NEW PANDEMIC HUB TO DEVELOP CAPACITY TO TACKLE EMERGING DISEASES
FThe World Health Organisation yesterday unveiled a global Hub for Pandemic and Epidemic Intelligence, a platform for creating shared and networked access to vital multi-sectoral data, driving innovations in data analytics and building the communities of practice needed to predict, prevent, detect, prepare for and respond to worldwide health threats. Interestingly, Dr. Chikwe Ihekweazu, the Director General of the Nigeria Centre for Disease Control, was yesterday named Assistant Director General World Health Organisation, WHO, and Head of the newly created Global Hub for Pandemic and Epidemic Intelligence, situated in Berlin, from November 1, 2021. In this interview, Ihekweazu and Mirjam Jenny, who leads the Science Communication Unit at the Robert Koch Institute in Berlin, spoke about the initiative as well as its role in the quest to develop capacity against pandemic. Obinna Chima and bring the excerpts: countries, within academic institutions, within regions and there isn’t enough capacity to pull all of this together in a collaborative way so that if there is a new emergent incident somewhere in the world, whether it is in South East Asia, Europe, Africa or China, how do we collect this information in an effective manner to analyse it and then use it to define a public health response. So, this has really been the thinking that has been going on over the last few months and in response to this, WHO and its partners and member states have come up with a concept of a new pandemic preparedness hub or pandemic intelligence and preparedness hub. But basically the concept is around getting better data, analysing it quicker and better and using it to make decisions to support the world in decision making. So, this is a new exciting project that would be carried out led by WHO but with active collaboration with many countries in the world working together with them in a way. If you can imagine some group that have the ability
What is the whole idea about a global hub for the World Health Organisation (WHO) global hub for pandemic and economic intelligence which was inaugurated yesterday all about?
irstly a little bit about the hub so that it provides context and why this has become necessary. Obviously we have seen an increasing number of new emergent infectious diseases globally over the last 50 years and we are all witnesses to the largest pandemic of our lifetime. In reviewing all these incidents that had happened, WHO set up several partners to look at the causes and how the world can actually come together to mitigate the impact of this to protect everyone from similar occurrences happening in the past and also to be able to respond quicker to incidents when they happen. So there have been a lot of thinking on how to do this and one of the biggest consensus area is that there is a lot of capacity in the world to detect, prevent and respond, but a lot of that capacity is not aligned in a way that makes the best use of it and these capabilities are within
Onyebuchi Ezigbo
to collect, synthesis and quickly use information. The world is now global village. So that is a bit of what the hub is going to do and it will start in Berlin and Geneva, working collaboratively but primarily out of Berlin and pulling together the word’s resources to support the different governments in the world to make the decision. So that is the summary of this new initiative which will kick off on Wednesday and which will be launched by the Director General of WHO together with the German Chancellor.
So where does Nigeria fit in this global health pandemic intelligence preparedness hub?
I think where Nigeria fits in is for instance the choice of the leader of the NCDC to lead this global initiative is probably a recognition of the work we have done in Nigeria with the NCDC and the Federal Ministry of Health led on by the presidential staring committee in responding to this pandemic in Nigeria; in responding to many other infectious disease threats that have happened over the last few years - monkey pox, Lassa fever and the rest of them. Also, in recognising that in order to have a global initiative to respond, there is need to have deep knowledge about how local systems work. For instance, when a report comes in the newspaper that there were XYZ number of deaths in a certain local government, someone needs to go there, collect these data and samples and report and we need the system to do that, which is the same thing that happens all over the world. So, I think it is a recognition that the work that we have done over the past five years to develop this system will have a big contribution in the global context. I think the choice of the leader of the NCDC to work along with the global initiative is something that needs to be celebrated in Nigeria as a recognition of the work that has been done so far.
How would this initiative improve our data reporting and collection challenges in Nigeria?
Yes, we struggle with our system, but we have made a lot of progress in Nigeria. We have built up a digital surveillance system for infectious diseases called SORMAS, which has now been deployed across all the 774 local government areas to report the cases of infectious diseases from the local level to the national level. In developing this system we have learnt a lot about what works in Nigeria and to make a system work in Nigeria you can probably get it to work anywhere in the world. So, the recognition that yes, we work in a very tough context which is not just about health, but agriculture, insecurity, internet and so on. If we can deliver a system that works in Nigeria then we may be have a chance of delivering systems that work across the world. In many parts of the world, when you are thinking about building a new architecture survey system, you’re not think about electricity, transportation or internet. A lot of these things are taken for granted because they work at the background. But in Nigeria, we have to think of all these things properly, same as in many other developing countries in Africa, in South East Asia and many other countries. This is what is translating to the local challenges that we have. Taking that into consideration and recognising that they are important and for someone to lead a new global initiative, you have to really understand the difficulties, challenges and impediment of making these things work in context in order to implement it at a global level.
Earlier you said the WHO came up with the initiative in active collaboration with countries, so is there a role for the private sector to play in this arrangement?
