On Wednesday, the Federal government confirmed a total of eight COVID-19 cases in Nigeria, but the unequal distribution of laboratory testing centres has come into sharp focus. Currently, there are five laboratories in the country with capacity to test for the virus. Across the six geopolitical zones, there are three labs in the South West (two in Lagos state, one in Osun state); one in the North central (FCT) and one in the South South (Edo state).
The laboratories currently in place are the NCDC National Reference Laboratory, Abuja, FCT and Irrua Specialist Teaching Hospital, Edo state. Others are the virology laboratory in the Lagos University Teaching Hospital, LUTH, Lagos; the Nigeria Institute for Medical Research, NIMR, and the Lagos African Centre of Excellence for Genomics of Infectious Disease, in Osun state.
There are virtually no COVID-19 testing centres in the South East, North West and North East zones of the country. Stakeholders within the health sector describe the development as worrisome. They have called for change. Excerpts: Lab structure put in place by FG is lopsided — Dr Casmair Ifeanyi, National Publicity Secretary, Association of Medical Laboratory Scientists of Nigeria. The National Publicity Secretary of the Association of Medical Laboratory Scientists of Nigeria, AMLSN, Reacting to the issue, Dr Ifeanyi Casmair, described the structure put in place by Federal and State governments to curtail the COVID-19 outbreak as lopsided. In his view, having only five laboratories with testing capacity in a country as large as Nigeria is unacceptable. His words “The NCDC has initiated the provision of five public health laboratories for molecular diagnosis, but I want to tell you that laboratories for testing infectious diseases like the coronavirus should be commonplace in all the Teaching and Federal Medical Centres across the country. “The government at all levels should build the capacity of medical laboratories in all these hospitals and Federal Medical Centres. “As a matter of urgency, government should review the minimum package for health to incorporate medical laboratories at the Primary Health Care level. That is when we will be taken serious among the Comity of Nations. Ifeanyi said there can never be Universal Health Coverage without quality medical laboratory testing system. “Once we get it right, we will deal with this entire outbreak without fear. The good outcome of any disease is early detection and you cannot have early detection if laboratory is not at right level. “Very soon the country will run out of the testing kits for COVID-19 because the core people providing medical laboratory testing were schemed out of the entire response programme from the diagnosis stage. “In Nigeria we continue to neglect, regulate and sideline the medical laboratory scientist. Our populace will always be worse off for this. It is happening in the coronavirus era now. The response group is skewed.
“There is a presidential group now, but there are no medical scientists in the group. Today, the President created another committee called the Federal government Task Team, and there is also no medical lab scientist on that team. “In a situation where you will rely on a test to identify and categorise people for an outbreak of pandemic nature, yet frontline professionals have been left behind, there is a problem. “We do not know those testing for this virus. If you watch the press briefings in Lagos, you will only see the State Commissioner for Health giving all this information. “The question the media should ask is who is doing all these testings that Nigerians are being told the results? Are they the right persons to provide the testing services or are they people who have assumed roles that are not theirs? “At a time, I start to wonder why there are discordant results. For example, somebody tests positive and later tests negative. We have heard of all those discordant findings because the right people with skills and capacity for the kind of testing required in this pandemic are not involved. It is worrisome.” Calabar experience Further, Ifeayin said: “Today, I had a sour experience. People were using their hands to drip hand sanitiser on the palms of passengers as they were boarding the aircraft. Of course I refused to be contaminanted because for me, that was hand contamination and not hand sanitisation. I created a scene out of it. “It is commendable that government has shown political will. I want to shock you that the N1 billion the President released is enough to procure laboratory capacity but we are spending it on press briefings and placing emphasis on what will not give us the commensurate outcome.” Movement of specimens On the movement of specimens from one point to the other, he said: “The movement of specimens for high palliative hemorrhagic conditions like Lassa fever, Ebola and now COVID-19 is also a way to drive the disease into the population. “There was a time a specimen was being moved from one state in the South South zone to the Irrua Specialist Hospital. Normally, it should take a day to arrive, but it took more than four days. “At a point, they lost track of the specimen. It was a sample from a suspected Lassa fever case. That was just one incident and an example of how vulnerable people are. These are the issues. “When we say there is no installed laboratory capacity for disease containment for for a population of 200 million, people continue to pay lip service. We can only boast of five laboratories, and they have just came onboard following the efforts of Dr Chikwe Ikeweazu. But the five are not enough. “There are over 55 Teaching Hospitals in Nigeria, and there is no reason why each Teaching Hospital should not have a Class 3 biosafety cabinet. “It is a shame because some people want to see patients and want to take samples and do tests. That is wrong and that is not the practice. it is one of the reasons the health sector in Nigeria is in shambles.” On the cost of laboratories, Ifeanyi remarked: “If you go to the Nnamdi Azikiwe International airport, Abuja, you will see about 200 private jets parked there. “One private jet can buy all the equipment required. At the Muritala Muhammed airport, you will see well over 300 jets that are in the hanger and some of them belongs to ministers and past governors etc. these can buy the equipment. We need to build capacity to detect, isolate and treat affected people — Prof. Afolabi Lesi, Provost, College of Medicine, University of Lagos “We don’t have enough laboratories and we also need to build capacity in diagnosis across the country to the extent that somebody with coronavirus in the north doesn’t have to come to Lagos for diagnosis, either for coronavirus or any other viral disease. “A lot needs to be done in expanding the laboratory facilities across the country, even America has challenges in diagnosing this disease because it is not something you can do everywhere. “There should be worldwide effort in containing this and other diseases because this will not be the last disease outbreak. “On sample movement, Lesi said that if samples are not properly transported, the quality of the result can be affected.” He said: “There was a time that we had to fly a sample to South Africa and it didn’t get spoiled, so transporting samples is not a special thing but each state should have its own testing capacity. “We need to build capacity to detect, isolate and treat affected people. We need enhanced technology, whereby we don’t need to have face-to-face interaction before making a diagnosis. “If we have the number of coronavirus (COVID-19) cases they have in Italy or Korea, Nigeria will be overwhelmed.”