 Welcome back to the breakfast on Plus TV Africa and it's time for Hot Topic and today we're taking a look at the World Immunization Week. Routine childhood vaccination has dropped in the wake of the COVID-19 pandemic years. Public perception of these vaccines has also fallen in 52 out of 55 countries surveyed, leading to a global coverage drop from 86% in 2019 to 81% in 2021. As the annual World Immunization Week is observed this year with the theme The Big Catch Up, the World Health Organization is working with countries across the globe to raise awareness of the values of vaccines with the aim of bringing the program back on track so that more people can be protected from vaccine-preventable diseases. Now joining us live in the studio to make sense of this discussion is Dr. Pedro Chinyu Moko, GM, CEO of Nigeria Solidarity Support Fund. You're welcome, Mrs. Moko. Thank you for having me. Good to be here. And joining us virtually, we have Dr. Doni Odubanjo, who is the past chair, APHPN Lagos Executive Secretary, the Nigerian Academy of Science. Welcome to the program. Okay, good morning. Good morning. Okay, I want to start with you, Dr. Moko. And let's start with the perception, the public perception that has dropped. What is the state of that in Nigeria here, as we talk about this Immunization Week, and how is your organization tackling that? Thank you for that question. Public perception for immunization dropped following the pandemic for them because of a lot of the misconception that came around on misinformation that was promoted at that time during the pandemic. It has always existed in Nigeria. However, it's important to note that a lot of people still trust in vaccines and the efficacy of vaccines to protect their children and the population from vaccine-preventable disease. The other large number of people that have distrust in vaccines have that because of a lot of lack of awareness. There's a lot of lack of awareness on the efficacy of vaccines and then the effects of vaccines on the children and on the population. People are not well-informed. They've not been well-educated. There's a lot of cultural and religious beliefs, so to say, said with vaccines that have been promoted over time. And we know that in Nigeria, we're a communal population. We feed off each other's energy. And so when a few people or a few leaders, be it cultural or religious leader, feel that the vaccines are harmful. It spreads to the general population. So that education, we need to raise awareness and we need to educate the public about it. And there's also the other part that this is being foiled by lack of trust from the government, for the government, by the people. And when people do not trust that the government's campaign is for their own benefit, then they create a lot of misconceptions around it. NSSF, the Nigeria Solidarity Support Fund, is working closely to unfunding the government to be able to reduce this vaccine hesitancy noticed in Nigeria and to increase the coverage of vaccine in Nigeria. That's what we're doing. But so far, how far? Because this awareness that you're saying we need to, it means that not much has been done or at least what has been done is not satisfactory enough. What's the plan? Thank you. A lot has been done. A lot has been done by the government, by global efforts, global collaborations, by the private and the public coming together. A lot has been done in a distance of 1,000 miles. That's with one step. And you are correct that a lot still needs to be done to promote the vaccine use in Nigeria. What is being done is that there are campaigns. We have the routine immunization campaign. We have the polio eradication campaign. We have the measles campaign. We have the yellow fever campaign. All these campaigns are different ways by which the government and the international community as well as the philanthropic organizations in Nigeria are promoting behavioral change. Behavioral change, the science of behavioral change doesn't happen within a day. It's not a day's job. It's a consistent, consistent effort. What we need to do is to monitor and evaluate our programs and see what is working and what is not working. And then we can tweak whatever is not working and make it more efficient and get to the root of it. I believe that as we, as more people, and that's why this week has been dedicated for immunization, as more people get aware of what we are doing and get aware of the challenges that are existing, we'll be able to move further faster. Okay, let's go to Dr. Dhoni Udubanjo. You are of the Nigerian Academy of Science. Dr. Dubanjo, can you hear me? I can hear you. All right. So how excited are you about the R21 matrix and malaria vaccine developed by the University of Oxford and manufactured by the Issyrum Institute of India? How excited are you about that? With some caution. Excited with a little caution. Because, again, you have to understand the malaria parasite is a moving target, which is something I think we've seen with the COVID-19 virus, which also is akin to what you find with the flu virus in general. And what that means is that you have organisms that are rather smart and change their constituencies in order to avoid being targeted by your drugs as it were. So these organisms, today what you produce can be very effective. Tomorrow it may not be as effective. The excitement, however, stems from the fact that this is the very first time in decades that any efforts to get the malaria vaccine out in the market has succeeded, has even reached that point at all. So that is some signal of good progress to say that, well, something is being done, we're getting there. And the vaccine