NigeriaThought Leadership

Why is no one talking about these three big challenges the Nigerian health sector is facing?

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The National Health Bill

For the second time since he became president, President Goodluck Ebele Jonathan has the chance to sign a new National Health Bill into law, which would help set the legal basis for urgently needed changes in the health sector around funding, access and delineation of responsibilities between the different tiers of government. This bill has been ten years in the making, in various forms and has been passed for the second time by both houses of the legislature in Nigeria, both controlled by the ruling party, the People’s Democratic Party. The first time the Bill came to his desk – he did nothing. He neither objected nor supported the bill … he just did nothing, until the time required for presidential assent passed and the Bill had to be sent back to the legislative arm to begin another lengthy process of deliberations.

This time, the members of the House of Representatives and the Senate have again done their bit, they have revised the bill, trying to resolve some of the concerns that have been raised by various interest groups – from health professional groups jostling for recognition to faith groups concerned about the transplantation section of the bill. Yet again, it is on the president’s desk, and, three days to the deadline for presidential assent, there is again a deafening silence from the Presidency and from opponents of the Bill.

Many people argue that there are some aspects of the bill that are imperfect, and yet they are not many coming out publicly to say what these concerns are, allowing us to have public debate around them. Many people have not even seen the revised version of the Bill (READ THE BILL HERE) and appear to be basing their opposition on earlier versions of the Bill. It is important to remember that few legislative bills are ever perfect. Most people, who have bothered to read the latest version of the Bill, agree that there is little of serious contention left.

Maintaining the chaotic status quo is just not an option. Mr President, it really is time to lead – we join millions of Nigerians in asking you to #signhealthbill and leave a legacy for 170 million Nigerians. Please if you have access to Mr President, ask him to sign the Bill. If you don’t, please read and sign this petition started by our friends from the NGO Education as a Vaccine (EVA). In most other countries, this would be a major campaign issue!

National Health Bill

The GAVI Alliance report

Since 2003, the GAVI Alliance has disbursed $356,986,321.73 Million to Nigeria to support the vaccination of our children – giving us $146,960,294.16 in 2013 alone. There are millions of Nigerian children alive today because of GAVI support. Two weeks ago, the GAVI Alliance released an extensive report that listed a series of very specific issues of fraudulent activities. For example:

“An example is the purchase of motor vehicles where third parties purchased Toyota cars from a licensed Toyota dealer and sold the same cars to NPHCDA at double the price”.

GAVI requested the Government of Nigeria to refund N2.2M and asked Nigeria’s EFCC to perform more detailed investigations of their findings. As expected, the Supervising Minister of Health, Dr. Khaliru Alhassan, released a statement calling the report “misleading” and “inaccurate”. He did not, however, respond to any of the very specific indictments in the report. A civil society organisation, Accountability for Maternal, Newborn and Child Health in Nigeria (AMHiN), has criticized the explanations made by the Minister of Health, Khaliru Alhassan, on the issue and called on the National Assembly to take its responsibilities seriously and conduct proper and comprehensive oversight of all agencies in the health sector. Yet no one seems to be taking this very seriously, not in the legislature, not in the media and not in public discussion. Quoting Professor Tomori (a widely respected Nigerian Virologist) during a recent interview;

“… our government should not just agree to pay back the money, the government should find out who misused the money, get the money back from those persons and not from public coffers. And those people should be brought before the courts to answer for the deaths of the children who did not receive the vaccines that the GAVI money would have provided“

Sadly, this is unlikely to happen.

Gavi Logo

Another strike crippling the public health sector

Earlier this year activities at all public hospitals in Nigeria were paralyzed because of a strike by doctors. This time it is workers in all the other healthcare professions organised under the aegis of the Joint Health Sector Union which has called a strike, now in its second week and again bringing all public sector hospitals to a halt. Notably absent in the reactions to the previous strike and this one is the fate of patients in all this. There is little public debate or comment about the strike, from a population, numbed by successive strikes. There appears to be an assumption that no matter the number of strikes or how long they last, patients will always come back and government will always continue to fund public hospitals. Many people made similar assumptions about NITEL and NEPA and we all know how they ended up. Our public health system has fundamental challenges and the constant industrial action by healthcare workers has not led to any improvements for the patients. Government continues to negotiate with each group, acceding to demands, only for the other group to come up with counter demands. This tax funded model is not working and something will give. Right now there is just not the courage to deal with the fundamental issues in the sector. Who will remember that the immediate past Minister of Health, Professor Chukwu, on appointment promised to reconcile all aggrieved health professional groups in Nigeria? Well, that was in 2010.

It is time that all Nigerian health professionals took a long hard look and asked a few questions: Why am I in this profession, what is my duty to my patients, and is that my first priority? Who do I need to work with? And it is time that the government and policy makers asked themselves the hard questions: What drastic changes do we need to put in place for this permanent cycles of strikes to come to an end? There is an election in February, and you would expect that this might be at the top of the presidential aspirants’ manifestos. We haven’t noticed it in any. If you have, please let us know.

Empty Beds due to Strikes in the Health Sector

(Photo: Freedom Radio Nigeria)

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