DRC-Uganda Ebola Outbreak Raises Nigeria Risk

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[00:00:00]Nigeria stopped Ebola in 2014 and the world applauded. But that was a different virus, a different strain and arguably quite different health system.

[00:00:11]Over the next hour, we will interrogate the nature of this outbreak, the regional threats and then Nigeria's specific preparedness and vulnerability.

[00:00:20]You're watching on one slot. I'm Felicity Wika. Thank you so much for joining us. My guest for today's conversation will be divided in two segments. For this first segment we have uh professor Marelene Baba, professor of medical viology, University of Maid teaching hospital. Um he joins us from Maid Bron state. Um I think he will be for the second segment but we do have professors Abdul Karim special advisor to the director general world health organization. He joins from New York for this first half. I'm a Zongveri editor in chief Ken Shasa Times Dr. Kongo is also in uh for this conversation.

[00:01:03]Gentlemen, thank you so much for giving us uh your time. Um okay. Um we also have Professor Owari, viologist and former president of the Nigerian Academy of Science, Lagos, Nigeria. Doc, it's good to see you again. It's been a minute. uh we've had a conversation on here so glad you could uh join us but let's start with uh professor Abdul Karim just to establish some basis this particular strain has no approved vaccine or treatment um can you explain exactly what that means in practice if someone contracts this virus what can doctors actually do for them >> good evening to all of the viewers I think when we are looking at this particular disease Ebola. We need to keep in mind that we've dealt with it before, but this particular strain is different. And the difference is that the Zerian strain is one that we've already known for a while. We've studied it extensively. We've got diagnostics for it, vaccines for it. So this new strain, the bundi bush strain does not react to the same diagnostic tests as the zerian strain and that's one of the reasons why it wasn't diagnosed early enough. It was coming up negative on our routine diagnostics.

[00:02:34]The same in the same way because it's different. Its genetic makeup is different. treatments are not available for this particular strain and we don't know if any of the vaccines we have will work against this strain. So we are at this point without a vaccine without a treatment that we know works and we have a diagnostic issue in that it's very hard to diagnose it simply at a clinic we have to send the specimens to a central lab and that's the big challenge that we facing and that's the reason why the Africa CDC emergency committee on which professor Tomorei also serves made the declaration of a public health emergency of continental security.

[00:03:21]>> All right, I let's come to you. You're on the ground in Dr. Congo and this is the 17th outbreak in 50 years and the last one we know just ended about 5 months ago. Why does it seem the world keep responding to outbreaks in the DRO without actually fixing what causes them? Do we even know?

[00:03:42]Well, I think that for the DRC and as the predecessor just said, we've had up until now 17 uh occurrences of the Ebola virus, even though the one that we have now is a different one, but the country has been able to build quite an amount of experience in handling that. And that experience now is being deployed to the region where the the new outbreak has uh is is unfolding.

[00:04:11]And also the DRC comes with a lot of experience in terms of um breaking the transmission chain. And it is on that experience that the country is counting in order to hopefully contain the spread of uh this uh yet uh another outbreak further across the border or across other parts of the country.

[00:04:34]Uh, professor Tomari if you can hear me.

[00:04:36]Uh, the fatality rate currently is 30 to 40%, roughly one in three patients die.

[00:04:44]Um, h how does that compare to COVID 19 and to the common strain that we already uh we had before this one and to maybe other infectious diseases Nigerians already live with?

[00:04:58]>> Uh, thank you. As as Sal mentioned, there are three or four of the Ebola group. There's Ebola Z, there's Ebola Sudan and there's this Bundi Bublio. The most vicious one of course is the Ebola which has almost about up to 60% case fatality rate. The Sudan comes in between about 40 50% and then this particular one the Bibu is a little on the lower side which is about 30% which I've just mentioned.

[00:05:29]um the situation that we have in our hand um I'm glad colleague mentioned about getting experience there's no use getting experience if you don't give them the where to use that experience and that what has happened as Ali mentioned we didn't even have the the facilities to do the diagnosis and so for the first 10 days or so we we returning negative results so what is the use of your experience if you don't have the facilities to put that experience to I think that's what we need to address in the African region.