found, yes, in the current clinical trials that was done, was very effective. However, there was also a predecessor to that particular vaccine, which was very effective initially and not so effective afterwards. So again, so there's excitement because it shows that the science is making progress at getting at this very important, I'd call it enemy of humankind and especially in Africa, but then we also have to, I mean, take it with some caution. And actually, let's say, take it without resting on our hearts to realize that this is a smart organism, this is a moving target. So we can say, yes, we found it, we've done it, let's go to bed. No, we haven't. We must continue working. And then building on the success of this particular one to say, what made this work? What made this go so far? And maybe we can further improve on that. Thank you. Some people think homegrown solutions could be even better than what we are having from clients that may not even be experiencing the malaria the way we do. And you know this, you know the characteristics of the thing we are trying to fight against and all that. And you, your institute, you are the secretary of the Nigerian Academy of Science. What homegrown solutions are we trying to get for this? Or are we just sitting to evaluate what comes from outside to give it a mark as being good or bad? What are you doing in your institution to make sure that we have homegrown solutions? Well first you have to properly identify what, when you say the institution I'm going to cast one is the Association of Public Health Physicians of Nigeria, Lagos chapter, which is the one that actually invited me, farm executive secretary of the Nigerian Academy of Science. And I believe that's what you're referring to. Science. And you have to know the identity of the Academy of Science, which is in Kolokwa language you can call the Supreme Court of Science. Okay. And so it is not research, it's not primary research. The job of the Academy of Science is the interpretation of research, and therefore being able to link scientific research to policymaking with the ultimate results that policies. Just a moment, because you said that you're excited that science was making a headway. And you are, like you just said, the Supreme Court of Science. You are in the science scientific world as it were. So you will have an insight into what is being done by the Nigerian science community to make sure that we have homegrown solutions. That's why I'm asking. Yes. No, I'm not, I'm not refuting anything you're saying. I'm just making sure that there's a proper grasp of what, what I'm saying, so that it's not misunderstood. And so that I'm sure that you also understand what it is that the fact that the Academy itself doesn't do the research. But like you said, yes, it does link with the scientific community. Otherwise, it will be unable to do its job, which is to bring that scientific research to policy, okay, or to the knowledge of policymakers, you know, in order for them to make proper policies. There are many people researching malaria if you go to all our institutions, but really all our institutions, because malaria is a very, very, very important disease here. Okay, so we have institutions, if I think of, say, the University of Ibadon alone, there are many research teams working on different aspects, including diagnosis, including therapy. Okay. And when you look at vaccination, like I said, that's very expensive work to do. Okay. And there are now institutions that deal with genetic, that deal with a lot of genetic work. And those are institutions that can't do proper or let's call it more cheaper, faster vaccine development work. Okay. So there are many institutions across the country that are working on different aspects of the malaria control. And I mean, up to Laurie, Ibadon, Lagos, there are many institutions in all the universities, almost all universities, you find researchers working on malaria. The vaccine is a different bogey mentality. And like I said, that's because of the nature of the organism. The fact that this is an organism that just like the COVID-19 vaccine now is almost not very effective anymore. So you have to keep developing. And that's a very expensive venture. So not many institutions here are that well funded, you know, to be able to do that kind of research. But there are a few coming up that are working on it. And hopefully we'll be able to get some of the results that want the ungrown kind of solutions you want. However, I mean, I once said that the ungrown solutions in terms of therapy that exists in Nigeria already, that people have worked on, again, when you walk and you do your research, there's a second, I mean, another phase to the research you have done, which is I've done my research, I have the results. Can I take that research and commercialize it? That's another bogey mentality, which is not very well developed. It's expensive also, but it's benefiting and taking it to commercialization is a different bogey. And we haven't totally, I mean, we haven't done very well in that regard. But again, a lot of people have identified these challenges and are working on them. All right, let me come back to you, Dr. Ngoku. A part of the reasons which has made a public perception fall is fears that some of these vaccines are linked to long term health problems, such as diabetes, multiple cirrhosis and autism. Now, is that true? That's one. And two, in the US, there is the national vaccine injury compensation program for those who may have been affected negatively adversely by vaccines or immunizations. Do we have such in Nigeria? Thank you very much. Okay. On the misconception