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EDITORIAL

Nigeria And Vaccine-preventable Deaths

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The World Health Organisation (WHO) lists 26 diseases for which vaccines are available. These include measles, rubella, cholera, meningococcal disease, influenza, diphtheria, mumps, tetanus, hepatitis A, pertussis, tuberculosis and hepatitis B. Others are pneumoccocal disease, typhoid fever, hepatitis E, poliomyelitis, tick-borne encephalitis, haemophilus influenzae type b, rabies, varicella and herpes, zoster (shingles). The rest are human papilloma-virus, rotavirus gastroenteritis, yellow fever, Japanese encephalitis, malaria and dengue fever.
There are, however, some vaccine-preventable diseases, which are not on the WHO-list, probably because the vaccine is not very good according to present standards, or the disease is no longer a threat. These are anthrax, plague, Q fever and smallpox.

In the light of the above, it is, therefore sad and unfortunate that Nigerians still fall prey to no fewer than 25 of these diseases while those in other climes with saner preventive cultures are free of them. WHO estimates that in 2015 malaria caused 214 million clinical episodes, and 438,000 deaths. But statistics from the National Malaria Elimination Programme (NMEP) shows that Nigeria accounts for 29 per cent of the global burden of malaria and has the highest number of cases of any country.
On February 20, 2017, WHO was notified by Nigeria of an outbreak of meningitis. The first case was reported in Zamfara State during the epidemiology week 50 (December 12-18, 2016). On June 23, 2017, Nigeria officially declared the end of the 2016/2017 meningitis outbreak in the country. Between December 2016 and 23 June 2017, a total of 14,513 cases with 1,166 deaths were reported from 24 states. Children between 5-14 years were the most affected, accounting for 6,791 (46.8 per cent) cases. The states that were most affected by this outbreak were Zamfara, Sokoto, and Katsina, which accounted for nearly 89 per cent of the cases.

As if that was not bad enough, WHO has also included Nigeria among the 11 countries that carry about 50 per cent of the global burden of chronic hepatitis. Other countries are Brazil, China, Egypt, India, Indonesia, Mongolia, Myanmar, Pakistan, Uganda and Viet Nam. Cholera is practically endemic and perennial in the country. As at June 22, 2018, a total of 13,009 suspected cases and 1161 deaths were reported from 12 states since the beginning of 2018. Also, a report released by the National Tuberculosis and Leprosy Control Programme, a parastatal under the Federal Ministry of Health, revealed that Nigeria was ranked the fourth country with the highest cases of tuberculosis worldwide. Statistics show that over 80 per cent of tuberculosis cases in Nigeria are still undetected, while it claims over 1.5 million lives annually in the country.
A vaccine-preventable disease is an infectious disease for which an effective preventive vaccine exists. If a person acquires a vaccine-preventable disease and dies from it, the death is considered a vaccine-preventable death. These vaccine-preventable deaths sadly constitute the major causes of death in the country.
With the above analysis, it is something to worry about that vaccine-preventable deaths still occur in the country. It is our considered opinion that enough has not been done by the government and its agencies to eradicate this scourge in the country. While enough fund may not have been voted to the health sector in general and preventive health in particular, responsible agencies should leave no stone unturned in making the citizenry aware of the availability of these vaccines where and when they are available through aggressive mass mobilisation and awareness campaign.

This will go a long way in changing some malformed and congenitally defective attitude and perception of some sections of the populace. Findings have also revealed that some unscrupulous health workers line their pockets with the illicit proceeds they make from charging fees for some of these vaccines that are otherwise provided free by the government and donor bodies. If this condemnable attitude is verified, then the authorities ought to put punitive measures in place to ensure that unscrupulous elements indulging in this act are apprehended and made to face the wrath of the law so as to serve as deterrent to others.
Furthermore, it gives real cause for concern that ineffective storage facilities that can render some of the vaccines ineffective and impotent are contributory factors to the scarcity of the vaccines. This, in our view, is shameful and the agency in charge should check this anomaly. In the circumstance, we urge health authorities in the country to take full advantage of these vaccines and put an end to preventable deaths.



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