7th September 2020
Attention: Members of the Liberian Senate
C/O Senator Albert Chie, President Pro Tempore
Liberian Senate and Senator, Grand Kru County
The Liberian Senate, Capitol Building
Dear Senator Albert Chie:
Re: Request for Senate Hearing or Independent Scientific Committee to Investigate Blunder and Negligence in Liberia’s COVIDF-19 Pandemic Response and Fragile Health System
My profound compliments to the Liberian Senate as I humbly petition this August Body to conduct an extensive Senate Hearing on the numerous ethical violations, corruption, and professional lapses that have characterized Liberia’s COVID-19 Pandemic Response amidst the fragile and dilapidated healthcare system in the country. This is my second call to the government since the first was made in April 2020. This call is meant to ignite an investigation of what has turned out to be a totally ineffective and confusing system.
Since the outbreak of what is now the SARS-Coronavirus-2 infection and COVID-19 Pandemic in December 2019, Liberia was alerted to prepare as earlier as January 2020 and to set up and activate its response-system that would allow technically competent and qualified expertise to combat the Pandemic. However, the opposite seems to have been the case wherein the National Public Health Institute of Liberia (NPHIL) was sidelined and the Incidence Management System (IMS) reorganized about three times and led by appointees with no expertise in infectious diseases, no experience in epidemiology and pandemic response, as well as no or limited knowledge and skills in diseases surveillance, control, and detection.
You will kindly note that these issues were repeatedly brought to the attention of the Liberian government through the Ministry of Health (MOH) and the NPHIL on multiple occasions from January through June 2020 (see attached letters). These problems were highlighted again when Liberia’s COVID-19 case fatality rate (CFR) reached about 11% in April 2020, far exceeding the CFRs of other countries in the region and the global CFR which was then at about 4-5%. These issues included:
- The lack of a defined epidemiological model and protocol in Liberia’s COVID-19 pandemic response;
- Non-reliance on facts and science and neglect in utilizing Liberia’s experience and personnel acquired from the 2014 Ebola Epidemic;
- Use of faulty or inaccurate COVID-19 testing kits and limiting testing capabilities;
- Shortages of COVID-19 testing kits for diagnosis and lack of personal protective equipment (PPE) for healthcare workers;
- Use of some unscientific testing methods by the NPHIL/IMS National Reference Laboratory, particularly the unjustifiable testing of chemically preserved or days-old dead bodies collected from street corners or communities for COVID-19;
- Giving of wrong, contradictory and indeterminate COVID-19 test results to patients;
- Lack of public health accountability and transparency as well as poor and infective communication to the public by non-scientific expertise (i.e. politicians like the Minister of Information);
- Importation into Liberia by the Government (and the reported) use of the untested Madagascar “COV Herbal Drink” that falsely claims to cure or prevent COVID-19;
- Wrong assignment of patients’ data and the discriminatory treatment of COVID-19 patients under the observation of the IMS and treatment units;
- Refusal by the Government on the voluntary free-offer to develop Liberia’s own COVID-19 testing kits;
- Reneging on as well as the belated implementation of suggested scientific public health measures such as the Lockdown, Mask Wearing and Social-Physical Distancing, among others;
- The continuous interference of the Monrovia City Corporation (MCC), a non-medical/scientific entity, in the work of the National Public Health Institute of Liberia (NPHIL), and possible diversion of resources;
- Government of Liberia using the WHO-Country Representative to undermine the integrity of its (Liberia’s) Diaspora scientific, medical, and public health expertise;
- Possible misappropriation of funds and resources intended for the NPHIL;
- Unethical and multiple technical violations including breach of confidentiality at or by the Ministry of Health, NPHIL, and the Ministry of Information, individually and collectively;
- The numerous unscientific approaches, public health blunder, and administrative negligence that characterized Liberia’s COVID-19 Pandemic Response; and,
- Liberia’s lack of innovation in its fight against the COVID-19 Pandemic, among others.