of vaccines leading to more chronic illnesses, research has shown that all those claims like autism, multiple cirrhosis, diabetics are not true. So, scientific research, peer review papers have come to debunk a lot of those misconceptions. So, again, when we're raising awareness, we need to show data and facts to people to understand that research has been shown. The research was carried out in X number of people and it has shown that there was no correlation. And that way we can alleviate the fears of people. Humans are, it's normal human nature to want to protect yourself from harm. So, it's okay to have those fears, but it's not okay for us as experts to not educate people on the research that has been done and how that has been falls. There are independent occurrences that would have occurred in that human being, whether or not they had vaccines. On your questions on how vaccine compensation, injury compensation in Nigeria, I know that there is a surveillance for adverse effects of vaccines in Nigeria. And when people have adverse effects and they report it, that surveillance can help us to begin to know what number of people actually suffer from adverse effects and how we can. Right now, I can't speak to any program that exists for compensation, but I know that there is a surveillance and based on data of surveillance, we can then advance and see whether there is a need for compensation. If the amount of people are there, if the huge numbers are there, then we can begin to move that conversation forward. Yeah, in this surveillance, have you identified any government agency where Nigerians can actually go to lay complaints when they encounter severe vaccines? Absolutely. The first place to go to is where you took the vaccination. So most times Nigerians go to the primary health center, the public hospital, primary health center where you took the vaccination is the first place. So for COVID vaccination, that was the place we told people go back there and report any symptom that is not the normal symptoms that you have been educated on. So wherever you take your vaccine as a first place, the word, the local government have a surveillance team that go to these primary health centers and go to these hospitals to collect data monthly. They collect surveillance data monthly and those people get the data and submit up and they are reported to the National Primary Health Care Development Agency and that is followed up. So go back to where you took the vaccines if there were any adverse effects and monthly complaint. Okay, let me go to Dr. Odubanjo. You mentioned something about researching, being one thing, to research is one thing, to commercialize this research is another thing and which probably is the reason we do not have some of the solutions that we need to have, homegrown solutions that I seem to be very interested in. So what's the real challenge? For instance, a long time ago when there was this new talk about HIV, someone in Nigeria, in the person of Dr. Abalaka, came up to say he has done a research and he could have some solutions to the problem of HIV and after a while we didn't hear anything from him, whether it wasn't good enough and they were still researching and they were adding some things or not and then we also had when we have had this case of COVID, another Nigerian doctor or pharmacist said that there could be a homegrown solution and he actually said a lot of things that could have been followed up and nobody seemed to have followed up. What really is the challenge of translating what you have researched into the commercial aspect of it so that we can start seeing these things? Okay, given the examples you have used, I would say one of the key challenges that I would emphasize at this point is the due process. Science is not magic. Your network is breaking. We can't hear you well, doctor. Maybe something from your end. Do something about it. While we're waiting for doctor to improve on his audio, I'd like to know what is your target for this year? This is immunization week. What is the target for this year? The numbers have dropped from the statistics we've seen and we're blaming it on the COVID and some other factors. So what are you targeting for this year? Okay, thank you for asking that question. Even though we know that the number had dropped globally to 81%, Nigeria is not even close. In Nigeria, we are at 57% vaccine coverage and the global target is 90% as of 2030. So there is still a lot to do. As a country, I know that there are a lot of efforts that are going into how we can close that gap and how fast we can do that as an organization. Our target for this year is to fund communities, the zero dose communities and communities that have poor coverage of vaccines in Nigeria. We're working with the National Primary Healthcare Development Agency to be able to do that effectively and in a transparent manner. We are also looking to improve on the transparency and accountability of the government as we know that that promotes trust in the people and they can see what the government is doing, what efforts the government is putting into increasing vaccine coverage and that will most likely reduce the vaccine hesitancy in the communities. We're also working with them to improve the transparency of using of data and making the data simple enough that the normal working Nigeria can understand what their vaccine coverage is. All of this is in the bid to be able to prevent the population from vaccine preventable disease. We want to get to a point where we have herd immunity, where we have broken the chain of the antigen to the point where those that are not vaccinated are protected by