On September 18, 2010, while declaring
his interest to contest in the presidential primaries of the Peoples
Democratic Party, President Goodluck Jonathan had said, “Let the word go
out that our health sector will receive maximum priority in a new
Jonathan administration, a priority that will ensure maximum health care
and stop our brain drain.”
If there was a crisis that exposed the
soft underbelly of the health sector in Nigeria, it was the outbreak of
the Ebola Virus Disease.
The
late Liberian diplomat, Mr. Patrick Sawyer, was the first case of Ebola
to be confirmed in Nigeria since its outbreak in other parts of West
Africa — Liberia, Sierra Leone and Guinea. Sawyer had arrived in Lagos
on July 20, 2014, via the Murtala Mohammed International Airport.
Some experts have noted that the lack of
preparedness of the country in dealing with infectious disease control
may have been the defining factor of the administration of Jonathan,
were it not for a stroke of good luck.
For veterinarian virologist and President
of the Nigerian Academy of Science, Prof. Oyewale Tomori, the lack of
an effective disease surveillance system in the country was one of the
areas the current government was not able to tackle; although he noted
that this problem was not only that of the Jonathan administration, but
also of previous administrations.
Seven people died of Ebola in Nigeria.
Although the World Health Organisation declared Nigeria Ebola-free in
October last year, Tomori, noted that the country still has a weak
disease surveillance system.
He said, “The case (of the Liberian) we
found was by chance and not by preparedness. We still don’t have the
system to detect diseases on time. We were lucky that the Ebola virus
came from outside the country. But for quite some time now, the Lassa
fever keeps cropping up every year and we have not done much about it.”
When contacted on the telephone, the
Director, National Centre for Disease Control, Abuja, Prof. Abdulsalami
Nasidi, said he was at a conference in Geneva, Switzerland. He said he
would respond to our correspondent later. The NCDC, an arm of the
Federal Ministry of Health, was established in 2010 to coordinate
national health responses and intervention activities to prevent and
control emergencies and outbreaks.
However, Tomori praised the current
administration for its effort in the eradication of polio from the
country. He said the country was doing something right in the fight
against the disease.
“So far, from having about 200 cases for
several years to having just one at the end of July last year is
commendable. The country has not recorded any polio case in the last 10
months. This means the Federal Government has made substantial progress.
“But, we must also recognise that there
are some parts of the country where we don’t have access to, like the
areas where there is insurgency; we might not truly know the number of
cases,” he said.
He also noted that the country, during
the Jonathan administration, made great strides in the area of
vaccination. “There have been some good measures also in the areas of
vaccines and immunisation. It has gone up a bit, but it is not really
substantial enough to be at the level WHO wants it. We are looking at 80
per cent coverage but we have not reached that yet.”
Some experts have also pointed out the
several cases of lead poisoning in some parts of the country, most
recently, in Niger State, where several children died. Tomori said this
issue should be swiftly addressed by the incoming administration. In
all, Tomori described the health sector under Jonathan’s administration
as a chequered success, especially in tackling diseases.
He said, “I won’t say this administration
has not done well, but I would give it a fair assessment. But as usual,
we could do much better than we are doing. There have been great
strides in tackling diseases, but there is still work to be done. For
example, people still find it difficult to get vaccines in the rural
areas, we need to address that.”
In the same vein, the President,
Association of Resident Doctors, Lagos University Teaching Hospital, Dr.
Ramon Moronkola, said the Jonathan administration recorded some
milestone achievements in the health sector. Moronkola pointed out the
passage of the National Health Bill and the National Health Insurance
Scheme as deserving commendation, but said the country’s health sector
still has a long way to go.
“The National Health Bill is a big plus
for the Federal Government, because it addresses some health issues such
as research and more. But I think there are still some contentious
issues in the bill, such as seeking medical treatment abroad. It’s an
area we need to look into. Nevertheless, the fact that government could
sign the bill into law is a plus for this administration,” he said.
The National Health Bill was signed into law last December by Jonathan.
Moronkola further said the National
Health Insurance Scheme was a good initiative by the current
administration, noting that the scheme had only existed on paper before
now. “Only a few Nigerians can afford out-of-pocket payment for health
services. But with the NHIS, this can be tackled. It is a plus for the
government,” he said.
However, Moronkola said there were drawbacks that needed to be addressed.
He said, “The drawback is that only very
few Nigerians have access to viable health insurance. The government,
cumulatively, has not been able to achieve 60 per cent health insurance
coverage, it is still hovering between 20 and 30 per cent. That is not
good enough for health development in the country. Our health care
system should be on a needs basis not on an affordability basis, or
Nigerians would not be able to access good health care.”
Beyond the issues in the NHIS, Ramon
noted that the inability of this present administration to effectively
address the incessant leadership crisis in the health sector was a minus
for it. In his view, the health sector would continue to experience
strikes by doctors and medical personnel if this issue was not resolved.
He said, “Generally, there has not been
serious commitment on the part of the FG to solve the leadership crisis
that has been bedeviling the health sector for a while. Government has
not come out with a clear position or policy to resolve this.”
Under Jonathan’s administration, there
have been several strikes by different health unions, with the recent
one being the three-month nationwide strike by medical doctors under the
Joint Health Sector Unions which was called off in February 2015.
In a piece published in SUNDAY PUNCH,
the Deputy Secretary, Nigerian Medical Association, Lagos chapter, Dr.
Peter Ogunnubi, noted that one of the ways the FG could have resolved
the leadership tussle in the health sector was to pass the report of the
Yayale Ahmed Presidential Committee on Intra-professional rivalry in
the health sector. “Nigerians have suffered enough and should not be
made to suffer any longer,” Ogunnubi noted.
Other experts noted that there was the
need for the next administration to invest more in the training of
health care personnel in the country.
The Director of the World Bank funded
African Centre of Excellence for Genomics of Infectious Diseases at
Redeemers University, Ogun State, Prof. Christian Happi, noted that this
was exposed by the Ebola crisis in the country.
The correct diagnosis of the Ebola virus
on the Liberian was successfully carried out in the laboratories at LUTH
and ACEGID, which was then confirmed by the WHO collaborating centre in
Dakar, Senegal.
He said, “Nigeria was able to contain
Ebola, not necessarily because we were prepared, but it was a stroke of
luck and good fortune.
“We were lucky that public hospitals were
on strike when Ebola struck, if not, our case would have been similar
to what happened in Sierra Leone and Liberia. Infection control is not
taken seriously or applied strictly in our hospitals,” Moronkola added.
In the same vein, Happi also agreed that the passage of the health bill and the NHIS were good initiatives by the FG.
Other experts pointed out the provisions
of more public health facilities for child and maternal care, as well as
the need for the incoming administration to increase the annual
budgetary allocation for health, which is still about six per cent of
the country’s annual national budget.
ARUKAINO UMUKORO
PUNCH
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