N10bn Ebola fund: What has it paid for ?

In June, President Bola Ahmed Tinubu approved N10 billion in emergency intervention funding to strengthen Nigeria’s Ebola preparedness, alongside a separate N21.2 million per-state disbursement under the State Outbreak Investigation and Response Fund. Three months on, there is no public breakdown of how the N10 billion has been spent, and Weekend Trust’s checks at airports and isolation facilities suggest the preparedness gap the money was meant to close is still there.

For Habebat Ajayi, completing Nigeria’s health declaration form was an exercise she believed could help protect the country from Ebola.

While returning to Nigeria, she was required to provide identification and health information through an app before travelling. But after the effort it took her to complete the form, particularly amid network problems at Jeddah Airport, she expected the information to be put to use when she arrived in Nigeria.

It wasn’t.

Ajayi arrived through the Nnamdi Azikiwe International Airport, Abuja, but said nobody asked to see or verify the information she had submitted.

“They didn’t ask me for anything. They didn’t check my provisional sign or QR code, and they didn’t check my temperature. No, they didn’t do any of that,” she told Weekend Trust.

For her, the experience raised questions about the purpose of the digital declaration system.

“For me, I it was almost a waste of time filling out the form,” she said.

Ajayi recalled struggling with internet connectivity at Jeddah Airport and having to find someone who could provide a hotspot before she could complete the form.

“But upon arriving in Nigeria, I didn’t see any officials approaching me or requesting to see the information I had submitted,” she said.

“I think there should be officials who check the responses submitted through the app from the backend and take the process seriously,” she added.

Ajayi also said she believed other passengers on her flight had a similar experience.

Ibrahim Shehu had a similar experience after completing Nigeria’s health declaration through the Port Health portal.

He said the form generated a QR code after it was successfully completed, which he presented after arriving at Abuja airport.

But, according to Shehu, his temperature was not checked, and the QR code was not scanned.

“My temperature wasn’t checked, and the QR code wasn’t checked,” he said.

Instead, he said officials appeared primarily concerned with whether passengers had completed the form and obtained a QR code.

“They just made sure you filled the form and have a QR code,” he said.

Shehu questioned the thoroughness of the process.

“I don’t think it is thorough. It is rather routine. Anyone can fill anything,” he said.

For Phillip Clement, the process started before he even boarded his flight to Nigeria.

Travelling from Addis Ababa International Airport, Ethiopia, he said passengers were given a QR code to scan and complete Nigeria’s Ebola declaration form.

But Clement could not complete his form because of network difficulties.

“Unfortunately, I couldn’t do mine as I had difficulties with the network, but some passengers did,” he said.

On arrival at the Nnamdi Azikiwe International Airport, Abuja, Clement said passengers who had not completed the declaration were not immediately allowed to leave the airport.

“The ones who filled were cleared while some of us who didn’t were given a QR Code to scan and fill the forms,” he said.

He completed the declaration and received a confirmation email, which he presented before exiting the airport.

But Clement said there was no temperature check.

“However, my temperature was not checked,” he said.

He said the screening process was not sufficiently comprehensive.

“I don’t think the current airport health-screening process is thorough enough because so many nationals are trooping into the airports and there are no proper checks,” he said.

For Fatima Damagum, the screening process began with a detailed health declaration before she was allowed to board her flight to Nigeria.

She said airline staff ensured that she completed the NCDC health declaration form.

The form asked where she had travelled from, the countries she had passed through, how long she had been away, where she would stay in Nigeria and whether she or her children had experienced symptoms such as fever, cough, headache or sore throat during the previous 21 days.

Damagum said she answered the questions truthfully.

“I had no fever. My children had no fever. None of us was unwell,” she said.

After submitting the form, she received a QR code.

She expected that to be the beginning of a more detailed screening process when she arrived at Abuja airport.

“In my mind, I imagined that when we landed at Nnamdi Azikiwe International Airport in Abuja, there would be another layer of public-health scrutiny.”