those that are vaccinated. Okay, Dr. Odubanjo, are you back with us? Dr. Odubanjo, it's gone off again, all right. I'll have to come back to you. Now I, okay. Hello, Dr. Odubanjo. All right. I can hear you. Oh, good. It's good that you're back. Let's talk about what we can do to accelerate. Oh, maybe he should just finish what he was, he started talking about. All right. Do you still have your thought before you went? If you still have your thought, please conclude on it. Well, I do. I was answering the challenge of some of our claims in the country to have found homegrown solutions. And I said, given the examples you have used, the particular problems we have faced with some of the people, some of our people is that they have not transparently followed scientific methodology. And I chose my words carefully. When researchers do their research, they have a particular aspect of it where they write up and they call it methodology. If you are reading a research paper, that methodology aspect is absolutely important. If that is flawed, the whole research finding is flawed and can be trodden in the garbage can. So what has happened in some of those instances is that the people did not follow proper scientific process or methodology or did not subject themselves to scrutiny or what the scientists will call peer review. And that's why you publish in journals and all of that. When you publish in a good journal, we call them good peer review journals. Other scientists like yourself in close fields or the same field as yourself are going to look at what you did. They will look at your methodology, look at your findings, look at everything critically. And then they would say, yes, this is a good paper. This was good research. You can publish this for the knowledge of the information of the scientific community. So that's a scientific community endorsement. So what has happened in many instances is that those people were not able to do that. They were not able to subject themselves to that kind of process. Nobody could prove that what they said they found was correct. In fact, I didn't want to mention, but I'll know to you, the Academy of Science was sued by the HIV man years ago. The Academy won that suit. It lasted about seven years for saying that what he found wasn't real. And what the Academy simply said was that what he found can't be proven because he refused to subject it to scrutiny. And so the Academy said, no, we can't endorse it because we can't quite prove what he said he found. And then he sued and he lost. Okay, so that is one problem with what all of these claims, these claims are being made in the media. They have been made on the pages of newspaper on TV without these people subjecting themselves to their scientific communities to say, this is what I've found. I've written my paper or I make my presentation at a scientific conference where your colleagues and ask you questions and all of that. And whatever you found can be reproduced by other scientists like yourself. They can do it and say, yes, what he found is correct. So they didn't do that. That's one side of it. The other side is what I caught pretending. In which case, it means that if you found something novel, Bendathin can be recorded in your name internationally. And anybody who's going to use that finding, therefore, I mean, to produce drugs or whatever in commercial quantities will have to acknowledge you in some way, most likely financially, it means that you're going to be a financial beneficiary of whatever they get, if you choose to get it, but they cannot use it without your permission. So we, but that costs a lot of money. If you're going to patent, there are many patenting boards. I mean, of course, the most important are the ones hosted in the US and Co. But if you don't do that, other people can also steal your work and reproduce it, find that it's genuine, and they have the means to patent properly, globally, and then go commercial with it. So you lose out. So those are some of the areas that we have institutions in the country that are looking into that. And I believe that things are getting better. We also have institutions that help people who have done research or are doing research in drug discovery and go like the National Institute for Pharmaceutical Research and Development. And I think people should go explore what possibilities there are, for some of these institutions to help them first prove what they found or prove what they know. For instance, our traditional Abel Elas, prove the remedies that they have, they will take it through scientific research and say, yes, truly, there is a content in that leaf that works for this effectively and it's safe. And once you do all of that, then the next step is that they will start exploring with you is a possibility of commercialization. And perhaps that's where our local drug companies can come in. Also, is to mix up with the scientific community in Nigeria and say, yes, if you find this thing, we will show that the burden of patenting and therefore we can go commercial and you will get your share of the proceeds. So the private companies can take it forward from there in collaborating with the scientists. Okay, according to a report by the World Health Organization, the African region bears a high burden percentage of the global malaria burden. Nigeria is one of the worst heat in the world, as we know. And where are we presently? I mean, you've said all these wonderful things and it's good. I want to believe you've also worked with government or interface with government one way or the other in the course of your work. How would you describe government's political will, if I may