Human Rights and Governance in COVID-19 Bulletin – Issue No. 7

Human Rights and Governance in COVID-19 Bulletin

Published by the Secretariat of the Joint Action Civil Society Coalition (Nigeria Mourns)

Weekly Bulletin: Issue No. 7                                                                       Tuesday, 30th June 2020

Learning A New Normal

When Heraclitus, the Greek philosopher said that the only constant thing was change, he spoke of centuries ahead, and his statement resonates today as the world grapples with many changes in its attempt to adapt into new ways of living amidst the coronavirus pandemic which has ravaged the world and occasioned a global death toll surpassing 500,000. As countries begin to ease off lockdown restrictions in charting the new normal, there is still a need for caution. As the World Health Organisation chief, Tedros Adhanom Ghebreyesus, warned on Monday, June 29, 2020, “although many countries have made some progress, globally, the pandemic is actually speeding up and the single most important intervention is tracing quarantine contacts.”

The situation in Nigeria aligns with Chief Ghebreyesus’ warning, as the COVID-19 numbers have been on the rise. Thus, Phase Two of the eased lockdown was further extended by another four weeks with effect from Tuesday, June 30, 2020, through midnight of Monday, July 27, 2020. The PTF observed with growing concern the non-compliances with measures designed to prevent transmission and protect vulnerable segments of the population, which has led to the current caseload of 25,133 confirmed cases, with 9,402 discharged and 573 deaths recorded, having carried out 134,257 tests in 35 states and the Federal Capital Territory as at Monday, June 29, 2020. A state by state analysis of the Covid-19 data can be seen here.

These statistics show that Nigeria accounts for 0.1% of the current global death toll. Though the percentage seems little, it should not be considered insignificant when compared to the actual numbers of death and most importantly, the value for life. One of the recent victims of COVID-19 deaths in Nigeria was the immediate past Governor of Oyo State, Abiola Ajimobi, who died on Thursday, June 25, 2020, at age 70 after battling coronavirus for a month. The Nigeria Centre for Disease Control, NCDC through its twitter handle on Tuesday, June 30, 2020, stated that 3 out of every 5 Nigerians who die from COVID-19 was more than 50 years old; this was after it released a COVID-19 Advisory for Vulnerable Groups on Monday, June 29, 2020.

 State of the Nation

A Recession Ahead

COVID-19 pandemic, coupled with the collapse in oil prices, is expected to plunge the Nigerian economy into a severe economic recession; the worst since the 1980s. A statement by the World Bank estimated that the country’s economy would likely contract by 3.2% in 2020. For more on this, click here.

Businesses have stopped operations

According to a research by the Nigeria Employers’ Consultative Association (NECA), 74.2% of businesses in Nigeria have stopped operations due to the COVID-19 pandemic.

Nigeria not considered a research location for COVID-19 Vaccines

The Executive Director and Co-founder, Health Africa, Adam Thompson, has said Nigeria has not been considered a research location for COVID-19, due to challenges of infrastructure, huge financial requirements, and bureaucratic issues, among other hindrances. Importantly, he noted that if Nigeria became a site for clinical trials of the COVID-19 vaccine, it would gain priority access to some of the vaccines, when developed. Otherwise, it will be at the back of the line, in terms of vaccine manufacturing.

PPEs from China

The Federal Government on Friday, June 26, 2020, received donations of  Personal Protective Equipment (PPEs) from China to further strengthen the fight against COVID-19. The items include: 40,000 disposable masks, 1,500 disposable medical protective suits, and 1 ‘Infra-Red’ thermal imaging thermometer unit. This comes at a time when frontline health workers have clamoured insistently for the provision of protective equipment to shield them from undue exposure to the deadly virus.

Schools open only to graduating classes

The Federal government on Monday, June 28, 2020announced, the restricted reopening of schools for only students in Primary 6, JSS3, and SS3 to enable them to prepare for their national examinations.


The Rape Pandemic

The rage against the upsurge in reported sexual violence cases across the country has continued to occupy frontpage news along with the COVID-19 pandemic. The Niger State government through the Secretary to the State Government, Ahmed Ibrahim Matane, on Thursday, June 23, 2020, suggested laws in the nation’s statutes were not strong enough to deter rapists, considering the increasing attacks on women across the country. He faulted the implementation of extant laws, stating that they were not punitive enough, because there were insufficient examples to show that offenders were being penalised for their crime.

