The indirect cost of illness in Nigeria as at 2015 has been estimated at $879 billion, more than double the country’s GDP, and accounting for about 36 percent (more than one-third) of the $2.42 trillion total productivity loss across the World Health Organisation (WHO) African region, according to a recent exhaustive report on ‘The indirect cost of illness in Africa’ produced by the WHO.
The report also noted that approximately 50.9 percent of loss in lower-middle-income countries (LMIC) was borne by Nigeria, which in 2018 had a paltry health budget of N340 billion ($946m), equivalent to $5 per person when divided by the country’s 193 million population.
“Things cannot get better once you do not put money in health, the country is playing lip service with health,” Francis Faduyile, president, Nigeria Medical Association, told BusinessDay in an interview when asked about the preference of political officeholders for overseas treatment.
According to WHO, the diseases afflicting the African population are responsible for a substantial loss in health, estimated at 704,765,879 DALYs in 2015 alone.
The disability-adjusted life year (DALY) is a measure of overall disease burden expressed as the number of years lost due to ill health, disability or early death. It is calculated as the sum of the Years of Life Lost (YLL) due to premature mortality and the Years Lost due to Disability (YLD) for people living with a health condition or its consequences.
“When we strengthen our regulatory system, we will reduce the cost of illnesses in Nigeria,” said Chimezie Anyakora, chief of party, United States Pharmacopeia (USP), Nigeria.
Anyakora explained that when poor quality medicines are removed from circulation by more stringent regulation, Nigeria will spend less because money spent on poor quality medicine is wasted fund. Also when medicines are of good quality, diseases are tackled early enough to avoid complications and more spending. NAFDAC has worked very hard on this front in the past few years.
In the WHO African Region, total losses amounted to 629,603,271 DALYs. Out of that total, 416,671,978 DALYs (59.1 percent) were from communicable, maternal, perinatal and nutritional conditions; 216,073,399 DALYs (30.7 percent) were from non-communicable diseases (NCDs), and 71,551,401 DALYs (10.2 percent) were from injuries.
Five countries (the Democratic Republic of the Congo, Ethiopia, Nigeria, South Africa and the United Republic of Tanzania) accounted for almost 50 percent of the total DALYs accrued in the region. To arrive at these values, the study quantified the GDP losses associated with these DALYs. Losses are estimated for all causes of DALYs by age group, by World Bank income group classification of countries and by regional economic community (REC). The estimated GDP losses due to ill health, disability and premature death vary substantially by age and disease categories and by economic group and REC.
To reduce Nigeria’s GDP losses, Anyakora explained it is important to rely less on importation of medicines, adding, “It will be cheaper.”
In medical conditions (such as malaria and tuberculosis) where Nigeria has very bad health statistics, he suggested developing capacity to at least be able to produce medicines for these conditions. Right now, over 70 percent of our medicines are imported.
“If we produce these medicines locally, apart from solving our health issues, we will also have some economic impact locally,” said Anyakora.
The WHO, 37 percent of total losses is due to non-communicable diseases (NCDs) while 27 percent are due to infectious diseases (AIDS, tuberculosis, malaria). The other causes are neglected tropical diseases (NTDs), road traffic injuries and maternal conditions. In 2015, GDP losses due to maternal and neonatal health conditions were estimated at $45.59 and $ 347.34 billion, respectively.
Optimistically, WHO says 47 percent ($796bn) of the total cost of illness ($2.98trn) in Africa can be saved in 2030 if the health-related SDGs are achieved. This is not just for the $2.4 trillion lost by the WHO Africa region.
The study illustrates how achievement of critical health SDG targets, including universal health coverage (UHC), would contribute to poverty eradication efforts on a large scale, reduce disparities in lifespan, tackle social exclusion, and promote political stability and economic development in the WHO African Region.
