Health Minister, Dr. Osagie Ehanire and the President, Major General (retd.) Muhammadu Buhari.
In this piece, FEMI MAKINDE examines the effects of low budgetary allocations to the health sector by successive governments on the preparedness of the nation for the dreaded coronavirus
Nigerian doctors and other health workers are the frontline ‘soldiers’ leading the nation’s war against the invisible but rampaging enemy called COVID-19. The virus, which started in Wuhan, China, has killed tens of thousands of people all over the world and the death toll is increasing menacingly on a daily basis.
Although Nigeria has its share of casualties, the number of deaths recorded in some of the advanced countries like the United States of America, Italy, Spain, France and China, which is the epicentre of the virus, is far higher than Nigeria’s. The neglect in the health sector explains why there are no testing centres in many states of the federation. The lack of testing laboratories, some believe, is responsible for the relatively low number of confirmed cases of coronavirus in the country.
Another direct manifestation of this neglect is the protest by doctors treating COVID-19 patients at the University of Abuja Teaching Hospital, Gwagwalada, Abuja. The health professionals selected and trained to treat patients lamented failure of the Federal Government to pay them their allowances and many see this as insensitivity on the part of the government.
Around the world, doctors, nurses and other health workers are the ones leading in the COVID-19 war, but, while the frontline soldiers in other climes are well-motivated and equipped, Nigerian medical workers are said to be ill-motivated, poorly equipped and the working environment is poor.
These have been the hallmark of Nigerian health workers. The health sector has suffered neglect from the hands of the successive governments of a nation known as African giant, and coronavirus has come to expose the rot in the system.
The Secretary to the Government of the Federation Boss Mustapha, shocked Nigeria when he said on Thursday that he was oblivious of the massive rot in the health sector until he was appointed as the chairman, of the Presidential Task Force on COVID-19.
It is appalling that basic things such as face masks, clean water and personal protective equipment, which are taken for granted in other places, are not freely available for those facing the virus here.
But this should be expected, especially when the health sector and the education sectors are always allocated pittances in the budget year after year.
Although the President, Major General Muhammadu Buhari (retd.), when he was seeking votes, promised a change and said political officeholders would no longer be allowed to travel outside the country for medical treatment, he has, on many occasions, broken his promise and many Nigerians believe he has not gone to the United Kingdom in the past weeks just because the UK had closed its borders to visitors as a result of coronavirus.
This development made some Nigerians express happiness on social media that the Nigerian elite, including the Chief of Staff to the President, Abba Kyari, and others, who tested positive for coronavirus, were being forced to be treated in the country.
The heads of government of African Union countries, having observed neglect in health sectors of the member nations, gathered in Abuja in 2001 and agreed to set a target of allocating at least 15 per cent of their annual budgets to resuscitate the bedridden sectors in African nations.
But Nigeria, like many other AU nations, has continued to shun the implementation of the resolution. This is probably one of the reasons the popular philanthropist, Bill Gate highlighted during a Nigerian visit, in 2018, the need to invest more in the health and education sectors.
Some analysts say China has been able to overcome coronavirus, which started in the country late December 2019, to some extent because of its investment in education that brought about series of research and health sector which made its health workers to wage a successful war against the virus.
Condemning the neglect, the zonal Chairman of the Academic Staff Union of Universities, (Port Harcourt) Prof Beke Sese, told Saturday PUNCH that governments in the country had always relegated the health and education sectors in allocation of resources. He said this was why the country could not prevent the virus despite three months’ of “warning.”
He said, “There cannot be a greater lesson to learn than what the whole world, including Nigeria, is going through at this time. This has exposed the level of negligence key sectors of health and education have been suffering. These are key areas that every serious nation pays special attention to. They give special attention to these areas because of their importance to development and wellbeing of human beings.
“We have been running a country where the leaders think it is normal to travel abroad to treat common flu or fever.
The ordinary man is left to the mercy of God. This is happening because they know that the health sector is not adequately funded and the same thing is happening in the education sector. The elite send their children abroad to study and leave the public institutions to die. When you neglect these public institutions, you are already killing the future of the country.
