The Particular Cruelty of Domestic Violence

Domestic violence is like no other crime. It does not happen in a vacuum. It does not happen because someone is in the wrong place at the wrong time. Homes and families are supposed to be sacred territory, the “haven in a heartless world,” as my college sociology teacher drilled into me. This is part of what makes the violence so untenable. It’s violence from someone you know, from someone who claims to love you. It is most often hidden from even one’s closest confidantes, and on many occasions the physical violence is far less damaging than the emotional and verbal violence.

Domestic violence is a serious social and public health problem that occurs in all countries around the world. Domestic violence includes an array of physical and sexual violence, emotional abuse, and controlling behaviors by intimate partners. In 48 population-based studies from around the world, between 10% and 69% of women reported being physically assaulted by an intimate partner at some point in their lives, and for many of these women, physical assault was part of a continuing pattern of abusive behavior. The World Health Organization recently conducted a study on domestic violence against women and women’s health in which 24,000 women were interviewed, at 15 different sites, in 10 geographically, culturally, and economically diverse countries. Even though the settings varied greatly, both among and within countries, the results indicate that violence against women by their male partners is common and has serious consequences.
Although estimating the extent of domestic violence depends upon factors such as the exact definition of domestic violence and how its incidence and prevalence are measured, in many studies women have been found to experience more intimate partner violence than men. Moreover, women victims of this violence suffered more severe injuries and experienced significantly more distress than men. The physical and psychological consequences of domestic violence are both acute and chronic. Research in several countries has shown that male partner violence is associated with physical and mental health problems in women, such as posttraumatic stress disorder, depression, and suicidal behavior. Adult domestic violence is also associated with child abuse and there is evidence that children who are victims of or witnesses to domestic violence have more emotional and social problems than children not exposed to such violence. It has also been found that developmental impairments and psychological problems may affect these children throughout adolescence and into adulthood. Exposure to family violence is associated with community violence and dating violence. Although some results suggest that extrafamilial experiences with violence bring a greater risk for dating victimization than intrafamilial experiences, it has been found in many studies that exposure to family violence was associated with dating violence and with attitudes condoning violence, such as when it is considered to be a justifiable means of relationship conflict resolution. Intergenerational transmission of violence has mixed support and some differences according to gender have been found.

Domestic abuse often escalates from threats and verbal assault to violence. And while physical injury may pose the most obvious danger, the emotional and psychological consequences of domestic abuse are also severe. Emotionally abusive relationships can destroy your self-worth, lead to anxiety and depression, and make you feel helpless and alone. No one should have to endure this kind of pain—and your first step to breaking free is recognizing that your relationship is abusive.

Signs of an abusive relationship

There are many signs of an abusive relationship, and a fear of your partner is the most telling. If you feel like you have to walk on eggshells around them—constantly watching what you say and do in order to avoid a blow-up—chances are your relationship is unhealthy and abusive. Other signs include a partner who belittles you or tries to control you, and feelings of self-loathing, helplessness, and desperation.
To determine whether your relationship is abusive, answer the questions below. The more “yes” answers, the more likely it is that you’re in an abusive relationship.
Are you in an abusive relationship?
Your inner thoughts and feelings

Do you:

feel afraid of your partner much of the time?
avoid certain topics out of fear of angering your partner?
feel that you can’t do anything right for your partner?
believe that you deserve to be hurt or mistreated?
wonder if you’re the one who is crazy?
feel emotionally numb or helpless?

Your partner’s belittling behavior

Does your partner:

humiliate or yell at you?
criticize you and put you down?
treat you so badly that you’re embarrassed for your friends or family to see?
ignore or put down your opinions or accomplishments?
blame you for their own abusive behavior?
see you as property or a sex object, rather than as a person?
Your partner’s violent behavior or threats
Does your partner:

have a bad and unpredictable temper?
hurt you, or threaten to hurt or kill you?
threaten to take your children away or harm them?
threaten to commit suicide if you leave?
force you to have sex?
destroy your belongings?
Your partner’s controlling behavior
Does your partner:

Act excessively jealous and possessive?
Control where you go or what you do?
Keep you from seeing your friends or family?
Limit your access to money, the phone, or the car?
Constantly check up on you?

