By Kestér Kenn Klomegâh

With rising cases of the monkeypox virus, Russians are back seeking again cheap health publicity in Africa. Just as Foreign Minister Sergey Lavrov completed his four African-nation tours, Russia plans to send monkeypox test kits to Egypt, Uganda, Ethiopia and Congo.

Russian consumer health watchdog Rospotrebnadzor said in a media statement that Russian test systems to diagnose monkeypox would be provided to Egypt, Uganda, Ethiopia, and the Republic of Congo at the end of July.

“Rospotrebnadzor is continuing to extend support to partner countries’ efforts to counter the spread of monkeypox. Test systems produced by Rospotrebnadzor’s Vector Research Center will be handed over to Egypt, Uganda, Ethiopia, and the Republic of Congo at the end of July,” the press service said.

“Furthermore, Rospotrebnadzor specialists are arranging special workshops for colleagues from partner countries that deal with laboratory methods to diagnose monkeypox,” it said.

Rospotrebnadzor said earlier that the Vector Research Center had produced monkeypox test kits, and such testing is currently available in all Russian regions.

Monkeypox is a rare infectious disease, most common in remote parts of Central and West Africa. Its symptoms include nausea, fever, rash, itch and muscle pain.

On July 12, Rospotrebnadzor announced the first national case of monkeypox: the patient had returned from Portugal. His symptoms were mild and did not endanger the patient’s life. Rospotrebnadzor said that all his contacts had been promptly identified and were under medical monitoring. The threat of spread has been contained.

Faced with a surge in monkeypox cases, the World Health Organization (WHO) has already declared the outbreak of monkeypox as a global health emergency — the highest alarm it sounded. Monkeypox has affected over 15,800 people in 72 countries, according to a tally by the US Centers for Disease Control and Prevention (CDC) published on July 20.

WHO, however, warned against discrimination. “A failure to act will have grave consequences for global health,” Lawrence Gostin, the director of the WHO Collaborating Center on National and Global Health Law, said on Twitter.

Some experts have asked why Russians have not chosen African countries such as Nigeria, or regions such as Central and West Africa where the virus is currently spreading most. But have listed as priority countries that Sergey Lavrov visited on 24-27 July: Egypt, Ethiopia, Uganda and the Republic of the Congo.

Is COVID-19 Pandemic Over? How Nigeria Can Prepare for Possible Future Pandemics

Dipo Olowookere is a journalist based in Nigeria that has passion for reporting business news stories. At his leisure time, he watches football and supports 3SC of Ibadan. Mr Olowookere can be reached via dipo.olowookere@businesspost.ng

WHO Calls for Global Solidarity to Stop Monkeypox

Monkeypox on the Rise in Africa, United States and Europe—WHO

Explainer: What is Monkeypox Virus?

Monkeypox: NCDC Urges Nigerians Not to Panic

Pingback: Monkeypox: Russians Are Back With Cheap Health Publicity – Business Post Nigeria

Although COVID-19 cases dropped significantly in Nigeria within the past year, cases are beginning to rise again.

Just recently, the Nigeria Centre for Disease Control (NCDC) recently reported 347 cases of COVID-19 and Lagos alone accounts for 265 (76%). This begs the question of how ready Lagos and the entire country are to quickly curb the spread of the virus or any other epidemic that may arise.

The initial outbreak of the Covid-19 pandemic and the resultant lockdown showed how unprepared and unequipped the Nigerian health sector was.

Although the NCDC responded remarkably well, much more could have been better if we were prepared. At a health security policy dialogue put together by Nigerian Health Watch in Abuja recently, Peter Hawkins Country Representative of UNICEF made an impressive remark on NCDC’s response.

He said, “We can affirm that Nigeria did a remarkable job to contain the COVID-19 pandemic. NCDC for instance stretched and brought on its a-game despite the challenges in the sector. Also, many initiatives like the Coalition Against COVID-19 (CACOVID) were timely interventions by the Federal Government and private institutions.”

He also added that “whilst we got several things right, much more could have been done. Knowing that the pandemic is not over, and we might be at the beginning of many other, there is a need to tighten efficiency within the sector.”

