COVID-19 and the Healthcare Sector in Nigeria: A Wakeup Call
Health is one of the most crucial sectors that drive the economy of any country. Developed countries with solid economies are known for making robust public health policies that propel the delivery of measurable health care to their citizens. Prioritizing health policy has helped developed economies cater to their citizens’ well-being, effectively. It has also made it easy for them to monitor and control the recent pandemic outbreak in their countries.
The COVID-19 pandemic has posed a few challenges for Nigeria’s health system and also emphasized its weaknesses, across the board. In the beginning of the pandemic, Nigeria witnessed COVID-19 ravage other parts of the world, expecting that it would only be a matter of time before it found its way to their doorstep. However, despite Nigeria’s expectations, COVID-19 still managed to take the country by surprise when it finally came.
In fairness, the country was able to trace its index case to an Italian expatriate who arrived by air on the 24th of March, 2020 and apparently brought the virus not only to Lagos State where he landed, but also to neighboring Ogun State. Four weeks later, Nigeria recorded 1,337 cases, with 40 of them dead and 255 discharged from the hospital.
Taking a deep dive into the health sector, in 2001 member countries of the African Union met and pledged at the ‘Abuja declaration’ to set a target of allocating at least 15% of their annual budget to improve the health sector. However, 19 years down the line, Nigeria currently spends less than 5% of its budget on health. In fact, a revised budget in June 2020 proposed a backdrop of Nigeria’s National Assembly, initial budgeting of ₦37bn for its assembly renovations, cut down to ₦27bn. This backdrop passed into law would still see funding for local, primary healthcare services cut by more than 40%. This would also go on to affect immunizations, childcare, maternal healthcare and family planning services.
The lack of adequate funding has a multiplier effect on the number of health facilities across the board and inadequate modern equipment in the existing facilities. The health workers on ground are deprived of adequate welfare packages thus leading to a substantial proportion of brain drain of homegrown health professionals. The Elites and a substantial proportion of the middle class (prior to the current pandemic) resorted to medical tourism in Europe, USA and India. A large portion of the rest of the populace who lack the capacity for foreign health treatments settle for self-medication and traditional medicine for their health needs. This past 7-month drought and inaccessibility to medical tourism is therefore a wakeup call to the appropriate tiers of government in Nigeria to invest hugely in the health sector by ensuring that adequate health infrastructures are put in place, coupled with attractive welfare packages for health workers across board.
In recent years, the country has faced similar global health crises, addressing both Ebola and polio disease. Authors of a paper published October 9, 2014, in Eurosurveillance attribute Nigeria’s success in “avoiding a far worse scenario” to its “quick and forceful” response. The authors point to three key elements in the country’s attack: Fast and thorough tracing of all potential contacts, ongoing monitoring of all of these contacts, and rapid isolation of potentially infectious contacts. The swift battle was won not only with vigilant disinfecting, port-of-entry screening and rapid isolation but also with boot leather and lots of in-person follow-up visits, completing 18,500 of them to find any new cases of Ebola among a total of 989 identified contacts. Similar to Nigeria’s approach in addressing ebola, the polio eradication initiative has been carried out from door-to-door in major cities and towns across the country successfully breaking through some initial skepticism birthed from primordial cultural and religious beliefs. This expedition with the outbreak of the Ebola epidemic and the eradication of polio has shown that given the right atmosphere, the Nigeria health sector could tackle arising health challenges.
The current approach towards the Coronavirus pandemic, is a wake-up call for the Nigerian health sector to be properly positioned to cater to the teeming population of the country. The reality of the ongoing pandemic is that all Nigerians, both highly and lowly placed will only benefit if the Nigerian health sector is properly positioned to cater to all cadres of healthcare. Working towards sustainable homegrown health services, the Federal Government of Nigeria can provide an enabling environment for medical research that would include local input by enhancing a collaboration between orthodox and traditional herbal medicines. The time is ripe for the Department of Traditional Complementary and Alternative Medicine, in the Federal Ministry of Health, to partner with the National Institute of Pharmaceutical Research and develop vaccines, curative medicines and relative antidotes to diseases.
Like many other crises, the current pandemic will not only leave a trace on how we interact with our environment, but with each other. This pandemic will add to the factors which are bringing developing countries, Nigeria in this case, closer to the self-determination of their development track and the choice of the most suitable policies and partners to accompany them. It will not be a drastic, but rather an evolving, change.