[00:06:02]>> Okay. Um, Professor Abdul Karim early, I think I'd rather ask this. Um, there are no approved uh vaccine for this particular strain, but we know that discussions are underway at the WHO about fasttracking experimental candidates. What is the honest timeline for even a trial vaccine to be available and what does that being available realistically mean for African countries in particular?

[00:06:36]>> There are candidates that were being developed uh for what we call a panbola uh strain. In other words, it would encompass the genetic makeup of the three or four different strains that are in circulation. And that's was underway uh some time ago. And there are two at least two candidates that were in advanced stages of development. And there's a current vaccine and that we think might not work against this particular strain that's also available and needs to be tested as to whether it would be effective against this particular strain. Now one has to take into consideration that we're dealing here with the bully bou strain that's spreading in a different way. So normally if you take the 2014 Zarian uh strain and the way in which it spread in the DRC the doubling time in other words the time it takes to go from you know 40 infections to 80 infections was about 15 to 20 days. The situation now when we look at the bundjo strain we are dealing with somewhere between 6 and 9 days. So the the rate at which it's growing is faster and that's what's you know leading to this concern and seriousness about the problem even though it's death rate or mortality rate is lower and currently estimates are somewhere around 10 to 30% depending on what data you use u which is lower than what we've seen previously. It's the numbers and the rate of increase that is a concern because that's what's going to saturate the population. We're going to have a lot of cases and that leads to cases going across the border and that leads to imported cases in other country and before you know it we've got several countries with cases. So the the goal of a vaccine which will take us several months. So in in other words, it's not going to be our solution today to this problem. Our solution today to this problem at least for the next few months before we have a vaccine is going to be public health measures and those public health measures are essentially three things which is the first is to ensure that every case is diagnosed. To do that the public needs to be educated, engaged with the community. the healthare workers need to be aware of what they're looking for. If anybody sees a patient that may be a suspected case, it's to report it to the health authorities. So that for me is a critical first step.

[00:09:24]Without that, nothing else is going to work. The second step is once a case has been identified to ensure that that individual is isolated and that the carers are protected because the career remember that you know Ebola doesn't spread by coughing and sneezing and you know casual contact with people. It spreads because an individual comes into contact with the infected patients blood and secretions like saliva and so on and carers are at very high risk. So it's to isolate the individual and to make sure the carers are protected.

[00:10:03]>> Yeah. But but there's a lot of challenge with actually knowing who has it because of the similarity in symptoms malaria and lasso fever and the likes. So we'll try and explore that in the later part of this conversation. But let's ask uh Mr. Zveni what is on the ground in the RC. Uh the outbreak is concentrated in the ite province and this is a conflict zone with active armed groups, a humanitarian crisis and we know for sure there is a collapsed held infrastructure. paint us a realistic picture on the ground on how efforts are really being expedited to contain this um issue and perhaps if the um um international presence um of health assistance is there uh for the people.

[00:10:50]>> Yes, as you've indicated the area where the disease started is a place known as Buna and the surroundings of Buna. But as we speak and that's in eastern part of the DRC and Buna sits at the border between DRC uh Uganda and South Sudan and uh as we speak uh there are reported cases in uh North Ku which sits next to Rwanda and that is that has prompted Rwanda to close its border and also Uganda to close its borders. As you've indicated, this is a part of the country that has been beset by conflict for close to 32 years and the health systems have practically collapsed. So insecurity and ineffective health systems are conflating in order to make it very difficult for the disease to be contained. But in the meantime, we have entities such as Doctors Without Borders. We have the WH and the National Institute of Public Health that are trying to leverage air force and deploy them there. And also as we speak the Buna airport has been shut down. So we do not have any flights departing from Buna in an effort to try and contain the disease where it has uh happened.

[00:12:11]>> Okay. Uh, Professor Tomy, Nigeria celebrated um, Ebola in 20 I mean the win of Ebola fight in 2014 and we built um, a real time uh, contact tracing uh, infrastructure that's 12 years down the line now and that system um, we don't know the functionality of it today. So being in the uh in that space I wanted to find out from you are we still having have we improved on that architecture?

[00:12:43]What is your optimism level that if something like that should come to Nigeria, uh, we will be able to tackle it the way we did in 2014?

