COVID-19: Assessing the Presidential Steering Committee

Established by President Muhammadu Buhari on March 9, 2020, the Presidential Task Force (PTF), which  later metamorphosed into the Presidential Steering Committee (PSC) on COVID-19, was mandated to provide overall policy direction, guidance and continuous support to the National Emergency Operations Center (EOC) at the Nigeria Centre for Disease Control (NCDC).

It also provided such direction to other Ministries and Government Agencies involved in response activities to devise and implement a National Response Strategy on COVID-19.

Headed by the Secretary to the Government of the Federation, Mr. Boss Mustapha, the PTF hit the ground running and gave hope that the health sector will finally receive the proper attention from the government in response to the lessons learned from the pandemic.

On arrival of the virus in Nigeria, testing became a massive issue because Nigeria had very few molecular laboratories to conduct the COVID-19 tests.

The PTF embarked on a massive establishment of laboratories for testing and commenced the use of GeneXpert across the country to scale-up testing.

Before the pandemic, the country had just five molecular laboratories that could scale for a virus like COVID-19. 140 new laboratories were built and commissioned across the country, as of July 2021.

Now every state has at least one public health laboratory with molecular testing capacity. The pandemic also engineered the establishment of 12 standard molecular labs with capacity beyond scaling for COVID-19.

The task force said that the country’s response had been led by science and driven by the power of coordination, collaboration and solidarity by federal and state governments, partners, the private sector and citizens.

Before confirming the first case in Nigeria, the country began preparedness activities with support from international donors. The PTF started working with states and hospitals to map out and establish isolation and treatment centres for the management of the virus. In addition to this, health workers were trained on case management, infection prevention control, surveillance, risk communication and other areas of epidemic preparedness and response.

Through the Private Sector Coalition Against COVID-19 (CACOVID), each state was to receive a 30-bed Intensive Care Unit (ICU) for critical care. President Buhari also approved the construction of one oxygen plant in each state of the federation and the FCT.

Meanwhile, the task force in March 2021 was rebranded the PSC to push further the coordination of the vaccine rollout, deployment and administration, while a private sector-supported transition consultant sustained the multi-sectoral relations and policy guidance.

Research and science have also contributed in taking the battle against COVID-19 to the vaccines stage. Global vaccine nationalism is still raging but the country has succeeded in accessing millions of doses of vaccines through partnership and diplomatic efforts.

The PSC has reported that the acquisition of sufficient doses that will enable the government vaccinate 70 per cent of its population is in progress.

With these steps, have the interventions changed the narrative in the nation’s health sector? Well, some health experts said the result is mixed. They said that the quality of health care services delivered is poor in the country and remains a huge source of concern. Most of the Primary Health Cares (PHCs), facilities that are supposed to meet the health needs of the poor and rural dwellers, are in a poor state due to poor budgetary contraints.

Some health experts noted that while the interventions of the PTF had improved quality of care and response in the public hospitals, the situation is far from ideal. This may have prompted President Buhari, to raise the Health Sector Reform Committee for the development and implementation of a Health Sector Reform programme for Nigeria.

The COVID-19 pandemic has presented extraordinary challenges for Nigeria and the world at large. The Nigerian government continues to deal with the double burden of managing a major public health crisis and stemming the spread of coronavirus, while trying to minimise the social and economic fallout from the pandemic.

The President approved that the PTF would transit to a Presidential Steering Committee (PSC) on COVID-19, which took effect from April 1, 2021, with a modified mandate to reflect the non-emergent status of COVID-19 as a potentially long-term pandemic.

He noted that the structure of the PSC would reflect a new focus on the response with a targeted approach on vaccine oversight, risk communication, international travel quarantine processes and sub-national engagement; and that the tenure of the PSC will last till 31 Dec, 2021.

The PSC, in the last months, had maintained the constitution, functions and strategies of the PTF; and had also been supported by a slim technical and administrative structure.

While the PSC is winding down, the country is currently on its fourth wave with the new Omicron variant emerging and reporting a rise in cases. The country’s data trends show that the pandemic isn’t over yet, as the country embarks on post-COVID-19 recovery and getting back on track with the Sustainable Development Goals, and also talking of “building back better.”

Some health experts said that the Federal government should continue to monitor the global response and, while they are hopeful about the path forward, it may restore parts of the committee‘s mandate should it be needed.

They recognized the important work of the PSC on COVID-19, saying “They undertook an enormous challenge in addition to managing their regular responsibilities to help the country respond effectively to the shifting pandemic landscape.”

Dr. Walter Mulombo, Country Representative, World Health Organization (WHO), said that the perspective from experiences supporting COVID-19 response in Nigeria, recommended that the PSC must not be dissolved, but needed to be strengthened to provide political leadership, coordination and accountability with the participation of Civil Society Organizations (CSOs).

Mulombo noted that mobilizing domestic resources to respond to the pandemic was important: “Lack of domestic resources was the major reason most countries were not prepared in the Johns Hopkins Health Security Index 2019 report.

“Improved stewarding of resources by the actual release of funding, etc is the most crucial aspect: money on paper is no money. Better engagement of communities is needed to provide accurate situation analyses and define strategies,” he recommended.

Dr. Olumide Okunola, Senior Health Specialist at the International Finance Corporation of the World Bank Group, who spoke on the need for the federal government Implementation of Public-Private Partnerships (PPP), at Sub-National Level, noted that there is the need for the domestication of federal policies at the state level.

Okunola said that PPP policies should exist in all states of the federation and the Federal Government should advance contract with oxygen manufacturers as oxygen plays a key role in the response to COVID-19.

He advised that the government should resolve issues around infrastructure, transform CACOVID into a pandemic framework and deploy one per cent profit from the private sector to fight pandemics.

He said that there should be a process in place that leads to private sector funding where all private sector players were required to donate a percentage of its profit to the programme.

“This would be achieved by co-creating a clear framework and is an alternative to the current model. We need to have something that is sustainable in terms of pulling-in the private sector,” he noted.

Dr Solomon Chollom, pioneer National Secretary, Society for Scientists in Infectious Diseases (SSID), noted that the committee had done a yeoman’s job first as PTF and today as PSC.

“Their activities were more visible, especially during the first and second waves of the pandemic.

“It is appropriate to sustain a central team to co-ordinate the national response and I will be glad to see new faces in the team and a redefined mandate on the table.

“The new team should consist of health professionals and technocrats. This will allow the current team time to focus on their highly-demanding tasks in government to avoid unnecessary fatigue and distraction,” he noted.

Chollom added that the mandate of the team should be around creating handy local and scientific evidence about the burden of the challenge on lives and livelihood in Nigeria, including escalating factors and how they could be tackled using home-grown approaches for COVID-19 and other health emergencies “peculiar with us.”

Meanwhile, Mustapha said that accountability is the bedrock of the response to health threats, including openness and providing information to Nigerians, while noting that this will engender trust and confidence in Nigerians and stamp out misinformation on the response.

The Chairman also disclosed that the legislature had played crucial roles and has been very resourceful in the COVID-19 response coordination since PTF started its assignment.

He added that the PTF and PSC have leveraged on partnership with a wide-range of stakeholders which had greatly impacted on the outcomes of the response activities in the country.

He, however, disclosed that the PTF and PSC had also leveraged on the pooled resources across sectors as well as effective policies backed by implementation.