During his campaigns to seek election in 2015, President Muhammadu Buhari made a lot of promises. Among those promises was the revamping and equipping of the country’s health system. He noted that most of the nation’s hospitals, including teaching and other specialist hospitals, had become mere consulting clinics.
On May 29, 2015, in his inaugural speech, President Buhari had vowed to end medical tourism and to revamp the nation’s health sector. If he failed in doing so in his first term, he had no reason to neglect the health sector in his second term.
But no sooner had he assumed office and power than he started looking away from the health sector. Buhari practically abandoned the country’s health system altogether.
The President, who spoke vehemently against medical tourism became the first to incessantly embark on that.
It took the intervention of the First Lady, Aisha, to get the government attend to the crisis at the Aso Rock Clinic.
The First Lady had decried the state of the clinic, saying that not even paracetamol was available in the clinic despite all the budgetary allocations to it.
Now, that rainy day appears to have come and the rains are drumming and pelting on every roof including the Aso Rock roof. Everybody is being beaten by the rain and it does seem the big and the mighty are taking the beating more.
Exposed by sudden pandemic
The COVID-19 (Coronavirus) pandemic spreading in Nigeria with rapid speed has posed a grim reality to the Nigerian leaders as the virus attacked members of the Nigerian political elite in recent days amid the poor medical system in the country. As of Friday March 27, confirmed cases have hit over 65 and still counting.
In ordinary times, the pass time of the elite is to catch the next available flight to treat even headache in foreign hospitals but now that COVID-19 has forced developed nations to impose travel restrictions into their countries, it appears quite logical the leaders would look inwards in order to revamp the long-neglected health sector.
But there are doubts as to the ability of the leaders to revamp the sector even as the virus appears furious in the way it infected the Nigerian rich and powerful in recent days.
On Tuesday March 24, the nation was jolted with the news that the Chief of Staff to President Muhammadu Buhari, Abba Kyari, contracted the deadly virus. Kyari visited Germany, where he was said to have contracted the virus.
Fear was rife that President Buhari may have been infected but some relief came later when it emerged he tested negative. Yet the tension intensified when three of Kyari’s staff also tested positive coupled with the sad news that came from Bauchi state on Tuesday that the state governor, Bala Mohammed had contracted the virus too.
Prior to these developments former Vice President, Atiku Abubakar had announced that his son Mohammed, tested positive to the virus and is currently on self-isolation at a facility in Abuja.
Nigeria has however, recorded one death from the virus when former Managing Director of the Petroleum Products Marketing Company (PPMC), Suleiman Achimugu, died of the virus in Abuja. Achimugu visited United Kingdom, where contracted the disease.
Very many people both prominent and non prominent have allegedly mingled with Kyari, Mohammed Atiku, Achimugu and their families, allies and staff, increasing the risk of spreading the highly contagious pandemic, which officially confirmed cases in Nigeria hit nearly 60 as of Thursday morning.
Although the Ministry of Health and the Nigerian Center for Disease Control (NCDC) have rolled out measures to contain the virus, many Nigerians have expressed fears and doubts over the capacity of the health facilities to contain increasing number of cases as some of the centers designated to tackle the scourge are said to lack basic testing tools and are also overstretched.
The grim reality is that the nation is in a health emergency in the face of poor facilities following successive years of neglect and lack of investment in the health sector by governments at all levels.
Consistent neglect of health sector
In the past five years, budgetary allocations to the health sector have been very abysmal. In his address to the National Assembly on the 2020 budget, President Buhari said his administration is interested in improving the health sector, stressing that was a major reason for the increase in value-added tax (VAT) rate draft as communicated through the Finance Bill, from 5% to 7.5%.
“As such, the 2020 Appropriation Bill is based on this new VAT rate. The additional revenues will be used to fund health, education and infrastructure programmes. As the States and Local Governments are allocated 85% of all VAT revenues, we expect to see greater quality and efficiency in their spending in these areas as well,” Buhari said.
