By Elizabeth Osayande

At the Lagos State University College of Medicine’s Health Symposium held this Tuesday, May 17, 2022, a prominent expert in infectious disease research offered invaluable perspectives on bolstering Nigeria’s public health infrastructure.

In an exclusive interview with Vanguard, Dr Olufemi Olulaja, a physician and researcher at the African Center of Excellence for Genomics of Infectious Diseases, ACEGID, Redeemers University, Ede, Nigeria, emphasized how insights gained from the COVID-19 pandemic can be harnessed to better prepare the nation for future health crises.

You played a frontline role in leading contact tracing efforts during the recent COVID-19 pandemic. What are the most significant lessons Nigeria learned regarding epidemic preparedness from this pandemic?

Nigeria’s most profound lessons from the COVID-19 pandemic in terms of epidemic preparedness include the need for robust and timely disease surveillance systems, effective communication strategies, and a well-coordinated national response that includes governments at all levels. The pandemic highlighted the value of strengthening healthcare infrastructure, including hospitals, laboratories, and emergency response systems, to handle future outbreaks. It also revealed the necessity for adequate stockpiles of medical supplies and personal protective equipment, which are required in large amounts.

Furthermore, the pandemic underscored the critical role of community engagement and public health education in ensuring compliance with health protocols. We learned that fostering collaborations between government, private sector, and international organizations is essential for a unified and rapid response. This is where each sector, including the private sector, plays a crucial role in preventing future outbreaks. The pandemic also revealed the need for investment in local vaccine production and research capabilities to reduce dependence on external sources during crises. The first set of Nigerians who received the COVID-19 vaccine had to travel abroad to get it; many other Nigerians only received the shot after it was available in Nigeria. Local production capacity would have ensured early vaccine intervention for Nigerians, too. These are some of the most significant lessons we learned during the recent pandemic that can help us strengthen our public health system.

How can Nigeria strengthen its disease surveillance systems to ensure early detection and rapid response to emerging infectious diseases?

We must invest in modern data collection tools and technologies, including real-time digital reporting platforms and mobile health applications, to track infectious diseases at the community level. Expanding the capacity of existing laboratories for rapid diagnostic testing and genomic sequencing is essential for the swift identification of new pathogens. At ACEGID, we currently have a pandemic preemption and prevention system that can help us detect viral threats before they spread. It uses advanced genomic technologies and can disseminate health information in real time. Nigeria needs to adopt similar initiatives across the country.

Also, training healthcare workers on surveillance best practices and ensuring timely reporting are key to ensuring data accuracy. Nigeria should enhance collaboration with international health organizations to promote knowledge sharing and support. Integrating a network of health centers and local governments into national surveillance efforts ensures broader coverage.

Additionally, implementing a robust data management system that facilitates quick decision-making and resource allocation can improve response times. Strengthening logistics for rapid response teams and stockpiling critical supplies are crucial for minimizing delays. Finally, ongoing public awareness campaigns can help communities recognize early symptoms and report cases promptly.

What role does genomic research, like that conducted at ACEGID, play in preventing future epidemics in Nigeria?

We are doing fantastic work at ACEGID by pioneering genomic research of infectious diseases in Nigeria and West Africa. Genomic research is critical in preventing future epidemics in Nigeria by enabling early detection, monitoring, and control of communicable diseases. Using sequencing technologies, we can identify new pathogens that were not previously known, track mutations, and unravel transmission dynamics.

This will ultimately help in designing effective diagnostics and treatments and in producing vaccines tailored to specific strains of pathogens. Genomic data can also help us monitor antimicrobial resistance and promote evidence-based public health policies. Nigeria can strengthen epidemic preparedness and safeguard population health by integrating genomic insights into public health systems.

What measures should be taken to enhance collaboration between federal, state, and local governments in epidemic preparedness?

During the recent pandemic, about two state governments did not believe SARS-CoV-2 existed. They declined to implement protective measures to safeguard the health of their residents despite available scientific and clinical evidence that substantiated the existence of a new virus. This scenario highlighted the need for better federal, state, and local government collaboration. Nigeria should establish clear communication channels and a unified response framework to enhance the cooperation between federal, state, and local governments in epidemic preparedness.

This involves developing standardized protocols for disease surveillance, reporting, and response across all levels of government. Regular training and simulation exercises can ensure that all stakeholders are prepared to act swiftly in the event of an outbreak.

Additionally, creating a central coordinating body for epidemic management can facilitate information sharing and resource allocation. Local governments should be empowered with the necessary tools and resources to monitor and respond to outbreaks. In contrast, federal and state governments must provide technical support and oversight. Collaborative planning and funding mechanisms are also crucial for building resilience across the healthcare system.

What strategies can Nigeria adopt to improve public trust in health authorities and increase compliance with public health measures?

To improve public trust in health authorities and increase compliance with public health measures, we must be transparent with the public by enlightening them on new developments as they unfold. During outbreaks of novel pathogens, there are limits to what is known about the new pathogen. Public health authorities must remain transparent about what is currently known and possible efforts being considered to contain the pathogen spread. When people believe they are being updated promptly about new developments, they are more likely to support government efforts and comply with health measures.

Additionally, the involvement of grassroots mobilizers and community gatekeepers are proven strategies that could increase compliance with public health measures since these individuals live and work closely with the community and have a level of influence on the people at the community level.

How important is local vaccine production to epidemic prevention, and what steps should Nigeria take to achieve this?

Currently, Nigeria has a low capacity for local vaccine production, but there are opportunities for growth in this regard. Since we already have the capacity for genomic sequencing, we only need to invest in vaccine manufacturing infrastructure, support research and development, and foster partnerships with local pharmaceuticals with the technical expertise for vaccine production.

Once these are done, we will have to strengthen regulatory frameworks and ensure compliance with international standards, as this will enhance trust in locally manufactured vaccines. Local pharmaceuticals can continue to build a skilled workforce for vaccine production while governments at all levels support creating an enabling environment for local pharmaceuticals to grow.

What role do public health education and community engagement play in preventing future outbreaks?

I am very happy and encouraged by the level of public health education and community engagement during the pandemic. An average Nigerian knows the basic information about COVID-19, such as symptoms of the disease, how it spreads, strategies to prevent spread, where to get tested, how to self-isolate if you believe you have symptoms, and where to get the vaccines. All stakeholders collaborated to defeat the deadly virus. Various religious organizations and civil society groups also organized health education sessions about COVID-19, in which they invited healthcare workers to educate their members.

That level of public education and engagement can easily defeat any future epidemic in Nigeria that night. When the vaccine rollout commenced, and some vaccine pessimists attempted to spread misinformation, the public did not buy into the narrative as many people visited their nearest primary health center to take the new vaccine. We can sustain such a level of public engagement across all disease prevention efforts, not just COVID-19.

What advice do you have for policymakers on integrating lessons from COVID-19 into national health policies and emergency response frameworks?

Policymakers should integrate lessons from COVID-19 by strengthening health systems by focusing on preparedness, rapid response, and resilience. This includes building robust disease surveillance networks, enhancing healthcare infrastructure, and ensuring timely access to vaccines and treatments.

Policies should emphasize cross-sector collaboration, clear communication, and transparency to foster public trust. Additionally, incorporating flexible emergency response frameworks that can adapt to new threats is essential. Continuous evaluation and adaptation of health policies based on evolving evidence will ensure sustained readiness for future health crises.