ASCAF KADACITY 20/21 Communique

Communique Issued at the end of the 15th Annual Scientific Conference and All Fellows’ Congress of the National Postgraduate Medical College of Nigeria held at the Hotel Seventeen, Kaduna in 2021

BACKGROUND

The 15th Annual Scientific Conference and All Fellows Congress of the National Postgraduate Medical College of Nigeria took place at the Hotel Seventeen, Kaduna from Tuesday 10th to Friday 13th August 2021. The theme of the conference was “The Covid-19 Pandemic: Impact on Economy and Health while the sub themes included Challenges of quality health care delivery in Nigeria, Medico-legal issues in Nigerian medical practice: whose interest? Surveillance of Emerging and Re-emerging infections and Role of Artificial Intelligence in Healthcare.

The opening ceremony was Chaired by Dr M. M. Borodo, FMCP, PNMC, the College President and supported by other principal officers. The ceremony was attended by Her excellency, the Deputy Governor of Kaduna State, Dr Hadiza Sabuwa Balarabe, a fellow of the faculty of public health of the College, who represented his Excellency Malam Nasir El-Rufai, the executive Governor of Kaduna State, the Commissioners of Health and education,  Kaduna state; Dr Amina Mohammed Baloni and Dr Shehu Usman Mohammed, Dr Faisal Shuaib, the Executive Director, National Primary Health Care Development Agency represented by Dr Nneka Onwu the Director Community Health Services (NPHCA), Past Presidents of the College, Representatives of Sister Colleges, Deans of Medical Colleges and several Chief Medical Directors. The presidential address was followed by the inauguration of the Board of Trustees of the Postgraduate Medical College Fellows Association.

The Prof. Theophilus Oladipo Ogunlesi FMCP, PNNMC, OFR (the Pioneer president of the NPMCN) lecture was delivered by Professor Eugene Edenomehi Okpere FRCOG, FMCOG, FNMA, of the Obstetrics and Gynaecology Faculty of the College, who delved extensively on the Management of Tertiary Hospitals in Nigeria. The guest lecturer, Professor Oyewale Tomori, DVM, FRCPath, NNOM, FAS, FCVSN, delivered a superlative insight on the impact of Covid -19 pandemic on the Health and Economy in Nigeria. There were 8 scientific sessions with 126 peer reviewed abstracts presented by colleagues from different specialties.

OBSERVATIONS

The College has produced over 6000 medical specialists serving the nation since its inception, thus saving Nigeria billions of dollars in postgraduate medical training abroad and has also recently introduced the optional Postgraduate MD and PhD program for Clinicians in our Universities.

The College graduated a total of 643 Fellows, Postgraduate MD degree holders by publications and Diplomates from her 15 Faculties during the 2020 hybrid (physical and virtual) convocation which held in January 2021.

The Board of trustees of the incorporated National Postgraduate Medical College Fellows Association was inaugurated by the College President during the 2020/2021 ASCAF opening ceremony.

Despite effort by College and other Sister Colleges to raise the Medical manpower, this effort is being defeated by the massive brain drain. This brain drain cuts across specialties and involves both the Specialist and non-specialist doctors.

The College has commissioned the Central Simulation Center with high Fidelity Medical simulators and is committed to developing another central and 6 zonal simulation centers across the country to enhance regional training of our associate fellows for additional skills acquisition.The College’s simulation endowment fund raising drive is expected to part fund the simulation project

The COVID-19 Pandemic has exposed the glaring level of inequity in every aspect of our society from health to education with abysmal standard of living and the failure to leverage on the successful Ebola 2014 control strategy.

According to the ED, NPHCDA, the federal government received 4,024,000 of Oxford/ Asra-Zeneca Vaccine in March 2021 made up of 3,924,000 doses from the Covax facility and 100,000 doses donated by the Government of India. Recently, 4million doses of moderna vaccines were received from the US government

The COVID-19 pandemic has further weakened the health system in Nigeria. There is inadequacy of facilities for managing patients requiring intensive care (oxygen, ventilators, and personal protective equipment). Only 2,534,205 Nigerians have been vaccinated as at 10 July 2021. It has also impacted negatively on the polio eradication efforts in Nigeria.

The full impact of Covid 19 is yet to be realized however, the greatest impact will be felt at the primary and secondary levels of education with over 10million children out of school currently and 27million performing poorly.

