Newly-sworn in as Coordinating Minister of Health and Social Welfare, Mohammed Pate, has set himself the challenge of revamping the battered health sector and improving the lives of Nigerians. Pledging upgrades across the health sector and to “actualise the vision and mandate of President Bola Tinubu,” he sounded upbeat in an otherwise gloomy environment. With the health care delivery system in crisis, Pate, the Minister of State, Tunji Alausa, and Tinubu will need to work very hard to reverse the country’s health care woes.
Health care facilities at every level are inadequate, ill-equipped, ill-staffed, and under-funded. Infrastructure is in a shambles. Described by the US National Institutes of Health as “poorly developed,” Nigeria’s healthcare industry, adds the International Trade Administration, has some of the worst healthcare indicators in Africa.
Citing poor remuneration, lack of equipment and filthy work environment, medical professionals are fleeing in droves. Of the over 80,000 doctors registered by the Medical and Dental Council of Nigeria by 2021, over half had left to practise abroad, said the Nigerian Medical Association. A 2017 survey revealed that 88 per cent of Nigerian doctors were seeking to work abroad.
By 2019, said the Pharmaceutical Society of Nigeria, over 5,000 of the 30,000 pharmacists registered in the country had left for better prospects abroad. One pharmacist serves 13,853 Nigerians stated the Pharmaceutical Council of Nigeria. The National Association of Nigerian Nurses and Midwives reported that in the six years to 2022, over 57,000 nursing professionals also moved abroad.
While the WHO recommends one doctor to 600 persons, Nigeria’s doctor-to-population ratio is 1:4,000-5,000.
Lacking quality medical care at home, many seek treatment abroad, and not the just the affluent. Even for poorer families, raising money for overseas treatment is often the difference between living and dying. The Federal Government in 2022 estimated spending on medical tourism at between $1.2 billion and $1.6 billion annually.
Meanwhile, the country contributes 34 per cent to total global maternal deaths. One in 22 women is likely to die in pregnancy or during delivery, compared to one in 4,900 in the developed world, says the WHO. In 2019, Nigeria overtook India as the highest contributor to global under-five deaths with 858,000 against India’s 824,000 deaths.
Additionally, Nigeria houses the second highest number of poor people in the world, which makes treatment very expensive and unaffordable for many simply because most drugs are imported. Drugs will cost even more as the naira further loses value, and domestic drug manufacturers, hit by higher costs, struggle to stay afloat.
Instead of successive governments – federal and state – to solve the problem, leaders jet out frequently for their own health care at public expense.
Pate has a rich international exposure and was junior minister for health 2011 to 2013; he should deploy his knowledge and with Tinubu’s backing, cleanse the national healthcare system through an integrated and multi-prong approach.
Funding is critical. Only five per cent of the federal budget was allocated to health in 2021 though Nigeria had pledged 15 per cent as part of the 2001 Abuja Declaration.
There should an emergency programme to upgrade at least six federal tertiary hospitals spread across the regions to international standards within the next three years, and several more subsequently. The WHO says Nigeria needs 237,000 doctors; efforts should therefore be made to encourage the 35,000 in the country to remain, lure back many who have left and train more doctors without sacrificing quality.
There should be sustained investment by the three tiers of government – from the training of professionals to the retention of their services through adequate remuneration – and provision, upgrade, and maintenance of infrastructure.
Pate should revert to primary health care delivery and community-based health services as the fulcrum of the national healthcare system. He needs to work with the states and local governments. Like Cuba, Nigeria should build from bottom up, with PHC taking precedence.
He should also ensure that Nigeria’s resumes vaccine production, upgrade the National Health Insurance Scheme and strengthen the regulatory bodies.
One of the few well-regarded technocrats in the Tinubu cabinet, Pate should not fail Nigerians.
