Minister of Health releases updated EVD status of Nigeria, gives details of FG's containment efforts
FEDERAL REPUBLIC OF NIGERIA STATEMENT OF THE HONOURABLE MINISTER OF HEALTH, PROFESSOR C.O. ONYEBUCHI CHUKWU AT THE 2ND EMERGENCY NATIONAL COUNCIL ON HEALTH MEETING ON EBOLA VIRUS DISEASE OUTBREAK IN NIGERIA AT THE BACELONA HOTEL, WUSE II, ABUJA 1ST SEPTEMBER, 2014
I welcome all members of the National Council on Health to our 2nd Emergency meeting on Ebola Virus Disease (EVD), which although we are making significant progress in curtailing its spread, still remains a National Health Emergency and an International Public Health Emergency by the World Health Organisation (WHO).
UPDATE ON THE CURRENT STATUS
As you are aware, Nigeria’s performance in curtailing the spread of EVD has been lauded by all stakeholders.
As of 31st August, 2014, the total number of cases of EVD in Nigeria stands at sixteen (16). The total number of cases treated at the isolation ward in Lagos State stands at thirteen (13). The total number of those discharged is seven (7). The total number of deaths among those treated in Lagos is five (5), and the total number currently under treatment in Lagos is two (2) and both patients are stable.
The three (3) confirmed cases not treated in Lagos comprise:
1. A surviving primary contact of the index case(Patrick Sawyer): an ECOWAS Commission staff who became symptomatic, evaded surveillance in Lagos, travelled to Port Harcourt and infected his attending physician. Presently, he does not have viraemia but other laboratory tests for antibodies confirm that he had suffered from EVD. He is under quarantine in Lagos at the moment undergoing further tests to ensure he is totally free from the virus.
2. A private medical practitioner who was infected while treating the ECOWAS Commission staff. He died from EVD. It was his death that led to the investigation that revealed the introduction of EVD to Port Harcourt and the beginning of contact tracing of secondary and third degree contacts in Port Harcourt. Arrangements are being made to decontaminate the body in readiness for proper disposal of his remains. His death brings to six the total number of persons who have died from EVD in Nigeria.
3. A female patient who was on admission in the same hospital where the late Port Harcourt Doctor was also admitted. She is presently under treatment in the Isolation ward in Rivers State.
Two other contacts of the late Port Harcourt doctor(one of the Doctors who managed him and a pharmacy technician working in the late Doctor’s hospital) are symptomatic and have been admitted in the Isolation ward in Rivers State. They have tested negative to the EVD but the laboratory tests will be repeated to reconfirm their status.
Now as of 31st August, 2014, the number of contacts under surveillance in Lagos stands at 72 while in Port Harcourt, the total number of contacts under surveillance stands at 199. There is nobody under surveillance in Enugu presently and no case of EVD in Enugu State. As of 31st August, 2014, 278 contacts in Lagos State had completed the 21 days surveillance and have been discharged from surveillance. While in Enugu, all the six identified contacts have completed the 21 day observation period and have been discharged from surveillance. No contact in Port Harcourt has completed the 21 day observation period.
It is expected that a few more contacts will develop the EVD especially in Rivers State before Nigeria will see the last case of EVD. While it is encouraging that so far, all confirmed cases of EVD in Nigeria have their roots in the index case, Mr. Patrick Sawyer, great vigilance is required particularly at our ports of entry to ensure we do not have cases of EVD from other sources other than Mr. Sawyer.
Just as in Lagos State, the Incident Management Committee has deployed a strong team to Rivers State to work with the Rivers State Government and just as the situation has been effectively managed in Lagos and Enugu, the situation in Port Harcourt will similarly be effectively managed and we have begun to do so.
Our strategies for containing the EVD in Nigeria have remained the same, focusing on appropriate information, education and communication; sustaining our surveillance systems; provision and equipping of isolation wards/centres; provision of adequate care for confirmed cases; active and aggressive contact tracing; and reduction in harmful practices that promote the spread of the virus.
