Climate change: perceptions and experiences
Although nearly 60% of Africans are aware of climate change, some of the continent’s most influential countries lag behind in widespread awareness
Across the continent, African citizens have begun to witness the consequences of climate change, driven by human industrialisation and the pursuit of economic growth. Climate change is a gradual process of average climate modiﬁcation, which is what has made it difficult to track or detect based only on human personal experience. Every day we experience variations in temperature according to the time of day or season of the year. This makes it challenging for ordinary citizens to really comprehend the risks associated with a global average temperature change of 1.5 or 20C.
Factors that influence Africa’s vulnerability to climate change stem from its high dependence on natural resources, limited ﬁnancial and institutional capacity, low GDP per capita and high levels of poverty. Employment in agriculture remains high across the continent; as of 2019 an average of 44% (of total employment) was in agriculture. The graph below provides the estimates for agricultural employment for African countries that have more than 40% of total employment in agriculture. Long-term temperature and rainfall variations will have a serious impact on the livelihoods of African citizens.
Agriculture remains an important economic activity for more than half the continent and will be a sector greatly affected by climate change. In the recent Afrobarometer Round 7 (2017- 18) Survey, “climate change” was not identiﬁed as the most important problem respondents believed their government should address, although many respondents cited water supply (23%), food shortages (17%) and agriculture (9%) as urgent issues that needed to be addressed. Those responses are embedded in the issues that climate change poses for African citizens. Climate change will certainly have an impact on any developmental progress made in these areas by African governments.
Preparing for, and adapting to, the effects of climate change will require a coordinated effort across the continent. North Africa will witness a reduction in arable land and a shortening of crop-yielding seasons due to a predicted decrease in rainfall and increase in average surface temperature. Similarly, East Africa and southern Africa are regions sensitive to climate variability and most farming practices are dependent on seasonal rainfall. West Africa’s vulnerability also relates to climate-sensitive economic activities such as livestock rearing, rain-fed agriculture, ﬁsheries and forestry.
The Intergovernmental Panel on Climate Change (IPCC) predicts that, under a high-emissions scenario, land temperatures over the African continent are likely to rise faster than the global land average. National governments are well aware of the risks climate change poses for future development on the continent, but under-resourced and fragmented institutional frameworks have caused most countries on the continent to be among the least prepared to adapt to climate change, according to the Notre Dame Global Adaptation Initiative Index.
Building up resilience and capacity will require a coordinated effort by both national governments and their populations at large. Perceptions of climate change are arguably guided by national government and business rhetoric on the topic as well as by the personal experiences of ordinary citizens with regards to weather pattern variability. Afrobarometer’s Round 7 Survey conducted 45,823 interviews across 34 African countries, covering almost 80% of the continent’s population, between 2016 and 2018.
The survey included nine questions relating to climate change. The ﬁrst question asked respondents to rate climate conditions compared to a decade ago; some 48% answered “worse” or “much worse”. An overwhelming majority of respondents from Uganda (85%), Malawi (81%) and Lesotho (79%) had witnessed worse weather conditions for agricultural activities. Only 23% of Mozambicans agreed that climate conditions had worsened, but this ﬁeldwork was conducted prior to the devastating cyclones that hit the country in 2019.
Figure 3 indicates the distribution of respondents who had heard about climate change and believed they had experienced “worse” weather conditions over the past decade. Less than half of the South African citizens had heard about climate change and even fewer believed it had made weather conditions worse. Most ordinary citizens had heard of climate change, but opinions were mixed on whether it had made weather conditions worse.
Citizens were asked to rate whether extreme weather events such as drought or flooding had become “more” or “less” severe where they lived over the past decade. Almost half the respondents reported drought as being somewhat or much more severe, while 28% thought it had become less severe. Figure 4 shows the countries where drought has worsened. In early 2017 drought hit Uganda and its impact was felt most along its so- called “cattle corridors” and into its agricultural sectors. During this period, food insecurity rose to acute levels across most of the eastern and northern parts of Uganda.
The severity of flooding was similarly seen as much worse in both Uganda (73%) and Madagascar (67%), which could be closely linked to the increase in drought intensity. When examining the demographic splits for the continent, respondents living in rural areas were more likely to observe worse weather patterns than those living in urban areas. There was a similar contrast among age groups; respondents over the age of 56 were more likely to provide a more negative view of historical weather changes than the younger age groups.
Occupation also played a role in the kind of response citizens gave: six out of 10 respondents whose occupations were in agriculture, ﬁshing or forestry observed worse or much worse climate conditions over the past decade. Exposure to news from any source was also associated with higher levels of awareness. However, those who got their daily news from either the internet or social media sources were much more likely to have heard of climate change. Part of being informed about climate change is understanding the meaning of the concept itself. Citizens were asked whether climate change meant negative, positive or other changes in weather patterns and on average two-thirds associated it with negative changes in the weather.
