How lack of political-will fuels recurrence of vaccine preventable diseases in Nigeria
Annually, Nigeria spends not less than N12 billion to import vaccines even as Global Alliance for Vaccine Initiatives (GAVI), UNICEF, WHO, Bill Gates among others pitch in financial and technical support; yet, over 20 per cent of deaths among children under five years of age are caused by vaccine preventable diseases in Nigeria. Daily Times’ LARA ADEJORO reports.
Going by the United Nations Children Education Funds (UNICEF) statistics, five countries account for around half of all child deaths: India, Nigeria, the Democratic Republic of Congo, Pakistan and China. India (24 per cent) and Nigeria ((11 per cent) together account for more than a third of all under-five deaths.
Children with diseases like pneumonia, meningitis, hepatitis, yellow fever, measles, of poliomyelitis (polio) need not die. With vaccine, adequate nutrition and basic medical and maternal care, most of these young lives could be saved.
Preventable or treatable infectious diseases such as malaria, pneumonia, diarrhoea, measles and HIV/AIDS account for more than 70 per cent of the estimated one million under-five deaths in Nigeria, according to UNICEF.
A vaccine is an antigenic substance prepared from the causative agent of a disease or a synthetic substitute, used to provide immunity against one or several diseases.
For instance, pneumonia kills nearly 1 million children under the age of five worldwide, causing more deaths than HIV/AIDS, diarrhea and malaria combined and Nigeria has the highest number of pneumonia child deaths in Africa, and the second highest in the world after India.
On the 11th of August, 2016, the gains in the fight of polio suffered a setback as the Federal Government of Nigeria reported that 2 children have been paralysed by the disease in the northern Borno state.
Experts however say, only one case of polio makes it likely that polio could be present through the area and leak across borders.
This current outbreak of two wild polio virus cases (WPV), first since reported in July 2014, has dealt a blow on Nigeria’s hope of being certified polio-free by July 2017 by the World Health Organisation (WHO).
UNICEF says, immunisation saves up to 3 million children each year by protecting them against disease but in 2015. But, in 2015, nearly one in five infants – 19.4 million children – missed out on the basic vaccines they need to stay healthy, adding that more than 60 per cent of these children who miss out on routine immunization live in 10 countries including Nigeria.
After the recent polio outbreak in Nigeria, the government earmarked 9.8 billion for polio with plans to immunize 56 million children by November 2016.
But the question on the lips of almost every Nigerian is: Do we have to wait for any disease outbreak before government’s prompt action?
This however, highlights the need to prioritise immunization of children in hard-to-reach areas.
Whither Federal Vaccine Production Laboratory?
Federal Vaccine Production Laboratory, YabaWhen Federal Vaccine Production Laboratory (FVPL) which was later called Biovaccine Nigeria was established in 1947, it was producing rabies, yellow fever and small pox vaccines.
When the initial yellow fever epidemic came up in 1984, that laboratory produced the vaccines that were used to battle yellow fever. It was also producing small pox vaccine until the disease was eradicated.
Though, there were efforts to revive the laboratory in 1984-1985, but all efforts failed as there hasn’t been any production of a single dose of vaccine till date.
En route the laboratory is an untarred road with a rusted wrought-gate on Edmund Crescent, Yaba. There was no sign board to indicate that any laboratory ever existed there.
There are other four buildings, including an administrative office belonging to the Pharmaceutical Council of Nigeria (PCN) at the extreme right.
With two security posts; the first post at the gate is occupied by the security officials in charge of PCN while the second post which is after the laboratory is occupied by the security officials manning the derelict laboratory.
The security officials who were supposed to man the laboratory were under a tree arguing about the politics of the day.
The two-storey decadent laboratory building with its white worn-out paint has been overtaken by bush, rodents, cobwebs. The door to the building was left ajar and some of the glass blades of the louvers are either broken or are pulled out.
The building has become a warehouse of old seats, tables and other equipment.
