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New WHO Guide to help countries expand access to essential medicines
WHO’s new user guide for countries, ‘Selection of medicines at country level’, is based on the WHO Model List of Essential Medicines. It sets out the key actions countries should undertake to develop and update their own
national essential medicines lists based on the treatment needs of their populations and their capacity to reimburse payments for medicines.

The document also aims to support countries in progressing towards universal health coverage. Today, approximately half of the world’s population is unable to access essential medicines. The large majority of these people live in poorer countries,
but rising prices of new medicines are also becoming a challenge for health systems in wealthy countries.

A careful selection of essential medicines is the first step in ensuring a population can obtain the quality-assured medicines it needs at an affordable price. Countries need to do more to ensure that all people and communities can access highly
effective medicines. WHO’s new manual is a resource to do just that.

The document, intended for policy makers in charge of national medicines and reimbursement lists, aims to increase transparency on how essential medicines are selected. Most national lists of essential medicines have several differences when compared
with WHO’s model list, which lists only medicines of proven safety and efficacy. Some national lists include medicines that bring little extra benefit to patients. Decision-makers should refer to the WHO global list to gauge the public health
value of listing certain medicines for their populations.

The essential medicines concept

Essential medicines are:
- those that satisfy the priority health care needs of the population
- selected with due regard to disease prevalence and public health relevance, evidence of efficacy and safety, and comparative cost-effectiveness
- intended to be available within the context of functioning health systems at all times in adequate amounts, in the appropriate dosage forms, with assured quality and adequate information, and at a price the individual and community can afford.
The essential medicines concept is global and forward-looking. It incorporates the need to regularly update medicines selections to reflect new therapeutic options and changing therapeutic needs; the need to ensure drug quality; and the need for continued
development of better medicines, medicines for emerging diseases and medicines to meet changing resistance patterns.

Achieving universal health coverage and equity in public health depends on access to essential, high-quality and affordable health related technologies for all. To achieve access for all by 2030, at least two billion more people will need to have access
to essential health services by 2030.

In an effort to make the Model List of Essential Medicines more readily accessible, WHO recently developed an electronic version of the list, bringing the traditional EML to computer screens, tablets and smartphones in a freely accessible, downloadable,
online database.

Link to manual: Selection of essential medicines at country level

Link to e-EML: Model List of Essential Medicines

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March 31, 2020
Presidential Order Not Enforceable Without Legal Backing! By Femi Falana

Following the national broadcast of President Muhammadu Buhari on the COVID-19 pandemic on Sunday, some lawyers have questioned the constitutional validity of the restriction of locomotion of people in Abuja, Lagos and Ogun states. No doubt, the President is empowered to adopt any measures deemed fit to combat the dangerous disease but such measures have to be spelt out in a Regulation made pursuant to section 305 of the constitution or under the Quarantine Act. Otherwise the presidential order on restriction of movement in the affected areas cannot be enforced by the police.

Even though civil rule was restored in the country 21 years ago the psyche of the political class has not been demilitarised. Hence, decisions taken by rulers are required to be obeyed “with immediate effect” without any legal backing. But in Okafor v Governor of Lagos State (2016) LPELR-41066 (CA) the Court of Appeal called on all authorities to appreciate the need to govern the country under the rule of law. Thus, the directive of the Governor of Lagos State restricting the movement of citizens and residents during the state’s monthly environmental sanitation exercise was struck down because of its unconstitutionality. It was the unanimous view of their lordships that the arrest of appellant for flouting the order or directive of the governor was completely illegal. According to Georgewill , J.C.A.

“It is my view, that democracy thrives more on obeying and promoting the rule of law rather than the whims and caprices of the leaders against the lead. I find the conduct of the Respondent in not only persecuting the Appellant, yes that is what in my view it amounts to when a free citizen of this great country such as Citizen Faith Okafor, is put through the rigours of criminal process for an offence not prescribed in any written law but merely on the directive of the governor of the Lagos State. An action which if allowed to thrive in a democracy such as ours could confer on such office holders infinite, absolute and autocratic powers contrary to the clear provisions of the constitution of the land, to which both the leaders and the led are subject. I refuse to allow such autocratic, absolute and infinite powers to fester upon our nascent democracy.”

