Why Nigeria may miss own 2 million testing target in three months

On April 28, the Nigerian government announced its target of testing at least two million people within the next three months.

At a Presidential Task Force (PTF) on COVID-19 briefing, the Director-General of Nigeria Centre for Disease Control (NCDC), Chikwe Ihekweazu, said the move became necessary as the country is lagging behind in terms of testing.

“The laboratory strategic group that is responding to this outbreak has set itself a target of testing two million people in the next three months,” Mr Ihekweazu had said.

To meet up the two million target, the NCDC chief said about 50,000 people will be tested per state and in the Federal Capital Territory (FCT), ‘depending on the population size’.

However, the goal of meeting this target in 90 days seems unachievable as the country’s current testing capacity per day is still very low.

On March 31, the Nigerian government said the national testing capacity will be increased from 500 to 1,500 to expand coverage.

The NCDC DG also said the centre would increase the testing capacity to over 3,000 per day across the country with 2000 samples to be done per day in Lagos State.

However, Nigeria still conducts only about 900 to 1,400 tests per day across 26 molecular laboratories in the country, a source confirmed to PREMIUM TIMES.

This is still far below its initial target of testing 1,500 persons per day.

As of May 28, Nigeria has conducted a little over 48,000 tests of its 200million population and found 8,733 infected persons. Out of these, 2,501 have been treated and discharged and 254 fatalities recorded.

Other Africa countries

Mr Ihekweazu earlier admitted that the country is lagging behind other Africa countries in terms of testing.

Although he said it is not a competitive race, Nigeria will still learn from other countries.

While Nigeria has only carried out just above 48,000 tests since the country recorded its index case in February, Ghana, South Africa, Uganda, Mauritius and Kenya have achieved commendable rates of testing. South Africa is leading in Africa with nearly 600,000 tests conducted.

According to data on Worldometers.info, Ghana, has so far conducted 197,000 tests, Egypt has tested over 135,000 people, Uganda has conducted 86,000 tests, Mauritius 104,000 tests and Kenya has tested 61,000 people.

Set Target

A PREMIUM TIMES analysis shows that Nigeria needs to conduct approximately 22,222 tests daily for 90 days to meet its two million testing target.

Exactly 28 days after announcing its target, Nigeria has only been able to conduct a little over 35,000 tests more.

This shows that less than 1,400 tests were carried out per day, within this period.

What this means is that the Nigerian government will have to conduct over 1.9 million tests within the next 62 days, if it is to meet the target.

Mr Ihekweazu earlier said the major response strategy to reducing the impact of the COVID-19 pandemic is to expand testing to a larger number of people.

The minister of health, Osagie Ehanire, also noted that the country is engaging in what he described as ‘calculated and smart testing.’

“Now we are doing house to house and cluster testing for people who live in an environment where we have seen positive cases,” he said.

Implication of low testing

A public health expert, Wale Akinboboye, said low testing capacity may lead to more deaths from the COVID-19 virus.

“Low testing capacity may lead to more deaths due to COVID-19. This can occur when individuals who are infected but asymptomatic transfer the virus to others who are vulnerable to the disease and may not be able to withstand the severity of the infection,” he said.

Rowland Aigbovo, a family physician also said low testing capacity will lead to more community transmission and non-containment of the COVID-19 virus.

The health ministry declined comments for this story. The NCDC director could not be reached immediately for comment.

Cost per Test

The Lagos state commissioner for health, Akin Abayomi, while speaking on AIT last week said a COVID-19 test cost between N40,000 and N50,000.

This, however, contradicts an earlier declaration by the NCDC DG that a COVID-19 test costs between $15 and $20 (N5400 and N7200).

(The exchange rate per dollar on the Central Bank of Nigeria’s website, as of May 28, is N360.)

Mr Ihekweazu, while responding to questions at the PTF briefing on Wednesday said the cost of a COVID-19 test differs depending on the costing.

“It really depends on what we are costing and what the Lagos state commissioner is costing. The cost of (a) test for one individual in terms of reagent is still about $20 but if you add the cost of equipment, Human Resources, generator and hazard allowance then you come up with a different cost of test,” he said.

Mr Ihekweazu had on April 27 said the country was in desperate need of test kits and gave specifications and preferred manufacturers.

“We’re desperately looking for more RNA (Ribonucleic Acid) extraction kits as we expand #COVID19 testing. Product: Total viral RNA extraction kits (preferably spin column and with a lysis buffer). Manufacturers: Qiagen, ThermoFischer, SeeGene, Inqaba, LifeRiver etc,” he wrote on Twitter

In a bid to scale up its testing capacity, the federal government decided to repurpose the tuberculosis GeneXpert machines already deployed in all the states and the FCT.

In a recent document, the NCDC noted that, “There are also available in-country, two mobile laboratories equipped with two GeneXpert instruments each. These will be deployed as needed to support COVID-19 testing surge in target states.”