vaccine production, Nigeria will be putting the health security of her citizens in its hands. Immunisation is a national health security issue. No country can afford to leave the health security of her citizens in the hands of foreign organisations.

“The venture would also save Nigeria substantial savings in foreign exchange and logistics costs of vaccine importation. Currently, the federal government spends over N6 billion to import vaccines every year, excluding what is imported by states and local governments.

“Local vaccine production will ensure Nigeria’s participation in an industry that is at the cutting edge of science by helping to transfer technology to Nigeria and build capacity for primary healthcare delivery.”

It is hoped that the federal government would stop making further overtures on local production of vaccines but just go into action.

Odimegwu Onwumere is based in Rivers State. He contributed this via apoet_25@yahoo.com