Coronavirus (345) Palliative care in the time of COVID-19 (2)

4 April, 2020

Prof thank you for prompting this very sensitive and difficult topic. But as you say we must discuss it before the need arises as we all fear it may.

In Nigeria it has exercised the thoughts of clinicians but I am not sure that the policy makers have yet gotten the message. Following the example of China, South Korea in this pandemic, Nigeria is putting interventions in place like social distancing, respiratory hygiene, lockdowns etc, to flatten the curve. Governments are building isolation centres too. There is massive public education and awareness in all 36 states and federal capital territory of the country.

But hospital capacity in equipment (ventilators, respirators, etc), human resource, utility needs, etc await visible actions. The greatest challenge remains that we don't know the extent of infections because testing is very restricted to only ‘symptomatic’ patients. In my post on this forum on another question, I said that if high income countries are struggling to counter this pandemic, as we all see on global cable news channels every day, spare a thought for the LMICs if the pandemic intensifies there. From what we read in the press and media, the situation in other African countries is not different. Infact, it may even be worse in some of them than in Nigeria. Nigeria successfully dealt with Ebola epidemic in 2014, and some of the infrastructure were still in place.

I have also talked about the apparent absence of global leadership as a major cause for why Coronavirus epidemic became a pandemic. To avert disaster in LMICs from this pandemic, including Africa, there needs to be a globally driven, supported and assisted Action Plan: including quantitative easing for developing countries, and immediate palliatives for the population, because these countries are starting from almost ground zero of readiness to fight this COVID19 pandemic, when compared with HICs. The multilateral global finance bodies, UN, Global big business, Big Pharma, etc need to come to the table, Now.

The benefit of such global support and assistance will be felt in the Whole world.

Joseph Ana.


@Health Resources International (HRI) WA.

National Implementing Organisation: 12-Pillar Clinical Governance

National Standards and Quality Monitor and Assessor

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HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.

Email: jneana AT