According to a WHO report, the devastating human, economic, and social cost of COVID-19 has highlighted the urgent need for coordinated action to build stronger health systems and mobilize additional resources for pandemic prevention, preparedness, and response (PPR).

World Bank’s Board of Executive Directors have also approved the establishment of a financial intermediary fund (FIF) that will finance critical investments to strengthen pandemic PPR capacities at national, regional, and global levels, with a focus on low- and middle-income countries.

It is believed that the fund will bring additional, dedicated resources for PPR, incentivize countries to increase investments, enhance coordination among partners, and serve as a platform for advocacy. This is indeed a welcome initiative!

Whilst the rest of the world is girding up and investing in the health sector to get prepared for a possible future pandemic outbreak, Nigeria must not be left behind. Here are three key things we must consider:

Increase funding for epidemic preparedness: Ifeanyi Nsofor, a public health doctor and Senior New Voices Fellow at the Aspen Institute, Washington DC. Recently opined that indeed, it is cheaper to prevent and detect than to respond to an infectious disease outbreak.

COVID-19 has shown how the impacts of pandemics go beyond the health sector. He believes that a simple way to implement this is via a budget line item called “epidemic preparedness” and then defines what that covers.

He stated that, “For example, in local councils, it could cover the cost of provision of clean water in health facilities, setting up a good waste disposal system for communities, stipends for community health volunteers who are the first line in reporting infectious disease outbreaks.

“The state government’s epidemic preparedness budget could cover recruitment and deployment of different cadres of health workers to last-mile health facilities, setting up and equipping state government-owned laboratories, health communications, advocacy interventions, etc.

“The federal government should budget and allocate more funds to NCDC to support its efforts to prevent and detect infectious disease outbreaks.”

    Invest in Human resources: The level of brain drain, and the massive exodus of doctors and other medical practitioners is worrisome, especially at a time like this. The president of the Nigerian Medical Association in an interview revealed that “Over 50 per cent of our doctors are outside the country, we estimate that about 80 thousand Nigerians have been trained as doctors but only about 40 thousand are at home. And these surely are not enough and adequate.”

This is a scary figure for a country looking to improve its health sector. Also at the just concluded policy dialogue by Nigeria Health Watch, many medical experts alluded to the fact that sealing the big black hole in managing human resources in the sector is a critical part to look at as Nigeria is losing its key health personnel to other nations.

    Set up an accountability structure across all levels: Medical experts present at the policy dialogue by Nigeria Health Watch also made a charge for setting a proper accountability structure across the national and sub-national levels. It is believed that all hands must be on deck to get Nigeria Pandemic Prepared.

For instance, Ifeanyi Nsofor said “It’s both sad and amusing when you hear Nigerians rant about the health sector. The belief that only the federal government is responsible for the workings of the health sector is a great disservice to us as a nation. We must realize that Nigeria is a federation and all levels including states and local councils must be held accountable.”

Nigeria and the World Health Organisation (WHO) are seeking to eliminate a severe and often lethal mouth disease, Noma.

Nigeria has developed and implemented the programme’s national action plan for Noma prevention and control in collaboration with WHO and other partners.

The Nigerian Ministry of Health has integrated Noma into its existing surveillance system and incorporated it into the curricula of all national and district health professional schools, while the country now commemorates an annual National Noma Day in November each year.

Funding from WHO, as well as Médecins Sans Frontières (MSF), has also helped the Ministry to scale up training of primary care workers, with 741 having received training on noma in 2021 and the first half of 2022.

On Thursday, WHO launched a new free and interactive online Noma course through OpenWHO, the first WHO platform to host unlimited users during health emergencies.

“This course will be a useful self-learning tool for health workers to increase their capacity to prevent, identify, treat and refer noma considering both public health and human rights aspects.

“Officers in charge of noma at the national and district level can also utilize the course material to train primary care workers,” says Yuka Makino, a technical officer for oral health at the WHO Regional Office for Africa.

In the absence of reliable epidemiological data, a 1998 World Health Organization (WHO) global estimation of 140,000 new cases yearly remains the most widely cited source on noma. The majority of these cases are found in sub-Saharan Africa in children between the ages of two and six.

Even for those who ultimately survive the disease, if not treated immediately, it takes mere days for them to be left with severe facial disfigurements that make it hard to eat, speak, see or breathe. In turn, this often leads to severe stigmatization within their communities and a range of accompanying human rights violations.