In a belated and impromptu reaction, you will carefully note that the Executive Branch set up a Presidential Investigative Committee on or about August 10, 2020, to investigate what it termed as “the reported breach in the health and administrative protocols which guide the issuance of Covid-19 test results by NPHIL.” The Director-General of the NPHIL, Dr Mosoka Fallah was suspended by President George Weah and placed under investigation.
The President’s Investigation Committee was given 72 hours to report its findings and the Committee comprised of the following: the President of the Liberia Medical and Dental Council (LMDC) as Chair; the Minister of Justice; the Deputy Minister of Foreign Affairs; the Country Representative of the US Center for Disease Control (CDC); and, the Country Representative of the World Health Organization, (WHO). Ultimately, Dr Fallah was dismissed on September 4, 2020, by President George Weah in response to the Committee’s report.
Although the aforementioned committee presented its report within the 72-hour prescribed time, the process seemed to have been marred by severe limitations, embedded with predetermined conclusions, and saturated with other biases as follows:
- Generally, the “committee’s” term of reference was limited in scope and ignored the major underlying issues within Liberia’s COVID-19 Pandemic Response, while the systemic problems with the Liberian healthcare system were also overlooked; specifically, then,
- The composition of the committee did not include the requisite scientific expertise needed to probed the SYSTEMIC PROBLEMS surrounding Liberia’s ineffective COVID-19 Pandemic Response which is a symptom of Liberia’s weak and fragile healthcare system;
- The committee did not investigate the actual culprits of the lapses; in this regard, for example, the exemption of the Minister of Health and other high ranking officials as the target of the investigation was discriminatory;
- The inclusion on the President’s Investigative Committee of both the WHO Liberia Representative and US Centers for Disease Control-Liberia Representative constitutes an oversight and is very questionable since these two entities also need(ed) to be queried about their “supervisory” role of the NPHIL/IMS under which Liberia’s COVID-19 Pandemic Response became ineffective and leading to the attendant lapses, blunder, and misappropriations of resources. It raises further questions as to why these potential witnesses were placed on the President’s Investigative Committee where they served as both the judge and jury at the same time in a hasty 72-hour investigation.
- Besides, the Justice Minister and Deputy Foreign Minister have no expertise in this domain of science, medicine, epidemiology and pandemic response that warranted their inclusion on this Committee;
- The seeming rush to conclusions by the President’s Investigative Committee in a 72-hour military tribunal-like summary trial apparently presents the semblance of a cover-up, while making Dr Mosoka Fallah the scapegoat of a SYSTEMIC PROBLEM that certainly requires an in-depth analysis by open-minded independent professionals.
Accordingly, the foregoing creates more doubt than clarity. Hence, there are certainly a number of unresolved contradictions, and a number of important questions that were probably skipped by the President’s Investigative Committee, thus raising more questions than providing answers and solutions.
The gravity of these issues, therefore, necessitates the intervention of the Legislative Branch of the Liberian Government to probe this matter by holding a Senate Hearing and/or Commissioning an Independent Scientific Panel to Investigate the Problems Surrounding Liberia’s COVID-19 Pandemic Response and the Healthcare System in the Era of COVID-19 Pandemic.
By so doing, the real truth will not be held hostage by the incomprehensive and inconclusive investigation conducted by the Executive Branch of government. Thank you very much for your attention and consideration in the interest of the Liberian people and the world at large.
Dr Dougbeh Chris Nyan, M.D.
Chief Medical & Scientific Officer (CMSO)
Laboratory of Emerging Pathogens
Dept. of Molecular Pathogen Diagnostics
Shufflex Biomed, LLC (USA-LIB-RW)
Cc: Senators Comany B. Wesseh, Nyonblee Karnga Lawrence, Oscar Cooper, Dr Peter Coleman, Alphonso Gaye et al.
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