Figure 5 indicates whether those who had said “yes” to hearing about climate change had in fact an understanding of its negative effects on weather patterns. Zimbabwe stands out in that although most of their respondents had heard of climate change, only 31% thought it might be an adverse phenomenon. Among the continent’s most politically influential countries such as Ghana, Nigeria and South Africa, only around one in four citizens had a basic awareness of climate change. Overall, Africa’s perceptions of climate change lack any uniform pattern and awareness remains as varied as its natural environment.
Many countries are experiencing changes in their weather patterns and evidence suggests these are having a dire impact on farmers and food security. Although nearly 60% of Africans are at least aware of climate change on average, some of the continent’s biggest players lag behind in widespread awareness and understanding. Collective awareness and an understanding of climate change by ordinary citizens will be crucial when governments try to adapt and mitigate its consequences for socio-economic development. Capacity building for early warning systems and mitigation strategies are important to assist those citizens who are most vulnerable to the effects of climate change.
On 7 January, 2020, the International Rescue Committee (IRC) published an article about ‘The top 10 crises the world should be watching in 2020.’
Then countries potentially facing devastating crises in 2020 were listed. Nigeria was ranked fourth, in the company of the likes of Yemen (1), the Democratic Republic of Congo (2), Syria (3), Venezuela (5), Afghanistan (6), South Sudan (7) Burkina Faso (8), Somalia (9) and Central African Republic (10). As regards Nigeria, the IRC said that the country’s decade-long battle with insurgency in Nigeria’s north-east was the most prominent of the multiple threats the country faced, along with rising communal violence in central areas and the north-west.
Moreover, a cholera outbreak in 2018 across 20 states in Nigeria aggravated the country’s battle with food insecurity, while large-scale displacement had left “over half of the 13.4 million people living in the conflict affected north-east states need[ing] some form of humanitarian assistance”, according to the article. The country would see “new constraints on humanitarian efforts, that would exacerbate existing conditions. The situation in the north-west could deteriorate even further, particularly if armed groups operating there establish links to counterparts active in the Sahel.”
But the IRC, like the Nigerian government and Nigerians generally, could not have foreseen the humanitarian crisis that would unfold in only a matter of months as a result of the Covid-19 pandemic, which has posed risks beyond mass displacement and food insecurity, including a major challenge to the country’s health sector. As recorded in my first blog in this series, Nigeria recorded its index case on 27 February. And the country went into its battle with the novel virus equipped with a health budget of $1.09 billion, or 4.14% of the annual budget.
Then countries potentially facing devastating crises in 2020 were listed. Nigeria was ranked fourth.
Beginning in March, the federal and state governments, with relevant agencies, announced a series of policies aimed at controlling the spread of the virus.
In mid-March, Nigeria’s National Centre for Disease Control (NCDC) provided guidance on planning mass gatherings, as initial cases of infected people were confirmed. Later that month, the country’s Central Bank rolled out N100 Billion credit support for the healthcare sector, as well as guidelines for its operations under pandemic conditions.
A few days later, Lagos State, where Nigeria’s index case originated, promulgated Infectious Diseases Emergency Prevention Regulation 2020, to become effective on 27 March. Ekiti State, in the country’s south-west region, soon followed with regulations detailing measures aimed at preventing the spread of the virus in the state.
In early April, when the country had only 209 confirmed cases of infection, the Nigerian government announced plans to create a N500 billion ($1.39 billion) coronavirus fund to strengthen its healthcare infrastructure to tackle the virus. Mid-month, the National Environmental Standards And Regulations Enforcement Agency (NESREA) published guidelines for handling chemicals used as disinfectant, as well as guidelines for handling infectious and medical waste.
The country’s Central Bank rolled out N100 Billion credit support for the healthcare sector, as well as guidelines for its operations under pandemic conditions.
Lagos State, which has been commended for taking the lead in regard to policies and guidelines dealing with the pandemic, launched Eko Telemed, a toll-free voice and video call service available in four major languages, for use in remote consultations. Later that month, the NCDC published guidelines for employers and businesses in Nigeria, effective from 4 May, aimed at ensuring that people interacted safely in the workplace.
With the first phase of the easing of the lockdown on 30 April, the Presidential Task Force on Covid-19 issued further guidelines aimed at containing the virus. On 7 May, the federal government also approved a waiver on import duties relating to medical equipment and supplies. It also directed the Nigeria Customs Services (NCS) to expedite the clearing of imported health and medical equipment and supplies. On 31 May, the Lagos State government also started a ‘register to open’ initiative aimed at assessing the level of preparedness of hospitality centres, places of worship, night clubs, events centres, gyms/spas, and social clubs to carry out measures aimed at curbing the spread of the virus.
Analysing these steps, Dr. Ejike Oji, chairman of the medical sub-committee advising the Ministerial Expert Advisory Committee on Covid-19, said the pandemic has exposed “the good, the bad and the ugly” in the country’s health governance capabilities.
The “good side” was that federal government had shown “tremendous leadership by making sure that funds are approved both for the public and private sector,” he told Africa in Fact. “We are talking about 600 billion naira. Every single case treated at public isolation and treatment centres costs 50,000 naira. The federal government bears that cost. That is leadership.”