In line with the resolutions of the last emergency NCH, I am happy to report the following progress:
We have further strengthened our Emergency Operations Centre in Lagos with support from the Dangote Foundation which has made available one hundred and fifty two million naira (NGN152m) for the operations of the EOC. On our part, we have continued to ensure that workers at the EOC have requisite knowledge to stay safe while helping to keep track of and provide care for EVD patients. We have also ensured that the workers have been receiving their incentives.
We have now concluded plans to conduct two major trainings in all the states. The states are however expected to cascade these trainings down to the LGAs with support from the development partners, whom we are already talking with in this regard among others. These trainings are as follows:
i. Training of Trainer (TOT) for Health Workers on the Ebola Virus Disease (EVD) outbreak and other Viral Haemorrhagic Fevers (VHFs)
ii. TOT for State Health Educators on awareness creation, community sensitization and mobilization. Arrangement has been made to include the military and para-military in the training.
The Nigeria Centre for Disease Control (NCDC) has received approval for the re-production of copies of the protocols and SOPs for management of EVD cases as well as protocol for submitting samples to the laboratories and burying of EVD victims. These will be circulated shortly after this meeting to all the states.
The Federal Government considers it very important to have the right Personal Protective Equipment (PPE) in ensuring adequate protection for our health care workers. We have also decided that all PPEs to be bought should be in line with specifications provided by the WHO. It was also decided that PPEs will only be procured from WHO recommended manufacturers/suppliers. WHO has already supplied us with over 6000 PPEs which we are currently using. However, we have already initiated discussions with the WHO for the procurement of 4000 basic PPEs and 500 Heavy Duty PPEs (for use by the morticians).
We have steadily been increasing the capacity to diagnose Ebola Virus Disease. Presently, EVD can be diagnosed in the following locations:
1) NCDC laboratory, Asokoro, Abuja;
2) NCDC laboratory at LUTH, Lagos;
3) NCDC laboratory at University College Hospital, Ibadan;
4) Irrua Specialist Teaching Hospital Irrua, Edo State;
5) Virology laboratory of Redeemers University,Ogun State;
6) The Irrua-based mobile laboratory which has now been relocated from Enugu to Port Harcourt.
Plans are at advanced stage to enable the following laboratories:
* NCDC laboratory at Aminu Kano Teaching Hospital, Kano;
* NCDC laboratory at University of Port Harcourt Teaching Hospital, Port Harcourt.
The Federal Ministry of Health plans to procure additional mobile laboratories to be based in the following locations: Abakaliki, Port Harcourt, Bauchi, Jos and Sokoto.
The Federal Ministry of Health has met with representatives of the following associations to sensitize them on EVD and secure their collaboration:
• National Association of Road Transport Owners
• National Union of Road Transport Workers
• Association of General and Private Medical Practitioners of Nigeria
• Guild of Medical Directors
We have also met with and briefed the Heads of Diplomatic Missions in Nigeria.
Mr. President convened and presided over a meeting with State Governors and the Minister of the Federal Capital Territory Administration accompanied by their Commissioners for Health. The Minister of Health made a presentation to the meeting while the Country Representative of the WHO and the Project Director of NCDC respectively addressed the meeting.
We have also planned other meetings with key stakeholders such as:
• Women groups including market women;
• Health Development Partners Group;
• Representatives of the hospitality industry and;
• Federal tertiary hospitals.
I am happy to report that in addition to the support the Dangote Foundation is giving to the Ebola Emergency Operations Centre in Lagos, the Foundation plans to support us with whole body scanners to be deployed at our ports of entry and exit. The US Government through its Ambassador to Nigeria had earlier informed the Honourable Minister of Health that it will support Nigeria with 30 body scanners but they are yet to be delivered.
Other support had come from the following:
• US CDC: Donated 35 nos. Handheld Infrared thermometers to the Nigeria Field Epidemiology and Laboratory Training Programme and 30 nos to the Port Health Service;
• Nigeria Customs Service:165 Complete sets of tents to be deployed to border posts to reinforce our disease surveillance at the ground crossing;
• Shell Petroleum donated an ambulance to the EOC and 10 handheld infrared thermometers to our Port Health Service;
• Total Nigeria donated 5 Vehicles to the EOC in Lagos;
• Tony Elumelu Foundation pledged a donation of N50million;
• Chief Olisa Metuh made a donation of N1 million to the Nigeria Centre for Disease Control;
• Mr. Atedo Peterside's ANAP Foundation is supporting affected private hospitals which complied with the policy of seeing all patients but reporting suspected cases of EVD with the sum of N100,000 per bed space per day for the period the hospital was closed for decontamination. Already, First Consultant Hospital in Lagos has benefited under this scheme to the tune of N8 million.
