Health Hub: 2019 in retrospect

By Lantana Nasir

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As the year 2019, closes its chapter, here are some major health events that made headlines in Nigeria and around the globe.

Nigeria health sector, despite its challenges has recorded success in handling some health issues in 2019

The Enugu State Government said it recorded over 98.5 per cent success in the just concluded statewide Meningitis A vaccination.

It can be recalled that government had targeted one million children aged between one year and five years for Meningitis A vaccination was officially scheduled from December 6 to December 11, 2019.

Dr. George Ugwu, Executive Secretary of Enugu State Primary Health Care Development Agency (ENS-PHCDA), said that the Meningitis A vaccination campaign was one of the best and most successful campaigns of the agency in 2019.

Another pressing issue in Nigerian health sector in 2019, is the concessioning and privatisation of the major Federal Health Institutions in the country.

The development has elicited concerns among stakeholders in the industry and as 2019 draws to a close, health workers under the aegis of the Joint Health Sector Unions and Assembly of Healthcare Professional Associations, JOHESU/AHPA, have called for the scrapping of the plan to privatize the federal health institutions in the country.

Three years without a case of wild polio virus

On August 21st 2019, major milestone in the history of Nigeria’s Polio Eradication Programme was marked, as the country reaches 3 years without reporting a case of wild poliovirus.

In a Press Conference, the Executive Director of the National Primary Health Care Development Agency (NPHCDA), Dr Faisal Shuaib, whilst acknowledging that Nigeria passing the three-year benchmark without a single wild polio virus case is a step forward to certifying the entire African region wild poliovirus-free.

“This achievement would certainly not have been possible without the novel strategies adopted in the consistent fight against polio and other vaccine preventable diseases. We commend the strong domestic and global financing and the commitment of government at all levels.

Since the last outbreak of wild polio in 2016 in the northeast, Nigeria has strengthened supplementary immunization activities and routine immunization, implemented innovative strategies to vaccinate hard-to-reach children and improved acute flaccid paralysis (AFP) and environmental surveillance,” The Executive Director of NPHCDA said.

Vaccination of Nomadic in Northern cross-border areas

Another major health event in 2019 is the renewed efforts to vaccinate children traversing in and out of Nigeria, the World Health Organization (WHO) is supporting the government in an initiative to improve supplemental and routine immunization activities in the North Western region, which has a significant nomadic population.

Nomadic pastoralists live beyond the reach of established health care programs that are designed to serve sedentary populations. As a result, these groups are often under-immunized and out of the reach of existing disease surveillance activities.

Reaching the nomadic population in the cross border areas of the North Western region has been particularly difficult due to the nature of the population which involves settling in hard to reach and sometimes security compromised areas, making the zone the highest with under-immunized children in the country.

Jigawa and Katsina states in particular are maximizing efforts in reaching these populations by identifying major migrant groups and characterizing the movement of nomadic populations in the region for effective administration of vaccines.

In collaboration with Katsina State government, WHO has intensified efforts to reach nomadic communities across the state with immunization services, sensitization on prompt disease reporting and on the need to access health care services. The nomadic settlements span across 14 Local Government Areas (LGAs), wards and settlements passing through international borders with Niger republic. LGAs with nomadic routes include: Baure, Dutsinma, Kafur, Ingawa, Kaita, Jibia, Mashi, Charanchi, Musawa, Batsari, Maiadua, Zango, Danja, Kusada LGAs among others.

On the global scale

Just like years past, in 2019 the world is facing multiple health challenges. These range from outbreaks of vaccine-preventable diseases like measles and diphtheria, increasing reports of drug-resistant pathogens, growing rates of obesity and physical inactivity to the health impacts of environmental pollution and climate change and multiple humanitarian crises.

To address these and other threats, 2019 sees the start of the World Health Organization’s new 5-year strategic plan the 13th General Programme of Work.

This plan focuses on a triple billion target: ensuring 1 billion more people benefit from access to universal health coverage, 1 billion more people are protected from health emergencies and 1 billion more people enjoy better health and well-being. Reaching this goal will require addressing the threats to health from a variety of angles.

Here are some of the many issues that got the attention of WHO and other health stakeholders in 2019.

