Lagos, Nigeria – In August, the University of Lagos temporarily closed its doors after positive cases of COVID-19 were reported in hostels on the main campus in Akoka.
Twenty-three-year-old Bolu and 24-year-old Veronica were among the thousands of students whose studies were interrupted.
The students, who asked Al Jazeera to refer to them by pseudonyms, are both in their final year of medical school. Neither was allowed to return to the classroom until the end of August – and only then if they could furnish the school with a negative COVID-19 test result.
COVID-19 tests are free in government-owned hospitals in Nigeria, but students and medical professionals Al Jazeera talked to say that demand for them far outstrips supply, and that results can be delayed for days, inhibiting public health measures to combat the spread of the disease.
There are private accredited labs students and others can turn to, but they don’t come cheap. Private labs in Abuja, for example, charge upward of 36,000 naira ($88 at the official exchange rate) for a COVID-19 test. In Lagos, a private test can leave someone 50,400 naira ($123) out of pocket. The monthly minimum wage in Nigeria is only 30,000 naira ($73).
Bolu and Veronica said they worked around the system by paying a fixer 3,000 naira ($7.30) to get them a forged negative COVID-19 test result from a private laboratory.
“I don’t even know the [actual] person who did the result, I just paid to a friend who works in a laboratory and then I got the result,’’ Veronica told Al Jazeera.
Neither of them said they even set foot in a testing centre.
“I just paid the money and they sent me the result to my email,” Bolu told Al Jazeera.
Both students said the practice of faking test results for COVID-19 – the disease caused by the coronavirus that is spreading around the globe – was widespread on their campus.
“Most of the results [students submitted] were doctored. It was not like the school was confirming with the laboratories if the results were genuine or not. In fact, I could have just written any letter and submitted it,’’ said Veronica.
The University of Lagos College of Medicine did not respond to Al Jazeera’s multiple email requests for comment.
But Dr Bamidele Mutiu, the director of Lagos State Bio-Bank and the specialist in charge of the laboratories, insists that anyone who needs a free COVID-19 test in Nigeria can get one.
“Testing is readily available across Lagos state,’’ he said. “The stock of reagents, sampling kits, and consumables at Lagos State Bio-Bank is more than enough for the ongoing response.”
Mutiu added that while results were delayed at the start of the coronavirus pandemic, the turnaround time for them now is now within 24 hours.
But a medical professional who worked with the coronavirus centre at Lagos State University Teaching Hospital (LASUTH) between April last year and August of this year told Al Jazeera that results take three to four days at government-owned laboratories.
“There is a shortage of the kits for reasons I don’t know,” he said. “So, it will take them two or three days to supply us the sample kits, and to take the test again, it takes about three or four days to get the results out. That means we have been managing COVID blindly for like a week, which does not make sense.”
I just paid the money and they sent me the result to my email.
Lowering test costs
Testing is a key weapon in combating the spread of the coronavirus – including in Nigeria, where over 205,000 confirmed cases have been recorded and at least 2,700 people have lost their lives to the virus.
Experts say COVID-19 tests are pricey, though – and not only in Nigeria.
“Generally, the cost of carrying out COVID-19 PCR [polymerase chain reaction] tests is high, alongside the costs of running molecular laboratories where these tests are carried out,” Chikwe Ihekweazu, the former director-general of the National Centre for Disease Control (NCDC), told Al Jazeera. “This high cost is not unique to Nigeria alone.’’
It is, however, more prohibitive for Nigeria than for wealthier countries.
Forty percent of Nigerians live below the poverty line, according to government figures. Some 20 percent of Nigerian workers have lost their jobs to coronavirus pandemic disruptions and the country is still crawling out of its worst recession in four decades. Meanwhile, the annual rate of inflation – which topped 17 percent in July – is eroding purchasing power, especially for poorer households.
“The high cost of PCR tests is not peculiar to Nigeria. The challenge is the poverty level,” said Ifeanyi Nsofor, a public health expert and senior New Voices fellow at the Aspen Institute.
“Most people cannot afford to pay 40,000 naira ($97) for one COVID-19 test. Imagine if you have to do several tests a month.”
Nsofor believes the only way for Nigeria to price private tests more within reach of its population is to lessen dependence on federally funded testing.
“State governments and local councils must also invest in COVID-19 tests to reduce costs,” he told Al Jazeera. “The overreliance on the federal government is unsustainable. It is time for health insurance companies in Nigeria to add COVID-19 tests to the list of things they cover.’’
The high cost of PCR tests is not peculiar to Nigeria.
Scared to the bone
University undergraduate Pelumi Oteniya was exposed to the coronavirus in August when his roommate in Bariga, a suburb of Lagos, tested positive for COVID-19.
“The mere thought that I came in contact with a positive person really messed me up because I was scared to the bones,” the 21-year-old told Al Jazeera.
Oteniya said his attempts to get tested at a government facility yielded only frustration.
“The first centre I went to in Shomolu, I was told there was no testing facility and I was referred to another hospital in Shomolu with the same story,” he told Al Jazeera. “I went to another in Akoka but the attendants there were not interested in administering a test, but only vaccines that weren’t available at the time.”
While richer nations have had the resources to secure millions of doses of coronavirus vaccines for their populations, Nigeria, like many developing economies, has had to wait in line and be drip-fed doses through the COVID-19 Vaccines Global Access Facility (COVAX) initiative. As a result, little more than two percent of Nigeria’s population has received at least one coronavirus jab, according to Our World in Data.
Ihekweazu said the government has instructed law enforcement agencies to investigate and prosecute anyone engaged in the production and use of fake test results.
“We cannot do it alone; we need Nigerians to support these efforts by only using accredited and approved laboratories, and reporting illegal activities to the relevant law and health authorities,’’ he said.
But public support could prove challenging if Oteniya’s failed attempts to get a free, timely test result are anything to go by.
“All the experiences I had [trying to get tested] kind of gave me a new perspective that if this COVID was not real?” he said. “Maybe it was just a way to extort people or maybe Nigerian COVID is different because the way you see COVID in other countries is different.”