Second wave of COVID-19 in Nigeria: Lessons from the first wave.

The COVID-19 pandemic struck the world unawares. The virus is now spreading as never before, despite the initial progress recorded by several countries towards kerbing the pandemic. As the pandemic continues to spread across Africa, there is a need for countries in the continent to re-evaluate, re-strategise, and re-invigorate their COVID-19 responses and efforts based on lessons from the first wave, and Nigeria is no exception. Before the second wave was officially announced by the health authorities on 17 December 2020, there were 78,434 confirmed cases and 1221 deaths reported with a case fatality rate (CFR) of 1.6%. To ensure that Nigeria achieves total pandemic control and reacts better given the possibility of a second wave, we propose workable recommendations to strengthen our preparedness and readiness efforts. Here, we argue that lessons learnt from the first wave of the COVID-19 pandemic can help Nigeria better react to the second wave.

Impact of COVID-19 on access to healthcare in low- and middle-income countries: Current evidence and future recommendations.

The COVID-19 pandemic continues to be a major public health threat globally and low- and middle-income countries (LMICs) are not an exception. The impact of the COVID-19 pandemic is far-reaching on many areas including but not limited to global health security, economic and healthcare delivery with a potential impact on access to healthcare in LMICs. We evaluate the impact of the COVID-19 pandemic on access to healthcare in LMICs, as well as plausible strategies that can be put in place to ensure that the delivery of healthcare is not halted. In order to mitigate the devastating effect of the COVID-19 pandemic on the already weak health systems in LMICs, it is much necessary to reinforce and scale up interventions and proactive measures that will ensure that access to healthcare is not disrupted even in course of the pandemic.

The State of Pharmaceutical Manufacturing in the Democratic Republic of Congo: The Journey so Far.

Despite a population of over 89 million people, the Democratic Republic of Congo (DRC) has just 30 local pharmaceutical manufacturers (DRC) with the majority of manufacturers based in Kinshasa, the capital city. Of the total number of pharmaceutical products sold in the DRC, just 10% accounts for those manufactured locally. The DRC remains dependent on other countries such as China and India for the supply of active pharmaceutical ingredients (APIs) -thus, local pharmaceutical manufacturing is therefore reliant on imported commodities and industrial machinery. Given the relevance of the pharmaceutical industry, it is vital to pay careful attention to the problems affecting it. Here, we assess the current situation of pharmaceutical manufacturing in the DRC, examine current challenges, and provide solutions for future development.

An Evaluation of Local Pharmaceutical Manufacturing in Zimbabwe: How Prepared is Zimbabwe to Produce COVID-19 Vaccines?

Globally, the COVID-19 pandemic has had a significant impact, given the rise in the demand for novel therapeutics such as vaccines that can be used in the treatment of COVID-19 patients. Compared to other regions of the world, gross vaccine inequity exists in Africa due to several factors tied to the acute lack of vaccines in the region. As a result, efforts are currently being made to ramp up the production of COVID-19 vaccines in the region. However, there are concerns that most countries in Africa lack the adequate pharmaceutical manufacturing capacity required to produce COVID-19 vaccines, and Zimbabwe is not an exception. This article, therefore, aims to evaluate the preparedness and readiness efforts of the Zimbabwean pharmaceutical industry in the production of COVID-19 vaccines.

The Urgent Need to Intensify Vaccine Development and Manufacturing in Africa: Lessons from Emerging Pandemics.

Over the years, the African continent has been severely plagued by disease outbreaks, most of which have resulted in devastating pandemics. Despite having the greatest burden and impact of these disease outbreaks, regional efforts to develop and manufacture vaccines in the continent have been inadequate, with a potential impact on pandemic preparedness and readiness efforts in the continent. Given that disease outbreaks are still likely to occur in the future, we discuss the urgent need to intensify vaccine development and manufacturing in Africa based on the lessons learnt from emerging pandemics.

The need for a functional pharmaceutical industry in Sierra Leone: lessons from the COVID-19 pandemic.

With an estimated population of 8.3 million, Sierra Leone has no existing pharmaceutical manufacturing company at present. The recent COVID-19 pandemic brought to the limelight the fragility and weakness of the Sierra Leonean pharmaceutical industry as it resulted in severe drug shortages and medicine insecurity in the country due to the restrictions imposed on importations, which validates the uncertainties if the country can sufficiently meet its local pharmaceutical needs and health demands. In this paper, we highlight the current situation of the Sierra Leonean pharmaceutical sector and provide recommendations for the country towards building a functional pharmaceutical industry based on lessons learnt from the COVID-19 pandemic.