The pandemic has exposed “the good, the bad and the ugly” in the country’s health governance capabilities.
Also, the federal government had set up the Presidential Taskforce (PTF) on Covid-19, which, working with the Nigeria Centre for Disease Control (NCDC), had given crucial direction to the country and helped to achieve uniformity of purpose at national government level in dealing with the pandemic. In particular, the participation of the NCDC had ensured that the PTF had technical support. “That shows leadership too,” Oji said.
But he was critical of the efforts of state governments. Overall, state governments had “failed woefully” to deal effectively with the virus. “Most of the states are not putting proper [administrative] structures in place. There are no isolation centres. They are also not tracking, testing and isolating people who are positive, but in denial.”
Indeed, the coronavirus pandemic has made everybody in Nigeria acutely aware that our healthcare system is broken. Since no one can leave to seek treatment abroad, everyone is dependent on what services they can find within the country – delivery of which is almost entirely in the hands of state administrations.
As regards public policy and implementation, the Nigerian government’s health portfolio is devolved to the states, and the federal government cannot prescribe policies to them. The federal government can only offer guidelines to be followed. Many of Nigeria’s state governments have acted irresponsibly in handling the pandemic, according to Oji. “The PTF handles the guidelines, while the states are supposed to deliver services on the ground. But some states are still in denial that Covid-19 is even occurring in their territory. And some state leaders who have taken ill – commissioners and even governors – have run to Abuja to get treated.”
The coronavirus pandemic has made everybody in Nigeria acutely aware that our healthcare system is broken.
Almost 50% of cases in Abuja had come from other states, such as Kogi and Kano, he noted. Abuja had the highest number of isolation beds, and had carried out more tests per capita than any other state.
Many states had also not done well with public education and community engagement – key measures in reducing the spread of the virus. Aid agencies seem to be stepping in for the government here. In Nigeria, the International Committee of the Red Cross, is using commercial rickshaws, commonly called keke, to spread Covid-19 prevention messages. In Lagos, UNICEF is supporting awareness campaigns by health educators in local government areas in Lagos State, which has a population of more than 14 million people.
The US Agency for International Development (USAID) has partnered with telecoms company Airtel to help the Nigerian government provide critical information on how to avoid contracting COVID-19. The project targeted “more than a million” Nigerians daily, and was part of a broader programme of US government support, with $6.7 million pledged “to bolster Nigeria’s efforts to prevent and respond to the spread of the virus,” according to the organisation’s website.
But efforts to control the spread of the coronavirus across Africa should go beyond such traditional public health measures, according to Evaborhene Aghogho Nelson, a physician and currently a global health and development post-graduate fellow at University College, London. “Response coordination should also be framed around symbols or figures that strengthen national unity in order to sustain community mobilisation,” he told Africa in Fact. “It is crucial African heads of state engage communities in ways that echo their shared beliefs and ideologies, and that approach should be reflected in planned behavioural change strategies.”
“It is crucial African heads of state engage communities in ways that echo their shared beliefs and ideologies, and that approach should be reflected in planned behavioural change strategies.” – Evaborhene Aghogho Nelson
Some states were showing signs of good leadership, such as the Federal Capital Territory (as it happens, it is the country’s capital). The FCT, with a population of more than 2.4 million people had tested 14 23,169 samples as at the end of July. Of these, 2,687 were positive, 810 had been treated and successfully discharged, while 39 deaths were recorded. The FCT minister, Muhammad Musa Bello, had set up an advisory committee, which Oji believed was “doing well” in supporting the healthcare department.
More recently, Kano had improved its performance in dealing with the virus, he added. As I referenced in my fourth blog, Zango and Dorayi, two pilot projects in Kano have taken the lead in engaging community influencers with knowledge transfer and the implementation of targeted health interventions. Kano, the most populous state in north-west Nigeria, with a population of more than nine million people, had tested 19,916 samples by the end of July. Of these 1,314 tested positive, with 1,035 treated and discharged, and 52 deaths.
In June, the Nigerian government introduced a plan to invest in healthcare infrastructure, the Economic Sustainability Plan. The plan constitutes a “12-month, N2.3 Trillion ($6, 052, 631, 578) ‘Transit’ plan between the Economic Recovery and Growth Plan (ERGP) and the successor plan to the ERGP, which is currently in development.” The ERGP, developed by the Administration of President Muhammadu Buhari in 2017, was aimed at restoring economic growth.
The new plan was announced on March 30, 2020 and includes measures to increase government revenues, a support package for private businesses (with an emphasis on strategic sectors most affected by the pandemic) and vulnerable segments of the population, specific measures to support the states and the FCT, and a strategy to keep existing jobs and create new ones, among others.
In June, the Nigerian government introduced a plan to invest in healthcare infrastructure, the Economic Sustainability Plan.
The Economic Sustainability Plan has been applauded as a step in the right direction. The country’s response to the pandemic was “well-planned and articulated,” said Edward Kallon, UN Resident and Humanitarian Coordinator in Nigeria. He added that “interactions between the federal government and stakeholders would aid a smooth implementation of the plan,” perhaps suggesting that co-ordination was failing at that point in the system.
