Following the country’s cholera pandemic, Nigeria’s Federal Government yesterday commenced discussions with the Global Alliance for Vaccines and Immunization, or GAVI, to secure emergency supply of the oral cholera vaccine, or OCV, as the country fights the disease in the face of a global vaccine shortage.
Dr. Jide Idris, the director-general of the Nigeria Centre for Disease Control and Prevention (NCDC), made this announcement in Abuja. Prof. Muhammad Ali Pate, the Coordinating Minister of Health and Social Welfare, is in charge of the doscussions with GAVI.
The discovery coincided with the NCDC’s announcement yesterday of a surge in the number of deaths and the disease’s spread in 32 states and 115 federation local government units.
Nigeria uses three oral cholera vaccines that are pre-qualified by the World Health Organization (WHO): Euvichol-Plus, Shanchol, and Dukoral.
For total protection, two doses of each of the three vaccinations are needed, and they should only be given to individuals or groups that are at a high risk, such as visitors to regions where cholera is still spreading or residents of places where outbreaks are occurring.
Regarding the call for cholera vaccine emergency dosages, Idris stated:”GAVI, a global health partnership, plays a pivotal role in improving access to vaccines in low-income countries. Through these negotiations, Nigeria aims to secure an emergency supply of cholera vaccines to curb the outbreak.
“Cholera vaccines are not stocked in our public facilities, though they are available in limited quantities in the private sector. But vaccines alone are not the only preventative measures we have at the moment; we must also ensure environmental cleanliness and proper hand hygiene.”
Idris went on to say that there is a heavy scarcity of cholera vaccinations due to an increase in demand worldwide, regardless of the fact that efforts to contain outbreaks in endemic areas, such as Nigeria, have been hampered by the shortfall.
“Poor sanitation, inadequate clean water supply, and limited healthcare infrastructure have exacerbated the spread of the disease, but in response to the crisis, the NCDC has intensified its public health campaigns, emphasising hygiene practices and the importance of clean water.
“However, these measures alone are insufficient without adequate vaccination coverage. The shortage of vaccines has hampered mass immunisation campaigns, crucial for preventing the spread of cholera.
“The situation in Nigeria underscores broader issues of global health equity and preparedness. It highlights the necessity for increased vaccine production and distribution infrastructure investment,”
While noting that more vaccines were being ordered because of the scale of the problem, the NCDC D-G called for stronger international collaboration to ensure that life-saving vaccines reach the most vulnerable populations immediately.
He complained that cholera, an acute diarrheal illness brought on by consuming tainted food or water, continued to pose a serious threat to public health in Nigeria, where outbreaks had a devastating effect on multiple states, killing many people and overtaxing medical systems.
The WHO approved the distribution of more than 3.5 million oral cholera vaccine doses to Nigeria in 2021. The nation asked for nine million more doses of the vaccine in 2022. Depending on the kind of vaccine and the number of doses administered, cholera vaccination efficacy varies.
A single dose provides maximum protection, as advised by the World Health Organization (WHO), however two doses are typically more effective, according to experts. A single dosage for young children may require a booster in the third year, even if considerable protection lasts for at least three years.
In a similar event, the NCDC has reported that the recorded number of cholera deaths has increased and that the disease has spread to 115 local government units and 32 states throughout the federation.
In an update yesterday, Dr. Muntari Hassan, the National Incident Manager for cholera at the Center and Deputy Director of Surveillance at the NCDC, stated that since the year’s commencement, 1,579 suspected cases and 54 deaths had been recorded.
The organization said on Monday that as of June 24, 2024, there had been 1,528 suspected cases of cholera and 53 confirmed cases since the start of the year in 31 states and 107 LGAs in Nigeria, with a case fatality rate of 3.5%.
“The current number of people that died is at 54 right now, it’s gone up from 53 and the total number of cases that we have today is 1,579 across 32 states of the Federation, covering 115 local government areas.
“The situation is getting worse in terms of when you look at the number and when you look at the deaths, you can say it is getting worse, but when you look at the total number of reported cases and suspected cases, in this week of 25, it has reduced from what it was in the week of 24, but we are still having cases across the country.
“The worst affected states are Lagos, Bayelsa, Abia, Katsina and about two others, are the six top states that I can say are the worst affected and are the ones with the highest number, but basically,the ones with the highest numbers are Lagos and Bayelsa states.
“It is a multi-factorial; one can’t single out just one problem. Like for example, we may have potable drinking water, but somebody is defecating In the open and he has cholera, so essentially a change of attitude and habits of people, what we need to do ourselves then we can look for support from government. It requires education and that is why we have developed some jingles,” Dr. Muntari stated.
Recall that earlier, because of the rainy season, Nigeria was at significant danger of increasing cholera transmission and effects.
In order to establish a central response system, the NCDC nationwide activated its Emergency Operation Centre, or EOC. The deputy director emphasized that Nigeria is still a nation where cholera is endemic while outlining the significance of initiating emergency operations.