use that term, in seeing an end, a quick end to this pandemic? And now perhaps you might also link it to our traditional healers who are working with herbs. How has government been able to bring some sort of synergy? Because talk here, walk here, yet we are still where we are. And result is the name of the game, isn't it? Absolutely. So I would say that government has done its bit. What we need to look at is that in other parts of the world, where these things have worked well, except for COVID-19, perhaps, you'll find that these things are driven by the science community and the private sector. So what I think is missing in Nigeria is that active private sector that should we call it community responsible private sector, that is not looking just to import things and sell. So it's not just a trading organization, but organizations that are willing to invest in scientific development. Let's put it that way. And therefore, this organization is a lot of investment and you have to be patient with it. But ultimately, you stand to reap a lot at the end of the day. Governments all over the world, we know, I mean, can be frequent. Sometimes policy directions can change easily. Again, but then that's not to say that the Nigerian government hasn't been trying. The Malaria control program has been one of the most longest sustained programs in the country. But there's a limit to what any government will do and can do because this is all very expensive. Resources as cars has to be shared among so many things and security has risen in the last 10 years to unimaginable levels and is consuming a lot of resources. But the private sector can just calm down and say, look, we're interested. We want to meet up and start dealing with the scientific community. If you look abroad, for instance, a lot of PhD students are actually being funded by private companies, pharmaceutical companies and all kinds of companies are funding the researches that are going on. Why? Because they have direct impact on their business with the potential for improving their own profitability at the end of the day, which is what they are about. Yes, so they will invest in it. But at the end of the day, they stand to gain a lot. It's that patient, that delayed gratification that I think is missing. So we as the Academy of Science, for instance, we stand as a bridge between the scientific community and the real world, which is a policymaking world of the private sector. So we are happy to be that neutral body that's able to bring all of us people to a round table and constantly develop programs that ensure that private sector funding can help the scientific community in Nigeria develop and at the end of the day, increase the profits of the private sector companies. Okay, let's come back to Dr. Morko here. The immunization, from next year you will have something else, one more component that will be added. That is for the malaria. We are being told that in 2024 it will come. How prepared are you to welcome that, as it were? Thank you. And I think that the way the routine immunization program has been structured, any other addition is a layer on. And so the program has been set up in a way that it can take on an additional vaccine and it would not be a parallel program. It will be synchronized in the current program. So we have the routine immunization program already for children within the same age. The malaria vaccine is for children five months to five years, the routine immunization for children under one, same spectrum, same health system. What we need to do is that we need to strengthen the health system to carry on another vaccine. But I don't think there is so much, it's not a different agenda. It's just going to be layering on the existing protocol for the program. Is the health system even favorable enough for all the things that you need to do? So that is the million dollar question. We know that our health system is weak. COVID revealed the weaknesses, the loophole, and maybe worsened the weaknesses in our health system. We need to strengthen the health system, some really for health, for investment, for health, financing for health, so human resource for health, strengthening it and increasing the capacity knowing that we're losing a lot of HRH to other countries. We need to invest in technology, we need to improve our data management system. We need to strengthen the health system as a whole. I guess that this conversation is to say that where are we in strengthening the health system? I like what Dr. Duin said is that the government cannot do everything. There is a rule for the private sector to put their money where they're mounted. So investing in this health system outside the country, health systems work now because the government funded 100% because their interested parties making sure that it works. So I think that it's a call for collaborative efforts. We saw that that worked in COVID. There was collaborative efforts between governments, international communities, as well as philanthropic organizations. This is a renewed call that we need to strengthen the health system in Nigeria to be able to withstand every of the assaults that it will come to us. All right. Well, thank you so much, Dr. Fajere Chinyongoku, GMTU, Nigeria Solidarity Support Group, and Dr. Doni Oduvangio, past year APHPN, Lagos Executive Secretary on the Nigerian Academy of Science. Thank you so much for joining us to take a look at the World Immunization Week and the World Malaria Day. Thank you so much for your insight and time. Thank you for having me. You're still watching the Breakfast on Plus TV Africa. Just stay with us. We'll take a break and return with sports.