Lawyers who are saying that the law should be completely relegated to the background in combating the coronavirus pandemic reminds me of the dissenting judgment of Lord Atkins in the case of Liversidge v Anderson 1944 UKHL 1. While accusing his learned brethren of being “more executive minded than the executive”, his Lordship said inter alia:

“In England, amidst the clash of arms, the laws are not silent. They may be changed, but they speak the same language in war as in peace. It has always been one of the pillars of freedom, one of the principles of liberty for which on recent authority we are now fighting, that the judges are no respecters of persons, and stand between the subject and any attempted encroachments on his liberty by the executive, alert to see that any coercive action is justified in law.”

However. while the nation’s armed forces should be commended for making their medical facilities available to members of the public in the fight against the highly dangerous virus the plan to dispatch armed soldiers to the streets to enforce the COVID-19 guidelines should be shelved because it is illegal. For the umpteenth time, I am compelled to draw the attention of the military authorities to the case of Yussuf v Obasanjo (2005) 18 NWLR (Pt ) where Salami JCA (as he then was) held that “It is up to the police to protect our nascent democracy and not the military, otherwise the democracy might be wittingly or unwittingly militarized. This is not what the citizenry bargained for in wrestling power from the military in 1999. Conscious steps should be taken to civilianise the polity and thereby ensure the survival of and sustainance of democracy.”

In the same vein, in the celebrated case of All Progressive Congress v Peoples Democratic Party (2015) LPELR 24349 Aboki JCA held that the President lacks the power to call on the Armed Forces to restore law and order in any part of the federation without the approval of the National Assembly as provided in sections 217(2) and 218(4) of the constitution as amended. His Lordship reminded the Federal Government of its legal obligation “to confine the military to their demanding assignments especially in these trying times of insurgencies and encroachment into the country’s territories…”

Finally, just last week the satanic Boko Haram force was reported to have massacred 47 Nigerian troops and 92 Chadian soldiers in two separate attacks. In view of such enormous challenge our patriotic armed forces should concentrate efforts on the counter insurgency operations being carried out in the north east region while the police and allied security agencies are allowed to enforce the COVID-19 regulations and guidelines.

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March 31, 2020
Babalakin Obsessed With The Vice-Chancellor’s Removal By Alabi Azeez

As expected, the Vice Chancellor’s response on the barrage of lies that Babalakin tried to peddle about the suspension of the 51st convocation of the university, elicited anger and rage from a faceless and dishonest ‘Concerned Stakeholders’ and a group of delinquent non-academic staff making scrupulous releases requesting for the Vice Chancellor to proceed on leave, because, for them Babalakin has an intimidating resumé and commands national respect.

A cursory look at the individuals issuing these publications will tell exactly why they have taken such an undistinguished position. Interestingly, they could not use the SSANU platform which they have tried tirelessly in the pass to desecrate. The team is led by Mr Adetomiwa Adekola, who was impeached as SSANU Chairman on account of his financial recklessness and dubious land scheme he purchased for SSANU members. He is assisted by a rag tag, Mr Babatunde Oseni, who the SSANU electoral committee disqualified from contesting election into any SSANU executive position on account of his terrible records of service in the university.

What sort of stakeholders are these? Whose interest do they actually represent? Certainly not the interest of any known group in the university, but that of their paymaster who is hell bent on destroying the university.

Their position is not only laughable but also pedestrian and lacking in any form of logical reasoning. How can anyone contemplate the exit of a Vice-Chancellor who has achieved so much in two years, even under the worst of conditions? Maybe these fellows need a reminding that it was the selflessness and ingenuity of Prof Oluwatoyin Ogundipe that brought the University of Lagos to number one in Nigeria and eighth in Africa. The university during his Vice Chancellorship has attracted about N8bn in research grants. He created the much needed atmosphere for students to develop their entrepreneurial skills. Under Prof Ogundipe’s watchful eyes, the students and staff have won several international laurels and have become globally relevant. The renaissance of the research culture in the university is largely attributed to the Vice-Chancellor’s zeal to make UNILAG a research-based university. His tenure has given the University more international visibility and global respect. It is not surprising that even Mr Adekola and his cohorts rightly referred to the Vice Chancellor as a “scholar and administrator of repute.” This is particularly so because he singlehandedly won a lot of research grants as a scholar; and to the admiration of many, he has held various key administrative position in his over 30years in the services of the university. On the flip side we have a Pro Chancellor who has done everything in the last three years to give the university bad image and publicity.