When we say WHO, it is the organisation and its member-states. Now, the whole concept of the hub is based on the recognition that we have to work with every sector to bring in the data that they have. So, whether it is the not-for-profit or academia institution – a lot of data are in academic institutions; the private sector, if you think about global travel, the airline industry how much data they have in terms of passenger transport. If you think about sea transportation, which is localised in cruise ship which collect data on people travelling; and that data is not in any way systematically included in the analysis that is required to be done. If you think about the animals, remember, most infectious diseases jump from animals to humans and we are still looking for the primary animal host for this new coronavirus because everyone agrees that it is most likely to have come from an animal host. So, we need to understand that we need data from agriculture, data from travel and that is really our engagement with the private sector. Once we get this started, we will demonstrate to the world that they must be a part of this and there is a lot of prediction that there would be a lot of support from the private sector. Remember, as much as there have been incredible human consequence of this pandemic if you think about up to five million lives lost, the human impact has been incredible, but the impact of this pandemic on the global economy is unprecedented. So, I think it would be to everyone’s best interest to invest in supporting the emergence of a hub that can warn us on time about the prevention of a new infectious disease threat so that we can all prepare and make sure we can prevent it if possible, but if not, reduce its impact on human life and also on the economies of our countries.
Considering the fact that Nigeria and the rest of Africa share a common experience in terms of many unreported epidemic or neglected epidemic cases, do you think this initiative will be of great assistance to address this problem?
I think this is a point that really demonstrates that there is recognition by the DG of WHO that every part of the world is important and Africa is just as important as every other continent in the world. It is in that context of wishing for a more equitable world and working towards it, that Africa is now being recognised as the front and centre of the work that needs to happen moving forward. So, I think that yes, there are many challenges on the continent but no doubt about it we have many human resources like many other continents in the world that focuses on the goals we set for ourselves in the continent but I think it is in recognition of the role that we need to play and the fact that we can’t continue to be recipient of solutions, but that we have a part to play in the creation of these solutions that will make the world a safer place. In that recognition, I think that Nigeria and Africa is going to play a big part in this new global initiative and I think we will make Nigeria, Africa and ultimately the world a safer place.
We can see that the third wave is ravaging countries globally even countries that have achieved 60 percent vaccination. Where does that leave Nigeria that is still around two per cent vaccination rate?
There is a lot that we are still learning about this virus and the emergence of new variants and one of the key part is the ability to get information and this happens when we work with academics that have information on the virus in other to then understand the impact it has, the tools we need to respond, one of which are the vaccines. Now, the hub in itself will not overnight change the access to vaccine, but will clearly, in an evidenced-based means demonstrate the link between the emergence of new variant and effective of vaccine deployment efforts. So you asked two questions in one: The first one which is access to vaccine and I think this hub will do a lot of things that are being done by small groups around the world, in an evidenced-based way. When the analysis and presentation is done by an initiative that has the authority and credibility to do so, hopefully that will help in making better decisions in terms of where to deploy the vaccines. So, I think we are undergoing a third wave in Nigeria but for the first time in a long time we have some substantial amount of vaccine and a good number of that will come in between now and the end of the year. We have started receiving the Moderna vaccine and many other sets of vaccines will come in between now and December and I believe before the end of the year we will be in a much better position to respond to this.
There has been this vaccine inequity and Africa has really lagged behind in vaccination. How will this hub help to tackle this aspect of the whole pandemic campaign and the vaccine inequity which is a major issue?
Jenny: WHO has a general mission to increase equity in access to all healthcare materials, not just vaccine and of course during this crisis vaccine is the biggest and most important equity that we have because it is the most powerful tool against the virus and I think a lot of people have being raising awareness in the political world on a policy level globally in supporting WHO’s ongoing campaign to promote vaccine equity, access to vaccine around the world in terms of more logistical detailed solutions. We don’t know exactly, but there is a lot of political convenience that we are negotiating to do in upcoming convention. So WHO is the convener of getting people together on one table to discuss these things as Dr. Chikwe already mentioned to discuss the evidence that people need to see more and have a global solution which is more effective, distribute vaccine equitably and that is basically the work that the hub is set to do. I think in away science is in a haste in terms of what works globally and the way scientists communicate and we have to find a way to get that global thinking and make them understand that it is in their own interest.
How would this global effort or new initiative also encourage heads of government to look towards the direction of improving the health budget?
What this new initiative will do is really raise the profile of what we need to do protect the world. Of course, you think about the investment made in military interventions globally and you think about the threat that it poses which you can’t equate with the threats of an infectious disease. I mean what else can lead to five million deaths globally in one and half years? There is very little that can do that other than a virus. What else can be done in preparing the world to mount defensives and prevent this globally? You will find out that the dollar spent on this particular threat is minimal.
So, what I think the main benefit of this initiative would be to raise the profile of a threat that affects all of us globally to the level that our politicians will have to listen and once they start listening the next step is to invest in the healthcare infrastructure that we need to do this because no matter how good WHO is or even National Public Health Institute is, ultimately what we need is a well-functioning healthcare delivery infrastructure in countries such that if you are ill, a patient will have the confidence of going to that primary healthcare centre, saying I have a fever, the sample would be collected from that individual, test can be done quickly if it is one of the common cause of fever, will treat the patient but on a rare occasion that it is one of something new that the system will work in order for that information to be taken up to a level that require a response to health.
