COVID-19: Trump severs US relations with World Health Organisation

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United States (US) President Donald Trump, yesterday carried out his threat, as he terminated the partnership between his country and the World Health Organisation (WHO).

Trump announced the end of the relationship during a news conference in the Rose Garden, White House, citing WHO’s handling of the pandemic in China as part of the reason.

“We have detailed the reforms that it must make and engaged with them directly, but they have refused to act. Because they have failed to make the requested and greatly needed reforms, we will today be terminating our relationship with the WHO and redirecting those funds to other worldwide and deserving urgent global public health needs.

“The world needs answers from China on the virus. We must have transparency,” Trump said.

According to him, the decision is part of steps intended to punish WHO and China for what he dubbed a “cover-up” of the coronavirus outbreak on Chinese soil.

Over 101,000 people have died from COVID-19 in the US and there have been at least 1.7 million cases. A forecast published by the US Centers for Disease Control and Prevention (CDC) projects that the number of deaths might rise to over 123,000 by June 20.

Meanwhile, medical experts in Nigeria, after examining the impact of the novel coronavirus (COVID-19) on healthcare delivery in the country, were unanimous that the pandemic has, among other things, further exposed gaps and inadequacies in the health sector; how unprepared Nigeria is in the emerging world diseases; brought out the best out of scientists, in terms of innovation regarding the production of common medical materials and equipment and uncovered the paucity of Infection Prevention of Control (IPC) provisions and practices in Nigerian hospitals, as evident by current the numbers of healthcare workers (HCW) infection and death from the disease.

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The experts said COVID-19 also exposed the sub-standard state of intensive care facilities and capacity in Nigeria hospitals, showed that the health sector and its affiliated programmes and commissions can easily be overwhelmed in a public health crisis and scarcity and exorbitant prices of pharmaceuticals have become the order of the day.

They, however, believed it was time to look inwards to develop and pay radical attention to the pharmaceutical sector that not only closes the gap in access to medicine but also contributes hugely to national development, stressing the need for an increased government funding and support for public health institutions and prime responders in a public health crisis.

The medical experts include virologist and Chairman of Expert Committee on COVID-19, Prof. Oyewale Tomori; virologist/vaccinologist, Founder and Chief Executive Officer (CEO) of Innovative Biotech Limited, Keffi, Dr. Simon Agwale; President of the Nigerian Association of Resident Doctors (NARD), Dr. Aliyu Sokomba; Director-General of the Nigerian Institute for Medical Research (NIMR) Yaba, Prof. Babatunde Salako; Executive Director, National Primary Health Care Development Agency (NPHCDA), Dr. Faisal Shuaib; consultant haematologist and Deputy Chairman of Medical Advisory Committee University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla in Enugu State, Dr. Theresa Nwagha.

Others are President of Pharmaceutical Society of Nigeria (PSN), Sam Ohuabunwa; consultant pharmacist and former president of PSN, Mr. Olumide Akintayo; National Chairman of Association of Hospital and Administrative Pharmacists of Nigeria (AHAPN), Dr. Kingsley Chiedu Amibor and Chairman, Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (PMG-MAN) and Fidson Healthcare Plc, Dr. Fidelis Ayebae.

When asked on the impact of COVID-19 on healthcare delivery in Nigeria, Tomori said: “Thank God for COVID-19, it has again exposed us for what we are. It is allowing us to see glaringly what we have been and to know that we have wasted these 60 years of our independence and turned our country into a toxic environment for human development.

“COVID-19 has shown us again that we are the nation that always manufactures ammunition at the waterfront. The disease has shown us that we fail to prepare for the future, preferring rather set tomorrow aside to vigorously and enthusiastically prepare for the problems of yesterday.”

“On general healthcare, COVID-19 is our newborn baby that has made the country to neglect other health issues and driven people away from the healthcare facilities for fear of meeting the terrible new baby face-to-face. In confronting COVID-19, we sent our health workers without combat gears and exposed a few hundreds of them to infection.

“If we must reverse the trend of health worker infections, we need to confirm the proportion of health workers who are actually catching COVID-19 at work with those infected within the community.

“More importantly, we need to provide our health workers all the protective materials- Protective Personal Equipment (PPE), gloves, masks, etc they need as they work in the frontline of COVID-19 control.

“We, as citizens, when we visit the hospitals can also help protect our health workers by answering the questions about our symptoms, travel history, etc. honestly and truthfully.”

