Category Archives: Hope iAfrica

Welcome to my space. I am a graduate of Physiology with subsequent training in Genomics and Global Health. My interests are Health, Medical Research and Civic Development.

I write about these interests to initiate discussions and policies that will lead to innovations as well as solutions in Africa. – Toyyib Oladimeji ABDULKAREEM

High Prevalence of Non-Communicable Diseases: Causes, Way Out, My Dream

It is no news that Nigeria is faced with several challenges, some of which are in health. We have read about the budgetary allocation and how our health institutions are doing. What we are not conscious of is the increasing burden and deaths due to non-communicable diseases (NCDs).

Nigeria accounts for not less than 27% of the global deaths due to NCDs according to the Director General of Nigerian Institute for Medical Research (NIMR) in 2016. What this means is for every given period, more than 1 in 4 persons die in Nigeria out of the total global deaths due to NCDs.

Causes of High Prevalence

It is known that genetics has a role to play in the development of chronic ailments. However, the situation has been worsened by health inequities, choice of lifestyle as well as the physical and social environments. We have accepted the situation and internalise it as our new reality. The government has not implemented the best buy interventions for NCD prevention and control.

We don’t have implemented rules guiding the sales of alcohol, tobacco and sugar. Our institutions are either not producing results or are not using them efficiently. The citizens keep abusing products that are bad for health, consume high salt and prefer sedentary lifestyle. We are not consciously doing something to change the narrative. The situation has led to increasing loss of family and friends to preventable deaths.

Way Out

What if we can prevent these deaths? What if we can extend the lives of those living with chronic ailments? What if we can reduce the rate of the development of these diseases among the younger generation? If all these are possible which are, by the way, we should explore the options. We only need to do more individually and collectively. Just as our Government and non-state actors, we need to take a stand and work to reduce NCDs in our lives, our homes and our neighbourhood.

I lead a consortium of young minds, The Wellbeing Initiative, who are troubled by the statistics and have pledged to work towards beating NCDs in Nigeria. I meet young minds who are advocates for better lifestyle and diet. I appreciate the steps taken by the government so far. I see the unrelenting attitude of non-state actors and organisations who dedicate their resources to curbing the menace. I read about the activities of international organisations and States to create a better world where people don’t die of preventable deaths.

My Dream

I have a dream of a different world, a world with reduced chronic diseases, where patients are cared for. A world with better quality of life for those living with NCDs. In this world, we don’t suffer the agony of losing loved ones to preventable deaths. Likewise, we are not losing our brilliant minds and future nation builders at a tender age.

Until we get to that world, we all have to realise the challenge and do our best in our roles. I believe that our government should unify our efforts using guided policies and strategic plans towards reducing NCDs in Nigeria. I believe that we need to implement strict laws guiding the use of tobacco, alcohol, sugar and other causatives of NCDs.

I believe that the civil society – academia, civic organisations, youths and other stakeholders should take up the challenge to intensify efforts towards doing what they’re doing to change the narrative. Above all, I believe that we all should individually consciously alter our lifestyle for better health and well-being.

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Hope for Medical Research in Nigeria

While on my quest for an understanding of the medical research in Nigeria, I documented my findings and shared the challenges. Looking beyond all that, I have found some reason to smile. In the face of these difficulties, there is some hope for the field.

From the work on Lassa fever at Redeemer’s University to the work on tropical health at the University College Hospital, Ibadan; All over the country, Nigerian researchers are providing answers to some of our questions in health. They have found a way to make things work.

Funding

There is a unanimous conclusion that the Federal Government should increase funding. However, some initiatives if sustained are paving way for more to be done. Recently, Professor Oye Ibidapo-Obe gave an account of a US$5-million research grant given to the Nigerian Academy of Science (NAS) by the Federal Government.

In 2011, The Tertiary Education Trust Fund (TETFund) was introduced to distribute public funding for infrastructure in the nation’s universities, and for research through competitive grants. In 2016, the Government also announced a ₦ 3 Billion National Research Grant.

Grants from donors like the World Health Organisation (WHO), United States Agency for International Development (USAID), African Development Bank and Non-Governmental Organisations like the MacArthur Foundation continually finance research works around the country. Either to set up infrastructure or carry out a particular research, donor funds are a big part of research in Nigeria.

Collaborations

In a paper, Banji Oyelaran-Oyeyinka and Bolade Abiola Adewale evaluated University collaboration in Nigeria. They stated that such collaborations propel innovation. While more collaboration will help the system, the synergies that have been formed and are forming are providing faculty members and students as well as the institutions with new insights on getting results.

Collaborations between Nigerian institutions and those in the United States of America, the United Kingdom and the rest Europe as well as with Asian institutions have increased. We now have more exchange of students and faculty members as well as training and fellowships.

There are more visiting faculty members and joint research works. Some partnerships even run joint degree programs. Nigerians in the diaspora now run research with a focus on questions in Nigeria. All of these are laudable and worth celebrating, they are yielding new innovations and providing a new way out around the country.

Translational Research

Translational research applies findings from basic science to enhance human health and well-being. In a medical research context, it aims to “translate” findings in fundamental research into medical practice and meaningful health outcomes.

This explores collaboration between and among teams to ensure that findings translate to better health in the populace. To put this in perspective, translational research is initiating discussions and influencing policies based on a finding to lead to better health.

Research findings are not accidental, they are scientific data collected from carefully thought and designed experiments with the motive to answer a particular question. There have been more done in this respective. We now have more synergies between our teaching hospitals and institutions. We now have a synergy between the academia and the community.

My first time of hearing about this was when President John Dramani Mahama talked about ‘the town’ and ‘the gown’ at my convocation. Since then, I have heard more and witnessed it put to practice. This should be encouraged and further exploited.