“We are lucky in Nigeria that we have health professionals that are still working despite the poor equipment and working environment. God forbid, if we have a situation like Italy, Spain, the United States or China, it will be a great disaster.
“Budgetary allocation to health and education sectors should improve at least to the recommended percentage given by the African Union and other international bodies. But despite this bad situation, I want to commend the Lagos State Government led by Governor Babajide Sanwo-Olu; he has been doing well. I know this coronavirus will go but, if we can sustain what we are doing in the health sector now, Nigeria will be a better place for all of us.
“When the Chief of Staff to the President, Abba Kyari, tested positive, why didn’t they treat him at the Aso Rock Clinic? Despite the funds allocated to the clinic, the President doesn’t use the clinic; his chief of staff was also flown to Lagos. This is a shame.”
Former Deputy Governor of Ekiti State, Mr Abiodun Aluko, in an interview with our correspondent, stated that the health sector had continuously suffered neglect but that the pandemic should be a turning point.
Aluko said, “What is happening now shows that the health of a nation is directly proportional to the wealth of that nation. Healthy people are a prosperous people. It is evident now that we have not paid enough attention to our health sector and that is why the doctors, the nurses and others in the sector are complaining that they lack necessary equipment to protect themselves despite the inherent danger they face.
“The coronavirus has exposed us and we are now running helter-skelter. All the things we are hurriedly putting in place ought to have been there a long time ago. This should be a wake-up call to the leadership of this country. The situation is sending a strong message to the leadership of this country that the health and the education sectors should be given better attention.
“When the people are healthy, the nation will be wealthy. If we have paid adequate attention to our education and our researchers have what it takes to do serious research, they will come up with a vaccine or a cure to this virus because Nigerians are among the world’s best. But there is nothing they can do without fund, water and constant supply of electricity. This should be a lesson to us.”
Also, a former Chairman of the Nigerian Medical Association in Osun State, Dr Suraj Ogunyemi, said, “I believe people learn from experience and I expect our government to learn from the COVID-19 experience. Provision of good health care is one of the functions of a government. It is a fact that the health sector has not been well-funded for a very long time.
“The World Health Organisation and the African leaders Initiative recommended that 15 per cent of a nation’s budget should be allocated to the health sector but what do we have in Nigeria? Nigeria budgets about three per cent for health and this explains some of the challenges we are facing in the sector.
“Coronavirus gave us enough warning. It started in China late 2019 but we did not do what we were supposed to have done. If not that COVID-19 is a virus that is affecting all countries where our leaders run to for treatment, they would have gone and we would not have seen even the efforts they are making now.
“Our leaders who travel outside (the country) to treat ordinary headache would have gone abroad for treatment but they cannot travel now so we are in it together.”
The National Publicity Secretary of the NMA, Dr Obitade Obimakinde, said it was no longer new that the health sector was grossly underfunded. He, however, said the current pandemic should serve as a turning point to make the government pay special attention to this critical sector.
The NMA spokesperson said, “The current situation offers a good opportunity to learn and begin to do things differently but, if the government fails to learn to adequately fund the sector after the COVID-19 episode, then I don’t think they will ever learn.
“Persistently, our budgetary allocation to health sector has been so low; it is not even up to five per cent of the total budget.
African heads of state came together in 2001 and came up with the Abuja Declaration. They agreed that about 15 per cent of the budget of each member of the African Union should be allocated to its health sector but we have not implemented this.
“The poor funding of the sector has shown in our level of preparedness for the war against COVID-19. You can hardly count up to 100 functioning ventilators in the whole of Nigeria, which has a population of more than 200 million people. It is not that ventilators are costlier than what we can buy but this is because we do not place priority on the health sector as a nation.
They are part of what we should have to manage patients in hospitals with intensive care units.
“The NMA is engaging the government now and it seems as though they are cooperating. We want to use this opportunity to push for better funding of the sector. The hazard allowance of doctors, pharmacists, nurses and others is just N5,000 per month, despite the risk. These are some of the things we are looking at and we pray government won’t turn a deaf ear after COVID-19 is over.”
He commended individuals and private organisations for rising up to donate to the sector to make the response to the pandemic better.
“They should not make this a one-off thing,” he added.