Physical and sexual abuse

Physical abuse occurs when physical force is used against you in a way that injures or endangers you. Physical assault or battering is a crime, whether it occurs inside or outside of a family. The police have the power and authority to protect you from a physical attack.
Any situation in which you are forced to participate in unwanted, unsafe, or degrading sexual activity is sexual abuse. Forced sex, even by a spouse or intimate partner with whom you also have consensual sex, is an act of aggression and domestic violence. Furthermore, people whose partners abuse them physically and sexually are at a higher risk of being seriously injured or killed.
It is still domestic abuse if…
The incidents of physical abuse seem minor when compared to those you have read about, seen on television, or heard other people talk about. There isn’t a “better” or “worse” form of physical abuse; severe injuries can result from being pushed, for example.
The incidents of physical abuse have only occurred one or two times in the relationship. Studies indicate that if your spouse/partner has injured you once, it is likely that the person will continue to physically assault you.
The physical assaults stopped when you became passive and gave up your right to express yourself as you desire, to move about freely and see others, and to make decisions. It is not a victory if you have to give up your rights as a person and a partner in exchange for ending the assault!
Physical violence has not occurred. Many people are emotionally and verbally assaulted. This can be just as frightening and is often more confusing to try to understand.

Emotional abuse: It’s a bigger problem than you think
Not all abusive relationships involve physical violence.

Just because you’re not battered and bruised doesn’t mean you’re not being abused. Many men and women suffer from emotional abuse, which is no less destructive. Unfortunately, emotional abuse is often minimized or overlooked—even by the person experiencing it.
The aim of emotional abuse is to chip away at your feelings of self a worth and independence—leaving you feeling that there’s no way out of the relationship, or that without your abusive partner, you have nothing.
Emotional abuse includes verbal abuse such as yelling, names calling, blaming, and shaming. Isolation, intimidation, and controlling behavior are also forms of emotional abuse.
Abusers who use emotional or psychological abuse often throw in threats of physical violence or other repercussions if you don’t do as they want.
The scars of emotional abuse are very real and they run deep. You may think that physical abuse is far worse than emotional abuse, since physical violence can send you to the hospital and leave you with physical wounds. But emotional abuse can be just as damaging—sometimes even more so.
Economic or financial abuse: A subtle form of emotional abuse
Remember, an abuser’s goal is to control you, and they will frequently use money to do so. Economic or financial abuse includes:
Rigidly controlling your finances
Withholding money or credit cards
Making you account for every penny you spend
Withholding basic necessities (food, clothes, medications, shelter)
Restricting you to an allowance
Preventing you from working or choosing your own career
Sabotaging your job (making you miss work, calling constantly)
Stealing from you or taking your money
Abusive behavior is a choice
Despite what many people believe, domestic violence and abuse does not take place because of an abuser loses control over their behavior. In fact, abusive behavior and violence is a deliberate choice to gain control. Perpetrators use a variety of tactics to manipulate you and exert their power, including:
Dominance – Abusive individuals need to feel in charge of the relationship. They may make decisions for you and the family, tell you what to do, and expect you to obey without question. Your abuser may treat you like a servant, child, or even as their possession.
Humiliation – An abuser will do everything they can to lower your self-esteem or make you feel defective in some way. After all, if you believe you’re worthless and that no one else will want you, you’re less likely to leave. Insults, names calling, shaming, and public putdowns are all weapons of abuse designed to erode your self a worth and make you feel powerless.
Isolation – In order to increase your dependence on them, an abusive partner will cut you off from the outside world. They may keep you from seeing family or friends, or even prevent you from going to work or school. You may have to ask permission to do anything, go anywhere, or see anyone.
Threats – Abusers commonly use threats to keep their partners from leaving or scare them into dropping charges. Your abuser may threaten to hurt or kill you, your children, other family members, or even pets. They may also threaten to commit suicide, file false charges against you, or report you to child services.
Intimidation – Your abuser may use a variety of intimidation tactics designed to scare you into submission. Such tactics include making threatening looks or gestures, smashing things in front of you, destroying property, hurting your pets, or putting weapons on display. The message behind these actions is that violent violent consequences will follow if you don’t obey.
Denial and blame – Abusers are adept at making excuses for the inexcusable. They may blame their abusive and violent behavior on a bad childhood, a bad day, or even on you and the kids, the victims of their abuse. They may minimize the abuse or deny that it occurred. Often, they will shift the responsibility on to you: somehow, their violent and abusive behavior is your fault.
Abusers are able to control their behaviors they do it all the time
Abusers pick and choose whom to abuse. They don’t insult, threaten, or assault everyone in their life who gives them grief. Usually, they save their abuse for the people closest to them, the ones they claim to love.
Abusers carefully choose when and where to abuse. They control themselves until no one else is around to witness their behavior. They may act like everything is fine in public, but then lash out instantly as soon as you’re alone with them.
Abusers are able to stop their abusive behavior when it benefits them. Most abusers are not out of control. In fact, they’re able to immediately stop their abusive behavior when it’s to their advantage to do so (for example, when the police show up or their boss calls).
Violent abusers usually direct their blows where they won’t show. Rather than acting out in a mindless rage, many physically violent abusers carefully aim their kicks and punches where the bruises and marks won’t show.

