Epidemic preparedness in Nigeria must include sanitation and hygiene

Date: 23rd June 2020

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Interview with Dr Ifeanyi Nsofor, CEO of EPiAfric

By Olajide Adelana

ABUJA, Nigeria – Dr Ifeanyi Nsofor, Chief Executive Officer of EPiAfric, an Abuja-based African population health consultancy group, is a leading advocate for water, sanitation and hygiene (WASH) and epidemic preparedness in Nigeria. Dr Nsofor sat down with WSSCC to discuss Nigeria’s COVID-19 response, the lessons the pandemic will leave in its wake and the importance of including WASH in epidemic preparedness.

WSSCC: What are the top five lessons from Nigeria’s response to COVID-19?

Dr Ifeanyi Nsofor, CEO of EPiAfric: Nigeria’s response to COVID-19 has been exemplary. It is essential to mention that Nigeria’s epidemic preparedness index improved from 39% in 2017 to 46% in 2019. The UN Secretary-General praised the Nigerian Centre for Disease Control’s (NCDC) leadership for the way the response is going. For example, the NCDC has supported 23 states in Nigeria in setting up public health emergency operations centres (PHEOCs) which, in turn, prepare states in preventing, detecting, and responding to epidemics.

For me, the top five lessons flowing from Nigeria’s COVID-19 response would be as follows:
1. Federal, state and local governments would begin to prioritize epidemic preparedness,
2. The private sector would increase its contribution to the implementation of the national action plan for health security,
3. Governments at all levels would increase their investments in clean water and basic sanitation to underserved communities,
4. Governments at all levels would invest in risk communications to communities and
5. Governments at all levels would train religious leaders to understand infectious diseases and their roles in educating their followers to do right. These training must be done before epidemics happen.

WSSCC: Would you say Nigeria was really prepared for the pandemic? If yes, can the same template be used in adopting WASH as a top priority issue when it comes to epidemic preparedness in Nigeria?

Dr Nsofor: Nigeria was relatively prepared, though there are gaps, one of which is the poor implementation of the One Health approach. This means that epidemic preparedness must go beyond the health sector to include social determinants of health such as sanitation and hygiene. As serious as COVID-19 is, its prevention is fundamental and dependent on WASH.

WSSCC: How important is WASH in health facilities, especially at this time of the pandemic?

Dr Nsofor: Data from WHO shows that a significant proportion of health facilities in Nigeria do not have access to water that arrives via pipes. This means that health workers are not in the optimal situation to wash hands between patients. Likewise, waste disposal is poor in most health facilities in Nigeria. Medical wastes are not properly disposed and can serve as mediums of infection to health workers, patients and their relatives. Public health centres lack clean toilet facilities and maternity wards are poorly disinfected.

WSSCC: Practicing hand hygiene has been advocated as a way of preventing the spread of the virus, but with the majority of Nigerians lacking access to portable and clean water?

Dr Nsofor: Because of the risks involved, Nigerians must, in the short term, go beyond the call of duty to ensure they get water to wash their hands. Running water does not only mean water coming out of a tap. It also means someone pouring water for one to wash his or her hands. In the absence of soap in poor, underserved communities, people can use ash and water to wash their hands.

In the medium-to-long term, governments, civil society groups, donors and the private sector should invest in the provision of clean water and sanitation to such communities.

WSSCC: How do you see COVID-19 as a problem beyond increasing advocacy for handwashing? How is it important to increase scientific literacy for the people of Nigeria to facilitate the appropriate behavioural change?

Dr Nsofor: I believe COVID-19 is about educating people in simple ways they can understand. It is about educating people on how the virus can be prevented, the roles of everyone in stopping community transmission and how poor lifestyle choices can predispose people to it.

Let’s leave science to scientists but ensure results of scientific studies are broken down in common sense ways for ease of understanding. The gown must meet the town or else scientific discoveries are wasted.

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