Fighting Tuberculosis in Africa: The Current Situation Amidst the COVID-19 Pandemic.

Globally, tuberculosis (TB) is one of the leading infectious causes of mortality, with around 4000 deaths daily. Since the emergence of the coronavirus disease 2019 (COVID-19) pandemic in Africa, the region has experienced a lapse in responses directed at TB control, because the priority has shifted to interventions aimed at managing COVID-19. In addition to an unprecedented burden on the region's already overburdened health systems, another major public health concern is the clinical similarities between COVID-19 and TB, making TB diagnosis increasingly challenging, which may lead to poor prognosis, especially in people with TB and COVID-19 co-infection. A likely implication is that TB patients may stop attending health-care facilities due to fear of contracting or being diagnosed with COVID-19 or to avoid being stigmatized, invariably resulting in a disruption in their access to health-care services. Therefore, massive global support should be provided for TB endemic countries to respond synergistically and strongly to the thousands of TB cases as well as the COVID-19 pandemic.

Why Nigeria Must Strengthen its Local Pharmaceutical Manufacturing Capacity.

With over 115 registered pharmaceutical manufacturers, Nigeria still depends on other countries for the supply of active pharmaceutical ingredients and excipients. Significant attention has not been paid to the local production of raw materials, pharmaceutical dosage formulations, or processing equipment, which has resulted in a decline in the country's pharmaceutical manufacturing capacity. Owing to the overall importance of the pharmaceutical industry, it is, therefore, essential to pay close attention to developmental issues affecting this sector. In this commentary, we explore why Nigeria must boost its local pharmaceutical manufacturing capacity.

Combatting Substandard and Counterfeit Medicines in the Nigerian Drug Market: How Industrial Pharmacists Can Rise Up to the Challenge.

Substandard and counterfeit medicines (SCMs) are a major public health threat in Africa. In Nigeria, the manufacture and distribution of substandard and counterfeit medicines in the drug market are booming, despite the efforts of law enforcement agencies to crack down on criminal syndicates over the years. The current situation has been exacerbated due to factors tied to unregulated open drug markets, lack of counterfeit detection technology, poor local pharmaceutical manufacturing capacity, and porous cross-border monitoring and surveillance systems. However, industrial pharmacists have a key role to play in combatting the production and circulation of SCMs in the Nigerian drug market. In this commentary, we examine the prevalence of SCMs in Nigeria and proffer feasible recommendations that industrial pharmacists can leverage to ensure its effective containment.

Impact of poor disease surveillance system on COVID-19 response in africa: Time to rethink and rebuilt.

Infectious disease outbreaks have long posed a public health threat, especially in Africa, where the incidence of infectious outbreaks has risen exponentially. Although, Africa has witnessed several outbreaks of emerging and re-emerging infectious diseases such as Ebola virus disease and other epidemic-prone diseases, little attention has been given towards strengthening the health surveillance systems. However, the recent COVID-19 pandemic has uncovered the region's already due to inefficient and ineffective health surveillance systems. However, the impact posed by the COVID-19 pandemic on health systems in the region has been catastrophic, it has also stressed the importance of rethinking and focusing on lessons learned during the COVID-19 pandemic. In this paper, we examine how Africa's poor disease surveillance systems affected the responses and strategies aimed at COVID-19 containment. To ensure early disease outbreak identification and prompt public health interventions in Africa, the current disease surveillance and response mechanisms must be strengthened.

COVID-19 and Antimicrobial Resistance: A Review.

As the world continues to respond to the coronavirus pandemic (COVID-19), there is a larger hidden threat of antimicrobial resistance (AMR) lurking behind. AMR remains worrisome in that the pathogens causing resistant infections to thrive in hospitals and medical facilities, putting all patients at risk, irrespective of the severity of their medical conditions, further compounding the management of COVID-19. This study aims to provide overview of early findings on COVID-19 and AMR as well as to provide recommendations and lesson learned toward improving antimicrobial stewardship. We conducted a rapid narrative review of published articles by searching PubMed and Google Scholar on COVID-19 and Antimicrobial Resistance with predetermined keywords. Secondary bacterial infections play crucial roles in mortality and morbidity associated with COVID-19. Research has shown that a minority of COVID-19 patients need antibiotics to treat secondary bacterial infections. Current evidence reiterates the need not to give antibiotic therapy or prophylaxis to patients with mild COVID-19 or to patients with suspected or confirmed moderate COVID-19 illness unless it is indicated. The pandemic has also brought to the fore the deficiencies in health systems around the world. This comes with a lot of lessons, one of which is that despite the advances in medicine; we remain incredibly vulnerable to infections with limited or no standard therapies. This is worth thinking in the context of AMR, as the resistant pathogens are evolving and leading us to the era of untreatable infections. There is a necessity for continuous research into understanding and controlling infectious agents, as well as the development of newer functional antimicrobials and the need to strengthen the antimicrobial stewardship programs.