[00:12:55]Or has the infrastructure and all the um, um, processes that was put in place uh, been dropped?

[00:13:06]>> The question is for me, sorry, there was a break in transmission.

[00:13:09]>> Yes. Uh, Professor Tom, I I was just trying to find out. Okay. Yes. Do you get a question or or >> let me two days ago I mean I heard that the NCDC has come up with whatever and I said that's a few days too late. The day who declared that problem we should have declared it in this country. That's number one. Number two going back on 2014 I think we're living on past glory.

[00:13:36]Let me give you a good example. take the COVID you know we build laboratories here for diseases which is the wrong thing lab yellow fever lab the bola lab that that's wrong you should be your lab to diagnose any disease that you want to and that's the problem that dear congo has now you remember during covid we had almostund and something laboratories but before even covid ended 50% of those labs were no longer functioning so you can imagine what the situ is today so don't let the accept that we are ready we are not and the past if we're talking of COVID 19 of Nigeria we or 2014 of Ebola we are living on past glory the reality on ground is that we're going to start from scratch again as we always do and that shows you from what has happened with Lassa fever fever has been with us for the last 60 years every year it's as if it's a new disease so let's not deceive ourselves I'm glad the NCD has now come out to say yeah let's do something but let's do something permanent this time not just for a particular disease but for diseases in general Okay. Uh in case I forget uh Prof, I I I would want you to speak to this. I want to bring in another guest, but that will be uh later on the place of Lagos and preparedness. The ministry of the state ministry of health has issued a statement on preparedness and what is being done. Uh Lagos seems to stand out in a lot of cases when we have this situation. So I would like you to speak to that and how what is being done here could be replicated or improved upon in terms of preparedness for um any possible scenario with Ebola. But for now let me bring in um professor Maryen Baba uh she's a professor of medical viology university of Muguri uh teaching hospital. Uh, Professor Baba, thank you very much for your patience and thank you for uh, joining us on this conversation. Uh, I'll just throw in the defend. The African CDC declared uh, this uh, situation a public health emergency of continental um, security.

[00:15:38]Is African institutional coordination say between the Africa CDC um, individual government and WHO actually functioning effectively on the ground?

[00:15:51]Now, how optimistic are you that should we get into a crisis, communication and interaction will be seamless?

[00:16:02]>> H thank you very much and good evening viewers.

[00:16:07]Um I I I I doubt whether such coordination is ongoing but it's something that I will say it's not too late to start but before I I dabble into more of that I want to suggest I want to suggest right now this particular strength is a mutated strain it's still a ber but it's mutated strain And that's why it is not easily detected by previous um diagnostic kits that detected Ebola of 2014. So is a mutated strain and that mutated strain is so the the level of mutation is so significant that it defies the the current diagnostics and defies the current vac the vaccine.

[00:17:00]Therefore, in my opinion, I want to suggest if it's be feasible, there should be molecular biologist that should gather the strengths compared with the strength of 2014 and quickly come out with um sequences that could guide and direct diagnostics. Like some of one of the speaker said, for now we need public health measures and one step, the first step to the public health measures is the diagnostics. You can only fight what you know. You cannot fight what you do not know. So it's better we know first. What is this trend? What how do we reach it? How do we catch it? How do we identify it? So when we are there then we can talk about so MANY OTHER THINGS WHETHER vaccine is come and from this molecular studies it will it will also hide guide if in terms of drugs in terms of vaccine I think that's what we need to do when for instance that is done in DRC it can be now extended what you are saying about coordination among the African countries it coordination personally I don't see it I don't know whether others have seen it And we have to bear in mind that Ebola is a P4 virus. Do we have even a P4 facility in the country that is suitable? I mean it's fit for containment of the virus. I don't know whether there is I know at least I heard about the hassiva virus facility that a P3 all right it can be managed there but you know this is something the country like Nigeria should really have a good functional P4 facility for such viruses so the coordination among African uh countries is not there I'm sorry to say >> communication is not there is not fast is not vast enough as it should be. It's something we can I will say it's not too late. It's never too late.

[00:19:04]>> It can be done.