Some notable cases within this period include:

A 50-year-old father, Adeleye Fayemiwo, allegedly raped his 13-year-old daughter in Ibokun Local Government Area of Osun State on Wednesday, June 17, 2020.

A 22-year old man, Ikechukwu Okoli, was arrested for allegedly raping a 10-year- old girl in Idemili North Local Government Area of Anambra State on Monday, June 22, 2020.

A six-year-old girl was raped to death at a mosque in Kaduna state, by yet-to-be-identified persons. Her lifeless body was found in a mosque located at New Road, Kurmin Mashi by Nnamdi Azikiwe bypass on Friday, June 26, 2020.

The Akwa Ibom State Commissioner of Police, CP Imohimi Edgal announced that the Police Command had arrested a Pastor and 11 other suspects for various cases of rape and defilement in the state. The 33-year-old pastor was said to have on several occasions raped a 15-year-old girl at his deliverance center and had attempted to rape a 21-year-old girl as well.

A 19-year-old girl revealed on Saturday, June 27, 2020, how her 61-year-old father had been having carnal knowledge of her since the previous year, in their home at Ikorodu, Lagos. When she discovered that she was pregnant, the father had taken her to a chemist who facilitated an abortion for her. Both the father and the chemist were apprehended by the police and the girl was taken to Mirabel Center; a Sexual Assault Referral Centre (SARC), for medical attention and forensic examination.

Across the Regions

North Central

Nasarawa State

The coalition of Nasarawa State Health Professional Associations embarked on indefinite strike action after 50 of its members tested positive for Covid-19. The indefinite strike action commenced after an initial seven days warning strike, due to the government’s failure to meet its several demands which included the non-implementation of promotion and annual increment policies for over 10 years; non- implementation of the new minimum wage bill; non-implementation of the Covid-19 memorandum of understanding (MOU) on hazard allowance and life insurance for all health workers in the state and local government areas.

Kogi State

Governor Yahaya Bello of Kogi State continued to insist that the state is COVID-19-free despite the recent death of the state’s Chief Judge, Justice Nasiru Ajanah, at an isolation facility. Governor Bello claimed that the late Chief Judge died of natural causes, having been battling an illness before the advent of COVID-19 in the country, and therefore urged Kogi residents to ignore any news of Coronavirus in the state. The governor’s insistence on the state being COVID-19-free is remains questionable as the NCDC had reported 4 cases on admission in the state. This refusal to recognise the existence of COVID-19 in the state reportedly led to an attack by unknown gunmen at the Federal Medical Centre (FMC), in Lokoja, on Wednesday, July 1, 2020. The violent attack was to prevent doctors from holding their press conference and protest against the lack of COVID-19 screening centre in the state.

North West

Kaduna State

The Nigeria Centre for Disease Control (NCDC) on Thursday, June 26, 2020, announced the activation of a GeneXpert laboratory in Kaduna State. This brings the total number of labs in the NCDC’s Molecular Laboratory Network to 39, with labs in Ondo and Gombe in progress.

Following a recent discovery of a COVID-19 case among the Assembly staff, Speaker of the Assembly, Hon. Yusuf Zailani gave the directive on Tuesday, June 23, 2020, that all members of the Kaduna State House of Assembly, and staff working in the Assembly were to submit themselves for coronavirus testing.

Kano state

As of June 20, 2020, about 13% of Kano state residents tested for COVID-19 tested positive for the virus, according to an official report released by the Kano State Ministry of Health titled: ‘COVID-19 response update: Kano laboratory overview’. It indicated that as of June 20, the state had collected 9,103 samples, with 8,948 results retrieved, 155 samples pending, and 1,191 confirmed positive cases.

 North East                                                                            

Bauchi State

Bauchi State Governor, Bala Mohammed during the commissioning of the state’s molecular test center at the Bauchi State Specialist Hospital on Monday, June 28, 2020, claimed that his administration spent more than N15 million weekly to fight the coronavirus disease (COVID-19). He explained that the money was used for healthcare workers’ allowance, contact tracing, surveillance, case management, risk communication, logistics and supply, infection prevention, and coordination.        