In the 2020 budget of N10.59 trillion, allocation for the healthcare sector is N440.73 billion, approximately 4.16% of the total budget compared to the approved 2019 budget. It increased by 3.94% from N424.03 billion. Experts however, said that despite the marginal increase, Nigeria in the last 10 years is said to be unable to meet the April 2001 African Union declaration which states that 15% of a country’s budget should be allocated to the healthcare sector.
However, even the 2020 budget which was based on oil-benchmark of $57 per liter at 2.2 million daily production estimates has suffered serious setbacks as the pandemic continues to wreck havoc on the global economy.
Nigeria’s main source of foreign exchange-crude oil prices are falling below $30 per barrel compounded by a depleted Excess Crude Account and the rampaging failure to meet production estimates as many nations have stopped buying Nigeria’s oil. The budget will definitely be scaled down meaning that any hope of more funds for health is not feasible now.
Speaking on one of the television stations, Special Adviser (Media) to former President Goodluck Jonathan, Ruben Abati, said it was an opportunity for Nigerian leaders to think home and revamp the health and avert this dangerous trend. He said: “Now that the leaders are being affected, they are all here with us, we are all in it together. The failure of the Nigerian leadership to provide infrastructure has now shown all of us that even when our leaders are sick in certain circumstances, they will also be victims of the circumstances they have created by their own negligence.”
He added that the developed countries are overstretched and would not take anybody from Nigeria. He said the lesson from the crisis is that “there is no place like home. If we develop our home then perhaps we are safer”.
President of the Association of Resident Doctors in FCT, Roland Aigbovo, also reacted in a not too optimistic fashion. He told BDSUNDAY that the current government has failed the country.
“I don’t think anything will change because the President of Nigeria spent months in the UK where he saw the level of facilities that kept him alive all through and ever since he came back, he has not put in anything, he has not shown efforts even if is to replicate just one facility to have a semblance of what he is using in the UK. Every now and then he jets out to London, which means he does not even care.
“If the number person in his country does not have that mindset on how to improve the health system, who else is going to do that? His own situation was a near death experience and what we have now is a similar thing. If not that the borders and international airports of foreign countries were shut down by now many of these big wigs that have tested positive would have left the country to seek care outside. But unfortunately they cannot leave.
“Series of agitations and appeals to the Federal Government have fallen on deaf ears even in the states. First and foremost the primary health care system is non-existent. Secondly calls for the improvement of our health systems vis-à-vis improved facilities and even manpower have also fallen on deaf ears.
“Now we have a situation where nobody, no matter highly placed, you cannot leave the country to another country to seek medical care. So, if the condition becomes so bad we will have to make do with what we have and if that cannot keep you alive then you answer the clarion call. So, all of us are in a fix,” he said.
He recalled that “We had the Ebola crisis; we were able to curtail it but what happened after Ebola, everybody went back to sleep. The President came back from London and we expected that he would fix even if it is the State House Clinic or at least one hospital in every geopolitical zone with facility that has a semblance of what he is obtaining over there. But he did not do that.”
A Public Affairs analyst, Katch Ononuju, blamed the current crisis on President Buhari’s alleged neglect of the health sector in the last five years.
“Buhari has been there for the past five years and he has not equipped even the Aso Rock Clinic. He has been going to London for medical care but since he heard about this Coronavirus, he has stopped traveling. We are all in this mess together, this is sad,” he said.
Another public affairs analyst and a civil society advocate, Ezenwa Nwagu, who is the Chairman of Partners for Democratic Change, stated that now that the pandemic affects the rich and powerful, they will pay attention to it just the way Ebola was handled. He however, tasked Nigerians not to recriminate and sow doubts, stressing that the virus can be tackled as it is not a death sentence.
“Now that it has affected the Chief of Staff, Atiku’s son and others, everybody will be mobilised to make sure the pandemic is ended.
“We need to create emergency situation because we truly have emergency. We should not politicise this because it has no political coloration, neither does it have tribal marks.
