COVID-19 testing issues in Nigeria, By Isaac N. Obasi

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Boss Mustapha, Chairman, PTF on COVID-19

In its April 2020 policy document titled: National Strategy to Scale Up Access to Coronavirus Disease Testing in Nigeria, the Federal Ministry of Health through the Nigeria Centre for Disease Control (NCDC) prioritised testing as one of the key interventions to the COVID-19 policy response in Nigeria. Again, it recognised that “diagnostic testing is essential response strategy to interrupt the transmission of the COVID-19 pandemic”. Consequently, in order to rapidly contain the outbreak, the Federal Government plans to rapidly also scale up diagnostic testing to cover all 36 States and the Federal Capital Territory FCT). 

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And following this directive, the NCDC in line with best practice recommends and implements COVID-19 diagnosis by molecular RT-PCR testing (For details of this important policy document (See https://covid19.ncdc.gov.ng/media/files/COVID19TestingStrategy_Lz3ZVsT.pdf). The   main thrust of this policy document resonates well with the key message of the World Health Organisation (WHO) on testing which is: test, test, test, as a way of stopping the spread of this deadly coronavirus. 

In Nigeria, like in many other countries especially the developing ones, testing for the coronavirus has been a big challenge under a weak public health system since the outbreak of the pandemic. Many factors conspired to complicate the problems aside from the well-known paucity of huge financial resources required. 

The competition for the testing materials between the well-endowed nations and the poor ones, posed a bigger challenge. The fact that the manufacturers of such urgently needed materials were themselves impacted negatively in their operations by the virus also made matters worse. Again, the inadequacy of specialised skills required to conduct the test itself in a pandemic emergency was equally a critical factor. The poor health facilities and infrastructure constituted yet another. In all, Nigeria’s public health system like in many other countries was not fully in a state of preparedness when the index was recorded.  

As at the time the index case recorded in February, 2020, there were only two laboratories where COVID-19 could be tested in Nigeria. According to the NCDC website, as of 2 July 2020, (8pm) there are forty (40) laboratories in Nigeria that can test for COVID-19 and they are all in the NCDC molecular laboratory network. These laboratories are located in the following states of the federation namely Lagos and Kano with 5 laboratories each; FCT 4 laboratories; Kaduna 3 laboratories;  Rivers, Edo, Oyo, & Ogun with 2 laboratories each; and one (1) laboratories each for Ebonyi, Osun, Plateau, Borno, Sokoto, Delta, Imo, Adamawa, Anambra, Katsina, Bauchi, Ekiti, Akwa Ibom, Jigawa and Ondo states. Ondo state was the latest that entered the NCDC website on July 2, 2020. 

Given the high number of COVID-19 testing laboratories established between February and early July, the NCDC and their supporting partners deserve a big pat on the back. This column had in the past commended the efforts of the NCDC, their supporting partners such as CA-COVID, international development partners, and some others in this regard. Their tireless efforts have not gone unnoticed and history will be kind to them. But there are some issues that need to be addressed.

First, one wonders what determined the locations of these laboratories across the nation. Based on the number of states with laboratories as listed above, 14 states still do not have laboratories, when other states have more than one. For example, two states have up to 5 each, with others having between 4 and 1. Few days ago, I was greatly concerned when the Taraba State Governor, Darius Ishaku was lamenting the absence of COVID-19 laboratory in his state. Since I do not know the criteria that determined the location of the laboratories, I can only appeal for one to be established there. And if for example a counterpart fund is required, the governor should be requested to make such contribution towards establishing one in the state. This is because, his people need it urgently like others that have as many as five, against the fact that Taraba State is very far away from Abuja for instance and also have large international borders with the Republic of Cameroun. By the way, are the five laboratories in Kano State optimally used given the numbers that come out of that state for quite some times now? 

Secondly, the issue of what has been happening in Kogi and Cross River States are getting a bit confusing. One had thought that the issue with the Cross River State has been resolved previously with the Federal Government until lately when one federal agency was wrongly accused of importing the virus sample into the state in the name of training. However, few days ago, a new reconciliatory attitude is emerging, and so the case of Cross River State is getting resolved. But the case of Kogi State is getting out of hand if nothing is done quickly by the Federal Government. 

According to the Chairman of the Presidential Task Force on COVID-19 and Secretary to the Government of the Federation, Mr. Boss Mustapha “the PTF has received with great concern, reports about the attack on the Federal Medical Centre, Lokoja, Kogi State by some hoodlums”. According to him again, “the PTF is particularly distressed and regrets the trauma to which medical workers, patients and others who went on their legitimate businesses were subjected.” He then assured that security agencies have been tasked with the responsibility for fishing out the criminal elements behind it and they will be brought to justice (See report by Joyce Remi-Babayeju, Sundiata Post, (2 July 2020). This column feels very strongly that a COVID-19 test laboratory should be established in Kogi State in the interest of the good people of that state. 

Thirdly, the slow pace of testing across the country should be quickened as planned in the National Strategy to Scale Up Access to Coronavirus Disease Testing in Nigeria. The number tested so far is incredibly too low (a total of 138,462 tests so far as of 1 July 2020). Again, the response time for a desperate person to establish meaningful contact with the testing officials via a phone call is to say the least very frustrating. At times there is absolutely no follow-up feedback from the officials even when such an official had promised to do so. This frustrates the would-be COVID-19 patient furthermore. It is gratifying to note however that during the briefing of July 2, the Honourable Minister of Health, Dr. Osagie Ehanire assured that many hospitals in Abuja are going to serve as test collection centres. The National Coordinator, Dr. Sani Aliyu specifically mentioned that 7 new collection centres have now been added. This is commendable. 

In conclusion, while the effort so far made in the area of testing is commendable especially in terms of the number of laboratories (from 2 in February to 40 as of July 2, 2020), there are still a lot to be done in respect to the spread of the laboratories across the nation. Again, the slow rate of testing has to be increased rapidly as NCDC policy document had planned excellently. ‘Test-test-test’ should be the watch word because no one can treat a patient unless that patient has been tested for the virus. This is even more urgent as the community transmissions across the nation appear to be getting more scaring with Nigeria recording on July 1, 2020, a total of 790 infections (the highest number so far in a single day).    

Prof. Isaac N. Obasi, a public policy expert (& former columnist in the Daily Trust, Abuja, March 2003 to October 2006, & Daily Champion, Lagos, April 2005 to December 2008), is of the Department of Public Administration, University of Abuja. Email: nnamdizik@gmail.com      


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