The cycle of violence in domestic abuse
Domestic abuse falls into a common pattern or cycle of violence:

Abuse – Your abusive partner lashes out with aggressive, belittling, or violent behavior. This treatment is a power play designed to show you “who is boss.”
Guilt – Your partner feels guilt after abusing you, but not because of their actions. They’re more worried about the possibility of being caught and facing consequences for their abusive behavior.
Excuses – Your abuser rationalizes what they have done. The person may come up with a string of excuses or blame you for provoking them—anything to avoid taking responsibility.
“Normal” behavior – Your partner does everything in their power to regain control and ensure that you’ll stay in the relationship. A perpetrator may act as if nothing has happened, or they might “turn on the charm.” This peaceful honeymoon phase may give you hope that the abuser has really changed this time.
Fantasy and planning – Your abuser begins to fantasize about repeating the abuse. They spend a lot of time thinking about what you’ve done wrong and how they’ll make you pay for it. Then they form a plan for turning the fantasy of abuse into reality.
Set-up – Your abuser sets you up and puts their plan in motion, creating a situation where they can justify abusing you.
Your abuser’s apologies and loving gestures in between the episodes of abuse can make it difficult to leave. They may cause you to believe that you are the only person who can help them, that they will change their behavior, and that they truly love you. However, the dangers of staying are very real.
The full cycle of domestic violence: An example
A man abuses his partner. After he hits her, he experiences self-directed guilt. He says, “I’m sorry for hurting you.”  What he does not say is, “Because I might get caught.” He then rationalizes his behavior by accusing his partner of having an affair. He tells her, “If you weren’t such a worthless whore, I wouldn’t have to hit you.” He then acts contrite, reassuring her that it will not happen again. But later he fantasizes and reflects on past abuse and decides to hurt her again. He plans on sending her to the grocery store, purposely choosing a busy time. She is then held up in traffic and returns a few minutes later than expected. In his mind, he justifies assaulting her by blaming her for having an affair with the store clerk. He has just set her up.
Recognizing the warning signs of abuse
It’s impossible to know with certainty what goes on behind closed doors, but there are some telltale signs of emotional abuse and domestic violence. If you witness these warning signs of abuse in a friend, family member, or co-worker, take them very seriously.
People who are being abused may:
Seem afraid or anxious to please their partner
Go along with everything their partner says and does
Check in often with their partner to report where they are and what they’re doing
Receive frequent, harassing phone calls from their partner
Talk about their partner’s temper, jealousy, or possessiveness
Warning signs of physical violence. People who are being physically abused may:
Have frequent injuries, with the excuse of “accidents”
Frequently miss work, school, or social occasions, without explanation
Dress in clothing designed to hide bruises or scars (e.g. wearing long sleeves in the summer or sunglasses indoors)
Warning signs of isolation. People who are being isolated by their abuser may:
Be restricted from seeing family and friends
Rarely go out in public without their partner
Have limited access to money, credit cards, or the car
The psychological warning signs of abuse. People who are being abused may:
Have very low self-esteem, even if they used to be confident
Show major personality changes (e.g. an outgoing person becomes withdrawn)
Be depressed, anxious, or suicidal
Speak up if you suspect domestic violence or abuse
If you suspect that someone you know is being abused, speak up! If you’re hesitating—telling yourself that it’s none of your business, you might be wrong, or that the person might not want to talk about it—keep in mind that expressing your concern will let the person know that you care and may even save their life.
Talk to the person in private and let them know that you’re concerned. Point out the signs you’ve noticed that worry you. Tell the person that you’re there for them, whenever they feel ready to talk. Reassure them that you’ll keep whatever is said between the two of you, and let them know that you’ll help in any way you can.
Remember, abusers are very good at controlling and manipulating their victims. People who have been emotionally or physically abused are often depressed, drained, scared, ashamed, and confused. They need help getting out of the situation, yet their partner has often isolated them from their family and friends. By picking up on the warning signs and offering support, you can help them escape an abusive situation and begin healing.