“We’ve had cases where when the patient presents to the hospital, the whole of the lower jaw is already gone, or the whole of their nostril pathway is gone,” says Dr Abubakar Abdullahi Bello, Chairman of the Medical Advisory Committee at Sokoto Noma Children’s Hospital.

“But if the cases present to the hospital early, then they don’t have such issues. That’s what we are advocating for. With early admission, we can also reduce the duration of the stay in the hospital and these patients will not require surgical intervention.”

Noma can be prevented by basic public health interventions such as improving nutrition and oral hygiene; controlling comorbidities such as measles, malaria and HIV infection; and improving access to routine vaccinations.

In recent years, Nigeria has sought to increase awareness of noma and scale up its response activities as part of a commitment to eliminate the debilitating disease. Since 2016, it has been among 10 priority countries to form part of the World Health Organization’s (WHO) African Regional Noma Control Programme.

The rapidly spreading Monkeypox outbreak can be stopped, the World Health Organisation (WHO) said on Tuesday, “with the right strategies in the right groups”.

However, there is no time as “we all need to pull together to make that happen”, warned Dr Rosamund Lewis, WHO Technical Lead on Monkeypox, during a regular press briefing at the world health authority headquarters in Geneva, Switzerland.

This is coming after WHO’s Director-General, Mr Tedros Adhanom Ghebreyesus, declared the spread of the virus to be a public health emergency of international concern (PHEIC), the organization’s highest level of alert.

“Through this, we hope to enhance coordination, cooperation of countries and all stakeholders, as well as global solidarity,” Dr Lewis said.

WHO assessed the risk posed to public health by Monkeypox in the European region as high, but at the global level as moderate. With “other regions not at the moment as severely affected”, declaring a PHEIC was necessary “to ensure the outbreak was stopped as soon as possible”.

This year, there have been more than 16,000 confirmed cases of monkeypox in more than 75 countries but Dr Lewis said the real number was probably higher.

She pointed out that in the Democratic Republic of the Congo, several thousand cases were suspected, but testing facilities are limited.

“The global dashboard did not include suspected cases,” she said.

First identified in monkeys, the virus is transmitted chiefly through close contact with an infected person (you can read Business Post’s detailed explainer on the disease, here).

Until this year, the virus which causes Monkeypox has rarely spread outside Africa where it is endemic but reports of a handful of cases in Britain in early May signalled that the outbreak had moved into Europe.

Dr Lewis pointed out that stigma and discrimination must be avoided, as that would harm the response to the disease.

“At the moment the outbreak is still concentrated in groups of men who have sex with men in some countries, but that is not the case everywhere,” she said. “It is really important to appreciate also that stigma and discrimination can be very damaging and as dangerous as any virus itself,” she said.

Monkeypox could cause a range of signs and symptoms, including painful sores.  Some people developed serious symptoms that need care in a health facility. Those at higher risk for severe disease or complications include pregnant women, children, and immunocompromised persons.

The WHO Lead said WHO was working with the Member States and the European Union on releasing vaccines, and with partners to determine a global coordination mechanism. She emphasized that mass vaccination was not required, but the WHO had recommended post-exposure vaccination.

Vaccine sharing should be done according to public health needs, country by country, and location by location as not all regions had the same epidemiology, she explained.

Dr Lewis stressed that countries with manufacturing capacity for smallpox and Monkeypox diagnostics, vaccines or therapeutics should increase production.

Countries and manufacturers should work with WHO to ensure they are made available based on public health needs, solidarity, and at a reasonable cost to countries where they were most needed.

The specialist explained that some 16.4 million vaccines were currently available in bulk but needed to be finished. The countries currently producing vaccines are Denmark, Japan, and the United States.

She reminded that the current recommendation for persons with Monkeypox was to isolate and not travel until they recovered; contact cases should be checking their temperature and monitoring possible other symptoms for the period of 9 to 21 days.

“When someone is vaccinated it takes several weeks for the immune response to be generated by the body”, she said.

According to Dr Lewis, the name “Monkeypox” is already present in the International Classification of Diseases, and a process had to be followed in order to potentially change its name.