By Abujah Racheal
As 2024 unfolds Nigeria finds itself at a critical juncture in its public health journey as a major health challenge emerged. Monkeypox, otherwise known as Mpox.
The zoonotic illness caused by the monkeypox virus primarily transmits from animals to humans, but human-to-human transmission is also possible, particularly in dense urban settings.
The Nigeria Centre for Disease Control and Prevention (NCDC) has confirmed 40 cases of Mpox from a pool of 830 suspected cases, marking a troubling spread across 13 states.
The NCDC said that significant clusters have emerged in the South-South and South-East geopolitical zones, as well as Lagos, and Ogun states, signaling a challenge that demands urgent attention.
As the nation grapples with the fallout, questions loom about Nigeria’s preparedness and ability to manage such public health crises effectively. Mpox is not a stranger to Nigeria.
Since the first recorded case in the early 1970s, the disease has appeared sporadically, often in rural areas with close interactions between humans and wildlife.
However, the current outbreak has become worrisome with the disease spreading more widely and swiftly than ever before.
Data from the NCDC indicates a 25 per cent increase in confirmed Mpox cases over the past month.
This trend poses not just a public health challenge but also reflects a systemic failure to contain the spread early enough.
Public health experts warn that if the situation was not brought under control quickly, Nigeria could face a much larger outbreak, with unpleasant consequences for public health and the economy.
In neighbouring Ghana, the approach to managing the Mpox outbreak has been clearly different.
Swift government action, backed by robust public health infrastructure, has kept the number of cases relatively low.
Ghana’s strategy has included rapid deployment of mobile health units to remote areas, ensuring that even the most vulnerable populations have access to testing and treatment.
Moreover, Ghana’s government has been proactive in engaging communities through local leaders and health workers, ensuring that accurate information about the disease is disseminated quickly and effectively.
Public health campaigns focusing on Mpox symptoms, transmission, and preventive measures have been rolled out across multiple platforms, from social media to traditional village meetings.
In contrast, Nigeria’s response has been slower and less coordinated.
The country’s vast geography and diverse population have posed challenges, but critics argue that these should not be excuses for the delays and inefficiencies that have characterised the response.
The failure to implement similar strategies to those used in Ghana, such as mobile health units and widespread community engagement, has exacerbated the situation.
One of the most glaring issues in the Mpox outbreak has been the delay in information dissemination.
Public health communication specialists criticised the lack of timely updates from health authorities, which they believed has eroded public trust and worsened the situation.
Some argued that the delay in acknowledging the outbreak has likely led to unnecessary panic and confusion.
A public health communication specialist, Dr Raheema Alao, said that in a country where misinformation can spread quickly, particularly in rural areas with limited access to accurate news, the absence of a clear and consistent communication strategy was a significant oversight.
“Reports of Mpox began surfacing in various states as early as March, yet it was not until May that the NCDC officially confirmed the outbreak.
“By then, the disease had spread to multiple regions, with many Nigerians unaware of the risks or how to protect themselves”, she said.
Alao further emphasised the potential consequences of poor communication.
“Imagine if Nigeria had faced a more contagious and deadly disease during this time.
“The lack of timely communication could have led to widespread panic, overwhelmed healthcare systems, and ultimately, a higher death toll,” she said.
The human cost of the Mpox outbreak is evident in personal stories from those affected.
In Abuja, Mr Shasudeen Ibrahim recounted the ordeal his family faced when his son contracted the disease.
“We were unaware of Mpox until it affected us. The lack of clear information made it difficult to manage the situation,” he said.
His son’s symptoms were initially misdiagnosed as chickenpox, leading to a delay in receiving the appropriate treatment.
Ibrahim’s story is one of many across the country where families have struggled to access accurate information and medical care.
In rural areas, where healthcare facilities are often under-resourced, the situation is even dire.
Reports have emerged of individuals resorting to traditional medicine or self-isolation out of fear of being stigmatised, further complicating efforts to control the outbreak.
These stories highlight the urgent need for improved public health communication and education.
When communities are left in the dark, the consequences can be severe, not just for those directly affected by the disease, but for the larger society.
Public health experts have been vocal about the need for significant reforms in Nigeria’s approach to managing outbreaks.
Prof. Oyewale Tomori, a leading virologist and former President of the Nigerian Academy of Science, highlighted the importance of local vaccine production.
“Effective disease control requires a combination of rapid detection, reporting, and treatment,” Tomori said.
He said that Nigeria’s reliance on international vaccine supplies has left the country vulnerable during times of crisis.
“Developing and producing vaccines locally would not only reduce dependency on global supply chains but also ensure quicker access during outbreaks.
“This capability is particularly crucial in a country like Nigeria, where logistical challenges can delay the delivery of critical medical supplies,” he said.
Reflecting on past successes, he said that Nigeria’s response to the 2014 Ebola outbreak offered valuable lessons.
“At that time, the country managed to halt the spread of the virus without the use of a vaccine, thanks in large part to a well-coordinated public health response.
“The Nigerian government, working in partnership with international organisations, quickly mobilised resources and implemented strict quarantine measures,” Tomori said.
He said that public health officials conducted widespread contact tracing, and community leaders were engaged to ensure that accurate information reached even the most remote areas.
“The success of the Ebola response was a testament to what Nigeria can achieve when it has the political will and resources to act decisively,” he said.
His called for local vaccine production was echoed by others who see it as a strategic necessity.
However, experts such as Dr Solomon Chollom argue that the lessons from the Ebola outbreak have not been fully integrated into current practices.
“We should have built on that experience to create a more resilient public health infrastructure,” Chollom said.
He said out the systems established during the Ebola crisis were largely dismantled once the immediate threat had passed, leaving the country ill-prepared for the next outbreak.
Nigeria stands at a critical juncture in its public health journey.
The Mpox outbreak has highlighted significant weaknesses in the country’s health infrastructure and response mechanisms.
To address these challenges and improve preparedness for future outbreaks it is essential to implement comprehensive reforms across the health sector.
At the core of an effective public health response is a robust disease surveillance system.
This includes not only the capacity to detect and diagnose cases quickly but also the ability to track the spread of disease and respond accordingly.
Investment in modern surveillance technology, training for health workers, and the establishment of regional centres of excellence are crucial steps.
The expansion of testing capacity, as emphasised by Dr Jide Idris, Director General, NCDC, is essential for managing outbreaks.
“Nigeria must invest in state-of-the-art laboratories capable of handling large volumes of tests quickly and accurately.
“This will require not only financial investment, but also partnerships with international organisations that can provide technical support and expertise,” he said.
The Mpox outbreak has underscored the need for sustained investment in public health and the systems and processes that support it such as supply chain, logistics and human resources.
A well-funded and effectively managed public health system is the foundation of a healthy and resilient society.
Nigeria’s future healthcare capacity depends on the actions taken today. (NANFetures)