Think for one minute, if Prof Ogundipe is the problem, why was Mr Babalakin also at logger heads with Prof Bello? If there is anything we should do at this material time, it is to praise the Vice-Chancellor, Prof Ogundipe, who in two years turned the fortune of the university around. Calling for him to take leave is pathetic and signs of the failings of the Pro Chancellor.

On the part of the Registrar, his Council Resolution Part 2 is a very interesting revelation. The reasons are not farfetched. He made a fair but failed attempt to divert the minds of the public away from the issue that made the university a subject of ridicule in the last three weeks – The suspension of the 51st convocation of the university. Mr Babalakin’s grand intention was to show the university management how powerful and highly connected he is by cancelling the convocation at the detriment of over 13,000 graduating students and then turned around to blame the Vice Chancellor and NUC. But the ploy failed woefully. The public saw clearly what went down, at least the letter from the Ministry of Education puts it pretty clear that the event was suspended at the instance of Mr Babalakin who claimed the ceremonies did not receive Council’s blessings.

The alumni and stakeholders who were tired of Babalakin’s repressive leadership style took to the social media to express their dissatisfactions and frustrations. The #saveMyUnilag trended for days on Twitter and Facebook. For many, it was crystal clear what the agenda was – a show of power. As Simon Kolawole succinctly puts it in his write-up, Babalakin the Bully, “…[Babalakin] he has gone too far by his latest power show which has forced Unilag to suspend its convocation…his ego fight at the expense of the graduating students and their families is ungodly.”

Secondly, the Resolution threw up a host of issues which he claimed was discussed at the Council meeting. One of such was the ‘Greek gift’ of 40 Hectares of land at Ogudu being proposed by the Pro Chancellor. First question to ask, is this not the same piece of land in dispute with the state government for many years? Little wonder the property has no title documents or survey. This is aptly validated by the Registrar’s statement that “it was resolved that steps be taken to retrieve the title documents and that Council should be updated” Haba! Now that he could not get contracts from Unilag, Babalakin has resulted to swindling Unilag staff of their meagre salary? It is important to urge Unilag staff to be vigilant and “shine their eyes” on this land matter o!!! Don’t forget the issue of the Lagos-Ibadan Expressway contract given to him, he did not do the job, yet collected huge sum of money to even accept to let go of the contract. Not even the road in Ondo State.

Nigeria is yet to know when Babalakin will fully handover MM2 to government as we are not sure if he will not again change the end of concession date as he did previously. Besides, even if they come up with fake papers for the land, the purported land is located in a swampy environment and a professor who earns the highest salary in the university will struggle to put up a foundation for any building there.

Pages 3-6 of the resolution was largely on financial matters. This Council led by Babalakin should be ashamed of its conducts! Throughout last year, the University was on a standstill over allegations that a sum over N4bn was misappropriated, embezzled, squandered, lavished and stolen by the university management. In fact, the song on Babalakin’s lips was “catch am, catch am, thief, thief, thief, catch am, catch am, robber, robber.”

The same Council, led by same Babalakin, in less than a year, is now publishing a resolution that money is no longer missing, albeit, the University Managements (past and present) have saved far too long and too much to the tune of N9bn in the TSA account of the university! Then the Council goes on to propose a lavish spending of the savings meant for the DLI building, School of Foundation Studies building, College of Medicine and School of Postgraduate Studies building. How can you make money saved for more than five years for capital projects available for spending?

Babalakin is definitely set out to destroy the 25-year strategic plan that the Vice Chancellor swore to up hold, in one sweep! Babalakin has not facilitated any building to the university and yet he wants to share the money saved in the university development account by more than three Vice Chancellors to construct educational edifices for the great citadel of learning. Our dear Pro Chancellor needs to take a cue from what his counterpart in Obafemi Awolowo University is doing.