Do’s and Don’ts

Do:

Ask if something is wrong

Express concern

Listen and validate

Offer help

Support their decisions

Don’t: 

Wait for them to come to you

Judge or blame

Pressure them

Give advice

Place conditions on your support


Project Alert on Violence Against Women
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Where to report: Police Stations with Special Family Units
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Find nationwide resources on legal, housing and shelter support, Helpline, Counselling etc. from the Nigerian Domestic Violence/Abuse resource centre

COVID-19: FG announces palliatives for MSMEs

The Federal Government has rolled out a set of palliatives to help Micro Small and Medium Enterprises (MSMEs) wade through the economic fallouts of the coronavirus pandemic in Nigeria.
The Vice President, Yemi Osinbajo made this known at the virtual launch of palliatives for MSMEs by the National Agency for Food and Drug Administration and Control (NAFDAC) in Abuja, the nation’s capital.
He described the launch of NAFDAC palliatives for MSMEs as “a thoughtful and strategic response to the devastation caused by the COVID-19 pandemic”.
“This is why the e-registration assistance for MSMEs through the Automated Product Administration and Monitoring System (NAPAMS) is so timely.
“These are all indicators of the new spirit of NAFDAC and foretaste of the support MSMEs stand to enjoy in wading through these trying times. But this is not a new undertaking for us. It is merely an extension or intensification of the Federal Government’s long-standing commitment to MSMEs.” he explained.
According to him, the palliatives reflect the President Buhari administration’s determination to support MSMEs and the priority the Federal Government places on small businesses.
The Vice President, therefore reaffirmed the commitment of the Federal Government to ensure that the projected growth in the Micro, Small and Medium Enterprises (MSMEs) sector were not affected by the pandemic.
“Just after the first index case of the disease was discovered in Nigeria and before the lockdowns began, Mr. President put together strategic teams to immediately determine the impact of the disruptions likely to be caused to the economy and what our immediate and medium to long term approach should be.
“This is our moment and the government of Nigeria and its regulatory agencies are prepared to back MSMEs and other businesses that are prepared for the innovative and interesting times that lie ahead of us,” he explained.
“The vulnerability of MSMEs to the severe shocks that were to follow was priority at every consideration of the issues. But perhaps even our best projections could hardly have predicted the massive economic disruptions, the unprecedented number of business failures, job losses of what began as a health challenge and the ensuing lockdowns would cause especially to MSMEs, who, of course as you know, are the backbone of our entire economy.
“As the President has repeatedly urged, we have no excuse not to be one of the most productive and prolific economies in the world. Our hope is to achieve this aim in the incredible numbers of MSMEs that we have,” the VP noted.
The Palliatives:
E-Registration of MSMEs/products at 80% discounted rate over a period of six months, zero tariffs for the first 200 micro and small businesses to register on the E-platform.
Waiver on administrative charges for overdue late renewal of expired licenses of micro/small businesses products for a period of 90 days.
The Vice President urged regulatory agencies involved in the MSMEs sector to improve on their service delivery noting that “we expect to see from them in terms of innovation, adaptability in the next few months and through the challenges that we will be seeing in business environment.”
“I am sure that NAFDAC, SMEDAN, BOI and all of our MDAs concerned with the MSMEs see this period as one when we must work with the MSMEs, identify with them, and must be quick on the job to ensure we are able to resolve all of the problems that they have, “ he added.