Agwale said the pandemic has shown how unprepared Nigeria is in the emerging world diseases, adding: “The zoonotic virus indeed shook the world, and it is still shaking. The fear it has created in Nigeria is because no one knows the level of infection of the virus.”

The virologist said the country does not have enough testing centres, in fact, only three at the initial stage, saying: “Currently, how many Nigerians have been tested? It is a far cry from realities. One would have expected that as a proactive measure, the country ought to have resorted to well-validated rapid test kits (just like what is currently being used for Human Immuno-deficiency Virus (HIV) and other viral diseases in the country), where thousands of people would get tested every day.

“It is amazing that some state governments are just building molecular test centres. What many concentrate on is designating some abandoned buildings as isolation centres.”

Agwale lamented that some of the centres are not situated in tertiary health centres where the facilities being deployed would be utilised post-COVID-19, noting: “This means that after this pandemic, these facilities might become abandoned again. So, the problem is that we don’t have a long-term approach to issues. There should be sustainable initiatives in our health sector.”

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Sokomba said COVID-19 exposed clearly, our inadequacies and neglect of the health sector, noting: “We lack coordination, funding, training, equipment. We are hopeful that we will be better off after COVID-19. We must henceforth do things differently.”

Salako added that COVID-19 has exposed the weaknesses inherent in our health system and underscores the role of poor infrastructure, saying: “Conversely, it brought the best out of us, in terms of innovation regarding the production of common medical materials and equipment.”

Shuaib said the NPHCDA is currently implementing a robust primary healthcare plan to respond to the COVID-19 outbreak in the country and has established the Crises Management Committee, which meets daily to provide guidance on the way to support the fight at the national and sub-national levels.

Nwagha said: “Our healthcare system appears overwhelmed, showing how ill-equipped we are, in terms of structure, implementation of healthcare policies, infrastructure, capacity in terms of a number of trained and experienced healthcare personnel and our ability to handle public health crisis.”

The haematologist said it has also exposed gross inadequacy of budgetary allocation to the sector and the need for a change in government disposition towards healthcare delivery, given the vast and varied nature of Nigeria, adding that it has further uncovered the paucity of IPC provisions and practices in our hospitals, as evident by current numbers of HCW infection and deaths from the disease.

“COVID-19 has also shown us that the health sector and its affiliated programmes and commissions can easily be overwhelmed in a public health crisis such as the COVID-19 pandemic. A case in point is the NCDC, which has provided a prompt response, sustained guide and coordination of response in this pandemic. However, given all their commendable efforts, there is still a need for increased government support for such a public health institution and prime responder in a public health crisis.

“Simply put, COVID-19 has uncovered again the need to reboot our health sector before we become a joke in Africa as far as health care delivery is concerned. It has made us realise we need to do more as far as health care is concerned. I expect there will even be more drastic positive changes in the health sector post-COVID-19 pandemic.”

Akintayo said: “I was telling a few people around me prior to recording our index case that we do not have a health system that can handle a pandemic if it ever gets to that. Globally, you can see that science and technology have already failed because of a total or near-collapse of economies around the world.

“I salute the gallantry of the value chain of the entire workforce, including cleaners, ward maids, drivers, security men, pharmacists, nurses, doctors, laboratory scientists and others without any derogatory inclination.

“COVID-19 has really exposed the shaky and deficient status of our health system.”

Amibor said the pandemic has placed immense pressure on Nigeria’s healthcare system, stating: “Leading democracies with well-organized healthcare delivery system were caught off-guard. Healthcare delivery systems in most countries nearly crumbled from the pressure created by the pandemic. All of a sudden, PPE became a scarce and hot commodity. Prices of essential medicines and PPE skyrocketed, with many people unable to access their regular medicines as a result of scarcity and increased costs,” he said.

Amibor said even the Nigerian pharmaceutical industry, too, was caught off- guard.

Ayebae said the impact of the COVID-19 on the healthcare sector couldn’t be over- emphasised, as it came with its negatives and positives.

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Ohuabunwa said the impact of COVID-19 has been devastating. “As we write, no one can say when Nigeria will hit the peak after nearly nine weeks of lockdown and easing. We were slow in responding and when we began, we adopted very conservative procedures. Testing has been very slow and difficult to access. At a time, all the testing was done in Abuja, but even now, some states have no approved testing facilities,” he said.

“Hopefully, we have learnt our lessons and should be better prepared and more open and accommodating in the future.

“One good lesson learnt and which government seems to have taken, is the urgent need to look inwards for a solution to our problems.”

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