She expected officials to scan the QR code, verify the information, and possibly check passengers’ temperatures.

Instead, she said, officials casually asked arriving passengers to show their QR codes.

“After immigration, a few officials stood in the lobby casually asking arriving passengers to show their QR codes,” she said.

But she said her QR code was not scanned.

“They didn’t scan ours. They didn’t verify the information on the form. Nobody checked our temperature. There was no obvious secondary assessment,” she said.

Then came the moment that left her questioning the entire process.

“An official glanced at the QR code on my phone and lazily said, ‘You can go, Hajiya.’”

Damagum said she was stunned.

“And that was it. Shikenan? Ah! Mogbe! Is that all? Where is the proper screening?” she asked.

Her experience left her questioning the purpose of the QR-code system.

“So, what exactly was the QR code for?” she asked.

She then linked her experience to the Federal Government’s emergency preparedness funding.

“Is this what the ten billion Naira is for? Filling out an online form and waving passengers away?” she asked.

Her question, however, does not establish that the money has been misappropriated. Rather, it raises a question about whether the preparedness measures announced by the government are being implemented as intended.

All those interviewed above travelled out of and back into Nigeria after June, when the Federal Government announced the prevention measures and set up the task force for the nation’s Ebola preparedness.

Lagos: No visible additional screening at MMIA

Despite the introduction of health declaration forms for travellers arriving from countries affected by Ebola, there appeared to be no visible additional screening activity at the Murtala Muhammed International Airport (MMIA), Lagos, checks by Weekend Trust have shown.

The Nigeria Centre for Disease Control and Prevention (NCDC) had said travellers arriving from countries with active or relevant Ebola transmission may be required to complete health declaration forms upon arrival.

The measure followed the ongoing Ebola outbreak in the Democratic Republic of Congo and an updated assessment of the potential risk to Nigeria.

However, checks at the Lagos airport suggested that the measure had not resulted in any noticeable disruption to normal passenger movement, with passengers continuing to arrive and leave the terminal without visible additional screening procedures.

The NCDC said travellers arriving from countries without active or relevant Ebola transmission are currently exempt from completing the forms.

The agency has stressed that Nigeria remains on high alert and is maintaining surveillance and preparedness measures as the situation develops.

At the MMIA, however, passengers observed by Weekend Trust were not subjected to any obvious additional screening for Ebola, including temperature checks, beyond the routine airport processes.

The Federal Airports Authority of Nigeria (FAAN) could not be reached for comment. Calls and text messages to its Director of Public Affairs, Mr Henry Agbebire, were not responded to.

Kano travellers recount experiences

In Kano, a resident who recently returned to Nigeria from Saudi Arabia, Asma’u Idris, said she was only given a yellow card and that upon entering through the Mallam Aminu Kano International Airport, nobody verified it or subjected her to what she understood to be an Ebola test.

“Even that yellow card, it was my brother who just called someone and collected it for us; no test or vaccine was administered to me, not to talk of any Ebola test,” Asma’u said.

Another resident, Abdullahi Suyudi, who also travelled into the country about a month ago, said nobody talked to him about Ebola testing upon entry.

“The only thing they ask for is a yellow card, which itself is not usually checked or verified. You just need to show it and pass,” Suyudi said.

He said it was only during the Covid-19 pandemic that passengers’ temperatures were routinely taken. “But since it passed, you only need to pay for it and pass,” he added.

Alhaji Kamal Yahaya said he underwent verbal Ebola screening at King Abdulaziz International Airport (IATA: JED) while returning to Nigeria after performing Umrah in August.

“The screening was conducted online. You had to log into their system and answer questions about Ebola-related symptoms, including cough and fever, among others.

“No medical test was conducted at all. Upon our arrival at Aminu Kano International Airport, officials only verified the forms,” he said.

He said some travellers expressed dissatisfaction with the screening process, alleging that it targeted only Nigerians.

“Our co-travellers, including a Malian and an Ivorian, were not screened,” he added.

