Apr 6, 2020

REVITALISING NIGERIA’S COMATOSE HEALTH SECTOR:POST-CORONAVIRUS ERA BY DEBO OLADINNI, ESQ


As I pen down my thoughts this morning, the 5th day of April, 2020, I am not in animal spirits, as the pandemic Coronavirus (COVID-19) continues to increasingly spread like wildfire across Nigeria and also globally. Like a bull in the china shop, it is threatening to decimate and ravage the world's population gradually. The virus has literally held the world populace hostage, as the only means of escaping from its blood testy jaws is to hibernate in our respective abodes and maintain strict hygiene by washing our hands with soap and water (as there is no vaccine available yet), amongst other preventive measures issued by the World Health Organization (WHO) and the Nigeria Centre for Disease Control (NCDC). 

The essence of this write-up is not to criticise the Federal Government of Nigeria, but to urge the Government to do the needful by ensuring the health sector is properly funded. The era of the Government at all levels paying lip service to the health sector, in terms of adequate funding, going forward should be gone with the wind. Clearly, the world was/is largely unprepared for the outbreak of this plague-like virus, as even first-world countries, with well-funded health sectors are battling tooth and nail to checkmate the spread of the virus. This fact should serve as a wake-up call to Nigeria, whose successive leaders have over the years under funded the health sector.

While surfing the internet for information relating to disease prevention, I was jolted by the heart wrenching caption of This Day Newspaper of 5th March, 2020 which stated: "FG Budgets 8 Naira for Disease Prevention of Each Nigerian in 2020". I must say that the said newspaper article is a must-read for all Nigerians to appreciate the extent of the retrogression of the Nigerian health sector. Our health sector is still in the wilderness, going round in circles with no hope in sight of reaching Canaan land anytime soon. The article revealed that only a paltry sum of N1, 673, 486, 127 was allocated to the Nigeria Centre for Disease Control (NCDC), the country's national public health institute (established in 2011), essentially saddled with the responsibility of epidemic preparedness, detection and response to infectious disease outbreaks and public health emergencies for over 200 million Nigerians. Unfortunately, a visit to the website of the NCDC would reveal that the above mentioned budgeted sum will be expended on preventing and managing Lassa fever, Ebola, Coronavirus (COVID-19) Yellow fever, Cholera, Meningitis, Measles etc; running, funding and maintenance of the six Departments (four of which are technical Departments) created by the NCDC namely the: Surveillance and Epidemiology Department, Public Health Laboratory Services Department, Health Emergency Preparedness and Response Department, Prevention Programmes and Knowledge Management Department, Administration and Human Resources Department and the Finance and Accounts Department. In order to appreciate the dire straits, foisted upon the Nigerian health sector by meagre funding over the years, I would proceed to quote copiously, portions of the pungent This Day Newspaper article  earlier referred to which served as a catalyst to my writing this article. The said article stated in part as follows:

"…NCDC's counterpart in the United States, the Centre for Disease Control (CDC) will spend $6.594 billion on epidemic preparedness this year, which is about N2.34 trillion, an amount that exceeds Nigeria's entire Federal Ministry of Health allocation for five years. This means, if the CDC budget is spread across the population, the centre will spend at least 20 dollars (N7, 200) on epidemic preparedness for every American resident, while Nigeria, a country which prides itself as the giant of Africa and the economic hub of the black continent, will spend eight naira on same disease prevention and management in a full year per citizen.... The health sector generally has had one of the lowest budget allocations in the country, even far lower than sectors relatively not as crucial as the health sector. This is despite the pledge made by the country in April 2001 during the 'Abuja Declaration' where it, along with other heads of state under the African Union platform, declared to increase health budget allocation to 15 per cent of the entire national budget every year. Since the Declaration, the highest health allocation for Nigeria was in 2012 where 5.95 per cent was allotted to the sector. In 2014, it allocated N216.40 billion to healthcare, representing 4.4 per cent. In 2015, it was N237 billion, which represents 5.5 per cent of the entire budget, same with 2016 (4.23 per cent), 2017 (4.16 per cent), 2018 at 340.5 billion (3.9 per cent), and 2019 at N315.6 billion (4.1 per cent)…the Nigerian government, again in 2020, followed the same trend with only 4.14 per cent of the entire budget allocated to the health sector, amounting to N427 billion; an allocation less than 25 per cent of what CDC alone will spend on epidemic preparedness. But the World Health Organisation (WHO) says for Nigeria to be seen to have prioritised healthcare, it must at least spend a minimum of N6, 908 per Nigerian in a year, which when multiplied by 200 million people will amount to N1.38 trillion, which is around 12 per cent of Nigeria's entire budget for 2020… For instance, Rwanda reportedly devoted 18 per cent of its total 2016 budget to healthcare. Botswana budgeted 17.8 per cent to health; Malawi, 17.1 per cent, Zambia, 16.4 per cent and Burkina Faso, 15.8 per cent. But Nigeria still lags behind in this regard, which has had direct consequences on the funding capacity of the Health Ministry and its affiliated agencies and parastatals, thereby making the fight against poor healthcare very unrealistic."

The above quoted portions of the article perfectly reflect the unfortunate doldrums that the Nigerian health sector is enmeshed in due to lack of proper funding. There is no gainsaying the fact that there is no use crying over spilt milk. It is time for the Government to seize the bull by the horn by adequately funding the health sector in tandem with global best practices. The outbreak of the deadly pandemic Coronavirus has shown that we cannot always resort to medical tourism to meet our medical needs. It is apparently clear that the Government must go back to the drawing board to re-strategize and chart a way forward, in order to revive our comatose health sector.  To my mind, the only way forward is for the Government to prioritize and adequately fund the health sector. Fortunately, the Federal Government of Nigeria can resort to its 359-page blue-print National Action on Health Security (2018-2022), which is a "comprehensive multi-sectoral plan that integrates multiple work plans including REDISSE, NCDC Strategy Plan, AMR Action Plan, and immunizations plans, addressing the major gaps identified by the Joint External Evaluation (2017) and Performance of Veterinary Services (2010) assessments, and prioritizing them by national strategies and risks. As such, the NAPHS is an "overarching" plan and can be used to create linkages and monitor progress of major health security initiatives."

Flowing from the above, can the Federal Government religiously, diligently and steadfastly implement the NAPHS, in order to ensure the Nigerian health sector is revamped, revitalised and repositioned to meet the health needs of all Nigerians? Most humbly and with all due respect, I must state that Nigeria is a country, whereby successive Governments have expended so much funds in drawing up plans, without the will to implement them. In this wise, I must plead that in relation to the health sector (and in fact all sectors), it can no longer be business as usual, bearing in mind the words of the 34th President of the United States of America, Dwight D. Eisenhower " In preparing for battle I have always found that plans are useless, but planning is indispensable."
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