One of the security officials who spoke under anonymity said, “the security men in charge of that building comes Mondays to Fridays and collect their salaries at the end of the month. It’s a government property and they can do it the way they like. The building has been abandoned ever since the Federal Capital Territory (FCT) has been moved to Abuja and they’ve not done anything there since.”
According to the President of the Nigerian Academy of Science (NAS), Professor Oyewale Tomomi, a renowned virologist, the lab is in such a state that cannot be revived because the location.
“I won’t want to produce vaccines in the centre of Yaba. Most times, vaccines production are far removed from where a lot of public move around. Accident happens around there, that’s an area where everything goes on. What we decided at that time was that, that centre should be a corporate headquarters of the bio- vaccine and become the storage centre for vaccines produced. Modern vaccine production doesn’t work in the direction in which that centre is built.”
Speaking with Daily Times, the Managing Director/CEO of May &Baker, Mr Nnamdi Okafor said, at some point, the company felt it was not good for a country like Nigeria to depend on importation of vaccine, “so we submitted a proposal to the FG to take over the facility and revive it. Eventually, there was an agreement for a joint venture company called Biovaccine.
“That company didn’t operate for a year. This country spends between N10-N12 billion importing vaccines annually, as at the figure I got. Even the cold chain like syringes, needles, refrigerators are brought into the country from abroad.
“This process is managed by UNICEF and they get paid for it, we also pay charges at the port, including the foreign exchange that is wasted.”
Most worrisome, according to Okafor is that, Nigeria doesn’t get the vaccines when needed. “After payment, the country has to wait and when there is an epidemic, we can’t afford to wait because the more we wait, the more deaths we record.”
He said, immunization is about the lives of our children and mothers. “Vaccine is a health security issue for any country, nothing will happen positively if we do not preserve the health of our children. If you look at where we are today, we are worst off as a country in regards to production of vaccines locally than where we were 50 years ago.”
Threats to local vaccine production
Professor Tomomi said, the attitude to work is a threat to local vaccine production.
Going back memory lane, the Don said, “I knew very much about FVPL because it was part of my training when I was in Veterinary school. They were using animals to produce the vaccines and part of the training was that twice a week, we go to the lab and check if the animals were okay for the production of vaccines. After that, when we started working, I knew the lab was producing vaccines.
“People’s attitude to work these days is different especially when it comes to anything owned by the government. When you put someone in charge of something, they won’t take care of it and that’s a wrong attitude because they feel whether your employer makes gain or not, you get paid. Anything belonging to government always end up that way.
“That is different in private industry because they are there to make money, so you can be sure that if you mess up, you’ll be sacked. But government has a role on the regulatory to ensure that what they produce is okay.”
However, the MD of May & Baker said, vaccines are required to keep the population healthy and prevent the children from vaccine preventable diseases.
“For a country to be strong, it must protect the children and mothers, therefore, if you don’t have the capacity to manufacture this vaccine locally and you have to depend on companies outside the country, then you can’t guarantee safety. The issue of local production of vaccine is a fundamental public health security issue and this government needs to take it seriously.”
According to the pharmacist, local vaccine production is capital intensive requiring billions of naira to set up and vaccines are 95 per cent procured by government and for a private operator, the market needs to be attractive to make investments.
“If for any reason, Nigeria has an issue with the West, the country will be cut off and no country can be great if it can’t be self-sufficient in basic human needs like food and medicine.”
Implications
Nigeria is Africa’s most populous country with the second highest maternal and child mortality rate after India.
When Africa health ministers and major donors gathered in February 2016, they harped on the need to sustain the tempo for polio eradication to avoid the risks of resurgence of polio virus as such would result in the loss of billions of dollars invested in past years, the continued crippling of innocent children as a result of a virus which is easily preventable but has no cure.
Already, some mothers are apprehensive about the resurgence of polio in Borno. “This is disheartening,” says Aisha Sanni, nursing 9-month-old baby planning to relocate with her husband to Gwoza, their hometown.
“We hope our government find a way to put a total stop to this, if not, many homes will be devastated and more innocent children will be crippled for life.”
