Health Workers Combat Lassa Fever

Since August last year, the country has witnessed a fresh outbreak of Lassa fever, which has thus far claimed over 100 lives, according to the National Centre for Disease Control. With at least 175 reported cases in about 19 states, in 2016, this is one of the worst epidemics of the Lassa haemorrhagic fever (LHF) in recent years. Members of the Medical and Health Workers’ Union (MHWUN) in all the states affected, have been at the fore of combating this deadly menace.

LHF is an endemic fever in the West African sub-region. It was first identified in Lassa town, Borno state in 1969. The fever is caused by the Lassa virus (LASV) which is an arenavirus i.e. viruses that particularly infect rodents. At least eight of these arenaviruses, which includes LASV, are zoonotic i.e. they could be passed on to humans from infected rodents.

The Lassa virus is spread by the multimammate rat (Mastomys natalensis), which is one of the most common rats in many households. Between 300,000 and 500,000 persons are infected annually in West and Central Africa, resulting in an average of 5,000 deaths, each year. This is because the disease tends to be asymptomatic in over 80% of infected persons i.e. they do not show any symptom and appear to be well, while being carriers. But they could then transmit the disease to other persons.

The extent to which the current outbreak has impacted on the country would have been very limited if as much concern as was given in establishing the Ebola Virus Disease (EVD) response two years ago, had been provided by the Federal Ministry of Health. Between August and the end of last year, 375 cases were reported with 12 deaths in 10 states. But it was not until January 2016 that an official declaration of an epidemic status of LHF was made by the ministry.

This could arguably be because of the rather endemic nature of the LHF. In 2012, for example, there were 1,723 reported cases, with 112 deaths recorded. But this questionable argument cannot but be fraught with a sense of not learning the right lessons from the EVD experience, which is that, a stitch in time saves nine. A more serious approach can be seen in the Republic of Benin. On January 25, 2016, just four days after detecting a fresh outbreak of LHF, the country’s ministry of health immediately declared an epidemic. This has helped in curtailing the outbreak in that country. 71 cases have been reported, with 2 deaths.

More importantly, the continued prevalence of Lassa fever in the sub-region can be traced to the grossly inadequate funding of medical and health research as well as the comatose state of infrastructure for public healthcare delivery. It is shocking that almost half a century after LHF was discovered in a sovereign state of Nigeria, a vaccine for the Lassa Virus (LASV) is yet to be developed. We are all living witnesses to how efforts at fast-tracking vaccine trials for Ebola were made in North America when EVD became a cause of concern globally, after a number of Europeans and North Americans were infected.

Neoliberal policies of privatisation and cuts in the funding of social services have had serious adverse effects on crisis preparedness in the health sector. A Federal Vaccine Production Laboratory (FVPL) had been established at Yaba, Lagos in 1947, which was during the period of colonialism. For decades it was the major centre for the production of yellow fever, smallpox and rabies vaccines, for Nigeria and other West African countries.

But the Laboratory was privatised in a “Public Private Partnership” deal with the health transnational corporation, May and Baker. Since 2005 when the PPP company known as Biovaccine Nigeria Ltd was formed, with May and Baker having controlling shares, not a single vaccine has been produced. Yet, Nigeria spends not less than N12bn annually on vaccines.

For years, MHWUN challenged the drive towards privatising the FVPL. The union argued that what was needed were more concerted efforts at revitalising the Laboratory towards enhancing the country’s health crisis preparedness, by expanding research and production work in the establishment and building greater synergy between it and related institutes such as the National Institute for Medical Research, also at Yaba, and the National Veterinary Institute in Vom, Plateau state.

Such concerted efforts require improved funding and the involvement of all stakeholders, including the unions in the decision-making processes and structures of these critical medical and health bodies. Stronger ties of South-South collaboration such as those experimented with in the 1990s between Nigeria and Brazil, to build the capacities of FVPL should also be further explored.

The present epidemic, which health workers have taken up the gauntlet of fighting, is an opportunity for the Nigerian state to reconsider its surrender to the neoliberal prescriptions of international financial institutions, which primarily benefit the rich bosses and transnational corporations like May and Baker. It is poor working class-people that bear the brunt of a health system whose effectivity is stunted as a result of privatisation. Health is a fundamental human right, which can be guaranteed only by keeping healthcare delivery public.