Alerts To Efforts At Containing Cholera, Yellow Fever, Malnutrition Crisis

The Federal Executive Council (FEC), on Wednesday, approved President Bola Ahmed Tinubu’s plan to upgrade health infrastructure in six teaching hospitals in six geopolitical zones of the country.

Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, at the media briefing after FEC, Wednesday, said there are four main categories of things the council discussed regarding health and social welfare.

“You all are aware that the President is focused on the well being of Nigerian people and health is key part of that alongside other sectors that have bearing with the welfare of the citizens. The first issue was that of infrastructure in our healthcare system,” Pate revealed.

The minister said Council considered and approved the engagement of transaction advisor to develop a public private partnership that would expand, modernise, refurbish, six teaching hospitals equipment on Public-Private Partnerships (PPP) arrangement for 20 years.

Pate said the transaction advisor would prepare a full business case, which is expected to lead to contraction. According to him, the hospitals are the University of Nigeria Teaching Hospital, Enugu in the Southeast, University of Uyo Teaching Hospital in the South South, University College Hospital, Ibadan, in the Southwest. In the North Central Zone is the National Hospital, Abuja. The Northeast has the Abubakar Tafawa Balewa University Teaching Hospital, and in the Northwest is Usman Danfodio University Teaching Hospital.

“That is a massive upgrade of the health infrastructure that’s underway. But this transaction Adviser will develop full business case, and then come back to council for approval for the mobilisation to do that within the next 12 to 18 months,” he said.

Earlier, on February 16, 2024, President Bola Tinubu had approved the immediate upgrade of 16 health institutions across all six geo-political zones in the country.

The president had directed that the infrastructure and equipment of the institutions should be immediately upgraded. The institutions include the Lagos University Teaching Hospital, Surulere and the Ahmadu Bello University Teaching Hospital, Zaria.

Among them are six teaching hospitals marked for the establishment of oncology and nuclear medicine centres per facility all to be delivered within 12 – 18 months.

The modernisations are “in line with his administration’s vision of overhauling the health and social welfare sector… to ensure that world-class cancer diagnosis and care is accessible… to all Nigerians,” said the Presidency in a statement signed by Tinubu’s Special Adviser on Media and Publicity, Ajuri Ngelale.

The statement is titled, ‘President Tinubu approves immediate upgrade of key health infrastructure across Nigeria’s six geo-political zones.’

Aside from LUTH and ABUTH, the four other teaching hospitals are the University of Benin Teaching Hospital, Edo State, University of Nigeria (Nsukka) Teaching Hospital, Enugu State, Federal Teaching Hospital, Katsina, University of Jos Teaching Hospital, Plateau State.

Pate said the second related item announced at the FEC meeting was expansion of the pathology laboratory and the mortuary at the University College Hospital. “A contract was awarded to expand that but also to build hostels for nursing and other health professionals at the University College Hospital. That is on a public private partnership arrangement,” he said.

Pate said the second category is an update that “we provided to Council on the ongoing intergovernmental negotiating body on the pandemic accord that is being done under the umbrella of the World Health Organisation, which Nigeria is a party to, and that is aiming to improve equity in terms of global response, enhancing prevention, readiness and response to disease outbreaks even before they become pandemics that allows sharing of information across countries. But in the context of Nigeria we provided an update to Council and a discussion issued in terms of the outbreaks that Nigeria have faced. In health, much of the success that we achieve is in preventing diseases that could have otherwise escalated. For instance, diphtheria was an issue late last year that was controlled as an outbreak in 14 states. Early this year, meningitis outbreak started in Yobe and a few state in the northeast and we promptly deployed vaccine, which was able to contain that outbreak.”

Pate added: “Now, we have cholera outbreak, and we discussed extensively in the council in addition to a new emergence of yellow fever, specifically in Bayelsa State. On cholera, we’re in the middle of a seventh pandemic globally, which is decades in the making. In 2022, the world had almost 500,000 cases of cholera.

“So, it’s not only limited to Nigeria. In 2023, almost 700,000 cases of cholera reported by World Health Organisation. This year, more than 200,000 cases of cholera have occurred in five regions of the world. And as you may recall, there was a huge outbreak of cholera in Eastern and Southern Africa earlier this year.

“It hit us a few weeks ago, and the Federal Ministry of Health and Social Welfare Working with the National Centre for Disease Control (NCDC) activated the protocol, the Technical Working, working with Lagos state in particular, which has a very strong institutional capability to be able to contain that. And then it spilled to a few other states.

“At the moment 31 states have recorded over 1,528 cases with 53 deaths in Nigeria. And that is something that we’re working on through emergency operations center that was activated by the NCDC yesterday. It is multi-sectoral as technical partners as other ministries of water environment, Minister of Health or the relevant partner, civil societies contributing in that effort to ensure that we manage it. Resources were deployed to 21 states to help them respond to the cholera in addition to improving awareness of our population, hand washing, hygiene, sanitation, in addition to treatment with drugs with intravenous fluids with oral rehydration solution, and why do we spread the message, that people should be aware of this outbreak of cholera so that we can control it quickly.”

Pate said FEC has approved a cabinet committee comprising the Minister of Health and Social Welfare, Ministry of Budget and National Planning, Water Resources, Environment, Youth, Aviation, Ministry of Education because some of “our children will be going back to school to ensure that we put safeguards in addition to the state governments. And we’ve been asked to co-opt one of the state governors with an important experience that can be contributed to this effort in terms of sanitation, open defecation, so that Nigeria makes progress in reducing open defecation, because cholera is a developmental issue. Is not just the health issue, is a multi sectoral issue. All of us as Nigerians have to lean in to make that happen. So, council took the position and the President directed that this Cabinet Committee be put in to oversee what this emergency operations center led by the NCDC doing and for the resources to be provided so that we are complemented by the state government as well.”

The minister said Nigeria has also reported cases of yellow fever. “There were 37 suspected cases in Bayelsa, three of which were confirmed mostly in Yenagoa Local Council and we have deployed vaccines, hundreds thousand doses of yellow fever vaccine is an effective vaccine for it to contain it and we have more than seven million doses of yellow vaccine in the country.

“So, that’s on yellow fever as an outbreak. Now that puts into context the need to strengthen pandemic prevention and the ability to respond to that,” he said.

Pate added: “And the third bouquet is to deal with the issue of acute malnutrition. Of course, Mr. President is very committed to food security of Nigerians, expanding the production through work of the with the Ministry of Agriculture, and all of us in the team, that there’s an acute situation with regards to severe acute malnutrition, where as you may recall, there is an alert in a few states, Borno, Adamawa, Yobe, Sokoto, Katsina and Zamfara states, that almost a million children had severe acute malnutrition.

“We have formed a ministerial task force that is mobilizing resources from the World Bank and also grant financing to provide ready to use therapeutic foods for the treatment of those severely malnourished children while the country is making progress to expand food production as you will hear also from the Ministry of Agriculture.

“All in all, to say that the President has directed us to ensure that we address the real needs of Nigerian population.

“We’ve raised multiple micronutrient supplements that will be distributed to pregnant woman to actualise and protect our population. So, these issues are very germane.”

The minister said the fourth bouquet, which has to do with the governance pillar of “our agenda in health, which is the regulatory bodies that we have, and I will ask my colleague, the Minister of State to update you on that. But essentially, to streamline the governance, so that we have effective governance of the institutions in the health sector.”

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