However, critics have argued that the stimulus package is small when compared to countries of similar size. “While Nigeria’s stimulus package is 1.6% of its GDP, Morocco, Namibia, and Senegal have deployed packages valued at 2.7%, 4.3%, and 7% of their GDP respectively,” Mma Ekeruche, an economist at the UK-based Centre for the Study of the Economies of Africa, told Africa in Fact. Only 11 million Nigerians would receive the ₦20,000 ($52) provided to families registered in the National Social Register of poor and vulnerable households, she said. “This is [in] sharp contrast to the 84.7 million Nigerians living below the poverty line.”
More generally, Ekeruche argues that the new plan is “overly optimistic” in saying that the ₦2.3 trillion stimulus package would result in an economic decline of 0.59%. This is against a backdrop of current recession projections of -5.4% by the IMF. Funding the financial package would be challenging, she added. “The low oil price has significantly depleted the country’s revenue source, [so] producing a bigger stimulus through more debt is a tough choice.”
Oji argues that a major cause under-performance in healthcare delivery is related to the funding of the Basic Health Care Provision Fund. The Basic Health Care Provision Fund stipulates that the federal government should set aside a minimum of 1% of National Consolidated Revenue for the Basic Health Care Provision Fund. But a decline in projected national 2020 income due to the pandemic had seen this reduced by N3.3 trillion (about 39%) from an initially approved amount of N8.41 trillion to N5.08 trillion. Oji suggested that legislators should see to it that the Basic Health Care Provision Fund (BHCPF) receives 2% of the national budget to meet future requirements.
However, critics have argued that the stimulus package is small when compared to countries of similar size.
The Nigerian government was heading in the right direction regarding its policies for the health sector against the backdrop of the pandemic and attempting to make them sustainable in the future, said Dr Henry Uro-Chukwu, a health policy and systems research specialist. But he echoed concerns that some states, such as Kogi and Cross River, had denied the existence of the virus. This was “obviously due to improper guidance. Community engagement by community leaders,” he said, was “completely missing”.
In a wide-ranging interview, he outlined a detailed view of areas where Nigeria’s healthcare system could be significantly improved, given the lessons from dealing with the coronavirus. “A health system is not only about money,” he said, adding that it’s also how money is used.
His proposals included reviewing human resources practices, upgrading information management systems, reviewing standards in medicine supply and logistics, and preventive medicine, among other measures to improve healthcare delivery. “If you have these pillars [working] together, that makes up a good and functional health system.”
In particular, he argues that “60% or 70%” of the plan’s health budget of N2.3trillion should be targeted at prevention activities and community mobilisation, with the other 40% or 30% going into therapeutic medicine. In outline, he argued that spending more on prevention of diseases would help to reduce the amount spend on treating them.
More specifically as regards the virus, the country needed to invest in local vaccine production and community engagement and education to create a two-pronged preventive approach to curbing its spread. The effort in developing this would also help to create a more sustainable medical infrastructure for the future, he concluded,
But will the lessons of the virus be learned? Looking back at my blogs for this series, I see that the lack of connection between federal and state levels has been a constant concern. In the immediate post-colonial period, Nigeria’s federal system was designed to address the “wicked problem” of its large and diverse population. But maybe that “solution” has created another “wicked problem”: how can the autonomous states be encouraged to devise policy and implement it more effectively within the context of our federal system?
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From the get-go, the Nigerian authorities publicised precautions for people to keep safe against COVID-19 and ways through which they could prevent the spread of the disease. These measures included frequent handwashing, the use of face masks, advising people to sneeze or cough into the elbow, and social distancing, among others.
As the number of COVID-19 positive cases in Nigeria picked up, movement was restricted to a certain number of hours daily and within certain places, and Nigerians were mostly observant of the rules. Security operatives at intrastate and border control checkpoints monitored the use of masks and social distancing. But when people, especially the poor, began to complain of hunger, and savings began to dwindle as businesses struggled to stay afloat, plans to ease the lockdown were announced.
When people, especially the poor, began to complain of hunger, and savings began to dwindle as businesses struggled to stay afloat, plans to ease the lockdown were announced.
An initial two-week easing of lockdown was announced on 4 May for, followed by an extension starting on 2 June. But the easing of the lockdown has caused some confusion in Nigeria, as it seems to mean that the government is getting lax about ensuring that safety protocols are observed.
The lockdown restrictions were relatively clear, and they helped people to be conscious of the need to adhere to the WHO guidelines for COVID-19 prevention, says Nafisa Atta, 41, a facilities management expert based in Nigeria’s capital city. “People policed one another about adhering to these rules, and security forces also ensured that people respected them by doing at least the minimum – which was wearing a face mask and the use of sanitizer,” she told Africa in Fact.
The easing of the lockdown has caused some confusion in Nigeria, as it seems to mean that the government is getting lax about ensuring that safety protocols are observed.
