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COVID-19: Experience Should Spur Health Sector Overhaul

That pronouncement elicited expectations that the high powered committee would tap experiences so far acquired from coronavirus to make health sector overhaul a priority item on its deliberations.  The health sector has obviously suffered severe setback as a result of a seemingly deliberate policy of apathy from successive administrations in form of mindless allocations and lack of investments.
Consequently, qualitative healthcare delivery has remained elusive; hospitals are inadequate, poorly equipped and under-funded. There is also shortage of personnel to man them.

Like many African countries, Nigeria has a gnawing deficit in the area of medical doctors. Latest reports revealed that only 72,000 doctors are registered in the country and almost half of them have emigrated overseas over unfavourable working conditions. And this has resulted in local hospitals being short-changed.
From official records, it is estimated that one doctor attends to between 5,000 and 6,000 patients as opposed to a doctor/patient ratio of 1:600 recommended by the World Health Organisation for optimum healthcare. This is unacceptable. Though the COVID-19 infection rate and fatalities may appear to have been relatively low especially when compared with records from countries having over 200 million populations, but latest spike in daily reports of confirmed cases are giving ominous signs that the fears that our health system could cave in under the weight of COVID-19 held by experts including the WHO may come to pass sooner than later.

The crisis in the health sector is further accentuated by the near-collapse of the primary healthcare system. In the early 1970’s the primary and secondary healthcare centres catered for many categories of illnesses. But that was then. As things stand now, these facilities are a shadow of their old status amid high mortality and morbidity rates. Emergence of medical tourism significantly being promoted by public officers is causing outward financial haemorrhage and this is blamed on weak healthcare system in the country. The WHO ranks Nigeria as the world’s fifth worst healthcare delivery system after fragile countries like Sierra Leone, Myanmar, Central African Republic and Democratic Republic of Congo. Nigeria also has a life expectancy of 55 – the world’s lowest according to the United Nations Population Fund.

Though the African Union countries agreed in 2001 to allocate 15 per cent of their annual budgets to health, the health sector receives far less – at best an average of about 4 per cent. Nigeria’s predicament is not the absence of qualified personnel but of misplaced priority and political will by authorities in government at all levels. So what is the way forward? There is the urgent need for a holistic overhaul of the public health infrastructure to a level where it could have the capacity to prevent disease, promote health, and prepare for and respond to both acute threats and chronic health challenges.

This can be achieved by deliberate funding and strategic investment in the provision of world class hospitals equipped with latest technological tools and first rate laboratories by governments at all levels with support from the legislative branch. The Nigerian Institute of Medical Research and National Institute of Pharmaceutical Research & Development, need adequate funding to conduct researches into myriad of health problems bedevilling the society and development of drugs, biological products, and pharmaceutical raw materials from indigenous sources respectively.

We believe that investment in Active Pharmaceutical Products manufacture in the country will boost local production of essential medicines and make them readily accessible as well as affordable. Extension of grants to universities is imperative in other to boost our quest for self-sufficiency in the healthcare delivery system that meets international best practices. For total overhaul of the health sector to make meaning to governments at all levels, its implementation must be anchored on the recognition that the health of the citizenry is a civic responsibility and not a privilege.

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