COVID-19 acted like a mirror of the country’s healthcare system by revealing vulnerabilities and putting the healthcare system at risk. As of this writing, more than 3 million people worldwide have confirmed cases of COVID-19, resulting in more than 220,000 deaths. When countries are balancing the tightrope of health, economics and, in some cases, security crises, the question everyone is asking is when this pandemic ends. The answer is if you have a vaccine or an effective treatment. But if a vaccine is found, can Nigeria deliver it to the public? To confirm that a pandemic will have a ripple effect on our social behavior, economic and health systems over the next few years.
Vaccines are still one of the most effective ways to prevent infections. Taking advantage of the body’s immune system and the creativity of modern science, vaccines hit us for life. This week is World Vaccination Week, and the theme is “Working of a Vaccine for All.” The world is focused on the heroic work of protecting, by the people who develop, deliver and receive vaccines, the health of all, everywhere. The swine flu (H1N1) in 2009 infected well over 700 million people and is still present. Due to several factors, including vaccines, H1N1 no longer makes headlines. Finding a vaccine is essential to ending the COVID-19 pandemic.
However, the vaccine itself is not given. You need a robust system that can deliver to anyone, wherever the recipient lives. Vaccines arrive through primary health care centers, whether they live in rural Socoto, in urban slums of Lagos, across streams in Bayersa, or on the hills of Adamawa State. Given that highly contagious diseases like COVID-19 are prevalent in the community, vaccines are the safest way to boost your immunity to keep you and your family safe. The fact remains that no one is safe until we are all safe.
The vaccine distribution method established in Nigeria is by the Primary Health Care Center (PHC). PHC is the backbone of all healthcare systems around the world. A primary healthcare center is ubiquitous that can reach anyone, no matter where they live. There are approximately 30,000 primary health care centers in Nigeria, and approximately 80% are dysfunctional. Only one of the five medical centers works to a considerable extent. This is terrible news for all Nigerians. Consider this scenario. Tomorrow, vaccination with the COVID-19 vaccine will make it impossible to reach most of the population living in rural areas or unable to provide private care. While some may feel safe based on their ability to be vaccinated, the vast majority of Nigerians may not be vaccinated. They interact with you, your child, and your loved ones. Is it really safe for you?
Gavi, a global vaccine alliance, is an international public-private partnership aimed at ensuring equity in access to new, unused vaccines for people living in poor countries. Briefly, Gavi raises funds for vaccine manufacturing, ensuring that rich countries where vaccines are often created share access with countries like Nigeria. Gavi started supporting Nigeria 19 years ago and has provided nearly $ 1.3 billion. A prerequisite for the Gavi partnership is that the Nigerian government must be aligned with the Gavi Foundation. Therefore, the Nigerian government has invested about $ 2 billion in vaccines by 2028. Our partnership with Gavi has allowed us to expand our cold chain. Even if a vaccine is available and has trained health care workers, it must be effectively distributed through the primary health care center.
Not all destiny and pessimism. A newly awarded Basic Health Care Fund (BHCPF), a national program stipulated in the 2014 National Health Code, already has funding approved by President Buhari-similar to GAVI, BHCPF Healthcare in collaboration with the primary federal government. The Basic Healthcare Provisioning Fund is currently the lowest hanging fruit to power the Primary Healthcare (PHC) system. The enormous challenge of funding health programs has already been met. However, our typical pattern seems to be stuck in the implementation. The Basic Healthcare Provision Fund, called Huwe (Ebira’s word for life), has already been funded to provide free basic services to those who need it most. Before the program begins, major healthcare needs to be modified and functioning, complete with tap water. The drug is then purchased for two months at a time and provided to each participating primary health care center. There must be one functional PHC in every ward of Nigeria based on current program design. Today, Huwe has not yet completely taken off. Due to this implementation delay, I was asked to review the operational guidelines for the program. Operation guidelines are the key to realizing Huwe. The Ministry of Health has completed a review of operational guidelines for a program launched in February 2020. New guidelines should be urgently shared with stakeholders and the Huwe program should achieve its intended purpose. It’s time to implement it.
Dr. Osagie Ehanire, Minister of Health, is, of course, obsessed with our national response to COVID-19. However, if you focus on short-term statistics such as confirmed totals, discharges, and deaths, without focusing on the solution, the battle is not complete. Ensuring Huwe’s work is an integral part of the battle of COVID-19. PHC already has a network to deliver therapeutic, drug, and life-giving information about COVID-19 to people in remote communities. Without Huwe, Nigeria would lose the opportunity to improve the functioning of its primary health care system. Without a functional PHC, the vaccine cannot be delivered. Without effective delivery of the vaccine, we remain under the control of COVID-19 and cannot reveal a pandemic for the future. In Nigeria we can’t afford to buy the horrifying 20% of functional PHC and you can’t.
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