South West

Lagos State

The Lagos State Government signed a memorandum of understanding with seven private medical laboratories to increase the testing capacity for COVID-19 in the state. The seven private laboratories included in the COVID-19 Laboratory testing strategy had undergone rigorous accreditation and validation process by the state’s Health Management Agency, HEFAMAA, and Lagos Biobank.

To improve teaching, learning, and safety in the face of the COVID-19 pandemic, the University of Lagos on Monday took delivery of three robots for temperature and blood pressure checks and the provision of other data thereby reducing human-human contact. The robots were donated by Platform Capital, a global investment firm.

Ondo State

The commissioner for health in Ondo State, Wahab Adegbenro, died on Thursday morning, July 2, 2020, at the state infectious disease hospital where he was receiving treatment for COVID-19. This occurred two days after the state governor, Oluwarotimi Akeredolu, tested positive for the deadly disease. The governor confirmed this via his Twitter handle on Tuesday, June 30, 2020, that he had tested positive for coronavirus and had gone into self-isolation. Akeredolu also directed all members of his cabinet, close aides, and others who had recent close contact with him to undergo a compulsory COVID-19 test.

Oyo State

Oyo State Commissioner for Youth Development and Sports, Seun Fakorede has tested positive for COVID-19. Although asymptomatic, the Commissioner stated that he had gone into isolation to avoid spreading the virus.

South East

Abia

Residents of Abia state remained anxious as several tests carried out on the state Governor, Okezie Ikpeazu continued to show that he still has the coronavirus after he was first tested positive a month ago. He has remained in intensive care at his home in Abuja, where he has been for almost one month.

Enugu State

Enugu State Governor, Rt. Hon. Ifeanyi Ugwuanyi has continued to set the pace with his administration’s proactiveness, commitment, and outstanding initiatives in tackling the spread of the COVID-19 in the state. Once the index case was confirmed in Nigeria, the Governor had released the sum of N350m to Enugu State COVID-19 Multi-Sectoral Rapid Response Team, set up by his government and made up of renowned health professionals and government functionaries. The state government had also built and equipped Treatment and Isolation centers at (GRA) Nsukka and ESUT Teaching Hospital Parklane, Enugu. To ensure the commitment and efficiency of the frontline health personnel, Ugwuanyi had also approved life insurance packages and improved work benefits for its COVID-19 health workers, which was the first of its kind in the country when the pandemic broke out.

Anambra State

Special Adviser to Governor Willie Obiano of Anambra State on Indigenous Medicine and Herbal Practice, Dr. Onyekachukwu Ibezim claimed that the government had identified six herbal drugs that could be used to manage coronavirus in the state. Ibezim told the News Agency of Nigeria (NAN) in Awka on Tuesday, June 30, 2020, that the agency had forwarded the products to the National Agency for Food, Drug Administration and Control (NAFDAC) for approval.

South-South

Delta State

Delta State governor, Ifeanyi Okowa, and other members of his family went into self- isolation after his daughter tested positive for COVID-19. The Secretary to the State Government (SSG), Mr. Chiedu Ebie, and the state’s Commissioner for Information, Mr. Charles Aniagwu, also tested positive for the virus. Urging the people to observe basic hygiene protocols, the governor raised an alarm over the increase in the number of COVID-19 cases in the state and warned that COVID-19 was not a hoax.

Rivers

Governor Nyesom Wike of Rivers State has directed all Government House personnel to undergo compulsory Covid-19 tests to ascertain their status. Wike, who disclosed this in Port Harcourt, on Monday, June 29, 2020, while receiving three ambulances donated by the BUA Foundation, said the increased testing had revealed more positive cases in the state.

Akwa Ibom

Akwa Ibom State Government House reported a rise in the number of cases of coronavirus infection among its staff, when in June 16 members of the Government House Press Corps tested positive for the virus and were all relocated to isolation centers at the Ibom Specialist Hospital for treatment. Other journalists who had contacts with members of the press corps were monitored for two weeks. Governor Udom Emmanuel, worried by the trend, had ordered the mass testing of personnel of other units and resulting in the further confirmation of 35 cases. Domestic staff, protocol staff, security, and others working in the Government House were on the order of the governor subjected to testing, and most of them had turned out to be positive.

