In Conversation with Naima Nasir, a Nigerian global health researcher

Naima Nasir is a global health researcher from Nigeria. Right for Education sat down to speak with her about meningitis research, healthcare provision in conflict-ridden areas, and improving global healthcare systems.

R:Ed: Could you tell us about yourself and your work?

My name is Naima Nasir. I have a background in pharmacy and international health, and I’ve been involved in global health research and practice. My particular area of interest is health policy and systems research. I live and work in Nigeria, but also do some research and work in the UK.

R:Ed: What is the current state of meningitis in Nigeria?

My research was focused on improving surveillance of meningitis along the Africa meningitis belt. This includes many countries spanning from Senegal all the way to Ethiopia. Bacterial meningitis is a very serious disease in Nigeria, and other countries on the African meningitis belt. It’s a devastating disease with fatality rates rising to 60% when it’s not treated, and it can lead to many severe complications. Around 10,000 cases occur annually in Nigeria, and some of the most affected groups are young children and women.

R:Ed: What are the forefronts of the research on this topic? How can we tackle this issue?

I worked on a project aimed at improving surveillance for bacterial meningitis. Specifically, we were interested in how to track people who have meningitis, and detect it early enough within communities to deploy treatment and vaccination? Diagnosis has been challenging due to inadequate funding, limited capacity and training among both laboratory staff and health workers. I was a research fellow on a project that trained African researchers to collect global genome data including countries in Africa. We were interested in the microorganisms/bacteria and looked at genome sequence data. The aim was to collect that data, analyze it, interpret it, and make it publicly available for the public. Currently, genome sequencing data is limited from African countries, due to challenges with technical know-how and the expertise needed and the funding to do genome sequencing. My research group set out to create a global collection of all the genome sequence data regarding the bacteria that cause meningitis and make that publicly available. This work contributed to the open access and publicly available global database called PubMLST. This way, researchers, particularly across Africa can access the data and improve how they diagnose and treat meningitis and enhance vaccine policy.

R:Ed: You have done research in conflict-affected areas in Nigeria and Southeast Asia. How can we improve healthcare provision in conflict-ridden areas?

In conflict-ridden areas, it is much more difficult to provide care, either due to difficult geographic terrains, insecurity, issues with funding, or the inadequacy of healthcare providers. The first step is understanding the needs of the people. This is possible only by working with the affected groups and all others that are providing care in the area. I have worked in Thailand across the Thailand-Myanmar border. I was particularly interested in how women gained access to blood transfusions in a setting where there was no blood bank. During pregnancies, there can be complications, which often come in the form of bleeding. My interest was, how were women getting blood to address these complications? We realized there was a parallel system that had developed solely through community relationships and volunteering. When a pregnant woman was about to give birth and there was an anticipation of a complication arising, they would get a family or community member to provide blood. We tried to quantify this system and see how we could improve it to be better able to provide blood. Listening to the needs of the people was essential, and then we discussed what innovations and strategies can help meet those needs.

R:Ed: On the whole, Africa has responded well to the pandemic and has had lower mortality rates than the rest of the world. Why do you think this is, and what can the world learn from Africa’s response to COVID-19?

The good response comes from largely from the lessons we learnt from the Ebola epidemic. Over the years, the infrastructure, the manpower, the technologies, and the systems needed to respond quickly to epidemics or pandemics have been growing in many African countries. Still, I think there is more to understand about why the burden has been lower than the rest of the world. Many possible explanations have been proposed, ranging from climatic differences, some pre-existing immunity, genetic factors, and behavioural differences. These need to be looked at more carefully. But I agree that the response has been much better than anticipated. I think that the quick response has come mainly from the lessons learned from previous epidemics that allowed us to improve our systems to quickly respond to future threats.

R:Ed: On a global scale, despite past epidemics such as HIV/AIDS and Ebola, our response to this pandemic could be better. How can we make global healthcare systems more resilient to epidemics and pandemics?

Firstly, preparation is very important. We need lean on what exists: there are many good research and epidemic response networks across the globe that have been put in place to deal with different pandemics from Ebola to HIV/AIDS. We need to leverage these existing networks through collaboration, data sharing and making these networks flexible to meet emerging threats. Secondly, we need more collaboration. During COVID-19, “nationalistic” ideas and systems emerged as countries tried to take care of their citizens first, which is understandable for national governments. Still, organizations like the WHO have emphasized the global nature of COVID-19 and success means beating it everywhere. We need to collaborate to come up with technologies and solutions that will improve people’s health across all settings.

R:Ed: This year has been a challenging one. Who or what has inspired you or filled you with hope these past few months?

As a researcher, I’ve been inspired by the work of researchers across the globe, particularly in developing countries like mine, who have remained steadfast in the face of limited resources and have contributed to the pandemic response efforts. For instance, Nigeria has contributed genome sequences of the COVID-19 virus, which has improved the understanding of the disease within this region. Countries such as Senegal and Nigeria have also developed rapid test kits. It gives me hope that even in the face of this pandemic, there are many people from all backgrounds willing to do the work to improve lives. I’ve also been inspired by humanity and how we have stuck together and looked after each other in this difficult time. I know this is not the case everywhere. I hope that even after we beat this pandemic, these sentiments and actions will persist.

Marwin Ramos

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