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Waiting for the promised Change in the Health Sector

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This piece is contributed by Remi Adeseun. Remi is a pharmacist and health sector entrepreneur, Chairman of Rodot Nigeria Limited (a Medical Devices/Water Technology and Healthcare Consulting Company) and Founder/President HEWS Foundation. He is an important thought leader in the Nigerian health sector.

On the eve of the change of government, the All Progressives Congress (APC), through its Policy, Research & Strategy Directorate headed by Dr. Kayode Fayemi, organised a policy dialogue chaired by the Vice-President elect Prof. Yemi Osinbajo and featuring Lord Mandelson, a key player in the UK New Labour government under Tony Blair as the Keynote Speaker, and a last minute substitute for Tony Blair. The choice of Mandelson over Blair was just as well, as it made it easier to focus on the message much more than the man.

Tony Blair with then President-elect Muhammadu Buhari and Vice-President elect Prof. Yemi Osinbajo just before the APC Policy Dialogue in May 2015. Photo Source:

Tony Blair with then President-elect Muhammadu Buhari and Vice-President elect Prof. Yemi Osinbajo just before the APC Policy Dialogue in May 2015. Photo Source:

It never ceases to surprise me how little attention we pay to the words of people we have, of our own volition, invited to counsel us. It reminds me of a recent wedding reception I chaired. While delivering the traditional admonition to the newlywed couple, I glanced at them and was bemused that they were so lost in themselves that they could not have heard a word of what I said. The audience was much worse! I could have been one of Nigeria’s many “ghost workers” for all they cared. They were lost in the chatter and merriment of the moment.

I draw an interesting parallel between Lord Mandelson’s admonition to the newly elected government-in-waiting and mine to the newly wedded couple. His first theme was about the need for the new government to be true to the words of their campaign; mine to the couple was for them to be impeccable with their words.

Sitting up after midnight prayers in the solitude of my hotel room in Abuja on my birthday recently, I randomly picked up a bunch of papers from my bag to read. The top of the sheaf was Mandelson’s speech to APC in May 2015, which I hadn’t had time to read. Very early in his speech he harped on the need for APC to ensure internal cohesion if they were to have any chance to deliver on their campaign promises to the people of Nigeria. He emphasised the importance of communication to keep the people informed, involved and inspired. He spoke about the need to demonstrably go from the rhetoric of “change” to palpable reality.

One of his ideas which I found commendable was to pick one simple example of an ailing government institution and change it to achieve desired results that are clear and uplifting to the people. He said, “If you talk in general about change, about reform, in principle everyone is in favour of it. It’s when you start reforming individual departments that suddenly there’s a thousand reasons why it shouldn’t be them. The best way to get around this is to take a specific and say we’re going to focus on this, focusing on that goal and building the team to deliver it. That’s the best way of getting the bureaucracy to move and change.”

He then gave an example from the UK’s education sector. “Take the education reform we started in the UK after Tony became prime minister,” he said, adding, “We started with one school, the one with the worst results about which it was hard to deny we should do something different. And then as we succeeded with that one school we were able to roll out the change to others. Suddenly the thousand reasons for not doing something became a good reason for doing it. So, concentrate on specifics.”

In February 2015 I moderated a Health Sector Leadership Interactive Session with then Vice Presidential Candidate Osinbajo. At a similar forum with one of the VP’s coordinators on Health on Saturday July 25, two months after the new government had come in to power, it dawned on me that there was nothing to suggest the Government has any clear strategy yet on how to galvanise the Health Sector to give Nigerians access to good quality healthcare at costs that are not catastrophic to the common man.

HFN’s Health Sector Leadership Interactive Session with Vice-Presidential Candidate Prof. Yemi Osinbajo. Photo source:

HFN’s Health Sector Leadership Interactive Session with Vice-Presidential Candidate Prof. Yemi Osinbajo. Photo source:

Government hospitals are still closed to the public arising from strikes or protests against the hospital leadership, amongst a plethora of reasons. Discordant tunes continue to emanate from the Health Sector arising from inter-professional and intra-professional “tribalism”, in which highly educated professionals seem incapable of putting the common good of the nation first but instead appear inflexibly hung on selfish interests and an “us” versus “them” parochial mentality.

Following Mandelson’s prescription is sure to yield positive dividends. The government should pick one clear example of a mal-performing public health institution, clear the “debris of deadwood” and replace with a new leadership that is competent, has antecedents of effective result-oriented leadership and is committed to showing that change is possible to provide the services for which people yearn. The government should support private sector initiatives that complement its’ efforts to provide affordable, good quality care to the people. Let the people’s money (government budget) follow the people to wherever they choose to access care, whether public or private, so long as such facilities meet defined non-discriminatory standards that are outcomes oriented.

Let this change be visible, let it be meaningful, one person and one institution at a time, ad infinitum. Surely, this cannot be too much for me to ask for as a birthday present, after shouting myself hoarse for change in the build up to the Presidential election!

God bless my country Nigeria, and her people.


P/S: Nigeria Health Watch in June hosted the Future of Health Conference to spark discussion and proffer solutions for the ongoing problems in the Nigerian health sector, in light of the elections and change in government. The videos and photographs from the Conference will begin to be disseminated from tomorrow, Wednesday, August 5th. We look forward to your feedback as you relive the experience of the conference and share the videos! Thank you for your continued support!

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