With the easing of the lockdown, though, all this seems to have gone with the wind. The WHO guidelines now seem to only exist only on paper, says Aisha Inuwa, 40, a stay-at-home mother. She recalls seeing television reports of the president, Muhammadu Buhari attending events without a face mask and reading about his reasons for not using a mask, despite his being in a vulnerable group at risk of contracting the disease (he is 77).
“The other day, we saw a senator take his mask off to sneeze during a session at the national assembly. What was more appalling was the fact that the [other senators] found it funny and began laughing. So, you ask yourself, if the people who should guide us are ignoring the WHO guidelines, who are ‘ordinary people’ supposed to respect?”
The WHO guidelines now seem to only exist only on paper, says Aisha Inuwa, 40, a stay-at-home mother.
Dealing with “a disease as serious as this” needed “a lot of leadership by example”, Inuwa felt. Having eased the lockdown, the government needed to make “a concerted effort to continuously educate citizens about current trends with regard to the pandemic and what it means for us,” she said.
Initially the number of daily cases was in the tens. Since the easing of the lockdown, we have seen hundreds every day, and in some areas, a thousand or more. New transportation and other protocols have been announced – including requirements that the offices of transport businesses are regularly sanitized, suggested limits on the number of people in a taxi at any one time, and advice not to share taxis and buses where possible – but they are not being monitored and enforced.
“If the people who should guide us are ignoring the WHO guidelines, who are ‘ordinary people’ supposed to respect?”
At a market like Wuse, in the heart of Nigeria’s capital, shoppers are required to use sanitisers and face masks before entering, but once inside the market, enforcement is not evident. At lower-end markets where cheaper foods and bulk buys are on offer, the protocols are not being enforced at all.
“I went to Diko Market on Kaduna Road – a wet market – and counted only three of us wearing masks, and only two people actually wearing their masks properly,” says Ali Umar, 53, a building technologist. “It was a free-for-all. People were breaking social distancing rules. I was ridiculed whenever I said people should be wearing face masks or practising social distancing. The general response was: ‘Corona has nothing to do with us.’”
It is not enough for the government to ease the lockdown, he says; it should still be trying to ensure that citizens respect the basic protocols of social distancing and sanitising.
“I was ridiculed whenever I said people should be wearing face masks or practising social distancing. The general response was: ‘Corona has nothing to do with us.'”
Commercial taxis, according to the protocols, are not supposed to carry more than three passengers – two behind and one in front with the driver. But things have returned to the status quo with drivers allowing five or six passengers. The authorities – in the form of the police and Federal Road Safety personnel – don’t seem to be on the lookout for this.
Commuters can find themselves caught between the devil and the deep blue sea. “Offices have opened, and work has resumed, so if you decide not to use the taxis, you do so to your detriment,” says Ikenna Onuoha, an office worker in his mid-thirties. “For the first three or four weeks after things eased up, I would barely make it to work on time because I insisted on using taxis carrying no more than three passengers.”
Commuters can find themselves caught between the devil and the deep blue sea.
One driver screamed at him: “You will die there, waiting for a taxi with only three passengers.” When the government eased the lockdown, the government had told taxi operators to carry only three passengers, the driver continued, but it had also immediately increased petrol prices. He wanted to know who would make up the difference to his pocket.
This was the turning point for Onuoha. He had “learned his lesson the hard way” and devised his own way of dealing with the problem. He now pays extra to sit alone in front to avoid physical contact with other passengers. Transport costs him at least half of his current salary but it’s a price he is willing to pay to keep his job – and his health.
The government had told taxi operators to carry only three passengers, but it had also immediately increased petrol prices.
His situation is one experts have analysed, stating that about 50% of all trips in Lagos are made by public transport (BRT, LAGBUS, Semi-Formal Mini Buses, Federal Mass Transit Train) and shared taxis. In Abuja, about 57% of trips are by public transport and shared taxis. The situation is similar in many other cities in Nigeria.
So the authorities think that public transport is an important element to control. But David Nabarro, a WHO special adviser on the coronavirus, says the evidence suggests that the “fleeting contact” people have when travelling together may not be the most important source of transmission. “For this reason and with similar mindset, authorities had not given specific attention to public transport for a while.”
By 27 July, the official tally for the country was 40,532.
In some areas of Nigerian life, people are respecting the lockdown guidelines. Some private businesses, banks and private schools remain closed, as well as some places of worship – which could come under fire if they did otherwise.
On Monday 20 July, Nigeria recorded 562 new cases in 21 of its 36 states, bringing the total number of confirmed cases in the country to 37,225. By 27 July, the official tally for the country was 40,532. Many private citizens hope that government will go back to the drawing board to devise strategies to curb the spread of the virus, and educate citizens better.
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The COVID-19 pandemic has thrown up challenges for Nigeria’s health system quite unlike those posed by the Ebola virus or other epidemics, and also emphasised its weaknesses, across the board.
Epidemic preparedness is not something Nigeria seems to be good at. The coronavirus pandemic has been ravaging other parts of the world, so you might think that Nigerians and the Nigerian government would see that it would only be a matter of time before it came knocking on our doorstep. Yet Covid-19 found the country asleep when it finally came.