[00:19:06]>> I think you you're you're echoing the the thoughts of most professionals and two of our guests uh today. Um let me come back to Mr. Zie and just ask about the health safety measures for the public because it's one thing to talk about um what the government is doing what needs to be done what is the public awareness and health measures being taken to your knowledge um in the DRC >> one of them is the safe burials of people that have died of Ebola because when somebody dies if you come into contact with the remains means the possibility of catching the disease is absolutely uh real. So that's the first thing that the government is doing making sure that any corpse of anyone died of Ebola is disposed of in a very safe uh fashion. The second measure is to uh tell the population that soon as you try and develop symptoms or you see symptoms that may be uh similar to those of any dis like Ebola including fever and vomiting you should immediately report to the nearest um treatment center and also there is what the the medical professionals are calling as a standard of care. So they are trying to treat every symptom separately whether it is diarrhea or whether it is fever in order to uh hopefully uh get those that are infected to recover from the disease. So they are they are employing standard of care and also practical measures such as washing your hands every time and uh the the use of personal pro protective equipment that WH and other um uh technical and financial partners have availed including met San Frontier and the Ministry of Health. Those are the practical measures and also sensitization amongst the population to know that the disease is prevalent and they should make sure that they report any case that or that seems to be suspect in the community.

[00:21:13]>> Okay. Uh Professor Abdul Karim, I I wanted to come back to you and ask a different question, but I just thought to uh the timing of the the incubation period, I mean, you're the expert, you know better. uh the incubation period makes it a bit tricky to identify some of um to identify um um Ebola particularly of this strain. um what is being done at the WHO level to um I don't know perhaps put in um lies with countries for um contact tracing mechanism um maybe measures to ensure people can tell u when it becomes necessary to look for um Ebola when it's gone beyond the fever and all those little symptoms uh that we associate with malaria Yeah.

[00:22:06]>> Yeah. The um we do know the incubation period of the Bundi BJO strain and that is anything between 2 days and 21 days.

[00:22:17]um most patients seem to be somewhere in the middle in that range and based on that the contact tracing and the isolation that uh is being pursued is based on that 21day uh incubation period. In other words, when we've identified a potent person who's been potentially exposed, for example, being at a funeral and has had contact with the body, then that individual is isolated for up to 21 days. If they are still fine after 21 days, then they can then be released from their isolation. So that approach is already in place. And in terms of what the key players are doing. So when we dealt with EMPOX, we had a joint incident management team in the DRC and that joint incident management team was led by the World Health Organization as well as the Africa CDC jointly and everybody who was involved in the EMPOX response was part of that team and as you couldn't do something unless you did it as part of that team that's to ensure coordination and it's to ensure effective use of resources. And so everybody is working together and that includes even foundations that are providing funding includes multilateral organizations like UNICEF and others includes NOS's like meta science frontiers and so so all of these bodies are working in one direction and to solve the problem with one plan and that's exactly the same mechanism was put in place just over a week ago for Ebola in the DRC. So everybody's working together using these same rules and so too with regards to the rules regarding isolation based on the incubation period.

[00:24:12]>> Okay. Um let me see what came to my head in terms of the working together part of it. U professor Tommory I asked you a question earlier. I said you should just think over. I want to just add to that based off of what you also said about the fact that NDC should have immediately the um Ebola came to be announced as something of public emergency should have started doing something. So it is not too late now is it for ordinary Nigerian to be seeing uh visible public health messaging maybe at airports, motor parks and in public places on preventive measures.

[00:24:57]>> Thank you very much. Just quickly before I answer that I want to stay on mind that came in in 2007 that's almost 20 years ago. If by now we don't have a vaccine, by now we don't have a diagnostic that mean it is our fault, there's absolutely no reason why we shouldn't have it at this time and I'm talking about African countries because we get the disease and Europe brings the vaccine and that's what I've been doing and that's why putting us where we are a lot of things my colleague from DRC said there's nothing new we talk about sit there hundreds of times ago wash your hand everything but we never we do it and we forget when the epidemic goes and these are messages we need to to inform other. I'm glad that Gdris who was in charge of Ebola in Lagos is also the in charge of NCDC now. So he has quite a lot of experience on what to do. You raised the point the public information.

