Since the outbreak of the novel coronavirus, Nigeria’s leaders including President Muhammadu Buhari, have cut back on frequent medical trips abroad as years of underfunding the health sector comes back to haunt everyone.
Buhari who spent nearly six months away on medical treatments abroad in his first tenure has continued the tradition of poorly funding the health sector allocating a paltry N427.3billion of the N10.59trillion 2020 budget to health.
Politicians who get into office promising to fix the broken health system fly themselves and their families abroad for qualitative healthcare leaving the sector worse than they met it.
With the coronavirus now, there are better chances that a trip abroad at this time may likely result in contracting an infection.
In any case, Western countries have shut their borders to international flights as their healthcare systems are ravaged by coronavirus.
In its 2020, budget, the federal government is spending N2,000 provide for the healthcare of each of the estimated 200 million Nigerian according to the N427.3 billion proposed for healthcare.
To put this in proper context, this miserable sum includes the salaries of all health workers in the Ministry of Health, cost of running government hospitals and the provision of drugs, vaccines and medical equipment.
Yet this is a country where about 20 percent of all global maternal deaths happen, where over 700,000 Nigerians live with HIV, and millions are treated yearly for malaria. It is also battling yellow fever, Lassa fever, polio, and coronavirus.
Though Nigeria churns out about 3,000 doctors yearly, many leave the country for better opportunities abroad after completing their studies. Of the 72,000 doctors on Nigeria’s medical roll, less than 42,000 are practising in the country according to the Medical and Dental Association.
Doctors in government hospitals are paid N5,000 as hazard allowance indicating that each time, they don scrubs to attend to a patient with highly infectious disease, they are engaging in extreme sports.
The pathetic state of healthcare in Nigeria has sometimes turned public hospitals into vectors for infectious diseases.
Many now rely on faith healing and experimenting with unregulated, sometimes virulent herbal remedies.
Analysts at a recent healthcare conference in Lagos said the parlous state of healthcare financing demands a state of emergency.
The Federal Government has been unable to meet the agreed 15 percent budget threshold in the Abuja declaration and states even spend less.
For example, 8 percent of the Lagos state budget goes to the health sector but the commissioner confirmed that drawdown is often around 50 percent at the conference.
This is replicated both at the Federal and State levels in Nigeria. Primary healthcare is virtually non-existent as people visit tertiary hospitals to treat common allergies.
“We need to start thinking of unconventional solutions,” says Ola Brown, CEO of Flying Doctors who renders evacuation services for business executives from Nigeria to foreign hospitals.
Brown proposed compulsory charges on phone recharges or entering into negotiations with foreign countries that attract Nigeria’s crop of doctors to earn revenues which could be pooled into a health insurance fund.
This kind of proposals indicate that analysts are already at their wit’s end in trying to resolve Nigeria’s complicated healthcare financing challenges.
The US per capita spending on health is around $10,000 while Nigeria spends only $6. Nigeria’s health budget for 250 years is what the NHIS spends yearly to maintain the health of 65 million people in the United Kingdom.
While Nigeria’s budget is small in comparison to its peers, it also spends even less on health. For example, in South Africa’s R1.95trillion (N42.9 trillion) 2020 budget, it is spending R200bn (N4.4trillion) or 10 percent of its budget on the health sector.
What complicates Nigeria’s situation is that while it struggles to pay for essential needs, it manages to find resources for frivolities including budgeting an outrageous N450bn to pay for subsidies in 2020.
Last year, estimates show that within the first 9 months in the year, it spends over N700billion in under-recoveries (fuel subsidies) a figure greater than its budget for health and education sectors.
This situation has led to a huge dependence on aids and international grants to fund Nigeria’s healthcare. In 2018, the United States Aids Agency (USAID) spent about $510million (N183billion) supporting various health care projects in Nigeria.