Covid-19 found the country asleep when it finally came.
With hindsight the country was able to trace its index case to an Italian man who arrived here by air on 24 March, and apparently brought the virus not only to Lagos State where he landed, but also to neighbouring Ogun State. Four weeks later, Nigeria recorded 1,337 people infected by the virus, with 40 of them dead and 255 discharged from hospital.
A 2017, Joint External Evaluation (JEE) rated Nigeria’s preparedness at 39% stating that the country was “not ready for the next epidemic.” The JEE is usually carried out every five years by the Nigeria Centre for Disease Control (NCDC) using a WHO-approved tool with 49 indicators to assess Nigeria’s capacity in the 19 technical areas. A mid-term review was carried out in 2019. Nigeria’s score had risen to 46%, indicating that while the country showed commitment to epidemic preparedness, it had “work to do to prepare for the next epidemic” – which we now know is Covid-19.
Against recommendations in the Abuja Declaration that governments spend at least 15% of their budgets on health, Nigeria currently spends less than 5% of its budget on it. A revised budget – proposed against the backdrop of Nigeria’s National Assembly budgeting ₦37bn for renovations – is expected to be passed into law that would see funding for local, primary healthcare services cut by more than 40%. This would also affect immunisations, childcare, maternal healthcare and family planning services.
Nigeria currently spends less than 5% of its budget on health.
Commenting on this, President of the Nigerian Medical Association, Professor Innocent Ujah, said, the proposed cut is coming at a time when Nigeria needed to invest more in health. Nigeria’s health budget was “unacceptably low, under 5%”, said Ujah, and the reduction in health funding was even more serious given the pandemic.
The reduction in health funding was even more serious given the pandemic.
The pandemic has thrown up many inadequacies in Nigeria’s health system, including its primary health care, the president-elect of the Nigerian Academy of Sciences, Professor Ekanem Braide told Africa In Fact.
Describing the country’s primary health care system as “very weak,” Braide said, most health facilities are run-down, with health workers mostly concentrated in state and local government capitals. “With the rising number of COVID-19 cases, the health system is overwhelmed. Routine health services are not being rendered as effectively as should be.” Some hospitals were reluctant to accept patients suffering from ailments unrelated to COVID-19.
Communities were left without access to the affordable health care which the Alma Ata declaration (1978) set out to achieve. (The Alma Ata declaration was “a major milestone of the twentieth century in the field of public health, and it identified primary health care as the key to the attainment of the goal of Health for All,” according to WHO.) Tertiary and secondary health facilities were overcrowded with patients who should have been treated either in or near their communities.
Some hospitals were reluctant to accept patients suffering from ailments unrelated to COVID-19.
Previous epidemics have brought about increased demand for “speculative therapies” in Africa, and the current epidemic is no exception, say Ejemai Eboreime, Chinwe Iwu and Aduragbemi Banke-Thomas in a July 2020 article in the Pan-African Medical Journal. The pandemic has brought a demand for alternative remedies with limited scientific evidence on their effectiveness to manage COVID-19 in Africa, they argue.
Recently, the president of Madagascar, Andry Rajoelina, elicited “heated debates” when he announced a “breakthrough herbal medicine” for COVID-19 developed from the Artemisia annua – “a medicinal plant whose use has long been reported in China, where it is locally known as qinghao, [and] now grown commercially in many African countries,” according to ScienceDirect.
Cameroon, they say, is experiencing shortages of herbal medicine due to high demand, while an undercover British Broadcasting Corporation investigation in Ghana revealed that “conmen and quacks” were selling fake and toxic substances as Covid-19 cures, sometimes for as much as $25,000. “Likewise, the current COVID-19 crisis has been associated with a covert epidemic of ‘miracle cures’ such as ingestion of bleach,” and enabled by the ubiquity of social media, they say.
An undercover British Broadcasting Corporation investigation in Ghana revealed that “conmen and quacks” were selling fake and toxic substances as Covid-19 cures, sometimes for as much as $25,000.
The pandemic is significantly shifting the dynamics of the pharmaceutical industry, including the supply and demand for unorthodox remedies, they add. The surge in demand for alternative remedies reflects badly on public health efforts to mitigate the spread of COVID-19 and the problem is likely to continue to plague health systems beyond the present outbreak.
“Africa, like China, has a broad diversity of natural pharma co-active products. But, due to poor government regulation and financing of herbal research, we are not only missing out on potential pharmaceutical and economic benefits, we are also exposed to the dangers of potential untoward effects of these substances,” one of the authors, Ejemai Eboreime told Africa In Fact.
“Governments need to strengthen regulatory processes and support clinical trials of traditional medical products,” he advises. “Policymakers must get their act together and dedicate substantial funding to health research, particularly on traditional medicines so as to establish their safety and efficacy.”