[00:25:49]What do we get to do? I think the first error we make is not to let people know that this information is about their individual safety. We're not doing this for Nigeria. We're doing it for you as an individual so that you don't die from the this disease. So when you tell me you you are stopping me at the gate, you have to fill a form, you must give me the reasons and let me understand that it is for my sake. When it is my own, I will do it differently. And let me give you a good example. When people fill out all those forms, this is not the first time we fill forms at the airport before. What do they do with the forms?

[00:26:22]Nobody knows. Did they get a feedback to the people what they what they have arrived from the form? Number two, you talk about the honesty of the people.

[00:26:29]You know you sit in one seat, you give a wrong seat, you give a telephone, a wrong telephone number. So people don't realize what this thing is all about.

[00:26:38]Our first message is to say this epidemic is coming and it is going to affect you. You are the one. Therefore, do something about it. And this is the message I think we need to stress on.

[00:26:48]It's not all these fancy things about wash your hand and this and this and that. Say it, but it pin it down to the fact that this is about you, your health. And you know how selfish we are as human beings. If I know it's going to affect me, I will answer the questions, the right question. I won't lie about my telephone number. I won't lie about my address because contact tracing and all those things, these are the difficulties you're going to have. Those forms, what do they use? They have no use to anybody. And that's the message I think we need to learn from the past and do things the right way. Get it down to the people. They are the ones that are affected. When you do it, it's for your safety. Over.

[00:27:23]>> All right. I I'll still come back to you on you know um the announcement made by the Lagos Ministry of Health and the seems the level of preparedness here is not replicated replicated rather across the country and your thoughts on uh you know using the having the same strength we seem to have in Lagos in other parts of the country when it comes to preparing for possible emergencies like this. Uh we'll go on a break now and when we come back, Professor Baba, I'm going to be asking you about your thoughts on uh professor Tomari saying we are at fault that we don't have a vaccine up until now and the likelihood of that um happening in the near future, very near future. Stay with us.

[00:28:11]Thank you for staying with us. We're still looking at the WHO's declaration of public health emergency, the cases of Ebola in DRC.

[00:28:21]Um before the break, I mentioned uh docu professor Buba um your thoughts on the possibility of Africa creating our own vaccine as against waiting for the importation from Europe.

[00:28:44]I'm sorry the the transition is breaking. I don't know. I know. I think if I repeat the question about my thoughts on >> uh the hope of >> All right. It's okay. I'm hearing you now. It's okay.

[00:28:58]>> Okay. I I just wanted you to speak to uh >> Hello.

[00:29:02]>> Yes, I can hear you. Matt, can you hear me?

[00:29:07]Yes, I'm hearing you now. Now.

[00:29:09]>> Okay. Just go ahead. Go ahead.

[00:29:13]>> All right. Yeah. Um I believe that there is hope. The problem with us in Nigeria is that we don't really value what we have in terms of human resources. We have what it takes to produce vaccines, viral vaccines in particular. In in terms of resources we have bet the idea and to put these ideas together and to create a favorable environment and facilities to make it happen that is we have problem but THE GOOD NEWS I have personally I'm very optimistic that things will change because passionate about producing vaccine within the country for most of these public health pattern. In fact, the starting point is on lacer fever. So I believe with this optimism that with this if we continue in this momentum, there is hope that a vaccine would be prepared for this for Ebola virus and other viruses of public health importance. But there I have a concern.

[00:30:21]The concern I have is the rate this Ebola virus is mutating and to produce a vaccine is very expensive and time consuming. Then by the time this is finished again another strength may emerge that is resistant to the already prepared vaccine. Where would we be? And then I want to also sell the idea that we should not only be concentrating on only the vaccine. What of therapeutics and with the current molecular technology but informatics can be used in producing drugs. WE NEED WE NEED ANTIVIRAL DRUGS. WE NEED antiviral drugs and this particular strength just like we did for a COVID THERE WERE COMBINATION of some v antiviral drugs that helped in the management of covid probably that could be done because there's what we call repurposing of drugs even though it was meant for something else it could be used so that measure could also be tried for for us to get a solution to the problem so I believe there is hope if only in Nigeria can make use of what they have to make it happen. There is hope.

