Nigeria’s bid to contain and eventually eradicate some killer diseases in the country will certainly be dealt a deadly blow by the recent decision of the Global Fund to suspend its financial support. Obviously, the last thing the country’s weak and underfunded health sector needed was the sudden cessation of funding from the biggest contributor to such a noble vision.
According to the Global Fund, despite the disbursement of huge sums of money in Nigeria for the fight against HIV/AIDS, tuberculosis and malaria, the situation continues to present “challenges of grants not achieving impact targets, poor quality of health services, treatment disruptions and fraud, corruption and misuse of funds.” This is indeed saddening; it is a classic case of the squandering of goodwill. Why should a country that has irresponsibly ignored investment in the health of her citizens decide to frustrate the efforts of outsiders willing to fill the gap?
Funding remains critical to success in the war against such formidable diseases as HIV/AIDS, tuberculosis and malaria, which is exactly what the GF, a Geneva-based financial institution that renders support to countries in response to the three diseases, has been trying to provide over the years. But the agency, which has reportedly disbursed more than $1.4 billion in Nigeria since 2003, is now withholding its cash, citing lack of transparency in the disbursement by Nigerian officials. The GF alleges irregularities such as the payment of $20 million to suppliers without confirming delivery and the failure to account for $3.7 million supposedly spent on anti-retroviral drugs.
“Despite the efforts made by the secretariat, and with $800 million disbursed to the country in the last four years, major deficiencies in the internal control environment persist in the portfolio,” the fund further alleged. These are very weighty allegations that should be thoroughly investigated to ensure that those who are bringing the name of the country into disrepute and hampering progress in the health sector do not get away with their crime. Although the National Agency for the Control of AIDS has already denied any culpability in the shady disbursements, it is indeed gratifying to know that President Muhammadu Buhari has taken an interest in the matter by asking for a probe.
It is in situations such as this that the full import of Buhari’s statement, “If we don’t kill corruption, corruption will kill Nigeria,” becomes more glaring. Despite the massive funding from international donors, Nigeria has totally failed to achieve any of the targets set for the three deadly diseases claiming millions of lives globally every year.
A typical example of the GF’s claims that its grants were not “achieving impact targets” can be located in the battle to contain malaria, which has emerged as a major killer of children. Many of the mosquito-treated nets sent to Nigeria for distribution free of charge have found their way into the markets for sale to those who can afford the price.
It is not surprising that an indicting verdict from the World Health Organisation has emerged, saying, “Two countries, Nigeria and Democratic Republic of Congo, accounted for more than 35 per cent of global malaria deaths in 2015.” While Nigeria struggles, five countries, namely the United Arab Emirates, Morocco, Turkmenistan, Armenia and Maldives, have successfully eliminated malaria, while Argentina, Kyrgyzstan and Sri Lanka are in the process of being certified malaria-free by the WHO.
The situation will be even worse in the case of HIV/AIDS, where less than 750,000 patients of the 3.5 million people, said to be living with HIV in the country, have access to treatment, which is considered vital in keeping such patients healthy and reducing the spread of infection. With the obvious lack of interest from the government at all levels in funding the treatment programme, it should not be surprising if a substantial number of people further drop off from the treatment programme. Obviously, many people who cannot afford the cost of treatment will develop AIDS, the terminal stage of HIV, and die.
In the case of tuberculosis, there has been a noticeable increase in the rate of infection and death. From being mentioned among the 22 most endemic nations in the world, the country is now adjudged to have the third highest TB burden globally, next only to India and Indonesia. As usual, TB has managed to flourish in the country while the incidence globally has witnessed a drastic decline in the last 15 years.
It should however be noted that the GF incident is not the first of its kind in the country. Two years ago, Nigeria was also hit by scandal over the disbursement of funds by foreign partners for the procurement of vaccines relevant to the immunisation of children against certain killer diseases. The government had to quickly refund a sum of $2.2 million that was misappropriated to Global Alliance for Vaccines and Immunisation after it announced its decision to stop funding the programme.
The suspension of foreign donor funds is coming at a very critical time, when the price of oil, Nigeria’s main source of income, is currently depressed. This makes alternative funding for the sector very difficult in a country that over the years, has been paying lip service to health funding. This point was well noted by the philanthropist, Bill Gates, at a meeting of the World Bank/IMF in Washington, the United States, in April. He said, “In a country like Nigeria that is dependent on oil prices for such a high percentage of its budget, we can face a situation where not only are the vaccines not being given but also the primary health care as a whole not being funded.”
These are indeed cases that should be considered as crimes against humanity since the effect of the actions of these criminals will end up claiming lives. They should not only be punished, the government should ensure that all the money that has been misappropriated or outright stolen is refunded. It should also devise checks to ensure that such practices do not occur in the future. This is important as WHO says sustenance of robust financial investment, political will and innovation are the only strategies to win against these killer diseases.
