A year of voices, viruses, vaccines

If you missed it before, here’s what U-report is. It is an SMS based platform uniting the voices of a growing crowd of Nigerians talking about anything they want. Sixty-eight percent of them are aged 20-30 years, 60% of them are males, and their population is approaching 90,000 this month.More than 10,000 of them responded […]

If you missed it before, here’s what U-report is. It is an SMS based platform uniting the voices of a growing crowd of Nigerians talking about anything they want. Sixty-eight percent of them are aged 20-30 years, 60% of them are males, and their population is approaching 90,000 this month.
More than 10,000 of them responded to a poll, which asked “what was the most memorable event for most Nigerians in 2014?”
Their response gave the largest circle to Ebola, the virus behind the first-ever outbreak of the dreaded haemorrhagic fever in West Africa. By December end, the virus had infected 19,497 people and killed 7,588, says the World Health Organisation. More thousands are projected to be affected before the outbreak begins to peter out.
The virus exposed the underbellies of weak national health infrastructure in most-afflicted countries as Guinea, Liberia and Sierra Leone, and forced Nigeria to shape up.
After Patrick Sawyer grabbed headlines with his arrival and eventual death in Lagos, health authorities went into overdrive—rumours about Ebola were quelled, hashtags flew around, warnings were issued against large gatherings and bushmeat and in favour of handwashing.
Twenty infections and nine deaths later—most of them healthworkers—Nigeria contained the virus, and was certified Ebola-free in October. By December, it sent volunteers into neighbouring countries to help contain the virus.
Never mind that weeks before Sawyer, doctors went off work in public hospitals across the country in what is considered the Nigerian Medical Association’s biggest strike to date.
The strike lasted more than a month—right at the height of Ebola’s presence in Nigeria, earning doctors public anger and government annoyance. The ire culminated in reported threats of hospital privatization and NMA proscriptions whispered in the corridors where negotiations to end the strike went on.
With its suspension came calls to honour the medical workers killed in the line of duty by Ebola. Dr Stella Adadevoh would be posthumously honoured in October, but the absence of doctors from hospitals in the face of Ebola became ammunition for other groups of health professionals. All healthworkers, other than doctors, are currently on strike, which is likely to enter 2015.
Joint Health Sector Unions and the National Union of Health Care Professionals accused government of “double standards” when government threatened them with “no work no pay”, different from how it treated striking doctors.
National Association of Nigerian Nurses and Midwives described the health sector as a failure, pointing to “lamentable decay of infrastructures, lack of motivation leading to ‘brain drain’, poor supplies of medics and equipment.”
The association’s president Abdulrafiu Adeniji said growth rate far outstripped turnout of nurses.
But the bad blood between both sides finally took a back seat when the National Health Bill got presidential assent this December—after years in legislation bedevilled by revisions, prompting strikes and counterstrikes.
With NHB in place, attention is shifting toward implementation, with committees and subcommittees set to spring up. NHB is just a framework law. The committees will flesh out how the law will work, and that could be whole new grounds for inter-professional bickering yet.
As strikes remained, so did Nigeria’s epic battle to kick out polio. Reported cases have dropped 90% this year, compared to 2013.
In a country considered the final barrier to polio in Africa, Nigeria’s progress—no case since July, reduction in extent of the virus reservoirs and tightened monitoring of how healthworkers administer the polio vaccine—could pull the country out of the polio-endemic club, leaving only Pakistan and Afghanistan.
Long lessons from dealings with polio helped against Ebola. In fact, experts were pulled from polio emergency operations centre to constitute the ground-zero unit at Ebola operations centre.
Shortly after sending contingents off to battle Ebola in West Africa, Nigeria’s health workers turned to another pathogen—pneumococcus, the primary cause of pneumonia and a handful of related diseases, which kill 130,000 children each year, according to experts.
A conjugate vaccine, named PCV10, targeting some 12 such diseases, was introduced into routine immunisation this December for children under age one, and could prevent the deaths of some 486,957 children in the next six years, according to the National Primary Health Care Development Agency.