Why Nigeria could become the next Covid-19 catastrophe after India

ABUJA, Nigeria— Nigeria has reported the Indian variant of the coronavirus, according to the World Health Organization (WHO), but there are fears across the country that Africa's most populous nation, which bears several similarities to India, could become the next Covid-19 hotspot.

Like India, Nigeria's main cities are massively populated and, like the South Asian nation, Nigeria suffers poor access to coronavirus vaccines and is experiencing a huge health crisis. Across the West African nation, hospitals already face huge burdens as alarming numbers of cases of infectious diseases and common sicknesses like malaria and HIV/AIDS are coupled with lousy health infrastructure and low numbers of medical workers. 

According to the Nigeria Medical Association (NMA), there are only 40,000 doctors in a country of around 200 million. Nigeria's doctor-patient ratio is among the lowest in the developing world, with four physicians looking after 10,000 patients, a report by the WHO, which also revealed that the country has only five hospital beds for every 10,000 people, noted.

"The country is nowhere near being equipped enough to deal with the same kind of situation we've seen in India," Dr Collins Anyachi of the Department of Family Medicine, University of Calabar Teaching Hospital in southern Nigeria, told TRT World. "If such an unfortunate situation befalls Nigeria, it's health system would collapse in no time."

Across the country, according to the most recent statistics from the Nigeria Centre for Disease Control (NCDC), 165,901 coronavirus infections and 2,067 deaths have been reported since the start of the pandemic. But virtually all these numbers are undercounted since testing has been very limited, and parts of the country — notably the northeast and northwest — are experiencing insurgent attacks that make any public health initiatives almost impossible to undertake. In the midst of this violence, the virus could be spreading without anyone even realising.

"Many people in the northeast and northwest regions will be more worried about surviving attacks by armed militants than whether or not they've come in contact with someone who has Covid," Okon Nya, a prominent Nigerian journalist and security analyst told TRT World. 

"Nigeria is not just in a challenging situation, it may be about to face a disaster."

It is still not clear how far the Indian variant (B.1.617.2) has spread in Nigeria, as health authorities don't seem to have comprehensive figures, but with the new detection, there are fears that if the disease gets into the country's poorest neighborhoods, like India, overcrowding and very poor sanitation could lead to extremely quick community transmission. 

Vaccine woes

What's even worse for Nigeria is its abysmal vaccination efforts, with only 1 percent of its population partially vaccinated (India has fared slightly better, fully vaccinating 3 percent of people in the country), and perhaps only a handful fully vaccinated. The African nation, unlike India with a couple of vaccine-making companies, has no industry to manufacture a shot.

Nigeria is one of many developing nations relying on vaccines made in India through the Covid-19 Vaccines Global Access program known as COVAX. 

The joint venture between the WHO, the Center for Epidemic Preparedness and Innovation (CEPI), Gavi, and the United Nations Children’s Emergency Fund (UNICEF) was set up in April 2020 to pre-purchase large quantities of vaccines from the major manufacturers and then give them out globally in such a way that each country received an equitable share based on the size of their population. But the devastating nature of the pandemic in India has ensured that the country is unable to meet demands overseas.

At the start of March, COVAX shipped nearly 4 million doses of the AstraZeneca/Oxford vaccine, manufactured by the Serum Institute of India (SII), from India's largest city of Mumbai to Nigeria's capital, Abuja. Since then, no new vaccines have arrived in Nigeria.

"COVAX is undersupplied," UNICEF Executive Director Henrietta Fore, said in a statement at the start of the week. “Among the global consequences of the situation in India, a global hub for vaccine production, is a severe reduction in vaccines available to COVAX."

A drastic rise in demand for coronavirus vaccines in India ensured that 140 million doses intended to be distributed in May to low-income countries, including Nigeria, were unsent. The problem doesn't end there.

 "Another 50 million doses are likely to be missed in June," said Fore, who maintained that "vaccine nationalism, limited production capacity and lack of funding, is why the roll-out of Covid vaccines is so behind schedule."

Multi-dimensional

Added to Nigeria's Covid fears is the worsening security situation in large parts of northern Nigeria. Violent extremist groups Boko Haram and the Islamic State West Africa Province (ISWAP) have become even more deadly in recent months and are expanding their operations beyond the northeast of the country. 

Criminal attacks have risen alarmingly in the northwest and herdsmen from Nigeria’s Fulani tribe, who have constantly been at loggerheads with farmers in the north-central region, are believed to be behind the increased killings in agrarian communities in large parts of northern Nigeria.

"Even if vaccines become available for everyone, there's going to be the problem of how to administer to people in conflict areas that are so unsafe and hard for medical workers to access," said Dr Anyachi, who has worked as a physician in conflict-hit north-central Nigeria in the past. 

"The problem isn't just acquiring these vaccines but ensuring that a vast majority of the country gets vaccinated."

For many, if the looming crisis adds to the mounting security problems Nigeria is facing, the country could be heading for a catastrophe never seen anywhere in the world.

"The armed forces, which, in a pandemic like this, can be deployed to assist with logistics and setting up of mass vaccination sites, are already overstretched in the fight against insurgents," said Nya, who's also the head of Nigeria's leading media consulting firm, Tre Gong. 

"If this new Indian coronavirus variant begins to spread like wildfire, Nigeria will be in deep trouble."