As any right discerning person can already see, Babalakin is trying hard to play the welfare game to divide and rule the staff of the university, further entrenching the acrimony, bad blood, discord and division that he already created in in the university. He is also struggling hard to divert attention away from the convocation issue. This is the biggest shame of leadership.

It is distasteful that the UNILAG Council matter has suddenly become a gutter matter that any individual can pick up on the streets of Lagos. Let us advise Council to stop wasting resources in printing resolutions. The next Council meeting should hold at the Main Bowl of the Sports Centre where all members of the university community, alumni and press can witness the plenary.

For many of us who are watching gleefully, the management of the university must be praised, in spite of all the grandstanding and unnecessary brinkmanship, the university rose to first in Nigeria and eighth in Africa.

No body and no lies can change what we already know, Babalakin cancelled the University of Lagos 51st convocation four days to the event.

On a lighter note or perhaps as a matter of national importance, the Pro Chancellor, Mr Babalakin was alleged to be in London on 11th March for Justice Oguntade’s birthday, he subsequently denied traveling to London but confirmed he was in Germany on medical trip. Whether London or Germany, since hi

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March 29, 2020
How to budget for COVID-19 response?

The COVID-19 pandemic requires sufficient public funding to ensure a comprehensive response. Reprioritizing public spending toward bolstering the economy and the health system requires timely action from government leaders and a supportive public finance environment. Highly-affected countries have taken various approaches to budgetary allocation, depending on their public financial management (PFM) and regulatory systems. Adjustments are required on the revenue side of budgets (e.g. loans) to account for these new economic and fiscal constraints. Quick decision-making on the expenditure side is also needed. That will be the focus of this blog. Every country must develop specific processes for allocating budget funds to the response. To inform budgetary response in countries where the pandemic may spread in the near future, a summary of observed budgetary practices in some highly-affected countries is provided below, with the aim of informing other countries about responses to three key questions:

1) What are the immediate spending actions that can be taken with existing budgets?

2) How to secure budget for COVID-19 response through revisions in finance laws?

3) What can be done to accelerate budget execution and funds release to the frontlines?

Please click here for the full article.

Authors: Hélène Barroy, Ding Wang, Claudia Pescetto, Joseph Kutzin

The authors acknowledge inputs received from Tomas Roubal (WHO Western Pacific Regional Office), Tsolmongerel Tsilaajav (WHO South East Regional Office), and Agnès Soucat (WHO Headquarters).

Sign-up for our Health Financing Technical Network here!
This online network is a place to share information, find updates on new materials or events related to WHO’s work on health financing policy.

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March 28, 2020
Abule Ado Explosion – Have We Moved On? By Oduche Azih

Does Nigeria possess the relevant forensic expertise to deduce the size of the explosive that devastated Abule Ado? I am referring here not to the trigger which could jolly well be a match stick, box of matches, a cigarette, a 12.5 or even a 50kg cylinder of LPG. If could also be a 2-ton industrial LPG storage.

Let’s leave the trigger alone for now.

Even as a layman viewing the field of devastation, I have deduced that the explosion proper cannot be less than 5kilotons TNT equivalent. No, I have no proof. At this point, I request professional backups or refutation? Please!

What exactly was this explosive? The statement by the NNPC boss at the scene that “it was gas” was unscientific, in view of the fact that the NNPC swears that none of its pipelines was involved.

Whether it was gas or not, it has been two weeks and the NNPC is yet to identify the ownership of the pipeline spewing those highly inflammable fluids (liquids or gas, we’ve not been told), burning over the next several days? How deep was that particular pipe buried? Is that standard? This is most doubtful. If the pipeline was carrying Natural Gas which the NNPC does NOT transfer from the Atlas Cove to Ejigbo and then to Mosimi and Ibadan, then it seems likely that the suspect pipeline must have been a natural gas line belonging to Gaslink Ltd, a subsidiary of Oando Plc flowing north to south toward the Dangote and other industrial operations on the shorelines by the lagoons. Was it a conspiracy that the ownership of this poorly installed gas delivery pipeline has been kept under wraps. I hope that Oando Plc, which is the ONLY gas distributor South of Ikorodu and the newer Igbesa cement plants in Ogun State, will come out with a statement. Was it one of their gas pipelines?

