By Adaobi Ezeokoli & Thelma Thomas (Lead Writers)
Every year since 2015, Nigeria Health Watch has organised the Future of Health Conference, our flagship event, to focus conversation and curate insights, evidence and a framework for action on critical topical health sector issues.
With the COVID-19 pandemic disrupting not just the health sector, but social, economic, and political life across the world, we felt we ought to use the privilege of being able to act as a convener with important connections in the Nigerian health space to address the issue. To explore what COVID-19 means for the health sector, for Nigeria and for Africa, and how we can, and are responding to the pandemic, we teamed up with sister organisation and public health consulting firm EpiAFRIC to hold the first Future of Health Webinar, on “Innovation in the Global Fight Against COVID-19”, on Thursday May 7th, 2020.
EpiAFRIC recently launched its COVID-19 Global Response Database. A database of innovations being developed or adapted across the world in the fight against COVID-19, it aims to harness potential solutions that could help the globe tackle pandemics more effectively in the future by providing a portal for successful innovations.
The inaugural Future of Health Webinar was to highlight some of the work being done in different spaces — public, private and community level — making use of dynamic innovations to tackle COVID-19. The Chief Executive Officer (CEO) at EpiAFRIC, Dr Ifeanyi Nsofor, moderating, reminded everyone at the beginning of the webinar that “Innovation is not rocket science”.
Speakers included Prof. Lynn Morris, Interim Executive Director of the National Institute for Communicable Diseases (NICD) and Principal Medical Scientist in the HIV Virology Section at the NICD in South Africa; Dr Abasi Ene-Obong, Founder and Chief Executive Officer of 54gene, a genomics research, services and development company; and Mr Collins Akanno, Founder Diet234.com, who launched the initiative, Communeating, to scale up nutrition awareness and education in Nigeria.
Molecular diagnostic labs — Nigeria was “caught unprepared”
Ene-Obong said 54gene was established to significantly improve the inclusion of African populations in clinical global genomics research. He pointed out that before the COVID-19 outbreak, Nigeria had less than 15 laboratories with the capacity for molecular diagnosis, and there were few high level clinical diagnostic labs in Nigeria. “By the time the (COVID-19) crisis hit, Nigeria had somewhere around 200–300 test capacity per day, for a country of an estimated 200 million people. So the entire country was caught unprepared,” he said.
54gene had started doing molecular diagnostics prior to COVID-19 using PCR, he said, and took several steps to help mitigate the situation Nigeria was in when the outbreak hit. Working in partnership with public agencies, they raised funds from private sector partners to equip government laboratories. “We bought a number of PCR machines, low to high tribute machines, 48 samples and 383 samples format,” he said, adding, “What this means, is that on the low end you can do 40 tests at once and on the high end you can do 400 tests at once every two hours”. The company also modified its lab in Lagos State, the epicentre of the outbreak, and repurposed it to test only COVID-19 cases, the country’s priority in face of the pandemic.
Challenges the team had to tackle in the midst of innovating for COVID-19, included the lack of proper equipment and properly skilled staff. Ene-Obong said they had to buy equipment and train the workforce in using it from scratch. Eventually, they set up and moved labs to Ogun and Kano states, with funding for the molecular diagnostic labs coming from partners, and the next step is automation of the labs. “Within the next one to two weeks, we should double our capacity to test,” he added.
Adapting to fight: HIV/TB structure used to tackle COVID-19 in South Africa
South Africa’s National Institute for Communicable Diseases is responsible for carrying out tests in the country. Prof. Morris said South Africa’s first case was confirmed on March 5, 2020, and three weeks later the country was put under a stringent lockdown. “Unfortunately, we have had 153 deaths and over 8,000 cases,” she said during the webinar. As at publication, South Africa has 10,652 confirmed cases and 206 deaths.
She said South Africa has been able to modify their existing structure to fight COVID-19. “The structure of HIV and TB has been used to manage COVID-19 cases,” she said, adding, “One of the things that we do is routine respiratory diseases surveillance and we plugged into the routine surveillance. That has given us a sense of where we are.”