This is great news as it means that data is put to better use aside from the publications and presentations as well as the personal glorification that follows scientific discoveries. It also means that every stakeholder (health care practitioner, policy makers and the government) can use this data to ensure better health for all.

Technology

We are yet to enjoy all the advancements in Technology like some countries do. While this poses a serious limitation, Scientists in Nigeria have devised means to ensure their experiments sail through. We have also had more research at the molecular level. This can be attributed to some laboratory in the country that now provide services that are before now can only be done outside the country.

From the new cancer research and training center of the Nigerian Institute of Medical Research, the Bioscience Unit at IITA to the new laboratories in our institutions, technology is helping scientists do more than before. With new infrastructures – governmental and non-governmental, we now have new choices. All of these reduce the burden of research and will help ensure quality, efficiency and reproducibility.

While we anticipate a better world of Medical Research in Nigeria, researchers should focus on using the resources available judiciously and sustainably. They need to get out; apply for grants, make good use of the limited source, work on forming synergies and learning, open their minds to advancement in technology as well as believe in translational science. The health and betterment of the community should be the ultimate.

The Deplorable State of Medical Research in Nigeria

Some weeks ago, I was in the office of one of my Professors. I had sought her guidance on my research prospect. The ensuing discussion was about medical research in our society. In the end she requested I do more findings on happenings around. This led me to seek an understanding of the subject. My findings were interesting and saddening.

History of Medical Research in Nigeria

Medical research in Nigeria is as old as humans can remember. According to Nwafor Chidozie in a 2015 publication in the Journal for Studies in Management and Planning, History has it that Nigerians always found a way to combat ailments through the use of crude concussions prepared mostly from plant sources. Even with the advent of modern medicine, these native practices strongly exist with accompanying results.

Emergence of institutes

According to reports submitted by the National Consultative Team and the National Advisory Committee on Essential National Health Research In a March 2000, Medical research began to develop in Nigeria in 1920 when the Rockefeller Foundation established the Yellow Fever Commission. The report recounts the evolution of bodies responsible for the management of science in general and health research in particular. The bodies mentioned include the Nigerian Council for Science and Technology (NCST, 1970), the National Science and Technology Development Agency (NSTDA, 1977) and The Nigerian Institute for Medical Research (NIMR, 1977). The later ones include; National Institute for Pharmaceutical Research Development (NIPRD) and National Agency for Food and Drug Administration and Control (NAFDAC).

Outcomes and Challenges

Nigeria has had a fair number of novel medical research with some making waves globally. There have been works on Lassa fever, discovery and testing of pharmacological compounds, molecular study of diseases and a host of others. However, this is shadowed by the numerous challenges present in the field.

Read: How Eight Nigerians Discovered the World Foremost Anti-sickle Cell Drug

In a research to sample the opinions of medical researchers in the country, published in the Journal of Human Research Ethics, Adeleye and Adebamowo, discovered that amidst several factors, researchers in the country admit several wrongdoings in the field. Also Nwafor Chidozie, in his publication highlighted problems associated with investment and funding, infrastructures, relocation of bright minds and the mode of communication.

Under-funding

Over the years, the Federal Government’s budgetary allocation to the Ministry of Health has been below par. In 2015, the health budget was 257 billion Naira, representing about 5.5 per cent of the national budget which is a far cry from the 15 per cent standard stipulated by the World Health Organization. Of this allocation, the Nigerian Institute of Medical Research (NIMR) which is under the Federal Ministry of health had a total allocation of 876,164,637 Naira. Again, only about 6 per cent of this (50 million Naira) covers total Capital Expenditure. Other related health and medical research agencies face almost the same ordeal.

Read: What Africa Loses By Underfunding Science

Poor Infrastructure

If funding is poor, infrastructure will equally be poor. This is simply because funds are needed to build and maintain structures, as well as purchase facilities and upgrade existing ones. Nigeria, a country of approximately 170 million people sadly cannot boast of 5 standard medical research centers functioning at full capacity. The resultant effect is that we cannot carry out comprehensive data collection and analysis for research within the shores of the country.

Brain drain

Brain drain is simply the loss of intellectual and technical labor through the movement of such labor to more favorable geographic, economic or professional environment. This sequence transcends almost all professions in the country. We continue to experience a mass exodus of our best brains to other viable countries because we have refused to take the necessary measures to keep them within.

Read: Scientific Research and Brain Drain in Africa

Wide Communication Gap

Looking critically at our system of communicating results and opinions, one would find a wide gap. It is assumed that if people knew better, they would do better. A large number of the populace do not have access to medical and health information. This is more evident in rural areas as most medical services are concentrated within urban settlements. The challenge herein lies in the fact that most rural dwellers cannot access major information platforms such as the electronic and print media; hence, information campaigns have to be taken physically to these places incurring more logistic cost. Another unfortunate scenario is the fact that local researchers hardly get their works published in reputable international journals.

Read: The Need for Science Communication in Africa

My Recommendations

My findings aligns with the Professor’s thoughts. The situation we have found ourselves is alarming and we must act soon. With my findings, I want to suggest:

  • Adherence to the World Health Organization set standard of 15 per cent national health budgetary allocation, revision of the budget structure and credence given to capital expenditure over recurrent expenditure.
  • Implementation of every aspect of the National Strategic Health Development Plan launched in 2010.
  • Sustenance of existing medical research institutes, and the establishment of more spread across the geo-political zones.
  • Encouraging corporate sponsorship of research programs in the country. We must also ensure training and retraining of the country’s researchers both locally and internationally.
  • Multi-sectoral collaboration, liaising with Nigerian academics and intellectuals in the diaspora, networking with western and European universities that have African-centered initiative programs, and funding by government, foundations, non-governmental organizations (NGOs), among others, to achieve synergistic effects.