With Legislative Authority, Can Nigeria’s Centre for Disease Control Reach for Perfection?

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HealthPolitics and Policy

One of the low points of the Ebola outbreak in 2014 in Nigeria was the ease with which ‘bathing with salt water’ spread as the immunization against contracting the deadly virus. It might have been the work of mischief makers who leveraged social media  to propagate a false miracle cure. That rascality cost at least two lives, a terrible tragedy given what we know of how much some dedicated professionals did to minimize the damage.

Ebola’s impact in Nigeria could have been much worse. For twelve weeks and counting, on social media and in editorials, Nigerians have poured their hearts out remembering Ameyo Stella Adadevoh again, the physician whose ad hoc and selfless intervention – whose ultimate sacrifice – ensured the fatality from the outbreak was restricted to a fraction of what it could have been. Indeed the World Health Organisation acknowledged this, the Director-General at the time Margaret Chan effusive in her praise of the coordinated response strategy that built on the heroics of Dr Adadevoh and her colleagues. A potential nationwide catastrophe was averted and we should tell our children to tell their children about it.

We should also tell our children that Nigeria could not have contained Ebola so effectively without the Nigeria Centre for Disease Control (NCDC).

Created by President Goodluck Jonathan in 2011, the centre was to be the agency for handling public health emergencies in Nigeria. About a year after it was established, a polio outbreak was its first major test. Analysts and researchers have written that much of the structure that provided for the prompt response to Ebola was set by the NCDC’s polio response in 2012. In the seven years of the centre’s operation, Nigeria has effectively withstood being overwhelmed by globally dreaded epidemics, from Ebola and Lassa fever, to Zika virus and the return of Ebola this year in neighboring countries. By virtue of its performance, NCDC has to be one of Nigeria’s most responsive and well-oiled public agencies in the last half decade. In a country where citizens have become used to dysfunction, it stands as an outlier for good.

But until this week when President Muhammadu Buhari signed an Act of Establishment into law, the centre has largely operated as a part-time project. As though we have long internalized a variant of “prevention is better than cure but na something go kill person”, Nigeria’s most effective disease prevention and response agency has been without legal mandate for so long. It has relied all the while on the high sense of responsibility and professionalism of its leadership. Does that make it more impressive that they have been able to achieve significant strides in the years past? One would be inclined to agree but another might offer that strictures typical of bureaucracies learn to ease up in the face of life and death matters. Indeed, ‘fast and furious’ diseases have little patience for slow-moving memos and files.

That said, granting legal backing for the NCDC to operate is most welcome and indisputably necessary. Theoretically, it should now be able to perform its functions to the utmost even if at the risk of its efficiency being adulterated by increased ‘bureaucratricks’. Like other aspects of democratic development, good public works and common-good outcomes are best perpetuated by finding ways to institutionalize them within the scope of a nation’s canon. Dr Chikwe Ihekweazu’s team has done fantastically well; the only way to ensure their work continues beyond their direct involvement is to codify their procedures and make it law for their successors. It was responsible of the Buhari administration to have committed to public health security by sending a bill for the NCDC’s establishment to the National Assembly last year and of the lawmakers to have earnestly attended to it. If its contents were drafted in the national interest spirit of the Adadevohs of 2014, we may have got the first act of parliament since 1999 which many Nigerians will be inclined to revere.

Public health emergencies are, as the word suggests, unpredictable. Health experts around the world remain frustrated with the apparent sluggishness of the global health authorities in declaring that certain outbreaks be treated as emergencies. Global cooperation will continue to be relevant for Nigeria in handling public health emergencies. But the country must have its feet on sure ground with respect to what it must do should normally glassy potable water become colourful; Code Red has to be initiated authoritatively!

Thankfully, the NCDC has played this role admirably without the stability, authority and substantial empowerment that come with legislative sanction. Becoming a legally-backed organisation, it can be hoped, will make them reach for perfection, achieving their simple but invaluable mission: to prevent, detect and control communicable diseases in Nigeria.

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