Other questions begging for answers:

– What part did the DPR play in the poor installation practices, now revealed?

– Since we have been made to understand that a truck was involved, was the sparking incident at a pipeline road crossing?

– Was there a provision in the design for a steel casing of the correct size and thickness in that location?

– Was it installed?

– At the Spec Standard depth?

– Was the Casing breached?

– Was there an Earthing Requirement for any/or all of the components?

– Was the Earthing implemented?

– Was there prior damage and dislocation there due to Soil Erosion and/or Wilful Trespass by property developers?

– Can we locate the last Right Of Way Inspection Report where this problem was indicated?

– When was that?

– What Remedial Action if any was recommended?

– Was it implemented?

– If not, why not?

My colleagues in the Nigerian Society of Engineers would have their hands full with this Case Study.

The leadership at the topmost echelons of the NNPC must recognise that what the people of Abule Ado, Lagos and indeed Nigeria need and want is JUSTICE not sympathy. That’s where the Attorney General of Lagos State needs to step in.

When the Dupont plant in Bhopal blew up more than three decades ago, the Indian government spearheaded by the Engineering Safety community rallied to find answers. Unlike here, every professional did not insist on being involved in the humanitarian relief effort, joining the CBN Governor to mobilize funds. Note that a good part of what we lost at Abule Ado cannot be redeemed by money. Ultimately at Bhopal heads rolled. The plant, manufacturing methyl isocyanate, was closed down permanently. Dupont paid billions in damages and I believe is still paying to this day.

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March 28, 2020
New WHO recommendations to prevent tuberculosis aim to save millions of lives
Geneva – New World Health Organization (WHO) guidance will help countries accelerate efforts to stop people with tuberculosis (TB) infection becoming sick with TB by giving them preventive treatment.

A quarter of the world‘s population is estimated to be infected with TB bacteria. These people are neither sick nor contagious. However, they are at greater risk of developing TB disease, especially those with weakened immunity. Offering them TB
preventive treatment will not only protect them from becoming sick but also cut down on the risk of transmission in the community.

As we mark World TB Day 2020, the disease remains the world’s top infectious killer. In 2018, 10 million people fell ill with TB worldwide and 1.5 million people lost their lives to this disease.

“COVID-19 is highlighting just how vulnerable people with lung diseases and weakened immune systems can be,“ said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “The world committed to end TB by 2030; improving prevention is key
to making this happen. Millions of people need to be able to take TB preventive treatment to stop the onset of disease, avert suffering and save lives”.

Dr Tedros highlighted the importance to continue efforts to tackle longstanding health problems, including TB during global outbreaks such as COVID-19. At the same time, programmes already in place to combat TB and other major infectious diseases
can be leveraged to make the response to COVID-19 more effective and rapid.

Although some progress has been made towards targets set at the UN high-level Meeting on TB in 2018, TB preventive treatment has been largely neglected. Global leaders committed to ensuring access to TB preventive treatment to at least 24 million contacts
of people with active TB and 6 million people living with HIV by 2022. To date only a fraction of that target has been reached, with countries putting less than 430,000 contacts and 1.8 million people on TB preventive treatment in 2018.

TB remains the top cause of death among people with HIV. TB preventive treatment works synergistically with antiretroviral therapy to prevent TB and save lives. Reinvigorated efforts by governments, health services, partners, donors and civil society
will be needed to increase access to TB preventive treatment to the levels targeted.

