Nigerians deserve an improved health sector!

Climate change has devastating environmental consequences such as extreme heat waves resulting in degraded air quality, drought, and diseases, amongst others. These environmental consequences affect directly and indirectly the physical, social, and psychological health of humans. The dilemma of many Nigerians during summer is better appreciated when they don’t have electricity supply. When there is lack of electricity supply, fans and air conditioners don’t work, children and adults become uncomfortable. Children particularly, are easily stressed by heat. Health is wealth, they say. A nation of many healthy people is a wealthy country by any known measure. But when most individuals lose their health because of poor medical facilities occasioned by inadequate funding, the nation has lost something.

Recently, I read the Economic Recovery and Growth Plan (ERGP), and I found that the federal government acknowledges that Nigeria’s health system doesn’t provide the level of service required to meet the needs of a population of about 170 million. Accordingly, policy objectives in the ERGP aims to improve within 4 years (2017-2020), the availability, accessibility, affordability, and quality of health services; expand healthcare coverage to all 774 local governments; provide sustainable financing for the health sector; and reduce infant mortality rate.

For some time, the health sector is not well-funded. If Nigeria’s health sector, according to the ERGP, is to recover and grow within the next 4 years, it cannot be allocated a miserable capital expenditure of N51 billion, and recurrent overheads of N252.9 billion in the proposed 2017 Budget. Considering the numerous challenges in the nation’s health sector, an allocation of 4.17% of the budget to health in 2017 will not create the desired impact in the face of epidemics and diseases in most parts of the country. As medical centers across the nation rely on foreign donor organizations for vaccines, they find it difficult to maintain medical equipment and acquire modern facilities due to poor funding. This, perhaps, is the reason why government officials and wealthy individuals travel abroad for medical treatment, leaving indigent Nigerians to manage the poorly maintained and ill-equipped hospitals.

As I write, there is an outbreak of meningitis in Nigeria. More than 2500 people are reported to have been infected, while the death toll has risen beyond 400. As the World Health Organization (WHO) and partners provide vaccines to control the viral infection, the FG advises on preventive steps to curb the spread of the epidemic. Regrettably, the Governor of Zamfara State, Abdulaziz Yari, says meningitis has spiritual connection. Yari prophesied the displeasure of the gods with his people in Zamfara. What has meningitis got to do with the gods in a world driven by engineering, science and technology? When a nation has many Yaris in positions of authority, sufficient funds cannot be released for medical research and development.

As Yari defends his religiosity on the outbreak of meningitis in Zamfara state, malaria is affecting many Nigerians. About 97% of Nigeria’s population is reported to be at risk of malaria. What about depression? It’s increasing. Perhaps, due to the economic crisis Nigerians are currently going through. Additionally, report from the WHO shows that depression cases, for instance, at the Yaba Psychiatrist Hospital increased by 59% in 2016, with less than 500 psychiatrists to the nation’s population.

Although, cancer is not necessarily a killer as advocated by experts, but poor funding of the health sector is one of the major causes of the increasing rate of the disease in the country. I understand that cancer causes a lot of mortality and morbidity amongst people in mid-life. Medical researchers in Nigeria have tried to find out if there are things peculiar to Nigerians that may be promoting cancer, but much has not been done. Why? Lack of funds and apathy to research endeavors by the federal government (FG).

From the report of an interview reflected in Businessday edition of 31 March 2017, only N23.0 million was released in 2016 out of the N56 million budgeted by the Nigerian Institute of Medical Research (NIMR), Yaba, Lagos.“Out of the N23.0 million, about N8 million to N9million was reportedly spent on research.”This revelation is likely to be true, as the large chunk of funds released to research institutes in Nigeria is spent on admin expenses- payment of casual staff salaries, procurement of fuel and stationeries, maintenance of vehicles and generators, amongst other office overheads. This is the way funds released to research institutes in Nigeria are spent for several years.

With only N9.0 million spent on R&D, Nigerians should not expect any innovation from a medical research institute saddled with the responsibility of researching into communicable diseases such as malaria, human parasites etcetera; nutritional defect problems and non-communicable diseases. Why? Research and Development (R&D) is a costly and risky endeavor. That “at least N2.0 billion is required yearly for optimal medical research funding” is likely to be correct because R&D is costly. R&D is risky because the failure rate is high, and that is why investment in R&D is “an act of faith.” R&D is inevitable, if the nation is to improve existing products and procedures in the health sector.

There should be significant increase in capital expenditure to the health sector so that the policy objectives of the sector reflected in the ERGP would be achievable in the next 4 years. Besides, the FG should ensure there is accountability and transparency in the health sector and ensure that all medical workers must be paid timely and given appropriate tools to do their work. The FG must fund research institutes in line with the African Union’s Addis Ababa Plan of Action, which mandates nations to allocate1.0% of Gross Domestic Product (GDP) for research by 2020. There must be intensive R&D effort on the effective control of malaria, meningitis, cholera, typhoid, tuberculosis, and Lassa fever, while accelerating research on raw materials for the production of drugs to manage hypertension, AIDS, sickle cell anemia and others.

MA Johnson