The accounts contrast with the Federal Ministry of Health’s stated protocol.

In June, the ministry said universal temperature screening, mandatory health declaration forms, travel-history assessments, enhanced risk assessment, secondary screening and isolation/referral mechanisms were operational at designated points of entry.

The ministry also said suspected travellers would be referred for further assessment and that emergency response structures were being reinforced nationwide.

What happens after the airport?

For the travellers, the immediate concern was what happened at the point of entry. The accounts do not, on their own, show how the emergency allocation has been deployed, but they raise a direct question about whether the funding changed anything there.

Weekend Trust also examined isolation and treatment facilities to establish whether preparedness on the ground matches the government’s public assurances.

Across Benue, Bayelsa, Kano and Katsina, the facilities created or used during previous outbreaks have followed different paths. Some remain available for emergencies. Some have been repurposed. Others are no longer clearly in use as dedicated isolation centres.

Benue centres on standby

In Benue State, officials said isolation and treatment centres established during previous outbreaks were being maintained for possible public health emergencies.

The State Commissioner for Health and Human Services, Dr Paul Ogwuche, said the facilities had not been abandoned.

“Regarding isolation centres, they are maintained in a state of readiness and can be promptly activated whenever the need arises,” he said.

The State Epidemiologist, Dr Asema Msuega, said the state earlier this year activated an isolation centre at the Federal Medical Centre, Makurdi, which had previously been used during the Covid-19 response.

The facility was activated to complement the isolation centre at the Benue State University Teaching Hospital.

According to Msuega, the centres remained functional as the state responded to the recent Lassa fever outbreak, while staff capacity was also maintained.

Bayelsa: An isolation centre with a different purpose

In Bayelsa State, the picture is different. At the Niger Delta University Teaching Hospital, Okolobiri, an isolation centre established in 2020 to house people under quarantine during the Covid-19 pandemic is now being used for other medical purposes.

A visit to the facility showed that people were working there, but there was nobody under quarantine.

An insider at the hospital said another department was now using the facility, while records from the Covid-19 period had been preserved for reference.

“After the Covid-19 era, the place was just left dormant. To avoid weeds growing out from there, some department or ward was given to run the place,” the source said.

However, the source said the facility could be brought back into use if another emergency required quarantine facilities.

“If there is any other emergency that people need to be quarantined, the isolation centre will be activated again,” he said.

He added that trained personnel remained available to manage such a situation.

“We have trained personnel who can handle the situation,” he said.

Katsina: Some facilities closed; others repurposed

In Katsina State, the current status of several isolation centres established during the Covid-19 pandemic is less clear.

A source within the state Ministry of Health said several of the facilities were currently closed, while some had been repurposed for other health services.

Among the facilities were the Federal Medical Centre, now Federal Teaching Hospital Katsina; the 160-bed isolation centre at the former IDP camp along Jibia Road; General Amadi Rimi Specialist Hospital; and Daura General Hospital.

The Federal Medical Centre was a major treatment facility during the Covid-19 outbreak, with 15 dedicated beds.

In June 2021, the NCDC also commissioned an infectious-disease treatment centre at the hospital to strengthen the state’s preparedness for future outbreaks.

The centre is now being used as a diphtheria treatment centre.

Kano: From emergency wards to routine services

In Kano State, several facilities were mobilised when Ebola and Covid-19 threatened the state.

Weekend Trust’s findings show that Yargaya Specialist Centre, Kano Infectious Diseases Hospital and Nasarawa Specialist Hospital played important roles in the state’s response.

But their post-outbreak journeys have been different.

At Nasarawa Specialist Hospital, a senior staff member who worked during the Covid-19 response, said the surgical ward and adjoining facilities were temporarily converted into isolation and treatment areas for patients.

“After the pandemic, the ward was returned to its original function as a surgical ward,” the source said.

The source also said some rooms at Tahir Guest Palace were used to accommodate prominent traditional rulers, politicians and wealthy residents who contracted Covid-19.