“Governments need to strengthen regulatory processes and support clinical trials of traditional medical products”
Research into and regulation of these products would need to observe the highest scientific standards, he added. This would give the world more confidence in African herbal medicines, and trigger a global demand for them, where validated. “Who knows, effective and safe treatments for Covid-19 or HIV may be hiding? somewhere in an obscure African village, waiting to be discovered.”
Eboreime, Iwu and Banke-Thomas argue that, going forward, governments must be proactive in engaging community influencers with knowledge transfer and the implementation of targeted health interventions.
Kano State in Nigeria’s north west has set the ball rolling with this. In two pilot wards, market women, youth, religious and community leaders are driving Covid-19 testing and explaining to residents – in Zango and Dorayi – why they should cooperate and submit themselves for testing. They did this by ensuring that their own families led the way.
In two pilot wards, market women, youth, religious and community leaders are driving Covid-19 testing and explaining to residents.
“Concerted efforts” are ongoing to address the problems with Nigeria’s health care system, says Professor Braide. The poor will have easier access to health care, health workers will be better trained and motivated, communities will be more involved in decisions about their health. But it is hard to see how this can happen when the health budget is chaotically managed.
According to a 2019 peer-reviewed study by Onwujekwe and others, Nigeria’s health financing mechanisms were not functioning “optimally” before the onset of the pandemic. “Allocation and use of resources are neither evidence-based nor results-driven. Resources are not allocated equitably or in a manner that minimizes wastage and improves efficiency. None of the mechanisms effectively protects individuals/households from catastrophic health expenditure,” according to the authors. They recommended that more funds were allocated to purchasing health care services, and that such expenditures be evidence-based and strategic.
In 2001, in the Abuja declaration, AU member states committed to spending at least 15% of their annual budgets to improving health care in their countries. Yet, according to a 2019 article by Paul Adepoju, the most that Nigeria spent on health after 2001 was 6% in 2012, while in 2018 it spent only 4% of its budget on health. Nigeria’s budget allocation for health care has been “consistently below the continental average of 9.8% since the 2001 agreement,” according to a June 2020 article by Oluwatola Toluwani. The country’s total allocation to health for 2020 was 4.14%.
That was the situation when the country, like others all around the world, was suddenly confronted with the coronavirus pandemic. It was not a good place to be in.
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Nella, 34, a single mother, was an air hostess in Nigeria’s private jet industry. When the Covid-19 pandemic hit, she had to agree to a three-month reduced salary. Ahead of a speculated resumption of flights on 21 June on specific routes in Nigeria, her company organised a training exercise, ostensibly to prepare staff to resume work. But at the end of the week, she was handed a lay-off letter.
“I wonder why they made us go through the training if they knew they would be sacking us right after?” she remarked to Africa in Fact. With no back-up plans, Nella is still consumed by shock and disappointment and hasn’t quite figured out what to do. “I don’t even know if I will be able to get back into the industry anytime soon.”
Last year (2019), Senator Chris Ngige, Nigeria’s Minister of Labour and Employment projected an unemployment rate of 33.5% (39.4 million people) by 2020. This is against 23.1% (20.9m people) at the end of 2018. Approximately 6% of this 2018 figure covered youth unemployment, which rose to almost 20% by the end of 2019.
Last year, Senator Chris Ngige, Nigeria’s Minister of Labour and Employment projected an unemployment rate of 33.5% (39.4 million people) by 2020.
Meanwhile, a recent household survey by Nigeria’s National Bureau of Statistics categorised more than 40% of the country’s households as poor. The survey projected that the economy would shrink by between 4.4% and 8.91%, depending on the lockdown period, the effectiveness of the government’s economic plans and the amount of stimulus spending.
Globally, the UN Secretary-General Antonio Guterres’ ‘Policy Brief on the World of Work and COVID-19’ predicts massive job losses in the second quarter of 2020 – as many as 305 million full-time jobs. The study, based on data and analysis from the International Labour Organization (ILO), warns that many who have lost their jobs and livelihoods in recent months will be unable to re-enter labour markets any time soon. Some 1.25 billion workers, or 38% of the global workforce, are employed in high-risk sectors.
A recent household survey by Nigeria’s National Bureau of Statistics categorised more than 40% of the country’s households as poor.
People in developing countries and fragile contexts face the most dramatic risks, partly because they have less economic resilience, according to Guterres. “They are disproportionately represented in high-risk sectors and are often amongst the first to lose employment and the last to return.”
Nella, the air hostess, is – or was – in one of those sectors. Others are facing similar nasty surprises.
On 16 June, after a period in lockdown, a fleet officer in the transport division of Dangote Cement Plc, one of Nigeria’s biggest cement companies, was summoned to resume work with other colleagues at the company’s Obajana plant in Kogi State, in Nigeria’s middle belt.
The day before, the fleet officer had heard rumours that people might be laid off. The fleet officer and colleagues were asked to sign a register. It turned out to be a register of everyone who was to be laid off. Those who were on it would be paid one month’s salary in lieu of notice. “I asked why I was being sacked, but no explanation was given,” said the fleet officer, who asked to remain anonymous for fear of not being paid their severance.
