Thought Leadership

#PreventEpidemicsNaija: Funding streams for a stronger Nigerian response to epidemics

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By Aloysius Ugwu and Olubunmi Oyebanji (Lead Writers)

The #PreventEpidemicsNaija dialogue seeks to set the pace for increased dialogue across all levels of government and private sector to create partnerships, synergy and collaboration to finance investments that will strengthen Nigeria’s epidemic preparedness and response capacity for public health emergencies. Funding drives improvements in healthcare systems and help countries inch closer to achieving Universal Health Coverage.
Epidemic preparedness is the development of national, intermediate and community response level public health emergency response plans for relevant hazards, according to the World Health Organization. Other components of preparedness include mapping potential hazards and hazard sites, identifying available resources, developing appropriate national stockpiles of resources and building capacity to support operations at the intermediate and community response levels during a public health emergency.
The coronavirus pandemic is first a public health emergency. However the socioeconomic effects cannot be ignored and the impact of increased funding to mitigate both health system and economic disruptions were the points of discussion at the #PreventEpidemicsNaija webinar held on June 3, 2020, and powered by Nigeria Health Watch.
The second #PreventEpidemicsNaija media webinar series held on June 3 2020, with the theme, “COVID-19 Funding Streams”. The webinar focused on identifying and reviewing different COVID-19 funding streams and using lessons learnt to prepare for future epidemics in Nigeria. Speakers at the webinar were Zouera Youssoufou, Managing Director and Chief Executive Officer, Aliko Dangote Foundation (ADF), and Her Excellency Dr. Zainab Shinkafi-Bagudu, Founder/CEO of Medicaid Radio-Diagnostics Centre and Medicaid Cancer Foundation and wife of the governor of Kebbi State. The webinar was moderated by Dr. Ifeanyi M. Nsofor, the #PreventEpidemicsNaija project director.
The Aliko Dangote Foundation is one of the largest foundations in Sub-Saharan Africa and has a mission to enhance opportunities for social change through strategic investments that improve health and wellbeing, promote quality education, and broaden economic empowerment opportunities.

Medicaid is a Radio-Diagnostic Centre established to rectify the paucity of scarce diagnostic tools in Nigeria. The centre provides Magnetic Resonance Imaging (MRI), Computed Tomography (CT) scan, Endoscopy, Mammogram, Echocardiology, and Digital Fluoroscopy among other services. A branch of Medicaid — The Medicaid Cancer Foundation (MCF) was created as a vehicle by Medicaid to support cancer patients, promote cancer awareness and drive community cancer campaigns for underserved populations in Nigeria.
Dr. Shinkafi-Bagudu stated in her opening comments that the Covid-19 pandemic took the country unawares. Nigeria had an approved budget from the Federal Ministry of Health for preparedness and responsiveness to epidemics for Lassa fever and other ravaging epidemics, but this budget apparently did not consider emerging disease outbreaks. According to Dr. Shinkafi-Bagudu, allocation for epidemic preparedness is grossly inadequate and is given less consideration at the state and primary healthcare levels where Personal Protective Equipment (PPE) and testing are ultimately required. One funding stream that she felt was incredibly relevant for the Nigerian health sector is health insurance. She stressed that out-of-pocket expenditure in Nigeria is high and must be reduced to the barest minimum or eliminated entirely.

Image credit: Nigeria Health Watch

Zouera Youssoufou said that the Aliko Dangote Foundation (ADF) learned from its efforts during the Ebola crisis to prepare for the COVID-19 epidemic. During Ebola, the ADF supported and strengthened ports of entry and ensured proper screening of travelers. The Foundation also installed thermal cameras in international airports in Nigeria and these have been maintained till date. The Foundation also supported the implementation of the NCDC incidence action plan with the sum of NGN 200 million, she said.
At the onset of the COVID-19 pandemic, ADF brought together private sector organisations to deploy a collaborative intervention for COVID-19, which gave birth to CACOVID — Private Sector Coalition Against Covid-19. CACOVID raised NGN 30 billion. The ADF contributed NGN 2 billion into this pool, Youssoufou said. The funds were focused on three deliverables:

  1. Increasing COVID-19 testing
  2. Setting up isolation centers across the country
  3. Making palliatives available across the country, targeting 10 million Nigerians

Dr. Shinkafi-Bagudu said that prior to the pandemic, Kebbi State had set up a functional Public Health Emergency Operations Centre (EOC) with personnel trained by the Nigeria Centre for Disease Control (NCDC). Also, she said the State had reasonably equipped hospitals to deliver health services. For Dr. Shinkafi-Bagudu, the Nigerian health sector has received increased funding and donations in response to COVID-19, more than has been received for epidemic preparedness in the past few years. She said epidemic preparedness requires both public-private collaborations and a public-public collaborations. For instance, she emphasized for a strong collaboration between the National Emergency Management Agency (NEMA) and NCDC..
Zouera Youssoufou stated that in addition to ADF contributions to CACOVID, the Foundation supported Kano State by mobilising and deploying a laboratory that can perform 1,000 tests daily. Health workers were trained, and the Foundation is currently working with the Nigeria Governors Forum to deploy trained health workers to states with high priority needs. The Foundation committed to pay allowances and transportation stipends to health workers while the state government will provide accommodation.

Image credit: Nigeria Health Watch

In response to the COVID-19 pandemic, Dr. Shinkafi-Bagudu said Medicaid Foundation supported cancer patients by providing necessary information and awareness on the prevention of COVID-19. This is due to the impact of cancers on survival of COVID-19 patients. Also, the Foundation distributed palliatives, most of which came as donations, and trained local women in the production of fabric face masks. She mentioned that some of these interventions were done under the auspices of the Nigeria Northern Governors Wives Forum. 
The emergence of COVID-19 has exposed the weak healthcare system that Nigeria grapples with, including poor funding for epidemic preparedness. However, this is also an opportunity to rebuild Nigeria’s health system. Government should ensure that COVID-19 funds are well managed to reopen the economy. Also, lessons learned from responding to COVID-19 should be used to develop a sustainable funding model for epidemic preparedness across all levels of governance in Nigeria.
Funding epidemic preparedness is no longer an option. It is a necessity. COVID-19 has shown epidemics do happen and can take nations unaware. Public and private sector stakeholders must collaborate to ensure funds are available to protect the health of Nigerians. It is the right thing to do.
Does your state have a line item for epidemic preparedness in its budget? What other ways can epidemic preparedness be funded? Share with us on our social media platforms, @nighealthwatch on Twitter, and @nigeriahealthwatch on Facebook and Instagram.

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