According to the source, some recovered while others died from complications associated with the disease.

The Kano Infectious Diseases Hospital, however, retained its original infectious-disease function.

A staff member said the hospital was already designed to handle infectious diseases before Covid-19 and had the wards, equipment and facilities required to admit and treat patients during the pandemic.

The hospital continued to treat patients with infectious diseases after the outbreak.

The Yargaya Specialist Centre was another important facility during Kano’s response to infectious disease outbreaks.

Established by the Kano State Government as a specialist facility for preparing for and responding to possible outbreaks, it became one of the key points for testing and other response activities during the Ebola and Covid-19 crises.

But questions remain about what happened to the equipment and other resources deployed there after the emergency.

It was gathered that most of the vehicles, equipment and other facilities used during the pandemic were subsequently handed over to the Kano State Primary Healthcare Management Agency.

Doctors raise concerns

The findings from the airports and states raise questions that go beyond whether a traveller’s temperature was checked.

For doctors involved in public health and epidemic preparedness, the effectiveness of an outbreak response depends on several links working together: surveillance at points of entry, early detection, laboratory confirmation, isolation, infection prevention, trained personnel, contact tracing and the ability to sustain those systems between outbreaks.

Speaking to Weekend Trust, Dr Lukman Abbas, an epidemiologist, said surveillance should function as an early-warning system rather than simply as an administrative exercise.

He explained that the system should bring together information from hospitals, laboratories, communities and points of entry so that unusual disease patterns can be detected early.

“The basic principle remains to detect early, isolate, treat, trace contacts and engage communities. Targeted vigilance at borders is more useful than blanket restrictions,” he added.

The doctor said sustained training remained necessary, particularly because frontline workers could become infected if Ebola was not suspected early enough.

Godwin Ekuwke, a medical doctor, stressed the importance of early recognition and prevention in dealing with Ebola.

“Nigerians need to be careful about possible zoonotic transmission. People should avoid contact with potentially infected animals,” he said.

He also stressed early reporting of suspected cases and adherence to public health guidance.

Dr Emem Peters, a consultant in Community Medicine at the University of Uyo Teaching Hospital, highlighted another challenge: the Ebola strain currently causing concern is Bundibugyo ebolavirus rather than the Zaire ebolavirus responsible for Nigeria’s 2014 outbreak.

Peters said the distinction was important because the medical countermeasures used against the Zaire strain could not simply be assumed to provide protection against Bundibugyo virus.

She said there was no vaccine available for the new strain and stressed the importance of early detection and supportive care.

The NCDC has similarly warned that existing Ebola vaccines and monoclonal antibody treatments are primarily directed against Zaire ebolavirus and should not be relied upon as available countermeasures for the Bundibugyo outbreak.

From QR codes to isolation wards

Taken together, the experiences of travellers and the findings from the states present two parts of the same preparedness question.

At the airports, travellers described a process centred heavily on completing health declarations and obtaining QR codes, with three of the four Abuja travellers saying their temperatures were not checked.

The Kano accounts also describe passengers who said they were not subjected to Ebola testing upon arrival.

The government, however, says temperature screening, health declarations, travel-history assessment, secondary screening and referral mechanisms are part of the national protocol.

The gap between the official protocol and what some travellers described is therefore an implementation question that requires clarification from the agencies responsible for airport health screening.

On the ground, the infrastructure available to isolate and treat suspected cases varies from one state to another.

So, what has the N10bn funded?

The questions become more significant against the backdrop of President Bola Ahmed Tinubu’s approval of N10 billion in emergency intervention funding for Ebola preparedness in June.

The State House said the money was intended to strengthen the operational preparedness of the Nigeria Centre for Disease Control and Prevention and support critical national public health emergency response activities.

The President also approved the establishment of a Presidential Task Force on Ebola Virus Disease Preparedness and Emerging Public Health Threats, chaired by the Chief of Staff to the President, Femi Gbajabiamila.