[00:31:37]>> All right. Thank you very much. Um Mr. Zvelli, back to you. In 2014, we had problems with misinformation, people who feel that, you know, it's all fake news. And then we heard about saltwater cures, conspiracy theories and all of these we know complicated the response at that time. Social media is still vastly powerful today.

[00:32:07]What is do we have internet penetration still? I know that seems like an ordinary question to ask, but considering what's going on in the DRC, there's always this concern about people having access to information. In terms of misinformation, where do you where do you stand and how is it being managed?

[00:32:28]>> Well, the the internet penetration in the DRC is in the region of 30% and the area where this this uh outbreak is happening.

[00:32:40]Buna itself is a little bit urban but if you go into the further you you go further a field it becomes more rural but still there is the belief that when somebody dies the loved ones the the the parents the people from the family would still want to see their loved one who has passed away of Ebola to have a proper funeral and that is why you find a lot of resistance people don't believe that they can catch the disease they still want to bury to do the funeral the way they've always done and that is where the real risk is and that is where sensitization needs to happen and the DRC being at its 17th occurrence of the disease we already know how bad this disease is and people know how devastating it can be so when they are sensitized they tend to listen but it's mostly when it comes to burial that where people are showing a little bit of resist because they want to bury their loved ones and see them for a last time and that's where the the highest risk really resides.

[00:33:43]>> Okay. Um, Professor Tomy, I I don't know if you could take on that question I asked earlier or you have you're open to me asking you a different one.

[00:33:52]>> Sorry, please ask it again. I wasn't too sure which of them.

[00:33:55]>> Yes, I I was trying to find out from you um in Nigeria in particular and I I I speak to Nigeria because we're doiciled here as well. U we need to know what's being done. I'm asking the Lagos state government have the ministry of health have have come out to say that this is what they they on top of preparedness they're ready and they reeled out all that they've put in place and all of that we haven't seen that simulated across states um what are your thoughts about you know the prominence of Lagos in terms of reaction to a crisis like this compared to other parts of the country and what can we do to emulate what's being done here in Lagos Thank you very much. I think you know even at the beginning I mentioned that it was the same Idris who is now in charge of the NCDC. He was in Lagos at that time. Lagos has always been at the forefront because of course they the first point of entry where Muslims come into the country into the country. So they are prepared they are better prepared than most other states and there's no doubt about that and I've seen it in talking with them. I think part of the problem we have in this country is that first of all many states think oh we are far removed from Lagos therefore it's not which is all nonsense. The second point is that states have abandoned their responsibility and in a way I I put part of that blame on NCDC. Why am I saying that? NCDC had f tended to run health sc all over this country thinking that the one in charge of everybody. In the days when we started disease control in this country, it was at the state and local government level that were they were doing it.

[00:35:30]Federal was only coordinating. Today we have NCDC doing all that and states abandoning their project. Everybody's running to federal. It shouldn't be. The problems are starting right at the bottom of the of the places in the local governments in the state, not at the Abuja. And so when states have abandoned their position, then it is important to tell them point blank that they are doing the wrong thing. Any anytime we reach a situation where those states continue to do what they doing? We need to put them in their place. They're receiving resources from federal government. What are they doing with the resources? What are they doing with the resources? These are questions we'll be asking. They should emulate Lagos and see what Lagos is doing. If any of those cases had occurred in any of the other states in the country, I'm sure would have been in problem by now. So Lagos is a good example which also brings me to the point about Uganda and DRC. While we are talking about problems in Africa, Uganda should be looked up on is a good example of a country that is doing the proper thing compared to what DRC is doing. Of course DRC has more problems in terms of security and all that. But let's put it the point it can be done.

[00:36:34]Uganda is doing it and therefore countries can do it. How much is it costing them? It's much cheaper to prevent than to to begin to beg for aid to control what what problem we have. So let's get our states to get back to the emulate Lagos state and let federal put down the rules down do your bit and not so that we sorry to get emotional about this one but I'm really quite concerned about the that we have the resources we have the human people say Africa is resource limited we are not resource limited we are resource wasteful and we resource country we're not using our resources for the right thing we're not creating the name environment we talk about capacity building we don't talk about capacity retention over.

