Health contribution to Nigeria’s GDP put at 5 percent

As the National Bureau of Statistics (NBS) is set to release results of Nigeria’s rebased Gross Domestic Product (GDP) statistics on April 6, 2014, experts have put the health sector’s contribution to GDP at 5 percent.

While the health sector’s contribution to the GDP for oil producing countries like Iran is put at about 4.3 percent, the sector’s contribution to GDP in South Africa is 8.5 percent, South-East Asia typified by Singapore (8.5 percent), India (5 percent), Mexico (6.7 percent) and Brazil (8.9 percent).

The GDP increase is expected to be dramatic at a gross level, but less so at per capita, which is a more accurate representation of the ‘purchasing power’ of the individual citizen.

Nigeria’s GDP in 2012 was $262.5 billion, making it number 37 in the world. South Africa was number 29 with GDP of $384.3 bn, Argentina (number 26 – GDP $477 bn), Austria (number 27 – GDP $394,458 bn), Thailand (number 28 – $385.6 bn) and United Arab Emirates (number 30 – GDP $384.6 bn).

Femi Olugbile, permanent secretary, Lagos State Ministry of Health disclosed that by comparison,the GDP per capita for the same period by the International Monetary Fund (IMF) placed Nigeria at position 143 with a GDP per capita of $2,697 (by comparison South Africa in position 83, Thailand in position 92, and Austria in position 11.

Olugbile explained that the business of Healthcare (both in terms of internationally sellable services and manufacture of equipment and consumables) is very well established in South Africa, Thailand, and increasingly so in the UAE, while Nigeria falls far short.

According to Olugbile “All the countries have a relatively easier climate for Healthcaremanufacturing than Nigeria (the infrastructure – power, ease of doing business is better in all the countries, except – perhaps Iran.)

There is virtually no manufacture of major health equipment in Nigeria. There is a very low level of manufacture of consumables, and an even lower level of manufacture of major drugs. It is more difficult to manufacture these items in Nigeria than any of its peers. It is a challenge that must be specifically tackled and surmounted.”

Lending his view, Ladi Awosika, managing director, Total Health Trust Ltd, a Health Maintenance Organisation (HMO) told BusinessDay that there are proper guidelines, along with an institutional thrust to encourage ease of doing business for healthcare manufacturers in the aforementioned countries, compared to Nigeria.

Awosika lamented that manufacturing in Nigeria is fraught with many issues beyond the control of the investor, such as power, tariffs, guarantees, rule of law, absence of medium to long-term conditionalties to mention a few.

In the area of financing model for healthcare manufacture, BusinessDay investigations show that in major countries across the globe, financing healthcare manufacture is private sector driven, with strategic support by government in the form of land allocation, easier taxation etc. with the potential impact on the economy being huge if healthcare is properly financed and structured.

Healthcare experts have lamented the current impact of medical tourism on the Nigerian economy, following huge outflow of foreign exchange to other countries for medical interventions that should be available locally.

They added that if Nigeria could attend domestically to its high-end medical needs,   medical tourism would have made a massive boost to the economy and morale of  the medical community.

“This will be achieved not by building huge government-owned white-elephant ‘centres of excellence’, or even pumping an inordinate amount of resources into bloated ‘Teaching Hospitals’ but by the government providing encouragement to the private sector to set up high-quality, efficiently run, internationally accredited medical facilities (on the model of the JCI-accredited Lagoon Hospital in Lagos.

“ The private sector should be encouraged to see Healthcare as a proper area for investment. The possibility of setting up a special bank to fund Healthcare should be considered and facilitated by government,” Olugbile said.

Awosika’s position is that, “Curbing medical tourism would not happen overnight. It requires deliberate planning and implementation. India decided to encourage PPP in health by providing land to the private sector in return for building large hospitals and innovation for affordable/free healthcare to disadvantaged populations.

“Saudi Arabia is building 100 new modern hospitals that would henceforth provide world-class services such that the state would no longer fund overseas medical care for citizens. We have the health human resources that migrated abroad. They need to be attracted back with the right facilities and working environment that guarantee professional satisfaction.”

Presently, Nigeria ranks very low in global terms on healthcare delivery, with quality availability and accessibility used as benchmark to measure excellence in healthcare service. There is presently only one hospital in Nigeria that is accredited by the Joint Commission International (JCI)-meaning its operation is of international standard.

The determining factor is not just high-tech equipment like Magnetic Resonance Imaging (MRI) and linear accelerators which occupy the attention of government, but standardised processes,procedures, protocols, and outcome measurements, comparable with what is obtainable in the best centres in the world.

Paradoxically, Nigeria probably has more highly trained medical personnel – especially doctors than for any country in Africa. Most of these people are practising in the diaspora and would be happy to return if the practice ambience could be made conducive.

The latest report by the United Nations Children Fund (UNICEF) reveals that every single day, Nigeria loses about 2,300 under-five year olds and 145 women of childbearing age. This makes the country the second largest contributor to the under–five and maternal mortality rate in the world.

Underneath the statistics lies the pain of human tragedy-for thousands of families who lose their children (under-five category) from preventable childhood diseases. Even more devastating is the knowledge that essential interventions reaching women and babies on time would have averted most of these deaths, according to recent research.

 Alexander Chiejina