“The first thing is to mobilise the citizens to understand that personal precautionary measure is the first step in addressing this emergency. To outsource that to government is to surrender your destiny to an outside influence,” he said.
Coronavirus, which broke out last year from Wuhan in the Hubei province of China spread quickly to other parts of the world. It has killed nearly 15,000 people as confirmed cases his hit over 300,000.
Paying the price of negligence
As much as Coronavirus (Covid-19) is something anybody should not wish even for his enemy, the pandemic has unraveled the world in ways people never expected.
It has also exposed the many lies and insincerity of leaders in Nigeria. Before now, all political leaders used to run to Europe and United States of America for medical attention even when the case can be handled at home. Beyond status symbol, they travel for medical care because of lack of adequate healthcare facilities in the country.
According to Price Waterhouse Coopers 2016 report, Nigerians spend $1 billion annually on medical tourism with 60 percent of it on four key specialties; oncology, orthopedics, nephrology and cardiology.
Sadly, successive governments in Nigeria have always budgeted huge sum of money for the ministry of health with little or no impact on the sector.
Again, Aso Rock Clinic has gulped N9.17 billion in four years, with government spending more on State House Clinic than on all federal teaching hospitals.
Martins Aligwe, a public heath analyst and lecturer, doubt if the money were truly spent on updating and procuring the world class medical facilities. If they were truly spent on the right things Aligwe asked, “Why do our President and top government functionaries still travel abroad for medical care?”
Toeing same line with Aligwe, Bada Amodu, a pediatric doctor, noted that Abba Kyari and other government functionaries that tested positive to Coronavirus should be taken to State House Clinic, which by the amount spent so far, should be the best in Africa.
“Our governments make us doctors look stupid when they deny you good facilities to aid your work, but they travel abroad where such facilities are in abundance as if they fall from heaven. Governments and private investors made that possible abroad. It is a shame that coronavirus is exposing our poor facilities further,” the doctor said.
Amodu lamented that even the private sector is not encouraged to boost medical facilities that are lacking because of high importation tariffs, multiple taxation, stress of getting approvals, among other challenges that make their services very expensive for ordinary Nigerians.
“If government offers incentives to private sector, there will be improvement on medical facilities across the country. For now, investors struggle to stay afloat”, he said.
But with the coronavirus spread, Aligwe asked why government is turning to Gwagwalada Hospital, which is less-equipped than Aso Rock Clinic.
The action, for him, further exposed government’s insincerity as the once neglected hospital by leaders is now their saving grace, as traveling abroad for medical treatment is not possible now because of the pandemic.
A big regret for Amodu is the many qualified Nigerian doctors who have been poached by some of these medical outfits abroad.
“If government had equipped our hospitals very well, most of our professionals who left would have been here in spite of poor remuneration. Now, they are part of the team helping countries where they are employed and are well-paid, to recover from coronavirus pandemic”, he noted.
EzennaOtuonye, an economist, thinks that government will still not learn from the coronavirus experience because of the mindset of our political leaders. “Having exposed our lack, a responsible government should in the aftermath of coronavirus rejig the laws to encourage more funding, investments and confirmable impact in the health sector”, he said.
However, he thinks that the way the much calls for economy diversification have gone is also the way call for result-oriented healthcare sector will go if there is no action plan, time of execution and assessment of results.
“During the 2016 recession, the talk everywhere was diversification, but after the recession, we all relaxed. The citizens are guilty too, we should hold government accountable, but we don’t and still expect different result”, he decried.
Abass Tijani, a commentator, said: “It appears Covid19 is the revolution many African nations have been waiting for. It has exposed the political class (who failed to develop local health systems and can’t travel abroad) and religious charlatans with no miracle cure either.
Another analyst said: “Any governor, minister, permanent secretary, Chief of staff or senator that tests positive to Coronavirus should be taken to the Specialist Hospital in his/her state for treatment, or Aso Rock Clinic. Let them taste their own hospitals.”
CHUKA UROKO, OBINNA EMELIKE (Lagos) and INNOCENT ODOH (Abuja)
