In the events leading to the appointment of a new Minister of Health by President Muhammadu Buhari as he settles down to the second tenure of his administration, key stakeholders in the healthcare sector were quick to task the government on what the agenda for the next four years should be like. In this Cover Story, PharmaTimes Editor, MORGAN NWANGUMA examines the opinions of these interest groups vis-à-vis their high expectations as held by industry experts and sector watchers alike.
Surprisingly enough, a school of thought had gone ahead to suggest that the president appoint someone who is not an expert in the healthcare sector, saying that the sector had performed better when people outside the profession were appointed to head the Ministry. The group, Assembly of Healthcare Professional Association (AHPA), added that the government should take a cue from other countries whose health sectors are faring very well. According to the Chairman of the group, Dr. Godswill Okara, this would go a long way to sustaining harmonious working relationship among the various professionals in the sector.
But as fate would have it, their wishes did not come to pass as the president had since inaugurated his cabinet which has already hit the ground running as it were. In the process Dr. Osagie Ehanire, a medical Doctor from Edo State is now the new Minister of Health. Following, health sector stakeholders have come out to task the health helmsman of the nation as he embarks on his ministerial duties.
Although the new minister is not a new comer to leadership in the Nigerian health sector in that he was the immediate past Minister of State for Health – from 2015 to 2019, working in close and harmonious relationship with Professor Isaac Adewole, the former Minister of Health. A highly experienced surgeon, Ehanire holds a medical degree from the College of Medicine, Ludwig Maximilians University of Munich, Germany. He also holds post-graduate diplomas from the teaching hospital of the University of Düsseldorf and Essen, Germany in the areas of anaesthesiology, general surgery, and orthopaedic trauma surgery. He is also author of the book ‘The severely injured limb’ edited By John Ackroyd.
But whatever be the case, AHPA has made clear what the agenda for the new health helmsman should take as priority in fostering progress and harmony in the sector, as well as general development in the health of the nation. Dr. Okara feels strongly that for the new minister to succeed well he must be a good manager of human resources through fashioning concord amongst the various health professionals in this very critical sector. He also urges the minister to consciously build harmony among all healthcare service providers so as to eradicate needless competition, mutual distrust and jealousy in the sector.
“The health sector has been very chaotic and very unstable for a while mainly because of the administrative style of the men at the helm of affairs. The ministry does not need a combative minister, but one that would administer the sector in a way as it involves multi-professionals in the sector,” Okara said.
And so in a recent development, a body of doctors under the employ of the Lagos State Government known as the Medical Guild, urged the Minister of Health to ensure improvement on the nation’s health sector while consolidating on the good works of his predecessor, Prof. Isaac Adewole. The Chairman of the Guild, Babajide Saheed made this call public while interacting with News Agency of Nigeria (NAN).
“First, the new minister should make sure he finds ways to achieve Universal Health Coverage for the country, which has only covered about five per cent of the population. “He has to make sure that the primary healthcare system is in place and functional before he goes to secondary and tertiary healthcare.
“There should be infrastructure development in terms of the secondary and tertiary level of care. “It has to be developed to the standard where qualitative healthcare will be delivered to the populace,” Mr. Saheed said.
Speaking recently, he stated that the policy on immunisation should be hands-on to enable Nigeria become completely free of preventable ailments such as polio and their recurrence. “The minister should also ensure that the new vaccine on meningitis be taken more seriously to reduce the incidence of the disease, especially in areas that were most affected,” Mr. Sheed said. He equally emphasised the need and urgency of making quality healthcare accessible to the greater majority of the populace, as well as affordable – through a functional health insurance scheme.
While calling for a National Health Summit as well as the need to bolster the role of the primary healthcare system in the country, the Chairman of the Medical Guild said, “If all these are put in place, the healthcare system of the country will be developed and it will be better off for Nigerians. “If the primary healthcare is functional, it will reduce the burden on both the secondary and tertiary levels of healthcare. “We should have specialisation at the tertiary level of care and ensure that the teaching hospitals are well developed and equipped. “Finally, the rivalry among health workers in the country should be resolved; in that way, the health system will be improved,” he stressed.
Due to its benefits and extensive effects of its services on the public, the Health ministry is usually looked at as very central to the growth and wealth of the country. But in recent years and even decades, the ministry has not entirely been devoid of rancour and incessant agitations from within. The unhealthy rivalry and frequent industrial actions have become a worrying issue that health watchers think has contributed to the disharmony in the sector. To this effect, stakeholders strongly believe it is an aspect of our health sector which the new Minister must not fail to handle dispassionately and with utmost alacrity.
It is believed therefore that failure of adequate and qualitative healthcare delivery at all tiers of the sector including the huge capital flight the country incurs due to the massive record of medical tourism abroad by Nigerians, have been mainly attributable to the elusive peace and the general low confidence in the sector. Experts lament the rather disheartening situation whereby Nigeria loses so much to medical tourism by Nigerians to foreign lands. Data shows that this activity alone gulps in the excess of $1 billion Nigerian foreign exchange annually, which is more than the entire health budget of the country in the year.
Speaking recently, Dr. Walter Ugwuocha, executive secretary, Civil Society for HIV/AIDS in Nigeria (CiSHAN) urged the new minister to make comprehensive implementation of the National Health Act a matter of urgent concern. He added that it would enable the full realisation of the much talked about Universal Health Coverage (UHC), as well as ensuring that basic healthcare services become available to those who desperately need it.
Ugwuocha called for the establishment of a National Health Trust Fund which will be a financial pool where the private sector could make contributions. Such fund he stated would be able to serve as an agency responsible for domestic resource mobilisation. “I think the new minister should ensure comprehensive implementation of the National Health Act with special emphasis on the full operationalisation of the National Primary Health Care Development Agency and making it mandatory for all states to set up operational SPHCDA. This will go a long way towards ensuring UHC and getting basic healthcare services to those who are most in need,” he said. Moving forward, stakeholders have continued to challenge the new health Minister with the urgent need to make Universal Health Coverage (UHC) a reality. In a response to this issue, Dr. Francis Faduyile, President of the Nigerian Medical Association (NMA) urged the new Minister to collaborate with the states Commissioners of Health to make the dream of quality and affordable health for all Nigerians come true. While synergising with the various state commissioners of Health the experts are in agreement that bringing UHC would become easier to attain in that both the primary and secondary healthcare delivery services are totally under the responsibility of the state governors.
Industry experts also feel that the minister should be able to look deeply into the issue of budgeting for health in the country. They suggest the minister put pressure on his colleagues in the Federal Executive Council as well as the president, towards the need to begin to forge a more meaningful budgetary allocation for the health sector. They decry the current situation whereby the country’s annual budget for health is just about a paltry 5 per cent or even below – of the total national budget whereas in 2001, at the meeting of all African Heads of Government, it was agreed that the least budget allocated to health should be 15 per cent.
On his part, a former Chairman of the Pharmaceutical Society of Nigeria (PSN) in Lagos State – Pharm. Gbenga Olubowale stated that it is expected that Dr. Ehanire will encourage Public Private Partnership (PPP) for the purpose of carrying along all stakeholders all over the country. He emphasised that the kind of personality best suited for the position is a “total healthcare person”, adding that the new man in the saddle should see himself as a Minister for Health and not a “Minister for medical doctors.” He said not having a minister that is dedicated to the overall development of the health sector is the reason behind the lack of progress to date. “We need someone who is nationalistic and is seen as a total healthcare person. It doesn’t matter who is there as long as it is in the interest of all,” Olubowale said.