Nigeria’s Lagos State government recently announced that private health facilities will start administering COVID-19 vaccines within the state. This is part of its effort to accelerate vaccine rollout beyond the 1.2 million doses that had been administered in the state by 27 October. This, the state governor admitted, is below the World Health Organization (WHO) target of 40% of the population of every country by the end of 2021. The private facilities will charge fees to individual citizens for their services. Virologist Oyewale Tomori spoke to The Conversation Africa about private sector involvement in the fight against the pandemic.
How has the government been managing the COVID-19 vaccine roll out so far?
As at 18 November, Nigeria has administered at least 9,017,951 doses of COVID vaccines. Assuming every person needs 2 doses, that’s enough to have vaccinated about 2.2% of the country’s population. AstraZeneca/Oxford, Janssen and Moderna are the vaccines Nigeria is administering. The government is doing its best under the circumstances. We still have an insufficient, inadequate, inconsistent and unpredictable supply of vaccines because Nigeria was almost fully dependent on supply through the COVAX facility, a worldwide initiative aimed at equitable access to COVID-19 vaccines. It has made limited efforts in procuring supply through other sources. You can only roll out what you have, and we do not have enough vaccines. This Lagos State initiative will still depend on the vaccines procured by the government.
What role has the private sector played in this?
The private sector – principally private faith-based health facilities – has been involved in administering polio, measles and yellow fever vaccines. Given the high level of efficiency associated with the private sector, their involvement in COVID-19 vaccination should enhance government efforts to ensure rapid and efficient rollout of available vaccines. In the USA and many European countries, private sector pharmacists are actively involved in COVID-19 vaccination. They play major roles in the delivery and administration of vaccines to the public. One hopes this planned increased involvement in COVID-19 vaccine delivery by the private sector will raise the level of public trust in the current and future vaccination exercises.
What are the other opportunities for private sector involvement?
The goal is to vaccinate four million residents by 25 December in the approved 400 private health facilities. If this experiment succeeds, we can get the private sector more involved in providing other vaccines, especially the routine vaccines like measles and diptheria-tetanus-pertussis.
While there is no law preventing the private sector from administering vaccines, I think there is a government reluctance in fully involving the private sector in mass and routine vaccinations. The reluctance has to do with some unscrupulous elements in the private sector. They are usually interested in profits alone, unlike faith-based organisations. I suspect this is why only one state is allowing the private sector at present.
What are the challenges in involving the private sector?
The private sector will charge some fees administration costs – for the extra services they plan to offer during the vaccination exercises. Though sometimes these services are better than those offered in public facilities. Possibly because of better environment, prompt personal attention and shorter waiting time. It is important to provide clear communication and appropriate information that the charges are for the extra services rendered and not payment for the vaccines.
Secondly, effectively monitoring the performance and service delivery by the private sector might be a challenge. And having insufficient vaccine doses to go round might be another.
Starting with a few private facilities that can be monitored by both the government and the private sector itself will be the right way to go. More facilities can then be included as time goes on and when more vaccines are available.
The vaccines are to be administered by the approved 400 private health facilities, as the governor said. Currently, there are 26 registered general hospitals, 256 public healthcare centres, 2,886 private hospitals or specialist clinics and laboratories or diagnostic centres in addition to an estimated 160 traditional medicine clinics in the state. So starting with 400 that meet the criteria looks like starting small for easier monitoring and evaluation.
How should the government address these challenges?
Government, in consultation with the private sector, should ensure that the guidelines and standards of operation for both the private and public sectors are effectively implemented and their implementation monitored as the performance of private sector health facilities are evaluated.
The government should also provide adequate vaccine doses and sufficient number of syringes and other requirements for administering the vaccines.