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By Victor Okeke
The COVID-19 pandemic has had devastating health and economic impacts, with over 3 million deaths to date and an expected total cost of between US$8.1 and US$15.8 trillion globally. The pandemic has focused global attention on the importance of diagnostics and testing data to drive public heath decision-making: the use of ongoing testing and surveillance to guide targeted lockdowns rather than broad restrictive measures, for example, could lower the economic burden 5-fold.
Although the threat of a global pandemic due to a rapidly spreading, lethal respiratory pathogen had been documented, prior to COVID-19, global funding for pandemic preparedness had been reactionary and not well sustained. While still contending COVID-19, the recent outbreak of monkeypox should of concern to the global health community. It should trigger and question our pandemic preparedness and the quest for attaining a universal health coverage premised in the right to health for everyone.
The ongoing outbreak of monkeypox was confirmed May 2022, beginning with a cluster of cases found in the United Kingdom. From 18 May onwards, cases were reported from an increasing number of countries and regions, predominantly in Europe, but also in North and South America, Asia, North Africa, and Australia. 1,033 cases had been confirmed as of 6 June. On 26th May 2022, the Nigeria Centre for Disease Control and Prevention (NCDC) activated a national multi-sectoral Emergency Operations Centre for Monkeypox (MPX-EOC) at level 2 to strengthen and coordinate ongoing response activities in-country while contributing to the global response. This was based on the report of a preliminary risk assessment done by a group of Subject Matter Experts from the NCDC, relevant government Ministries Departments and Agencies and partner agencies. This year, as at 29th May 2022, a total of 21 confirmed cases with one death have been reported from 9 states and the FCT – Adamawa (5), Lagos (4), Bayelsa (2), Delta (2), Cross River (2), FCT (2), Kano (2), Imo (1), Rivers (1). The death was reported in a 40-year-old patient who had underlying co-morbidity and was on immunosuppressive medications.
The rapid response by the NCDC to the ongoing monkeypox outbreak is example of how a locally led integrated Human-Animal Disease Surveillance and Response system can be used effectively to define the outbreak, and points the way forward. Nigeria’s experience is important for regional training and help build networks to improve surveillance capacity, laboratory diagnostics, best public health and clinical practice, and regional capacities to launch locally led efficient responses.
This would contribute to the need to build public health and surveillance capacities across the country even at the state levels to guide appropriate surveillance, data collection, prevention, preparedness and response activities to monkeypox and other emerging and re-emerging infections with epidemic potential. There is an urgent need to have resilient and robust health systems at the national and state levels, reaching those who are vulnerable or in vulnerable situations. In the event of the absence of international attention, future epidemics could surpass previous outbreaks in terms of intensity and gravity. There is great need of raising awareness, the exchange of information, scientific knowledge and best practices, quality education, and advocacy programmes on epidemics at the local, national, regional and global levels as effective measures to prevent and respond to epidemics.
It is important to strengthen epidemic prevention by applying lessons learned on epidemic management and how to prevent the stoppage of basic services, and to raise the level of preparedness in order to have the earliest and most adequate response to any epidemic that may arise, and recognizing also the value of an integrated One Health approach that fosters integration of human health, animal health and plant health, as well as environmental and other relevant sectors.
Advancing public health preparedness and aligning proactive surveillance activities to priority research will require a coordinated, locally-led, multidisciplinary efforts aligned closely with capacity development and training. As a nation, we must collectively invest in and build strong preparedness systems that are better adapted to increasingly fragile healthcare systems. The goal is to achieve a better health for all Nigerians.
Okeke writes from the Centre for Social Justice, Abuja, Nigeria