[00:37:15]>> Yeah, it's it's hard not to get emotional with subject matter like this and I had probably different questions prepared half the time and then I just have to change them as we go. Uh, Professor Abdul Karim, earlier you talked about you give us an idea of how long it takes for a confirmation uh to happen, but in an outbreak hours matter.

[00:37:39]Is there any plans to perhaps expedite the workings in the WHO to expedite the timeline um for confirmation so that we can reduce the risk um of extended contact tracing and all that comes with that?

[00:37:57]>> Yes, there are efforts underway. There are three streams of work that are currently involved and they involve several organizations in Africa, the WHO and private companies, SEPY and Garvey as well. So what are they doing? Well, there's a stream focused on vaccines which we've already discussed. There's a stream focused on therapeutics and at this point rem disappear and two monoconals are uh under consideration for entering clinical trials. And then on the diagnostic front and I have to agree here very strongly uh with our with all the colleagues on this uh interview and that is that a diagnostic is key. If you can't diagnose somebody it's a real problem. But at this point there are really two challenges that we facing. The first is that there seems to be one kit that may work. It comes from a company Kish Medical in Korea and it's called Rady One and it seems to be picking up the Bundesio strain but we're not sure about how accurate it is. So that's currently underway to assess how accurate what its reliability is. If it is reliable then we need to get that company to make us more cartridges and make it available. The challenge with the ready one kit is that the machines are not widely available whereas the machines are available for another kit called gene expert which is very widely used in Africa for TB and other diseases. And so Gene expert a company called Sephiad has been approached and there are discussions underway and the sequences have now been made available.

[00:39:39]It was in fact the sequence of the this particular strain was made available the day after the declaration of the public health emergency. And so all of that information is gone into developing new primers to make new cartridges uh to for the gene expert machines. And if that and that can be done quite quickly and if that works and that the kit works well in picking up these strains then we have got a particularly new weapon that we can use to help identify cases and build the rest of our program.

[00:40:12]>> All right. Um professor Baba Nigeria has lost thousands of doctors and nurses to immigration um in recent years. I mean that is still an ongoing conversation here and then we have this insistent uh challenge of uh threat of industrial action by various arms on the in the medical sector. Does this country today have the same depth of experienced public health personnel as we had in 2014? If not, what in your thinking could we do to bridge this gap to improve our response uh capacity?

[00:40:55]Yeah, thank you very much for that question.

[00:40:58]I don't know what to say but the only thing I can say is that though many health workers have left the country but we still have competent health workers starting from physicians, nurses, medical lab scientists and all that. We still have where the country is not completely emptied of competent and qualified um human resources to handled outbreaks like this. No, I don't think but and then again there is need for government to do what it takes to return the ones we that are still available that are still in Nigeria in terms of um um salary in terms of condition and of service and you know whatever it takes but I don't know whether the government of Nigeria will ever think in that direction and then the continuous um industrial action from the health sector is not really it should not even be if the government does it homework. It should not happen and we should discourage it and the government needs to know that health is wealth but the government will prevail to seek medical attention outside Nigeria. So for such what what do they have what plan do they have for Nigeria itself that's the question >> okay >> so why don't they bring what they see the kind of services they have outside so that when need arises they don't need to go out but they receive this similar treatment in Nigeria well this is something government I don't know fight for government but but Please again permit me even though it's not my question. I want to ask the that are being used in the detection of this current strength. Do we have such consumables in Nigeria in preparedness to the outbreak? I don't know if we don't have there is to handle it as a matter of urgency in case happens. And then again I want to dabble again into diagnostics because Ebola has a bifphasic phase in the clinical presentation just like many viruses or viralic viralic fever viruses then it start with malaria like so in endemic place or where you have the epidemic going on many malaria suspected cases should be tested should be tested because you catch them you will you detect more in that face than when it emergic symptoms already commences. So we we we have to be alerted that preparedness should be in Nigeria. Public awareness should be in Nigeria and we should CITE WHAT IS going on in Congo and it can be spread. Why Nigerian should wake up in right now in terms of diagnostics in terms of public public health aware messages everywhere to alert people and the possible preventive measures that should be done.

[00:44:19]IT SHOULD BE EVERYWHERE SHOULD SPREAD THROUGH SOCIAL MEDIA, RADIO, TV. We don't need to wait it till when it happen before we swing into real action.

