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Dear President Buhari, honour the 2001 Abuja declaration and deliver a genuinely Pro-Poor 2016 Budget

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Editor: On the 19th of December 2015, we at Nigeria Health Watch joined the ONE Campaign and 24 other Non-Governmental Organisations in writing a letter to the President of the Federal Republic of Nigeria on health and the associated budget currently going through the legislature. The letter was delivered to the Presidency, the leadership of the Senate and House of Representatives and published in national dailies. We reproduce the letter in its entirety here. Pay attention to health in the budget process – your life may depend on it. 


We thank you for prioritising the needs of the poorest Nigerians and the fight against corruption in your recent proposals. Your leadership on both is timely as the start of your presidency (2015) was marked by the Country’s adoption of the new Sustainable Development Goals (SDGs). If followed through, these proposals and the new SDGs commitments will create a new Nigeria, as they will unleash opportunities that will transform our country, our continent, and the world. We are writing because we want to help you realise these goals. We believe the starting point is through bold and targeted pro-poor public investments spelt out in your 2016 budget.

Specifically, we salute you for your stated commitment to spread basic health benefits to a majority of Nigerians, because access to basic health care in the country is still the privilege of a few. Secondly, we commend your commitment to ensure that Nigeria’s wealth is shared with the poorest Nigerians and that they are given a lift through the planned social welfare program.

Basic Healthcare Provision Fund 2

Regarding the health focus, we are sure you are aware, Mr. President, that our great country, Nigeria, is amongst the worst places in the world to be a child, infant or mother. This is because one in eleven of all children who die in the world under the age 5 are Nigerian. Every year 58,000 Nigerian infants receive HIV from their mothers during childbirth – a completely preventable tragedy, for want of pills that cost a few Naira.  No country in the world, not even in South Africa with its large HIV burden, has more babies still acquiring HIV from their mothers. This is a glimpse of the situation we believe your administration has a historic opportunity to reverse, starting with the upcoming 2016 Budget, particularly by implementing the key provisions of the 2014 National Health Act (NHA).  We urge you to ensure that the Basic Health Care Provision Fund provided in the NHA (which requires 1% of the consolidated revenue fund) is provided for as NEW funding to be invested in child vaccines, expansion and upgrade of health facilities, research and human capital development to address key communicable diseases. Without these investments, the economy will continue to lose billions of Naira through Nigerians that travel abroad to access medical services, while the poor continue to die from treatable and preventable diseases.

A healthy population is truly the best insurance we can have for our economy to thrive. This was the main premise of the 2001 Africa Union “Abuja Declaration” where the leadership of the continent, right here in Abuja, committed to prioritising the development of the health sector by investing 15% of their national budget to the health sector. Rwanda, Swaziland, Ethiopia, Malawi, the Central African Republic and Togo have kept this promise. Countries such as Rwanda and Ethiopia are reaping great benefits, not only in the health of their population but also in sustained economic growth. Nigeria keeping this promise in the 2016 budget would translate to not less than N900 billion for Health, in view of the proposed N6 trillion budget.  We implore you to move the Nigerian Government in Abuja boldly towards living up to its commitment in the “Abuja Declaration”.

Who pays for Healthcare in Nigeria 2

Your Excellency, malnutrition in Nigeria remains a silent killer that must be stopped. It particularly affects mothers and children. It contributes to the deaths of about half a million children each year. In Nigeria, 36% of children younger than 5 years are stunted. Because it is a slow burner, its impact is not obvious but cumulative over generations. Nigeria, as part of the African Union in 2014, pledged to work towards reducing this number to less than 10%.   To ensure that Nigeria’s children have a fair shot at life, we also respectfully request nutrition specific investments in the 2016 health and agriculture budgets that address the stunting and wasting among Nigerian children, especially girls. The planned social welfare programmes must help achieve this objective. To ensure the potential multiplier and sustainable effects of the feeding programs, we recommend that they must be delivered through locally sourced nutritious produce which would directly boost markets for local agriculture. This approach will ensure that this expenditure is not merely consumption but spurs long term production and employment, especially of Nigeria’s small holder farmers and young people.


Mr. President, Nigerian children are waiting on you to give them proper nutrition so they can grow up healthy. Photo credit: Nigeria Health Watch

Mr. President, Nigerian children are waiting on you to give them proper nutrition so they can grow up healthy. Photo credit: Nigeria Health Watch

The success of the social welfare program pilots will need these elements and require inter-ministerial coordination managed by a senior political champion. When the world meets in Rio De Janeiro in 2016 to take stock on actions and progress in the fight against high levels of malnutrition, a successful implementation of this type of social welfare program will demonstrate Nigeria’s leadership on this pressing matter. Mental health is another area where there is an overwhelming impact on the poor, yet fewer than 10% of sufferers receiving any treatment at all.


All these urgent priorities across health, agriculture, school feeding and social safety payments must target to lift up the poorest, and be administered through accountable national and local budgets that are transparently implemented. This will help targeted beneficiaries to monitor and provide automatic feedback to improve program delivery and limit pilferage. We therefore call upon you to fully open the budget making, approval, implementation and evaluation process to the common Nigerian. Let Nigerians help you in holding your government to account on the promises that you made, and the reason that they serve. Within our current resource levels, high levels of citizen’s engagement will triple the impact of the budget.

We believe your bold leadership on these issues will catalyze and guarantee economic expansion and sustainable inclusive growth that ensures that Nigeria leads the world on SDGs progress starting in 2016.

Your Excellency, you have shown the political will to move our country forward in the pursuit of social justice, economic diversification and transparency for the benefit of each and every Nigerian. The eyes of the world are on Nigeria’s 2016 budget. We urge you to make fighting preventable diseases and malnutrition a hallmark of your legacy. A healthier Nigerian population would help our great nation leap-frog economically and socially by 2030.

Signed by: ONE campaign and:

  1. Nigeria Health Watch
  2. Rotary International District 9125 Nigeria
  3. Sustainable Healthcare International
  4. Evidence for Action Nigeria
  5. Silver Lining for the Needy Initiative (SLNI)
  6. Ummah Support Initiatives (USI)
  7. White Ribbon Alliance Nigeria (WRAN)
  8. Health Reform Foundation of Nigeria (HERFON)
  9. National Association of Nigerian Traders (NANTS)
  10. Strengthening Advocacy and Civic Engagement
  11. Public Health Foundation of Nigeria (PHFN)
  12. Civil Society Scaling-Up Nutrition in Nigeria
  13. Health Policy Research Group
  14. Nigeria Health Economics Association
  15. West African Academy of Public Health (WAAPH)
  16. Wellbeing Foundation Africa (WBFA)
  17. Glamorous Mothers Development Initiative
  18. SDGs Children
  19. Women Advocates Research and Documentation Centre
  20. Pan-African Community Initiative in Education and Health (PACIEH)
  21. Journalists Against AIDS
  22. BIIRE Child and Maternity Health Foundation
  23. Positive Action for Treatment Access (PATA)
  24. Association for the Advancement of Family Planning

25.   Global Network for Neglected Tropical Diseases, SABIN Vaccine Institute

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