“I asked why I was being sacked, but no explanation was given,” said the fleet officer, who asked to remain anonymous for fear of not being paid their severance.
In the early days of the pandemic in Nigeria, only “essential staff” were allowed to carry on working. These included health workers, journalists and people in emergency and frontline services. In line with that, some staff at Dangote were told to take compulsory leave for two weeks but were then recalled after only five days. While Covid-19 infections spread and cases rose, it was business as usual.
Trucks in escorted convoys headed to troubled destinations around the country, such as Sokoto (north-west), and Madagali, Yola and Maiduguri (north-east), all hot beds for the Boko Haram insurgency. Trucking staff soon found themselves getting arrested for violating movement restrictions, and the company would bail them for a minimum of ₦10, 000, according to the fleet officer.
The fleet officer passed a work appraisal only this January and had been expecting a promotion to manager. People in all of the company’s departments had been similarly affected, the person said. At the time of writing, no fewer than 3,000 staff had been laid off from the company during the COVID-19 pandemic.
Trucks in escorted convoys headed to troubled destinations around the country, such as Sokoto (north-west), and Madagali, Yola and Maiduguri (north-east), all hot beds for the Boko Haram insurgency.
The job crisis in Nigeria became even more worrisome when Access Bank announced plans to cut staff salaries to avoid job losses. Earlier this year, a spokesperson told journalists that the bank would not downsize, but instead would reduce salaries to retain workers. However, in a video now uploaded to YouTube, on 1 May, the bank’s Group Managing Director, Herbert Wigwe, told members of staff, in a town hall meeting via video conferencing, that it was “a fact that we do not need the same complements of staff to take us to where we are going”.
The pronouncement seemed to suggest that large-scale layoffs were at hand. The bank’s move was widely criticised – especially given that the bank, and Wigwe, are active members of the Coalition Against COVID-19, to which the bank made a ₦1 billion donation. Access Bank has denied that large-scale layoffs were planned.
The bank’s move was widely criticised – especially given that the bank, and Wigwe, are active members of the Coalition Against COVID-19, to which the bank made a ₦1 billion donation.
The Central Bank of Nigeria (CBN), the country’s regulator of banks, and Nigeria’s Bankers Committee waded in. To help minimise the negative impact of the Covid-19 pandemic on families and livelihoods, no bank in Nigeria would be allowed to retrench or lay-off any staff of any employees, full-time or part-time, CBN’s Director of Corporate Communications, Isaac Okoroafor, stated in May. Staff layoffs would require “the express approval of the Central Bank of Nigeria”.
The Nigerian government has announced a ₦2.3 trillion (about $5.9 billion) stimulus package aimed at “bouncing back,” or re-establishing economic sustainability. The package, produced by a presidential committee led by Nigeria’s Vice-President, Yemi Osinbajo, is expected to keep the economic contraction to -0.59%. The plan aims to prevent business collapse, create jobs “using labour-intensive methods”, create jobs by investing in infrastructure, promote local manufacturing and “extend protection to the very poor … through pro-poor spending.”
The Nigerian government has announced a ₦2.3 trillion (about $5.9 billion) stimulus package aimed at “bouncing back,” or re-establishing economic sustainability.
The package is a good start, said Tolu Olarewaju, a lecturer in economics at Staffordshire University, in an article on The Conversation. Nevertheless, it left “a lot to be desired”, as some of the “features of the plan [we]re very vague.” The broad objectives of the plan were “like the typical campaign promises of successive Nigerian governments”.
Olarewaju said the plan ignored fundamental problems that have plagued previous economic plans, including crucial sectors such as power and education. He called for more investment in the power sector to boost the storage and processing of agricultural produce and to support the manufacturing sector, adding that education needed to address entrepreneurship and practical skills. He also queried how the social safety net would be strengthened. The plan did not mention support for the health sector, he argued. Finally, Olarewaju questioned whether it would be implemented.
Two factors – specific and measurable objectives and creating an enabling environment for businesses to thrive – would be better ways to stimulate the Nigerian economy at this time, he concluded.
The only way to prevent pay cuts and job losses is for government to provide financial support to businesses, an Abuja-based human resource specialist, Hilda Abu, told Africa in Fact. Some countries were supporting businesses by paying a percentage of employees’ salaries, but it was not clear that the Nigerian government could afford this approach. She also questioned the government’s data. “Without reliable and verifiable data, no planning can be done,” she said. “[Good] data is not something Nigeria can boast of.”
The lockdown and travel restrictions had caused many businesses with no access to financing to go under. Some ripple effects of this include depression and other mental health issues. “These are not currently being prioritised,” she said.
According to the Nigeria Employers’ Consultative Association (NECA), government must urgently initiate specific and direct business sustainability schemes to save organised businesses from the debilitating effect of the Covid-19 pandemic and to avert mass layoffs of workers. Such measures were already being taken in other countries. NECA urged the government to review its stimulus package, arguing that the CBN’s intervention in the banking sector should be replicated in other sectors.
Meanwhile, people like the fleet officer and Nella the air hostess are left to face their life-changing dilemmas on their own.
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