The scientific sessions, revealed that the Covid 19 pandemic negatively impacted on hospital attendance at all levels evidenced by the decline in maternal health service utilization, paediatric admissions and surgical operations with resultant negative impact on residency training.

There is significant poor perception of Covid 19 vaccine with resultant low acceptance amongst the general populace predicated on vaccine safety. Surprisingly, there is a very low acceptance rate of 38.8% even amongst medical doctors.

Artificial intelligence systems was useful in contact tracing during the Covid 19 pandemic and provided insight into research directions for public health informatics, policy makers and health practitioners.

The guest lecturer Professor Oyewale Tomori itemized the seven social determinants of the society as Wealth without work, Pleasure without conscience, knowledge without character, commerce without morality, science without humanity, religion without sacrifice and politics without principle.

The highly industrialized and technologically advanced economies reaped huge returns during the pandemic with production of relevant health related consumables and organization of virtual meetings. The current vaccine market size is projected to reach USD75.75 billion by the end of 2021 which Nigeria and other African countries  as consumers only. There is no vaccine production in the country.

The funding for teaching hospitals has dropped below the level to maintain facilities. Funding of medical schools is abysmally poor. Funding for training of residents/specialists doctors is even poorer. The National Postgraduate Medical College of Nigeria is not spared. The cumulative effect of this is that the training of doctors and trainers is under great challenge.

The bottle neck bureaucratic rules and regulations, staff shortage, preventable industrial actions by staff unions, poor power supply and grossly inadequate funding has crippled optimal functioning of our hospitals. Over 50% of drugs prescription are unavailable in our hospital pharmacies and this significant revenue generation is lost to private markets.

 RECOMMENDATIONS

Following fruitful deliberations at the workshop, conference and All Fellows Congress, the following recommendations were made:

The NPMCN appeals to government and other philanthropic organizations to support its laudable simulation program drive by donating to its simulation fund

Government must urgently do what it takes to stop brain drain by providing job opportunities and improving the working environment of medical doctors.

The conference posits that the government and industry must see research, science and technology as instruments for socioeconomic development and must apply adequate funding to science and technology to solve the country’s problems of underdevelopment.

The Scientists in Nigeria must identify with and be seen by the society as a part of the society by asking the right questions relating to the problems of our society with advocacy for conducive and enabling environment for scientists to function efficiently and maximally.

The Conference enjoins society to demand, as a right, a better and improved standard of living from the Government and Scientists and work with Government and Industry in attaining science based developmental targets.

The conference recommends the review of current policies on private partnerships with tertiary health institutions in Nigeria and a comprehensive regular monitoring system that evaluates performance output of each hospital.

The conference recommends streamlining of TETFUND funding for development and research in tertiary health institutions in Nigeria and inclusion of National Postgraduate Medical College of Nigeria as one of the institutional beneficiaries consistent with the spirit of the law that established the Fund.

The conference recommends that the specialized hospitals in the six geopolitical zones be appropriately equipped and manned by well trained personnel to curtail the legitimate proportion of medical tourism outside the country due to paucity of radiotherapy units, renal transplant procedures and open cardiac surgeries.

The conference recommends a single 5-year term for CMDs of teaching hospitals and MDs of Federal Medical Centers and other specialist medical centers and urgent streamlining of the current evaluation processes for appointment so that the best candidates are chosen.

The Covid 19 infection low risk perception is frustrating the National response thus there is urgent need to improve public health information on awareness and non pharmaceutical protection as well as  device strategies  to  manage Covid 19 and polio infections simultaneously to forestall fear of disclosure, discrimination and stigmatization from Covid infection.

APPRECIATION

The College is deeply grateful to the Governor of Kaduna state, His Excellency Malam Nasir El-Rufai, the Deputy Governor Kaduna State, Dr Zainab Balarabe, Presidents and Past Presidents of the Postgraduate Medical College, Presidents of Sister Colleges, our distinguished Fellows, Chairman and Members of Local Organizing Committee, security agents, partners and supporters, distinguished guests and participants.

Dr. Abdulmumini H Rafindadi, FMCPath                  Dr. Fatiu A. Arogundade, FMCP
Chairman, LOC ASCAF 2020/2021                              College Registrar, NPMCN