The #Bopdaddy Challenge involves people video recording themselves transforming into a variety of clothes.

The Nigeria Immigration Service has suspended the transfer of five of its officers to Borno, Yobe, Kano and other states for participating in a social media competition known as #Bopdaddy challenge.

The NIS made this known in a series of tweets on its Twitter handle on Friday, saying the transfer was put on hold pending the outcome of an investigation into their conduct.

   The five officers – Priscilla Irabor, Catherine Bakura, Blessing Udida, Binti Attabor, and Ockiya Eneni – were transferred to states far from their duty posts for participating in the #Bopdaddy challenge initiated by musician, Folarinde Falana aka Falz.

Eneni was moved from the Combined Expatriate Residence Permit and Aliens Card Production Facility to the Borno State Command.

The service transferred Irabor from the Lagos State Command to the Nigeria Immigration Training School, Kano, while Attabor was posted from the service headquarters in Abuja to Yobe State Command.

Udida from the FCT Command was sent to the Akwa Ibom State Command while Bakura was transferred from the Nnamdi Azikiwe International Airport, Abuja, to the NIS Training School Ahoada, Rivers State.

Eneni was moved from the Combined Expatriate Residence Permit and Aliens Card Production Facility to the Borno State Command.

The service transferred Irabor from the Lagos State Command to the Nigeria Immigration Training School, Kano, while Attabor was posted from the service headquarters in Abuja to Yobe State Command.

After their transfer, there was an outrage on social media, with Nigerians, including Falz, the son of Femi Falana (SAN), urging the NIS to reverse its position.

Reacting to the outcry, the NIS tweeted, “The attention of the Comptroller General Muhammad Babandede MFR has been drawn to some trending matters on some social media platforms regarding the deployment of some of our Personnel to some Formations across the country.

“It is important to note that staff deployment remains a vital practice of regimented organisations such as ours and should be seen as such.

“As an agency, we maintain zero tolerance to any matters bordering on offences against discipline among members of our workforce irrespective of gender.

“We have a high premium for staff development and indeed encourage personal efforts but that must be within the confines of our rules and regulations.

“The matter involving the Personnel in question is still being investigated and therefore, the Comptroller General has directed that the earlier Posting Order be put on hold pending the conclusion of the investigation.”

Pregnant COVID-19 patient delivered of a baby boy in Lagos State (Photo)

A positive COVID-19 patient on Saturday gave birth to a baby boy after a successful caesarean operation at Gbagada Isolation Centre, Lagos.

It was a moment of joy and celebration from health workers when the mother finally gave birth to the baby boy early in the morning.

Announcing the great feat recorded by the State Government through her health workers, Governor Babajide Sanwo-Olu said the feat “is another validation of the government’s position to stamp out the Coronavirus virus from our state.”

He said: “I bring you great news from our isolation facilities. Today, (Saturday) a pregnant COVID-19 positive patient was delivered of a baby boy through the caesarian session at the Gbagada Isolation Centre. Both Mother and baby are doing well.