So, for all of that to work, for the system to work in every country, we need a significant amount of investment in healthcare and that investment hasn’t happened because I think the threat that we face are not positioned in a way particularly to enable our government to pay attention. But if we don’t use it in a way the opportunity that the global pandemic has provided for the health sector to make this investment, they would never be made. So one of the drivers of this initiative is to really use the momentum of the attention right now on this infectious disease threat to build the systems that we need for the future so that we don’t lose the attention span of our political leadership if we don’t act now that this is very present.
I still have a lot of people who don’t believe that there is COVID-19, what message do you have for such persons?
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five million have died from this disease and because one of those people are not within our immediate family network doesn’t mean that each of the five million doesn’t have a family, friend, loved one that their lives has been torn apart by this loss. We have been fairly lucky in Nigeria so far and with fingers crossed that we haven’t been hit as hard as many other countries. In my work around the country, part of it includes international work, the impact has been devastating. Just last week, I was speaking to a colleague who works in the main national hospital in Nairobi, I don’t want to use a more distant example because sometimes it appears too distant. But this colleague works in the main National Hospital in Nairobi.
He was completely exhausted because literally for the past five months he hasn’t had a day of rest as their hospitals have been overwhelmed; he has lost colleagues that he worked with every day; doctors, nurses and still their wards are full and they are struggling to provide patients the care that they need. I think at this stage, all of us have a responsibility to that this is not only for health workers, we all have to continue educating our people that God has given us a brain for a reason, to be able to help those that don’t really understand how viruses lead to diseases and make that as simple as possible and educate them on how they can prevent themselves from contacting the diseases.
Don’t you think that politics or political decisions by heads of governments of member countries might affect the smooth operation of this initiative?
Jenny: I think you are raising a very hard issue there and that is going to be one of the biggest challenges as I mentioned earlier to make politicians think globally and make them realise that some of the local actions can get them re-election but global actions can clear all from future pandemics. Nigeria is a federated state where you have compromise and talk to people, learn from and collaborate with climate scientist because they have similar challenges because if we must fight the climate challenges globally, then you have to work together to fight it and emerging diseases are part of the climate crisis. This would be very hard but we have no other chance but to try and the WHO of course is the one you need which is the organisation that can tackle this because it is a member of aid organisation and because it has the mission of keeping the world safe.
The time to act is now; like I can speak for Germany where the funds for healthcare has increased and take this thinking to a global and how people understand and again at the end it is important to find global solutions because viruses will always fight back. In a way it is a question of continuous campaigning. By the way, about this earlier question on what you say to someone who doesn’t believe there is COVID 19, of course one of the reason could be you have a person that doesn’t know much about medical illness and infections but sometimes you also have some persons that actually know quite a lot about this but are derailed by conspiracy theories which are very hard to erase from people’s mind. If you have that kind of situation where the person has been convinced by conspiracy thinking that COVID-19 doesn’t exist, usually it is better to talk to them about what kind of benefits do they get from joining such conspiracy theory and thinking, how does it make them feel better and kind of address those issues that the person has and give them some sense of security and not trying to discuss the details of the illness because that is usually much harder because what helps is usually to think with them on a personal connection.
Why is it difficult to convince political leaders in Africa to develop the health sector?
You know we are faced with many challenges, security, basic infrastructure, among others and very often health is not present in our day to day discussion. People are not talking about health, so it won’t be on the political agenda and the reason I think is that we all take health for granted until we lose it and when we lose it we are not in the best place to ask for it because we are either very ill or we are gone. If you read about development of modern society you will see that relationship between the role of health and reducing health challenges and health inequalities really played a big role in the development of societies in countries. This question demonstrates that at least you are aware of this, the issue then is how do we, at least from the point of view of the media, put it more in the national consciousness of all.
I hope this new hub will have a role to play with that by providing the world and Africa as a big part of it the information in a way that we can use it for running these organisations in our communities and drive the conversations with our political leaders in other for them to find a link between investment in health and economic development of country and once we can achieve that narrative I think we will have a better position and chance of convincing them because ultimately politics is the same globally. We have to offer them a link between health and political sustainability like I call it now. If we sell health as something you just do as an altruistic activity for the people it doesn’t have political value, it doesn’t have value. So, we have to change the narrative a bit and I am hoping this hub will provide not only the data but also the interpretation and presentation in order for our politicians to understand why they need to increase investment.
I don’t know if we have touched on the issue of funding of this initiative, are there any form of assistance to member countries on this initiative?
At this stage that the German government has provided an initial $100 million grant for this hub and ultimately the hub will attract the support which will not just go and sit in the hub, the hub will work with countries around the world and once it delivers, it will attract more funding to them and all the other countries, WHO member states and deliver on what it needs to succeed. Really, this hub will be linked to countries and work together with countries to develop the data and resources needed in making decisions. While the initial funding in the beginning we are hopeful that there would be a lot more funding as soon as we demonstrate the value of collaborative thinking, collaborative working, collaborative decision making in tackling the world’s hardest problems.