With most of the world under lockdown and nowhere to go, Nigeria’s political elite would have put their faith in the country’s underfunded and underinvested healthcare system as high-ranking government officials and families become the latest coronavirus cases.
President Muhammadu Buhari tested negative to the deadly coronavirus on Tuesday, but Abba Kyari, his chief of staff, and Bala Mohammed, governor of Bauchi State, are the latest casualties as the number of reported cases in the country officially stood at 42 as at press time.
At least three persons working in the office of Kyari have also been reported to have tested positive to COVID-19, although the Nigeria Centre for Disease Control (NCDC) was yet to officially tally that number as at 7:30pm yesterday.
Senior government officials will be among the list of those the NCDC will be contact-tracing. These elites, used to travelling abroad for medical care, are stuck in Nigeria.
“Will the countries they have invested hugely in be willing to accommodate them on health emergency basis? No,” said Olohunlana Aminat Olanyinka, an economist and policy analyst at the University of Lagos. “It is indeed time for our leaders to have a rethink and understand there is no place like home.”
Olanyinka pointed to the low recovery rate noted in the country, attributing it to poor healthcare facilities in the country.
So far, of the 42 cases reported, only two patients have recovered, although there has been just one death.
A son of former Vice-President Atiku Abubakar has been infected and Buhari’s daughter is in self-isolation after returning from the UK.
Kyari was confirmed as a carrier of the virus by the NCDC after returning on March 14 from Germany, where he went for a meeting to discuss a power deal with Siemens.
But as opposed to the proper tradition of self-quarantining for at least 14 days after returning from a trip to a coronavirus-burdened country like Germany, where over 31,ooo of its populace have been infected, Kyari was at Aso Rock last Sunday for a meeting that had in attendance top political leaders, including President Buhari and Vice President Yemi Osinbajo.
This has sparked serious outrage and fear, with health experts saying the virus may have been transmitted to others present at the meeting, which might escalate the country’s affected numbers.
The growing list of the elite class would add to the increasing number of Nigerians jostling for the country’s limited health-care facilities which are already insufficient to contain the spread.
There are few COVID-19 testing centres in the country while isolation facilities, like in Enugu, are sub-standard, prompting lawmakers to decry the situation recently.
Africa’s largest economy is banking on its failing health sector, which has suffered low budgetary allocation and years of neglect from the government, for rescue to contain the coronavirus pandemic, at a time when advanced countries have shut their borders in order to keep the virus at bay.
Olanyinka of the University of Lagos said the situation in Nigeria could have been different if the government had paid attention to the healthcare system.
Taking a cue from some of the worst-hit countries, South Africa’s President Cyril Ramaphosa on Tuesday announced that sub-Saharan Africa’s worst affected country would be on lockdown by midnight on Thursday.
The aim is to reduce stress on the country’s healthcare system and flatten the curve.
South Africa and other countries that are badly hit can boast of better healthcare systems, indicating Nigeria could have it much worse if preventive measures do not go according to plans.
Nigeria has 0.5 hospital beds per 1,000 patients compared to 2.9 in the United States, 3.4 in Italy, 4.2 in China, 2.8 in the United Kingdom and 2.8 in South Africa, according to latest data from World Bank.
There is 0.4 doctor per 1,ooo Nigerians compared to 1.8 in China, 2.8 in the United Kingdom, 4.1 in Italy and 0.9 in South Africa.
According to the World Health Organisation (WHO), Nigeria has one of the lowest doctor/population ratio in Africa. A poll citing the Medical and Dental Council of Nigeria (MDCN) reported that there are about 72,000 nationally-registered Nigerian doctors, with only 35,000 practising in-country.
Factoring this figure with national population estimates, there is a deficit of over 260,000 doctors in Nigeria and a minimum of 10,605 new doctors need to be recruited annually to meet global targets.
An earlier BusinessDay investigation showed that the country’s emergency system is morbid, with facilities in the Lagos State University Teaching Hospital unable to accommodate emergency cases.
The problem can be directly linked to underfunding of the healthcare system and has seen many medicine graduates leave the country for better climes, a medical doctor at a private hospital told BusinessDay on anonymity basis due to his company policies.
No less than 5,405 Nigerian doctors are practising in the UK alone, according to Nigerian Medical Association (NMA) data.
The indirect cost of illness in Nigeria 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 WHO African region.
This was contained in an exhaustive report on ‘The indirect cost of illness in Africa’, produced by the World Health Organisation.
The report also noted 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 ($946 million), equivalent to $5 per person when divided by the country’s 193 million population.
Nigeria’s health expenditure as a percentage of the Gross Domestic Product (GDP) averaged 3.4 percent between 2007 and 2016, compared with South Africa (6.5 percent) and Kenya (4.5 percent), according to data sourced from the World Bank.
In the pharmaceutical aspect of healthcare, the cost of drugs also makes it difficult for many people to get treatment. 70 percent of drugs used in Nigeria are imported, implying the already financially challenged Nigerians have to a pay premium for most medicines.
“In Nigeria we import most of our raw materials, it is only water that we do not import,” said Moji Adeyeye, director general, National Agency for Food and Drug Administration and Control (NAFDAC.
The almost non-existent and equally weak health insurance in Nigeria has seen out-of-pocket payments for healthcare become the norm, driving many people into poverty. Fifteen years after the inception of the National Health Insurance Scheme (NHIS), it has only managed to enrol about 4 percent of Nigerians, roughly 7.7 million of the 193 million population.
In the face of the critical health crisis and its consequent effect on the economy, the Central Bank of Nigeria announced a N1.1trn credit support for the manufacturing and healthcare industry, especially, while it released foreign exchange to 10 pharmaceuticals to boost medical supplies in the country.
“The problem is when or if the number of infection starts hitting hundreds. For now we can cope,” a medical doctor told BusinessDay. “We cannot build a hospital in 10 days like China but can fall back to makeshifts.”
Michael Ani & Segun Adams