“Today’s achievement is a pointer that our strategies in Lagos state are working and yielding the desired results. It is also a sign of victory and motivation for us as we push ahead in the battle against the Coronavirus pandemic.”

Sanwo-Olu also announced the discharge of 67 more patients from four isolation centres after testing negative two consecutive times for the coronavirus.

PDP gives FG 48-hour ultimatum to declare whereabouts of Chinese medical team

The Peoples Democratic Party (PDP), yesterday, gave the Federal Government 48 hours ultimatum to declare the whereabouts of the Chinese medical team that came into the country, purportedly to assist in the fight against the spread of the COVID-19 pandemic. The PDP in a statement by its National Publicity Secretary, Kola Ologbondiyan, said the ultimatum was predicated on the declaration of the Minister of Health, Dr. Osagie Ehanire, that he could not account for the whereabouts of the Chinese team.

The opposition party noted that Ehanire’s statement had heightened apprehensions in the polity that the Chinese team, whose identity and activities have been shrouded in secrecy, might have been brought in by a certain cabal for another purpose outside the general public good.
It stated that it was suspicious that the Health Minister, who had previously assured that the Chinese came to support the country’s fight against COVID-19; and personally received them at the Nnamdi Azikwe International Airport, Abuja on April 8, 2020, turned around to claim ignorance of their whereabouts.

How First 32 COVID-19 Cases Were Treated

Meanwhile, Nigerian researchers have published the first-ever study on how the first 32 COVID-19 patients were treated with lopinavir-rotonavir, with no recorded death.
The study titled, “Clinical Presentation, Case Management and Outcomes for the First 32 COVID-19 Patients in Nigeria,” was published in The Pan African Medical Journal. The researchers led by a consultant public health physician and former Chief Medical Director of Lagos University Teaching Hospital (LUTH), Prof. Akin Osibogun, include, Abimbola Bowale, Akin Abayomi, Jide Idris, Sunday Omilabu, Ismail Abdus-Salam, Busayo Adebayo, Folarin Opawoye, Ore Finnih-Awokoya, Emmanuella Zamba, and Hussein Abdur-Razzaq among others.

They are drawn from Mainland Hospital, Yaba, Lagos; Lagos State Ministry of Health; College of Medicine, University of Lagos; Lagos State University Teaching Hospital (LUTH); Office of the Senior Special Assistant to the Governor; Lagos State Primary Health Care Board; World Health Organisation, Nigerian Office, Lagos; Nigerian Centre for Disease Control, Lagos, and African Field Epidemiology Network, Lagos. According to the researchers, success in curtailing pandemic depends largely on a sound understanding of the epidemiological and clinical profile of cases in a population, as well as the case management approach.

“This study documents the presenting characteristics, treatment modalities and outcomes of the first 32 COVID-19 patients in Nigeria,” they noted. The retrospective study used medical records of the first 32 patients admitted and discharged from the Mainland Hospital, Lagos State, between February 27 and April 6, 2020. The outcomes of interest were death, promptness of admission process and duration of hospitalisation.

According to the results, “the mean age of the patients was 38.1 years (SD: 15.5) and 66% were male. Three-quarters (75%) of the patients presented in moderately severe condition while 16% were asymptomatic. The most common presenting symptoms were fever (59%) and dry cough (44%). The mean time between a positive test result and admission was 1.63 days (SD: 1.31). Almost all (97%) the patients were treated with lopinavir-ritonavir with no recorded death. The median duration of hospital stay was 12 days.”

They concluded: “In this preliminary analysis of the first COVID-19 cases in Nigeria, clinical presentation was mild to moderate with no mortality. Processes to improve promptness of admission and reduce hospital stay are required to enhance the response to COVID-19 in Nigeria.”

On what this study adds to existing literature on the scourge? Osibogun told The Guardian: “Literature on COVID-19 is currently unfolding worldwide and the study would contribute to the growing body of knowledge. In particular, this study helps in identify the defining clinical characteristics of COVID-19 and shares experience with case management in an African context.”