• The Federal Ministry of Health has also proposed a special fund to support such affected hospitals.
• The Federal Government made a direct financial support to Lagos State to the tune of N200 million.
Our technical teams have also concluded analysis of options for equipping our isolation wards as identified at the last meeting. At this meeting we shall receive updates on the status of the isolation wards in the states, after which the FMoH will conclude arrangements and issue the contracts for the refurbishment and equipping of sites identified to serve as isolation wards. We are aware that available resources may not be sufficient. Therefore, we shall prioritise and also explore the possibility of development partners supporting this work in some states.
The Federal Government has since implemented the Council’s resolution banning the repatriation of corpses into Nigeria as well as inter-state transportation of corpses. However, waivers are being granted by the Minister of Health in appropriate cases (non Ebola Virus Disease or Lassa fever related deaths).
Lastly, we are happy to report, as you all are aware, that the Nigerian Medical Association (NMA) has now suspended its strike as urged by Council at its last meeting. Furthermore, following appeals by a number of Nigerians, the suspension of Residency Training Programme in Federal hospitals has been lifted and affected residents reinstated. The on-going appraisal of the Residency Training Programme will continue and a meeting of key stakeholders has been scheduled for Tuesday, 2nd September, 2014.
While thanking Mr. President for his magnanimity in lifting the suspension of the Residency Training Programme, I would like to express my appreciation to the President of the Senate of the Federal Republic of Nigeria whose intervention was key to the resolution of the industrial crisis.
Distinguished Council members, despite these achievements, we are aware that there is still a lot of work to be done. We must sustain our current momentum, ensure that the outbreak in Rivers State is resolutely contained and strengthen systems across all the states to handle any eventuality now and in the future.
The Treatment Research Group (TRG) which I had informed you about, has been working hard to identify experimental drugs like Zmapp, and also make recommendations to government on further research on these drugs as well as vaccines for EVD treatment and prevention.
Following the TRG’s recommendation and in consultation with NAFDAC and NHREC, Nigeria has indicated interest to participate in the clinical trials for two candidate EVD vaccines and are considering a third that may be added to the list. We have also applied for experimental drugs such as TKM-Ebola.
The TRG has submitted a detailed profile and brief on the oral antiviral agent which the Japanese Government has offered to make available to affected countries through the WHO. We are now considering this profile and brief to enable us reach a final decision on making it available to our patients. Our initial knowledge of the agent is that it has been shown to have strong antiviral activity against the influenza virus following phases I and II human trials, it is now going through phase III clinical trials; it is shown to have strong antiviral property against Ebola Virus in vitro and in vivo. These and the fact that it is considered safe, having passed through phases I and II clinical trials, makes it a good candidate drug for use in emergency situations as the EVD.
As is evident from this update, we are taking a holistic approach to the containment of EVD in Nigeria. It is however important, if we are to triumph in the end, to continue to work together both government and non-government stakeholders alike.
I wish to thank Mr. President for his continued leadership and support in ensuring the speedy resolution of this outbreak. Once again, I wish to convey the appreciation of the Federal Ministry of Health to the Lagos State Government for collaborating with the Ministry and its agencies in the containment of the disease in the State. Similarly, I commend the Enugu State Government and other State
Governments which territory has either been threatened or which had alerted the Federal Ministry of Health of suspected cases.
I look forward to similar collaboration with the Rivers State Government in the on-going campaign in Rivers State.
Our Development Partners, particularly the WHO, the US Centres for Disease Control ( US CDC) and UNICEF have played and continue to play key roles in our succeeding efforts to contain and eliminate the Ebola Virus Disease. We applaud them.
The biggest thanks go to the individual doctors, nurses and other health workers who are in the frontline of these efforts. We however regret the loss of doctors, nurses and others to this deadly disease.
We thank the media for also associating themselves with the containment efforts.
I thank you.