Morris also pointed out that the NICD has a program where they go into communities to look for cases and once identified make referrals.
“We know that as the lockdown starts to ease, we will see many cases, but like many countries, we have time to prepare for it,” she said.
She commended the progress of African countries in the area of genomic sequencing. “We have been sequencing the virus and it is done in real time. On the African continent there has been quite remarkable progress. Congo, Senegal, Ghana and SA have contributed some sequencing. This is to monitor the virus as it spreads. Remarkably, this virus is not like HIV, it is much more stable,” she said.
The NICD is also carrying out serological testing, evaluating the anti-bodies to know exactly how many people are actually infected, Morris said. “This will help us support vaccine production. We have harnessed our knowledge from HIV and TB in the fight against COVID-19.”
She pointed out that getting access to test kits in the middle of a global pandemic was difficult. “Dependence on the rest of the world to get things done has been quite tough in this crisis. Getting test kits has been difficult. I think our manufacturing capacity really needs to be invested in,” she said.
Harnessing the power of social media and technology… for social good
Mr. Collins Akanno, popularly known as “The Diet Doctor” said Diet234.com helps scale up nutrition awareness through programs and seminars in low-and-middle-income communities. Their plans screeched to a halt with the arrival of COVID-19 in Nigeria. “Earlier this year our community program was struck by challenges thanks to COVID-19,” Akanno said. With restrictions on movement and social distancing measures in Lagos State, their in-person programmes had to stop.
Rather than simply go home and wait, Akanno and his team looked for a way to keep their program alive. “To mitigate the challenges, we used social media and adopted community volunteering,” he said. “We used WhatsApp, graphics and polls, and developed an online community. We created platforms where people can come on to give free advice about nutrition.”
The platform the team created was called Communeating. “Every one of our activities is carried out on our platform,” he said, adding, “If you are interested in making a poster to sponsor a family food bag, (for families with difficulty getting food during the lockdown) you can go online and make a poster, tag friends and aggregate funds together to get a family food bag. A family food bag costs N5,000.”
This initiative aligned with the desire of many Nigerians to do something to help, and they were pleasantly surprised by the passion to get food items to people during the COVID-19 outbreak and they leveraged on it. “We partnered with a delivery company that picks up food items and takes to the community where it is needed. We get real time feedback from the community chief in the intervention area,” Akanno said, adding that the entire foodbank is online, and their target is to feed 500 families. “So far, we have been able to reach 120 families with food items,” he said..
Innovation is new, but it is not rocket science
Ene-Obong noted that we need to start looking at ways of supporting many of the things that happen within Africa. “Innovation is a new way of life for everybody. We must think of how to do things better in order to survive and that is innovation,” he said. Akanno surmised that COVID-19 dealt Africa a blow, and to get to a new sense of normalcy, “We must collaborate to fight COVID-19.” Prof Morris said difficult times force innovative solutions. “With all these desperate shortages, innovation really will come. People will develop new and cheaper ways of doing things,” she said.
Often when people think of innovation, technological marvels we have never seen before come to mind, such as seen in science fiction movies. The inaugural Future of Health webinar showed how, sometimes, innovation does not require creating something new, but simply adapting, collaborating, and utilizing existing tools to solve problems.
Dr. Nsofor ended as he began, reiterating that innovation is not rocket science, and that everyone has the capacity to develop innovations “All of us should innovate, it is not rocket science,” he said, adding, “Look within the work that you do on a personal basis and see how you can do things better.”
And as each of us looks at how we can do things better, we begin the journey towards ensuring our communities, countries, and continent, curbs the spread of coronavirus. Innovate today, for a COVID-free tomorrow.
Have you seen a great example of an innovation for COVID-19? How are you innovating to tackle COVID-19? Share with us below or on social media, @nighealthwatch on Twitter and @nigeriahealthwatch on Facebook and Instagram using the hashtag #Innovate4COVID19. You can also enter details of any innovation you know into the COVID-19 Global Response Database.