Experts fear Madagascar’s organics could accelerate malaria resistance

President Muhammadu Buhari, yesterday, at the State House, Abuja, received the Madagascan native formulation against the Coronavirus Disease (COVID-19), and reiterated that he will listen to scientists before allowing traditional or any new medicines to be administered on Nigerians.
While receiving a sample of COVID-Organics from the President of Guinea Bissau, Umaro Sissoco Embalo, Buhari said his position on all such herbal or traditional medicinal postulates had remained the same, stressing that he would not allow the solution, or any other drug to be administered on Nigerians without scientific instructions.
It would be recalled that President of Madagascar, Andry Ranoelina, recently dispatched consignments of the drug to African countries, some of which were sent to Guinea Bissau for onward delivery to West African countries.

According to Buhari: “We have our institutions, systems and processes in the country. Any such formulations should be sent to them for verification. I will not put it to use without the endorsement of our institutions.”

Embalo said one of the reasons he was in the country having stabilized his country after the crises that attended the general elections won by him, was to come and seek counsel from his “father,” President Buhari, on his plan for a “government of national unity,” and a proposed war against corruption in his country.

He also said that his new government met a country beset with a number of issues and problems, the resolution of which would require tremendous assistance from “big brother,” Nigeria.

“Problems of Guinea Bissau are problems of Nigeria. I have come to you as your son. I need your help and assistance to make the people happy. I will not let you down, neither will I put you in any difficult situation,” the visiting leader told President Buhari. In response to these demands, the Nigerian leader commended “General“ Embalo on his confirmation as President and for stabilising the country.

“I commend your political dexterity in getting the opposition to join the proposed unity government,” he said, adding that Nigeria was determined to keep West Africa politically stable and promised to support the new government in Guinea Bissau. “I will cooperate and help in every way possible,” assured the Nigerian President.

But as Buhari promised not to allow the Madagascan solution, or any other drug to be administered on Nigerians without scientific instructions, some experts have warned that the misuse of Artemisia, one of the main plant extracts in the tonic (from Artemisia annua), could accelerate malaria resistance to artemisinin-based drugs, used as treatment for malaria.
Already, Artemisia annua, which is a source of artemisinin, a significant component of modern anti-malarials, has been the subject of some international research looking at possible Coronavirus treatments. Scientists at Germany’s Max Planck Institute, in Potsdam are among a group of researchers from Germany and Denmark collaborating with a United States company, ArtemiLife to explore whether Artemisia plant can be used against the raging contagion. Lately, the Minister of Health, Dr. Osagie Ehanire, during Presidential Task Force (PTF) briefing on COVID-19, in Abuja, also said that samples of plant from Madagascar would be compared with the ones that grow here in the country. He said, “The cure from Madagascar has been making the news and we have promised to get samples of the herb or the botanical products that is there for analysis and (also) use (that) as an opportunity to speak with the health authorities, particularly the scientific community, on how they use it.

“We will give that to the research community with us here to examine and see what they can do with it. We understand that it is something called Artemisia annua, which also grows here but if we get it, we will like to compare it with the strain here whether they are identical or whether they are similar, and see what properties they have. Things like that are subjected to analysis.

“All countries in the world are interested in finding a cure and we are no different, and we will look at all options, possibilities, and promises that were made. But before we give them to our people, we will ensure they are safe and make sure they work.”

The WHO recently also warned against using untested herbal therapies to treat COVID-19 patients without first “establishing their efficacy and safety through rigorous clinical trials” in step with global standards. The United Nations agency in a release this month acknowledged that medicinal plants such as Artemisia annua, were “being considered as possible treatment of COVID-19,” but stressed that they “should be tested for efficacy and adverse side effects.”

The organisation added that efforts were underway to find treatment for COVID-19, but cautioned against misinformation, especially on social media, about the effectiveness of certain remedies.