Threats and outbreaks of cholera in Africa amidst COVID-19 pandemic: a double burden on Africa's health systems.

Every year, about 4 million cases and 143,000 deaths due to cholera are recorded globally, of which 54% were from Africa, reported in 2016. The outbreak and spread of cholera have risen exponentially particularly in Africa. Coupled with the recent emergence of the Coronavirus Pandemic (COVID-19) in Africa, the local health systems are facing a double burden of these infectious diseases due to their cumulative impact. In this paper, we evaluate the dual impact of cholera and COVID-19 in Africa and suggest plausible interventions that can be put in place to cushion its impact.

COVID-19: challenges affecting the uptake of e-learning in pharmacy education in Africa.

The effort by countries and relevant stakeholders to improving the quality of pharmacy education globally is being countered by the outbreak of infectious diseases. In order to curtail the spread of the coronavirus, unprecedented measures such as total/partial lockdowns and ban on public gatherings have been put in place by several governments. These measures implemented have put a halt on academic activities and schooling and have invariably affected the delivery of pharmacy education globally and Africa is no exception. In order to ensure the continuity of pharmacy education, the e-learning strategy has been utilized by several countries in the world today and Africa should not be left out. There is an urgent need for Africa to meet up with the present education demands by adopting the e-learning strategy but this is not without challenges. We examine the impact of these measures on pharmacy education as well as the challenges affecting the uptake and applicability of the e-learning strategy in pharmacy education in Africa. It is therefore essential for the government and relevant stakeholders in the pharmacy education sector to address the numerous challenges that may hinder its uptake in Africa.

South Sudan: a young country's fight against COVID-19.

COVID-19 is a highly infectious disease that has started to creep into African countries including South Sudan. Following confirmation of the first few cases, the government enacted preventive measures to curb community transmission. However, daunting challenges deter these precautionary measures. Just after two years the country took its independence from Sudan, civil conflicts sparked and continue to overburden and undermine the fragile healthcare system. The conflicts have caused disruption of health services, destruction of health facilities, death and migration of health workers, displacements of a huge number of people. This scenario continues while the country is grappling with the pandemic. Other concerning issues include: insufficient COVID-19 testing capacity, limited medical and personal protective equipment and an inadequate number of health workers which leave the country ill-equipped in the battle against the pandemic. Non-compliance of COVID-19 prevention protocols by the general public due to high rate of poverty and social stigma contribute to the spread of the virus. The current situation in South Sudan make evident that there is a need for an immediate ceasefire by the warring sides so the available health services including COVID-19 efforts, are not disrupted to ensure the safety of all. The government needs to further build the capacity of its health sector with the cooperation of its international health allies to be able to provide its citizens with the health services they need.

Telemedicine: an imperative concept during COVID-19 pandemic in Africa.

With social distancing being a key preventative measure of COVID-19, proper provision of healthcare services becomes a challenge as healthcare professionals are concerned about the risk of potential infection. Telemedicine, a practice that uses telecommunication networks for the delivery of healthcare services and medical education, has been adopted by several countries and has shown to provide positive outcomes. This concept is poorly practiced in African Countries compared to other countries of the world. This paper reiterates the need for the expansion of telemedical systems in Africa for the dual goals of COVID-19 prevention and provision of quality healthcare services to people.

COVID-19 Misinformation and Infodemic in Rural Africa.

The world has witnessed rapid advancement and changes since the COVID-19 pandemic emerged in Wuhan, China. The significant changes experienced during these times remain unprecedented. The African continent has initiated significant responses to curb the spread of the pandemic. However, there is an increasing concern that rural Africa is facing serious challenges in their responses to the COVID-19 pandemic. This is due to the uncertainty if the populations are detached from or in synch with information on COVID-19. The findings reported here suggest that rural Africa is burdened with misinformation and infodemic regarding COVID-19 due to widespread misconceptions and anecdotal reports. It is, therefore, necessary to engage with community leaders to provide awareness campaigns in rural communities to ensure access to reliable information issued by local and international health authorities. It is pertinent to set up avenues that improve health literacy in communities in rural Africa as it is a major determinant of information assimilation.