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COVID-19: Nigeria lacks political will to invest in research, vaccine trial – NMA president

Prof. Innocent Ujah is the President of the Nigerian Medical Association (NMA). In this interview with APPOLONIA ADEYEMI, he discusses some factors hindering the production of vaccine locally and its uptake from international community, issues setting back the fight against Coronavirus pandemic in the country, why many remain skeptical about the virus and what can be done to change the narrative, among others. Excerpts

In this era of COVID-19, the practice of doctors and other health care workers rejecting patients and refusing many sick people needed treatment is widespread in the country. What can be done to stop this practice?

It is difficult to say that doctors are rejecting patients unless either they come late or because some of the investigations had been seen before. There is no reason at all for any doctor to reject any patient who comes to the hospital because that is not our ethics. We are to see every patient that is there. Unfortunately, the doctors are overwhelmed by a large number of patients with limited number of doctors. That weighs them down. The burn-out sessions are becoming increasingly severe, but doctors have no reason at all to reject any patient treatment.

For some patients who experience this, what do you advice?

No, patients should not experience this; it is a zero option. We should not experience this. If forany reason a patient is not seen, I wouldn’t say rejected, there are avenues in the hospital to report. It is very important. If a patient is not seen in the hospital and there are no good reasons, such a patient should report.

There has also been a spike in the number of doctors that are infected with COVID-19 recently in the course of their work. What is the estimated number of doctors involved?

I think the number is not important; I think what is important is why are they being infected. As you know we have been talking about the provision of personal protective equipment from the beginning. We expect that any doctor seeing a patient should be properly protected. In addition to that we advocate that all doctors from time to time must upgrade themselves in the infection prevention and control training to build their capacity because as you know right now it is difficult to know who has COVID- 19 and who doesn’t have it. Many that are asymptomatic may be actively transmitting the virus. So, any doctor seeing any patient now must have minimal acceptable protection, that is, wearing gloves, if it means wearing double gloves and of course, wearing face masks is a must. It is not in all cases that the doctor should wear the protective gown, but we need to protect ourselves, be trained and of course, protective equipment should be provided.

Nigeria seems to be comfortably waiting for international community to take the initiative of addressing the issue of vaccine production to tackle COVID-19? Why is this so?

I am not aware that the government is waiting for international community. As you know, Nigeria has never had any priority for research whether in health, in agriculture or in engineering and we have said that research drive development is key to development. What Nigeria needs to do is to invest in health research in this case. When we say invest we mean put money because to do any vaccine trial requires a lot of money; it requires to recruit experts and it is not just one person or two people. When you want to do that, you want to allocate substantial amount of money. The National Institute of Health (NIH) in the United States (US) allocates billions of dollars for health research; this is not what we have in Nigeria. Hence, what we are looking at in Nigeria is that Nigeria should invest in research. I don’t think Nigeria is waiting for any inter nat ional Agency. I think the political will for the investment in research for clinical trial of vaccine is not there.

Should Nigeria accept vaccine that Russia recently unveiled?

As you know, even where drugs are approved, it has to undergo some trials. We cannot just take the Russian vaccine and start injecting our people. It must undergo some studies here in Nigeria because the biology of Africans, the environment in which we operate and so many other factors must come to play before we can accept; and the only way to do that is to do our own trial of the vaccine in Nigeria.

There has been controversy around the use and success of hydroxychloroquine in the world. What is your take on this?

I am not on the field but we have reports that are either in agreement or in discordant. That is what science is all about. But what we will accept is the real possibility of research outcomes whether it is in America, United Kingdom (UK) or in Nigeria. Research is conducted using similar research protocol and we all agree. Of course, it will have some credibility. If they don’t all agree or majority do not agree on the protocols it will have some credibility but the discordant tunes we are getting from various parts is either that the protocol are not the same, either what they said they are getting is not what they are getting. The outcomes vary from factors of protocol for which hydroxychloroquine is used. The truth of the matter is that there is scientifically significant result and clinicals. I have always said that: if you treat one patient, or two patients with hydroxychloroquine and they survived, for you that is 100 per cent, but the number is small to generalise for public health use.

In spite of varied testimonials from some COVID-19 survivals and the heightened awareness about the pandemic in the country, majority of Nigerians don’t believe the pandemic it is real. They call it a scam used to siphon funds by the authority. In your opinion why do you think many are skeptical about COVID-19 here?

Let me say that Nigerians are very of skeptical of anything. The only thing they are not skeptical about is where to go and enrich ourselves unjustly. When HIV came out Nigerians said there was nothing like HIV. If it were not because of this sexual transmission, we would have denied it. Till today, even when the first case was studied and found out at the Nigerian Institute of Medical Research (NIMR) in 1985/86, the Nigerian government denied it, but that did not change the science that the scientists put forward and today we have accepted the fact that HIV exist; we have accepted the fact that it can have some treatment without necessarily curing it and Nigerians are doing well. The truth of the matter is that those who are supposed to show good example are not showing that example and that results in a lot skepticism to the reality of COVID-19. Where they said there will be no mass gathering and that burials should not be celebrated… Look at what is happening in Edo State in political campaigns, in your own opinion, do you thinks the political class is showing good example? There is nothing like social distancing; there is nothing like the use of face mask. The campaign that we see from the people that want to lead us are now throwing the advice of experts into the dustbins. When they become leaders what will they be?

What can we do better to change the situation?

What we can do is to continue to pray to God and lament for the failure of good leadership because we believe that leaders should show good example. Leadership is very important and the quality of leadership is very important. The president has said clearly that people should listen to the experts and these are the doctors and scientists, but what is happening in Nigeria is: do you think anybody is listening to anybody? Some said unless someone they know die or their relation die, it is only then that some will believe that there is COVID-19. We could have done better if Nigerians were following the basic Nigerian Centre for Disease Control (NCDC) protocol of using face mask regularly, hand washing and social distancing. Probably, we should have contained the community transmission of COVID-19, but Nigerians will not listen to that. I don’t know what the problem is: is it hunger? Is it illiteracy or is it indiscipline?

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