“Many plants and substances are being proposed without the minimum requirements and evidence of quality, safety and efficacy. The use of products to treat COVID-19, which have not been robustly investigated can put people in danger, giving a false sense of security and distracting them from hand washing and physical distancing, which are cardinal in COVID-19 prevention, and may also increase self-medication and the risk to patient safety,” the agency wrote.

Worries Over Artemisia Annua

One of the earliest concerns about accelerate malaria resistance to artemisinin-based drugs was raised by a Professor of Pharmacological Science and Experimental Medicine at Stony Brook University, New York, Dr. Arthur Grollman, who speaking to CNN said: “Widespread use of Artemisia annua in the pandemic will accelerate resistance to it, endangering people in countries, including Madagascar, where artemisinin-based drugs are being used to treat malaria.

“The product won’t work and will result in more people dying from Coronavirus due to the false sense of security created by the advertisement and also more people dying from malaria due to artemisia resistance,” Grollman said.

Reacting to this, a clinical pharmacist and public health expert Kingsley Chiedu, said: “In treatment of malaria, if artemisinin is used as monotherapy (that is alone without combining with an additional antimalarial medicine, then resistance could develop to it. That is why the World Health Organisation (WHO) insists on artemisinine being combined with other anti-malarial medicines. When the product is used alone at sub-optimal doses, resistance could develop. When used at higher than recommended doses, toxicity or adverse drug reactions can set in.”

The plant artemisia is found to be effective in treatment of malaria, but according to Chiedu, if used in sub-therapeutic dose, could lead to years of treatment failure.
Malaria is endemic in many African countries, and as many as 400, 000 people died of it globally in 2018, according to WHO. In terms of side effect, Chiedu said, “Artemisia herb is known to be quite safe. Safer than some orthodox medicine, but the problem is standadisation of dose. People tend to use such drugs as they like. In terms of efficacy tests, it is trial and error.”

Regarding injecting higher than recommended therapeutic doses, Chiedu said this could lead to toxicity and adverse reaction. “But for now, it is too early to speculate that it can lead to drug resistant. What we need to do now is to encourage our own local herbal products up to the point of testing,” he said. Another pharmacist, Olumide Akintayo, said when people begin to misuse herbs, they are exposed to consequences like ulcer, and gastrointestinal diseases. “Before you get to the stage of drug resistance, you must have abused the drug over and over again. If you begin to abuse lime for instance, within a week, I can assure you that you will come up with a gastrointestinal issue.

“There is no prophylaxis for the virus. The best people can do is to use supplements like Vitamin C- a high dose for a short period then substitute with fruits and vegetables. Avoid crowded areas, avoid air-conditioned areas were you have lots of people, this is why you have lots of people contracting it through flying in aircraft. People should focus on these preventive measures instead of focusing on herbal preparation,” he said.

Akintayo stressed the need to evaluate the safety profile of the drug saying: “It’s important that pharmacists embark on national dialogue with NAFDAC, to agree on the necessary pharmacological tests of some of these herbal preparations.
Artemisinin is not the first malaria treatment to gain attention in the search for a treatment for COVID-19. The malaria drug hydroxychloroquine has also been hyped in recent months despite little data supporting its effectiveness against coronavirus infection.

The Co-Chair, Presidential Taskforce on COVID-19 in Kano, Prof. Abdulsalam Nasidi, yesterday, said there was urgent need for Nigeria to search inward for a veritable treatment and cure for the pandemic. The professor of infectious diseases and public health, who spoke in Kano, noted that it was high time Nigeria and Africa focused more on local scientific research and development in a bid to finding homegrown treatment for the virus. Although, Nasidi disclosed that several clinical tests on vaccines for the cure of COVID-19 pandemic were presently at advanced stages, he reminded that such vaccines when finally certified may be difficult to access in Africa, even as he alleged that world powers may make it extremely expensive and reserved for their citizens first, before thinking of Third World countries. Nasidi, who expressed the belief that Nigeria and Africa have the scientific and alternative medicine competence to finding a cure for the virus, urged government to increase funding for research centres in the country.