COVID-19 in Africa

The World Health Organisation’s (WHO) Regional Office for Africa in Brazzaville, Congo, reported on the confirmed number of cases of COVID-19 on the African continent on Monday, June 29, 2020, as being over 380,000 via its regional official Twitter account @WHOAFRO. It stated that “there are over 380,000 confirmed COVID-19 cases on the African continent – with more than 181, 000 recoveries and 9,500 deaths’’. According to the report, South Africa had recorded 138,134 cases and 2,456 deaths, followed by Nigeria with 24, 567 confirmed cases, and 567 deaths, and Ghana with 17, 351 confirmed cases and 112 deaths. It also reported that countries currently with the lowest confirmed cases in the region were Seychelles had 77 confirmed cases with no deaths, Gambia, 45 cases and two deaths, and Lesotho had 27 with zero deaths.

African Union Ministers of Health and Heads of Delegation virtually met on the 24–25 June 2020 at a conference to develop a vaccine strategy for COVID-19 in Africa. The delegation commended the efforts of Africa CDC to coordinate the implementation of the Africa Joint Continental Strategy for COVID-19 Outbreak and to rapidly establish an Africa COVID-19 vaccine development and access strategy, which would serve as the roadmap to better coordinate and scale-up efforts across Africa. According to them, the strategy is intended to have two major prongs which would secure sufficient vaccine supply and remove barriers to a vaccine roll-out. The full report from the conference can be viewed here.

Opinion

PROFLIGACY, OPACITY, CORRUPTION, AND GOVERNANCE FAILURE: THE UNDERLYING PUBLIC HEALTH PANDEMIC IN NIGERIA. By Jaye Gaskia, June 2, 2020.

Let me begin with my conclusion. The ongoing COVID 19 Pandemic is happening on the back of a preexisting structural and congenital pandemic of dysfunctional, irresponsible, opaque, and incompetent governance, engendering a monumental failure in the delivery of basic social services in general, and public health care service delivery in particular.

I will now proceed to illustrate the basis for this conclusion with the following:

According to a Premium Times report, in mid-July of 2017, the FGN had announced plans to revamp 10,000 Primary Healthcare Centers (PHCs) across the country at an average cost of N25M per PHC.

The reason for this initiative had been laudable – to reverse the dilapidated and discredit condition of PHCs across the country.

When the initiative was announced by the then Health Minister, investigative reports by some journalists had found that between 2004 and 2015, there were 806 abandoned PHC projects across the country for which a whopping total of N25.2bn had been expended. The report had found that contractors had vanished into the thin air with contract sums without ever undertaking the contract, or after executing part of the contract and abandoning the projects, leaving communities unaware that they were supposed to have had a PHC, or at a loss as to what had become of the uncompleted PHC.

SE Nigeria for instance accounted for N5.8bn (23%) of the total, with 96 such PHC projects which were either untraceable or abandoned.

The ICiR Nigeria, an online investigative media which conducted the investigative report had found a total of 1250 contracts valued at N30.59bn awarded by the FGN for the supply of equipment and construction of PHCs nationwide in the 10 years from 2004 to 2014 were either abandoned or not properly excited to specifications.

Yet in spite of this, and since then, no one had been indicted, prosecuted, and punished, nor has any of the apparently embezzled funds recovered. And this by a supposedly corruption-fighting regime, for which healthcare delivery is supposed to be a priority!

Furthermore, in December 2018, the same government through the previous Health Minister (let us not forget that the current Health Minister was then the Minister of State for Health), had with funfair at a colorful media ceremony inaugurated a Special Health Intervention Fund (SHIF) of N28bn to be disbursed and utilised in 2019.

According to Premium Times report of December 7th, 2018, in a report of their coverage of the Ministerial inauguration of the Fund, the Special Health Intervention Fund was to cover the following:

  1. Revitalization of 774 PHCs across the country (one PHC per LGA);
  2. The purchase and provision of additional ant retroviral drugs for 20,000 Nigerians living with HIV-AIDS;
  3. The conduct of nationwide screening for common cancers like Cervical, Breast and Prostate cancers;
  4. Performance of free surgeries for 10,000 persons suffering from cataract (with at least 250 per each state of the federation and the FCT);
  5. Free Treatment for 800 patients with confirmed diagnosis for Hepatitis C infection;
  6. Revitalisation of 21 Federal Teaching Hospitals (FTHs) spread across the country, with each of the benefiting 21 FTHs to get N300M; (N6.3bn total)
  7. Revitalisation of 31 Federal Medical Centers (FMCs) again across the 6 geopolitical zones, with each getting N150M; (N4.65bn total)
  8. Refurbishment and equipping of 4 Specialist Hospitals (SHs) – across the country at a cost of N200M each (N800M total); and
  9. The refurbishment and equipping of 14 Fistula and Cleft Palate Centers across the country at the cost of N150M each (N2.1bn total).