Air pollution and climate change

Nine out of ten people breathe polluted air every day. In 2019, air pollution is considered by WHO as the greatest environmental risk to health. Microscopic pollutants in the air can penetrate respiratory and circulatory systems, damaging the lungs, heart and brain, killing 7 million people prematurely every year from diseases such as cancer, stroke, heart and lung disease. Around 90% of these deaths are in low- and middle-income countries, with high volumes of emissions from industry, transport and agriculture, as well as dirty cookstoves and fuels in homes.

The primary cause of air pollution (burning fossil fuels) is also a major contributor to climate change, which impacts people’s health in different ways. Between 2030 and 2050, climate change is expected to cause 250 000 additional deaths per year, from malnutrition, malaria, diarrhoea and heat stress.

Antimicrobial resistance

The development of antibiotics, antivirals and antimalarials are some of modern medicine’s greatest successes. Now, time with these drugs is running out. Antimicrobial resistance the ability of bacteria, parasites, viruses and fungi to resist these medicines threatens to send us back to a time when we were unable to easily treat infections such as pneumonia, tuberculosis, gonorrhoea, and salmonellosis. The inability to prevent infections could seriously compromise surgery and procedures such as chemotherapy.

Resistance to tuberculosis drugs is a formidable obstacle to fighting a disease that causes around 10 million people to fall ill, and 1.6 million to die, every year. In 2017, around 600 000 cases of tuberculosis were resistant to rifampicin – the most effective first-line drug – and 82% of these people had multidrug-resistant tuberculosis.

Drug resistance is driven by the overuse of antimicrobials in people, but also in animals, especially those used for food production, as well as in the environment. WHO is working with these sectors to implement a global action plan to tackle antimicrobial resistance by increasing awareness and knowledge, reducing infection, and encouraging prudent use of antimicrobials.

On December 10th, 2019, The Stop TB Partnership launched the Global Plan to End TB 2018-2022, which calls for 2.6 billion USD per year for vital research and development of new tuberculosis (TB) diagnostic tools, new drug regimens and a new vaccine, and 13 billion USD per year for TB care and prevention. With the new Global Plan, the Stop TB Partnership is also launched the largest ever call for proposals, 2.5 million USD, to fund grassroot organizations as part of the TB response as well as new, child-friendly drug-resistant TB treatments.

A growing health crisis

In November 2019, the Centers for Disease Control and Prevention (CDC) released the newest data on antibiotics.

The situation is dire indeed: According to the newest data, more than 2.8 million people in the United States experience an infection from antibiotic resistant bacteria each year. Moreover, these “superbugs” cause 35,000 deaths per year in the country.

While medical research has helped us overcome many health threats, we now face a new type of crisis: Many dangerous bacteria are becoming resistant to the drugs meant to fight them.

Healthcare professionals frequently use antibiotics to treat many forms of bacterial infection from those that are mild to those that are potentially life threatening.

When a doctor finds that a bacterial infection is not responding to traditional antibiotic treatment, they are forced to use stronger, more aggressive antibiotics or antibiotic combinations, an increasingly restrictive approach that can also bring about unwanted effects on health.

“Antibiotic resistance has long been a problem, but the threats we face are real, immediate, and demand immediate action. Antibiotic resistance threatens modern medicine our ability to safely perform routine surgeries and complicated organ transplants, as well as chemotherapy, all rely on the ability to prevent and treat infections,” Dr. Jesse Jacob said.

The Way Forward

In the face of this growing threat, policymakers have been pushing for a more careful use of antibiotics in general, while researchers have been searching for treatments that could effectively fight antibiotic resistant bacteria.

“More and more studies suggest ‘shorter is better,’ in terms of how long to treat common infections, but we need more evidence for many of the more complicated infections.

We need research to find new drugs but can’t rely on a pipeline of new drugs alone to solve this problem, since resistance eventually happens to all drugs,” Dr Jacob said.

What, then, should doctors do? According to Dr. Jacob,

“Healthcare professionals can prevent infections by cleaning their hands and following infection prevention practices, using antibiotics appropriately (only when needed, for the minimum effective duration), vaccinating patients, and communicating between facilities to ensure awareness.”