The World Health Organization (WHO) has lamented governments’ inability to provide mental health treatment to individuals all around the world, especially during the COVID-19 pandemic, when they were most in need.

According to the latest edition of the Mental Health Atlas, which was released on Friday and painted a dismal picture of mental health around the world, most 2020 mental health targets have been missed, and the extension of the WHO Mental Health Action Plan to 2030 provides new opportunities for progress.

Despite increased attention to mental health in recent years, quality mental services that are aligned with needs have yet to be scaled up, according to the report.

The latest edition of the Atlas, which includes data from 171 countries, provides a clear indication that the increased attention given to mental health in recent years has yet to result in a scale-up of quality mental services that are aligned with needs, according to a recent report released by WHO and made available to newsmen in Abuja.

The Atlas is a compilation of data provided by countries around the world on mental health policies, legislation, financing, human resources, availability and utilization of services, and data collection systems. It is published every three years.

It also serves as a framework for tracking progress toward the WHO’s Comprehensive Mental Health Action Plan’s goals.

Director-General of the World Health Organization, Dr Tedros Adhanom Ghebreyesus said, “It is extremely concerning that, despite the evident and increasing need for mental health services, which has become even more acute during the COVID-19 pandemic, good intentions are not being met with investment.

“We must heed and act on this wake-up call and dramatically accelerate the scale-up of investment in mental health, because there is no health without mental health.”

His words : “None of the targets for effective leadership and governance for mental health, provision of mental health services in community-based settings, mental health promotion and prevention, and strengthening of information systems, were close to being achieved.

“In 2020, just 51% of WHO’s 194 Member States reported that their mental health policy or plan was in line with international and regional human rights instruments, way short of the 80% target. And only 52% of countries met the target relating to mental health promotion and prevention programmes, also well below the 80% target. The only 2020 target met was a reduction in the rate of suicide by 10%, but even then, only 35 countries said they had a stand-alone prevention strategy, policy or plan.

“Steady progress was evident, however, in the adoption of mental health policies, plans and laws, as well as in improvements in capacity to report on a set of core mental health indicators. However, the percentage of government health budgets spent on mental health has scarcely changed during the last years, still hovering around 2%. Moreover, even when policies and plans included estimates of required human and financial resources, just 39% of responding countries indicated that the necessary human resources had been allocated and 34% that the required financial resources had been provided”.

He noted that transfer of care to the community is slow, saying, “While the systematic decentralization of mental health care to community settings has long been recommended by WHO, only 25% of responding countries met all the criteria for integration of mental health into primary care. While progress has been made in training and supervision in most countries, the supply of medicines for mental health conditions and psychosocial care in primary health-care services remains limited.

“This is also reflected in the way that government funds to mental health are allocated, highlighting the urgent need for deinstitutionalization. More than 70% of total government expenditure on mental health was allocated to mental hospitals in middle-income countries, compared with 35% in high-income countries. This indicates that centralized mental hospitals and institutional inpatient care still receive more funds than services provided in general hospitals and primary health-care centres in many countries. 

“There was, however, an increase in the percentage of countries reporting that treatment of people with specific mental health conditions (psychosis, bipolar disorder and depression) is included in national health insurance or reimbursement schemes – from 73% in 2017 to 80% (or 55% of Member States) in 2020.
Global estimates of people receiving care for specific mental health conditions (used as a proxy for mental health care as a whole) remained less than 50%, with a global median of 40% of people with depression and just 29% of people with psychosis receiving care.”

Ghebreyesus said the increase in mental health promotion, but effectiveness questionable. “More encouraging was the increase in countries reporting mental health promotion and prevention programmes, from 41% of Member States in 2014 to 52% in 2020. However, 31% of total reported programmes did not have dedicated human and financial resources, 27% did not have a defined plan, and 39% had no documented evidence of progress and/or impact.”

He, however, noted that there us a slight increase in the mental health workforce. “The global median number of mental health workers per 100 000 population has increased slightly from nine workers in 2014 to 13 workers per 100 000 population in 2020. However, there was a very high variation between countries of different income levels, with the number of mental health workers in high-income countries more than 40 times higher than in low-income countries.”

Speaking on the new targets for 2030, he said the global targets reported on in the Mental Health Atlas are from WHO’s Comprehensive Mental Health Action Plan, which contained targets for 2020 endorsed by the World Health Assembly in 2013. This Plan has now been extended to 2030 and includes new targets for the inclusion of mental health and psychosocial support in emergency preparedness plans, the integration of mental health into primary health care, and research on mental health.