Now, what is the point of going into this much detail? Simple – what has happened to these funds and to the purpose for which they were designated?

Where are the 774 PHCs that benefitted from these funds located? In which communities? And in which LGAs? Were the Local Government Council administrations and the state governments where these 774 PHC s are located involved in Any way in the execution of the projects? Were the communities hosting the PHCs involved? Who are the contractors that handled these projects? How were they selected? Was the money ever actually disbursed?

Let us add to the forgoing another instance. In 2018 for the first time, the NASS appropriated for the 1% of the consolidated revenue fund to be designated for primary health care delivery development in a Basic Health Care Provision Fund (BHCPF).

This 1% which is in accordance with the National Health Act amounted to N55bn in the federal 2018 appropriation act.

If we recall, the 2018 Appropriation Act was signed into law by the President in June 2018. However, according to the Business Day Report of May 21st, 2019, one year on, and almost at the tail end of the budget, only 22 states out of the 36 states of the federation had registered and signified their intention to fulfill the conditions to access the funds. 14 states as at that time, had not registered. The fund is specifically set aside for meeting the needs of primary health care delivery across the country.

And What were these conditions? To qualify by law each state is expected to establish their own primary health care agency; as well as establish a state health insurance scheme to fund coverage of citizens and residents. The final condition was that each state was to provide a counterpart fund of N100M to add to whatever amount the state was applying to access from the BHCPF.

The import of the above instances is that in 2019 alone from the Federal Government the total sum of N83bn (N55bn + N28bn) was made available for public investment in improving primary health care delivery. This sum does not include what states and LGAs were to allocate to primary health care.

If we set this N83bn available in 2019 against the backdrop of the N30.59bn that had been expended on 1250 primary health care delivery contracts that were either not executed, or improperly executed between 2004 and 2014; within the context of lack of information and opacity surrounding the 2018/2019 allocations, then we should be very wary indeed.

Why is the relevant NASS committees not raising any issues? That such huge sums of public funds appropriated by the NASS could have disappeared into abandoned projects speaks volumes of the capacity and the ability of the legislature to perform effective and efficient oversight functions over the executive. It is also a manifest indication of the faulty foundations of our budgetary processes.

If all the resources allocated for primary health care delivery since the inauguration of this 4th Republic had found their way to the PHCs and had been diligently utilised, primary health care delivery as the foundation of public health care delivery would have been enhanced, the PHCs would not have been in their current state of dilapidation and disrepair, and perhaps, they would have been better placed to play a significant role in preventive and containing measures for infectious diseases in general, and the current COVID 19 Pandemic in particular. The PHCs would have been to support an efficient contact tracing and tracking system, as well as to provide efficient support for containing community transmission through community testing.

But alas we are where we are now. Questions need to be asked, answers need to be provided, and culprits need to be identified, punished, and prosecuted, with looted public funds recovered.

So, once again, where are the 774 revamped PHCs? Where are the 21 revitalized Federal Teaching Hospitals? Whatever has become of the 31 Federal Medical Centers? And what on heart happened to the 4 Specialist Hospitals and the 14 Fistula and Cleft palate Centers?

The Joint Health Sector Unions (JOHESU), the Nigeria Medical Association (NMA), the National Association of Resident Doctors (NARD); and the central trade union centers – The NLC and TUC), along with journalists and media practitioners as well as Civil Society, all need to take up these issues, raise these questions and demand answers from appropriate authorities.

Citizens as the ultimate beneficiaries of services and right holders must raise their voice.

I conclude by urging all citizens to demand action, to demand accountability from relevant authorities on these issues.

What is the current status of the N28bn Special Health Intervention Fund inaugurated in December 2018? What is the current status of the BHCPF – from the 2018, 2019 & 2020 Federal budgets?

Let us demand accountability for these routine and previous funds, and by so doing also signal our determination to demand accountability for the billions and trillions already being set aside for special COVID 19 Intervention funds – the N50bn TCF for MSMEs and the N100bn Special facility for the medical and pharmaceutical sector, both already established by the CBN for instance.

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