Members of the task force include the Chairman of the Medical Advisory Committee of the State House Medical Centre, Dr Victoria Ogala; Lagos State Commissioner for Health, Prof. Akin Abayomi; FCT Mandate Secretary for Health Services and Environment, Dr Adedolapo Fasawe; Rivers State Permanent Secretary of Health, Dr Vincent Wachukwu; Enugu State Commissioner for Health, Prof. George Ugwu; Director of Public Health at the Federal Ministry of Health, Dr Charles Nzelu; and epidemiologist Dr Ismail Abdulsalam, among others.

The government’s announced measures included intensified passenger screening at international airports, enhanced temperature checks, monitoring of high-risk airline routes, activation of referral and isolation centres at Lagos and Abuja airports, and mandatory QR-code-based pre-arrival health declarations for passengers originating from or transiting through designated high-risk countries.

The government later inaugurated the task force and said its work would include border management, immigration control and disease surveillance, with the NCDC providing technical leadership and coordination.

A separate funding stream was also announced on June 20, when the Federal Government approved the release of 50 per cent of the State Outbreak Investigation and Response Fund (S-OIRF) allocation, amounting to N21.2 million per state.

The money was to be channelled through the NCDC Gateway of the Basic Health Care Provision Fund.

The Federal Ministry of Health said beneficiary states would be required to retire both current and previously disbursed outbreak-response funds within six months and comply with financial-management and reporting requirements.

That means there are now at least two distinct funding questions that should not be conflated: the N10 billion emergency intervention approved by the President for national preparedness and the separate S-OIRF disbursement of N21.2 million per state.

The evidence available to Weekend Trust does not establish that the N10 billion approved by the President has been stolen, misappropriated or otherwise lost.

What it establishes is that the government announced a major emergency intervention, subsequently announced additional outbreak-response funding for states, and publicly listed a series of measures that were expected to strengthen Nigeria’s preparedness.

The investigation also found uneven experiences at points of entry and different levels of readiness among facilities examined in Benue, Bayelsa, Katsina and Kano.

That creates a more specific accountability question: what has been released, to whom, for what activities, how much has been spent, and what measurable preparedness capacity has been created with the money?

Several efforts by Weekend Trust to get an update on the N10 billion intervention fund from the task force were unsuccessful as of the time of filing this report.

However, its public announcements reviewed by Weekend Trust explain its broad purpose but do not provide a detailed public breakdown of how the amount has been allocated across surveillance, laboratories, airport screening, isolation facilities, logistics, training, personal protective equipment and other response activities.

Meanwhile, the NCDC has issued a public health advisory following the Ebola outbreak in the Democratic Republic of Congo and Uganda.

The Centre said Nigeria’s risk of importation was high because of international travel, regional population movement, major airports, seaports, porous land borders and informal crossings.

At the time of its advisory, Nigeria had no confirmed case of the outbreak.

The NCDC said it had activated its national Emergency Operations Centre and called on states to strengthen their preparedness.

It classified Lagos, the FCT, Rivers, Kano, Enugu, Borno, Akwa Ibom, Cross River, Taraba and Adamawa as high-risk states because of factors including international airports, seaports, trade routes and porous borders.

It also placed Katsina and Bayelsa among states in the moderate-risk category.

The Centre directed states to identify functional isolation facilities, strengthen infection prevention and control, ensure safe sample transportation, prepare frontline workers and intensify surveillance around airports, land borders, transport hubs and other high-mobility areas.

It further directed states to submit readiness updates and immediately notify the NCDC of suspected cases, high-risk exposures, unusual febrile clusters or significant preparedness gaps.

Additional reports by: Abdulyassar Abdulhamid (Abuja); Hope Abah (Makurdi); Bassey Willie (Yenagoa); Ibrahim Musa Giginyu (Katsina); Abbas Tijjani Madabo, Sani Ibrahim Paki (Kano); & Abdullateef Aliyu (Lagos)