“We have been having sporadic cases all through, but when cases rise or we have an upsurge in cases, then there is a concern, which prompted us to conduct what we call dynamic risk assessment.
“We rank Nigeria as high risk, then there is a need for us to have a coordinated structure where we can have a multi-disciplinary, multi-sectoral response to any of the epidemic diseases, not only cholera.
“We rank Nigeria as high risk, then there is a need for us to have a coordinated structure where we can have a multi-disciplinary, multi-sectoral response to any of the epidemic diseases, not only cholera.
“So the Director-General of the NCDC, Dr Jide Idris, inaugurated an Emergency Operations Centre yesterday and appointed an incident manager for the response. The essence of this is to have a well-coordinated response.
The Emergency Operations Centre comprises the NCDC, the other ministries, departments and agencies like the Federal Ministry of Health, Federal Ministry of Environment, Federal Ministry of Water Resources, WHO, UNICEF, MSF, among a host of others. This response is multi-sectoral.”.
In the first eight months of 2023, Nigeria grappled with a major cholera outbreak that resulted in over 3,000 suspected cases, with some areas being particularly heavily hit. Over 2,860 suspected cases and 84 deaths across 25 states were reported by the middle of the year, yielding a 2.9% Case Fatality Ratio. Zamfara (787 cases), Cross River (718 cases), and Katsina (302 cases) were the states most hit. Comparing the same time in 2023 to 2024, the NCDC recorded a 62% drop in suspected cases.
Health experts credit the decrease to the efficiency of the controls that were put in place.
Lagos State Governor Babajide Sanwo-Olu yesterday connected the state’s contaminated water supply and declining community hygiene to the cholera outbreak’s expansion.
This was said by the governor during the Victoria Island-hosted 2024 Lagos International Water Conference.
According to Sanwo-Olu, if the state administration had not taken preemptive measures to contain the spread of the water-borne pandemic, the current cholera catastrophe in the nation would have gotten out of hand.
The governor said that the country would have been facing the “catastrophic consequence” of the epidemic’s recurrence if not for the prompt activation of the state’s incident command mechanism and surveillance system to contain the infectious sickness.
“Today, we are talking about cholera outbreak and we have seen the disease spread in last couple of weeks with not too serious fatalities like we had during COVID-19.
In a similar incident, all supermarkets and retailers in the state were instructed yesterday by the Lagos State Consumer Protection Agency, or LASCOPA, to make sure that vital information on consumable products was prominently displayed as a means of preventing the spread of cholera.
As of June 23, Lagos had reported 579 confirmed cases of cholera and 29 confirmed deaths. Afolabi Solebo, General Manager of LASCOPA, was cited by agency spokeswoman Toyin Oni as mandating that products must display information, such as the NAFDAC registration number, to determine whether they had received regulatory approval.
In order to demonstrate transparency regarding the shelf life of products, Solebo additionally mandated that the dates of manufacture and expiration be prominently displayed.
“Solebo informed that the manufacturer’s address must also be included on products at all supermarkets in the state to facilitate traceability and accountability. He warned that failure to comply with these regulations would result in the immediate closure of affected supermarkets or stores.
“The General Manager maintained that the PLO proactive measure is crucial in preventing the spread of cholera and ensuring consumers have access to safe and regulated products and restated the agency’s commitment to protecting consumers’ rights and ensuring adherence to health standards during this critical period,” Solebo said.
In keeping with their rights and obligations, he further exhorted all customers to be watchful and notify LASCOPA of any instances of non-compliance so that swift action can be taken.
The bacteria Vibrio cholerae is the source of the infectious disease cholera, which is mainly transmitted by tainted food and drink. Severe diarrhea (“rice water stool”), weakness, cramping in the muscles, fever, vomiting, and dehydration are typical symptoms.
Poor hand hygiene, such as not washing hands after using the restroom and then handling food, can transmit the cholera bacteria. It can also spread by drinking untreated water and consuming tainted food. Opportunities for microorganisms to contaminate water supplies are created by open defecation, overflowing sewage systems, and inappropriate waste disposal.
Many people consider Nigeria to be the world leader in open defecation. According to data from the 2021 WASH National Outcome Routine Mapping, or WASH-NORM, almost 100 million Nigerians, or 48 million people, lack access to basic sanitation facilities and urinate outside.
Every year, the Federal Ministry of Water Resources and the National Bureau of Statistics collaborate to produce the WASH-NORM report, which tracks advancements made toward national objectives with assistance from UNICEF, the World Bank, WHO, and other development partners. It disclosed the startling expense of Nigeria’s inadequate sanitation, which results in an annual loss of 1.3% of GDP, or around N455 billion.
Impacts on productivity and healthcare spending are to blame for this loss.
This trash ends up in rivers and streams, which are many communities’ main supplies of drinking water, when it rains. Bacteria that cause cholera grow in abundance in this tainted water. In Nigeria, open defecation is a common practice, especially in rural areas and densely populated slums. This combines with inadequate hygienic practices and sanitation systems to produce an ideal environment for cholera outbreaks.