[00:44:30]>> Okay.

[00:44:30]>> Over.

[00:44:31]>> Okay. Um, so many points you made there, Professor Baba. I I want to go to I'm supposed to go to uh Mr. Zumi. But I'll go to Professor Abdul Karim because of something that Professor Boba said about us going out to seek um for medical um help as against working on our own systems here. And then I remember that I do have a question on the story about an American doctor who was working in DRC testing positive and being evacuated to Germany for treatment. Um Prof. What does that contrast evocation to Europe versus treatment in countries say about the global equity gap in outbreak response?

[00:45:19]Well, I have to start by saying that if any country uh you know was dealing with this kind of situation with Ebola, the DRC is better placed than most because they have the most experience. they have you know a world-class research facility that professor Muami runs uh they've got huge infrastructure to deal with this problem like very other few have in terms of experience so what is uh uh at issue here is that the facilities the actual physical facilities may not match what you're seeing in Europe and the US and everywhere else. But in terms of experience and knowledge, I would want to be treated by a doctor from the DRC who's been seeing Ebola in the past as well. So I think it's it's a it's a misnomer to believe that actually the best care will be elsewhere. On this particular issue, you know, the US has its own rules and so on and uh transferring this particular doctor to a military base in Germany makes sense.

[00:46:31]And you know we know I know most of the biologists at this level in Germany and they are outstanding. So you know there's no question the quality of care that this doctor will receive and from that point of view it made sense.

[00:46:45]>> All right. Uh Mr. Sveni you are in the media space. So I want to ask you this very uh tricky question. Um mostly people say we report but we also have a responsibility not to make people uh panic or raise tension um and just get them to do what needs to be done to stay safe. What would be your assessment of the work of the media? Is there any in the DRC at this point that is helping with this situation?

[00:47:16]I think the media we are doing our job in ensuring that uh we report factually on what is happening on the ground and today the DRC has a lot of online media.

[00:47:27]So they cover most of the ma the main cities in in the country while community radio stations cover the rest of the country where we cannot reach with online presence. And the other thing is that so far we there has not been any case to my knowledge reported in cities such as Kinshasa or outside of Eastern VRC and that is what the National Institute for Medical Research led by Professor Mu that Professor Abdul mentioned is trying to contain or deploy all the air force to to ensure that the transmission chain is broken and that the disease stays does not expand further.

[00:48:09]across the country and we are telling our viewers and our audience that they need to be careful and they need to make sure that they comply with all the prevented measures that uh the medical profession professionals have uh uh enacted.

[00:48:24]>> Okay. Professor Tomari um there is always tension between uh transparency and uh panic in public health communication.

[00:48:34]the NDC N DDC I beg a pardon the NCDC's advisory um some person say is technical and measured so the question is how do you communicate real risk to somebody that sells business um that's a trader in onicha for instance or a bus driver somewhere without triggering either complacency or panic Thank you very much. We've had experience before when we're dealing with polio in Nigeria when the data and all information was based in Abuja polio raged on until we got to the community until we got to the community leaders. I I told one of our ministers I said in the street where that polio is occurring nobody knows you there so you can go and say what you like they won't listen to you they listen to the people who understand them so we need to get involved at the market there must be a chairman of the market people those are the kind of people we need to start talking to explain to them in simple terms this is what will happen to you this is what will happen like my brother was talking about burial and something of course we knew about barriers before but it's a matter of choice you want to bury and go with the dead person to the grave or do you want to stay alive? You know, because we doing this thing and in quick quick 1995 when we were there, the issue of safe started way back then.

[00:49:59]>> So why can't we now continue to run it?

[00:50:02]Thank you very much. Get to the people who are dealing with the people, not to tell information.

[00:50:08]>> I wish we had more time, but we have to go now. Uh thank you so much for being here with us today. Um, professor Owari, viologist and former president of the Nigerian Academy of Science. Uh, we also have a Zumi, editor and chief Ken Shasa Times, DRC. Uh, Professor Salim Abdul Karim, special advisor to the DGW.

[00:50:36]And then we also have um professor um Mary Selene Baba professor of medical biology university of m degree teaching hospital. Thank you very much to all of you for being here.