“The new data from the Mental Health Atlas shows us that we still have a very long way to go in making sure that everyone, everywhere, has access to quality mental health care,” said Dévora Kestel, Director of the Department of Mental Health and Substance Use at WHO. “But I am encouraged by the renewed vigour that we saw from governments as the new targets for 2030 were discussed and agreed and am confident that together we can do what is necessary to move from baby steps to giant leaps forward in the next 10 years

As a gift from the French government, the National Primary Health Care Development Agency (NPHCDA) received 501,600 doses of AstraZeneca vaccines from the COVAX facility in Nigeria.

The Executive Director of the NPHCDA, Dr. Faisal Shuaib, said that Nigeria was one of the first African countries to get vaccines from the French government while collecting the vaccines at the National Strategic Cold Store in Abuja on Friday.

It is heartening to notice that France has not only been a solid development partner for Nigeria, but has also been extremely fraternal in all directions, according to him.

France’s belief in Nigeria’s ability to be a proactive and forward-thinking partner in the worldwide struggle to halt the COVID-19 epidemic is demonstrated by AstraZeneca’s donation of nearly half a million medicines to Nigeria.

According to the NPHCDA’s director, Nigeria’s vaccine storage facilities have remained efficient and well-maintained.

While also stating that no logistics requirements for optimal management and utilization of all COVID-19 vaccinations accessible in the country were compromised.

The federal government, he said, had put in place the necessary mechanisms to ensure vaccine monitoring and accountability.

His words ; “We track utilization of all COVID-19 vaccines in all the states of the Federation and receive daily report from our Senior Supervisors and State Immunization officers who are on the field to monitor the management and administration of the vaccines“.

Earlier in his remarks, the French Ambassador to Nigeria, Ambassador Jerome Pasquier, commended the Presidential Task Force on COVID-19 in addressing the pandemic through procurement of vaccines and getting them across the country.

He said that he was happy that the French government was donating over half a million doses of the vaccine and encouraged Nigerians yet to take the vaccine to do so.

“After 3 years in Nigeria, today happens to be my final assignment in Nigeria as i leave the country for France tomorrow, to begin my next assignment,” he disclosed.

The ambassador noted that the French board was fully opened to Nigerians that were vaccinated.

“If you have a proof of vaccination, that will be said you can go to France. You do not need to have a COVID-19 test before boarding the plane. You do not need to have a COVID-19 test, when you are in France,but with your certificate from Nigeria, you can get tested, which is required in some places around the world. So, both regulations apply to Nigerian nationals. Fresh nationals, or any other nationality, because we know wherever the progress, doesn’t make difference,” Pasquier said.

Meanwhile, the World Health Organisation (WHO) Country Representative Dr. Walter Mulombo said that Nigerians need to get vaccinated to meet the new target of 40% benchmark, by Dec.2021.

He also stated that the organization had also called on countries which have already achieved high coverage to swap their place in the vaccine distribution line with countries that have had less access.

He commended Nigeria on its vaccines distribution and also its technology approach in its vaccination programme, saying, other countries need to come to Nigeria to learn the act of vaccine distribution.

Fully vaccinated passengers from Nigeria to England will no longer need to undergo a pre-departure test, a day 8 test, or self-isolate for 10 days, as was previously required.

The new policy goes into effect on Monday for people who have been fully immunized with AstraZeneca (including Covidshield), Pfizer, Moderna, and Johnson & Johnson.

Previously, fully vaccinated Nigerian passengers were obliged to remain in the UK for ten days and undergo a COVID-19 test.

However, quarantine processes have been eliminated under the new policy.

In a statement titled, ‘UK changes travel rules for fully vaccinated travellers from Nigeria,’ the British High Commission said the traveller must also have a valid proof of vaccination recognised by the British Government which is the certificates with valid QR codes as issued by the National Primary Health Care Development Agency.

The statement read I have parts , “From Monday, 11 October 2021, fully vaccinated travellers from Nigeria will be able to come to England without needing to provide a pre-departure test, undertake a day 8 test or self-isolate for 10 days, although will still need to book and pay for a day 2 test.

“This policy applies to those fully vaccinated with AstraZeneca (including Covidshield), Pfizer, Moderna and Janssen (Johnson and Johnson). Fully vaccinated means that you have had a complete course of an approved vaccine at least 14 days before you arrive in England.