The new consolidated guidelines recommend a range of innovative approaches to scale up access to TB preventive treatment:
- WHO recommends a scale-up of TB preventive treatment among populations at highest risk including household contacts of TB patients, people living with HIV and other people at risk with lowered” immunity or living in crowded settings.
- WHO recommends an integration of TB preventive treatment services into ongoing case finding efforts for active TB. All household contacts of TB patients and people living with HIV are recommended to be screened
  for active TB. If active TB is ruled out, they should be initiated on TB preventive treatment.
- WHO recommends that either a tuberculin skin test or interferon-gamma release assay (IGRA) be used to test for TB infection. Both tests are helpful to find people more likely to benefit from TB preventive treatment
  but should not become a barrier to scale-up access. Testing for TB infection is not required before starting TB preventive treatment in people living with HIV, and children under 5 years who are contacts of people with active TB.
- WHO recommends new shorter options for preventive treatment in addition to the widely used 6 months of daily isoniazid. The shorter options that are now recommended range from a 1 month daily regimen of rifapentine plus isoniazid
  to 3 months weekly rifapentine plus isoniazid, 3 months daily rifampicin plus isoniazid, or 4 months of daily rifampicin alone.
“As people around the globe come together to commemorate World TB Day, WHO is calling on governments, affected communities, civil society organizations, health-care providers, donors, partners and the industry to unite forces and step up
the TB response – notably for TB preventive treatment – to ensure no one is left behind,” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme. “The new WHO guidance shows the way forward for millions to rapidly
access new tools and shorter, safer options for preventive treatment. The time for action is now.”

TB preventive treatment is an affordable intervention that can prevent families from sliding into poverty and preserve the health and economy of whole communities. WHO anticipates that as new and safer drugs come onto the markets, and as prices
fall, it will become a highly-cost effective way to save millions of lives.

NOTES FOR EDITORS:

WORK BY WHO AND PARTNERS

WHO works closely with Member States including the US Government and technical and funding partners such as UNITAID to enhance access to shorter TB preventive treatment regimens. UNITAID-supported projects such as IMPAACT4TB and Cap-TB projects
enabled by WHO with partners in Brazil, Cambodia, Cameroon, Côte d’Ivoire, Democratic Republic of Congo, Ethiopia, Ghana, India, Indonesia, Kenya, Lesotho, Malawi, Mozambique, South Africa, Uganda, United Republic of Tanzania and
Zimbabwe are leading the way. The new treatment options are also now more affordable, thanks to the significant price drop of rifapentine – a key drug – facilitated recently by UNITAID, the Global Fund to Fight AIDS, Tuberculosis and Malaria
and global biopharmaceutical company Sanofi, along with forthcoming arrangements underway with generic manufacturers.

MORE ABOUT THE GUIDELINES

The new consolidated WHO guidelines come with an operational handbook to help guide countries step-by-step as they take TB preventive treatment to scale. This includes guidance on how to prioritize and invest from demand creation for TB prevention
to supervision and monitoring of the programme.

The guidelines and operational handbook are also accompanied by an innovative mobile application – Prevent TB –to help health-care workers manage TB preventive treatment in their communities. Its online dashboard allows programme
managers to visualize and monitor data in real time. The application can be customized by countries to suit their specific settings and is currently being adopted in India and Philippines.

WORLD TB DAY

The new guidelines and tools are being released ahead of World TB Day. World TB Day is observed on March 24 each year to raise public awareness and understanding about the world’s deadliest infectious killer – TB and its devastating
health, social and economic impact on people around the world. Under the theme “It’s Time”, the spotlight this year is on urgently accelerating the TB response to save lives and end suffering.

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March 24, 2020
Small, precise and affordable gyroscope for navigating without GPS

A small, inexpensive and highly accurate gyroscope, developed at the University of Michigan, could help drones and autonomous cars stay on track without a GPS signal.

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March 23, 2020
David Attenborough’s A Life on Our Planet is a powerful call to action

David Attenborough’s highly personal new documentary A Life On Our Planet allows the nature filmmaker to say what he really thinks about our destructive ways

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March 23, 2020
Westworld season 3 review: Five-star TV where nothing is what it seems

Westworld is soon to return with season three. Four episodes in to the impossibly glamorous, highly urbanised future, I can’t wait to find out what’s going on, writes Emily Wilson

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March 22, 2020
New research improves drone detection for increased public safety

Unmanned aerial vehicles (UAV), commonly known as drones, are widely used in mapping, aerial photography, rescue operations, shipping, law enforcement, agriculture, among other things. Despite great potential for improving public safety, use of drones can also lead to very undesirable situations, such as privacy and safety violations, or property damage. There is also the highly concerning matter of drones being harnessed to carry out terrorist attacks, which means a threat to public safety and national security.

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March 18, 2020