“The day you had your final dose does not count as one of the 14 days. You must be able to prove that you have been fully vaccinated under a vaccination programme and have valid proof of vaccination recognised by the British Government: (for Nigeria, the certificates with valid QR codes as issued by Nigeria’s National Primary Health Care Development Agency are recognised).”

But unvaccinated Nigerian traveller to England, the Commission clarified, is still required to take a pre-departure COVID-19 test – to be taken three days before travel, book and pay for day 2 and day 8 COVID-19 tests – to be taken after arrival and complete a passenger locator form – any time in the 48 hours before arrival.

“After you arrive, you must: quarantine at home or in the place you are staying for 10 days, take a pre-booked COVID-19 test on or before day 2 and on or after day 8,” the high commission further said.

The statement quoted the acting British High Commissioner, Ben Llewellyn-Jones, as saying, “The exemption of fully-vaccinated Nigerians travelling to the UK from providing a pre-departure test and self-isolating for 10 days, is a very welcome development.

“To make this happen, we have been working closely with Nigeria’s National Primary Health Care Development Agency on recognising Nigeria’s vaccine certification, which we have now done.

“The UK remains committed to opening up international travel and enabling those who wish to enter the UK, to do so safely. Vaccines work and – as the pandemic has shown – no one is safe until we are all safe. I would encourage all eligible people to get vaccinated.

Gavi, the Vaccine Alliance, Unitaid, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria applauded the World Health Organization’s (WHO) proposal for the RTS,S malaria vaccine to be used more widely in routine.

The advice was based on data collected over a two-year period by the Malaria Vaccine Implementation Programme (MVIP) in Kenya, Ghana, and Malawi.

More than 2.3 million RTS,S doses had been provided throughout the three countries as of September 2021, more than two years after vaccinations began, and more than 800,000 children had received at least one dose of the vaccine.

Despite the COVID-19 epidemic, the RTS,S pilots achieved and maintained strong coverage levels.

The fact that severe malaria hospitalizations were decreased by 30% was largely recognized by caregivers and healthcare staff.

In Mali and Burkina Faso, nations with considerable seasonal fluctuation in malaria transmission, a clinical research led by the London School of Hygiene and Tropical Medicine looked at the impact of seasonal malaria vaccine administration combined with seasonal malaria chemoprevention.

When the vaccination was combined with preventive antimalarials, severe malaria cases in children decreased by more than 70%, according to the findings.

“Today marks a historic achievement in our fight against malaria,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance, in a statement.

“Malaria still kills over 250,000 children every year.

“The vaccine is an important additional tool to help control this disease alongside other interventions, such as bed nets, and especially when delivered seasonally in combination with antimalarial medication.

“I applaud the countries and communities who participated in the trials and pilots to provide this critical new tool for African countries.”

Ministries of Health led the implementation of the vaccine, which was delivered through routine immunisation programmes, with WHO playing a coordinating role, working in collaboration with GlaxoSmithKline, PATH and UNICEF.

Following its investment of around $700 million dollars in the development of RTS,S, GSK has donated up to 10 million doses for the pilot programme. Gavi, the Global Fund and Unitaid have together committed nearly $70 million dollars to fund the pilot.

It was designed to address several outstanding questions related to the public health use of the vaccine following the Phase three trial showing the efficacy of RTS,S.

“We welcome this new tool in the fight against malaria,” said Peter Sands, Executive Director of the Global Fund.

“In countries where the Global Fund invests, we have reduced malaria deaths by 45 per cent since 2002 with testing, treatment and prevention tools such as mosquito nets.

“In the vaccine pilots, the RTS,S vaccine was most effective when used together with these existing tools.’’

Dr Philippe Duneton, Executive Director of Unitaid, said significant additional resources would, however, be necessary to enable wide deployment of the vaccine alongside other innovations, and as part of a sustained and comprehensive response in the countries that need it the most.”

“Even before the COVID-19 pandemic hit, progress against malaria was stalling.

“This vaccine is a welcome new tool that, when used in combination with existing interventions like bed nets, has the potential to drive down malaria and extend protection to children across Africa.

“Pilot implementation has demonstrated how we can equitably reach children with this life-saving vaccine – now we need to ensure adequate and affordable supply to truly reignite the fight against malaria”, Duneton said.