Govt under pressure to wade in as health sector hurdles linger

As critical shortages and systemic issues continue to disrupt healthcare delivery, the government is under pressure to provide solutions to improve the operating environment.

With the government lacking the funds to implement its health sector plans, the private sector is emerging as the indispensable player in improving Nigeria’s healthcare fortunes. But some thorns have persisted in stifling their operations.

The long-standing challenge of high tariffs on imported medicines and medical equipment which has worsened the cost of drugs and diagnostics services in the country is one of the pressing issues stakeholders expect the government to act on swiftly.

For most private clinics, for instance, the high demand for essential equipment clashes with limited affordability, leading them to rely on used machines or lower-cost options.

Medical devices in high demand include diagnostic equipment such as Magnetic Resonance Imaging, Computed Tomography scan, Digital X-ray, Ultrasound, Mammography and Ultrasound Scans.

Medical disposables, especially those for testing for malaria parasites, drug abuse, and infectious diseases such as HIV/AIDS and tuberculosis, are also in high demand.

China has been a dominant supplier of fundamental, low-tech instruments that most private clinics can afford.

All medical devices and medicines entering Nigeria must first be registered with the National Agency for Food and Drug Administration and Control before importation.

But despite a zero-import duty that applies to all medical equipment by law, importers pay rates close to 20 percent, BusinessDay learnt.

Sammy Ogunjimi, the founder of Codix Group, a company that manufactures blood glucose meters and strips, said: “I used to do importation before but I do manufacturing now. The reason is that if I needed $1,000 before bringing in finished products, I would probably need about $400 to buy the raw materials. Any other thing I will pay for will be in naira. Unfortunately, some of the raw materials I bring in have import duties attached and if I bring the finished version of the same product, the import duty is zero. How does that make sense?”

“The equipment and accessories that I need to manufacture these products also have import duties attached. Having a waiver for raw materials and manufacturing equipment may naturally be a good thing, but the difficulties or bottlenecks that may arise from the grant of such waivers may make some people to look for ways to circumvent the process inexorably leading to corruption. So, why can’t the government make it zero import duties for raw materials, equipment, and accessories for manufacturing pharmaceuticals?”

According to Muhammad Ali Pate, coordinating minister of health and social welfare, supporting companies such as those involved in domestic manufacturing of in-vitro diagnostics, generic pharmaceuticals, vaccines, biologics, and medical devices is one of the key goals to advance healthcare delivery this year.

He said part of the president’s aim is to optimise end-to-end research and development pathways for addressing priority diseases in Nigeria.

Last November, the minister had pledged to engage pharmaceutical companies to explore strategies for reducing drug prices, following an increasing outcry over how the unprecedented rise in drug prices has worsened the cost of living crisis facing many Nigerians.

He said the ministry was working towards policy actions that may address the high prices of medicines, especially for the most vulnerable Nigerians.

Stakeholders however want the promises backed by actions as patients could be at the receiving end of inactions.

Pamela Ajayi, president of Healthcare Federation of Nigeria, said the federal government urgently needs to eliminate all taxes and duties and ensure people can bring in equipment for local drug production to flourish.

She urged the government to work with big pharmaceutical industries like Emzor and Fidson that can turn things around.

She said: “Already we have the challenge of weak infrastructure and lack of power supply in Nigeria. To set up any industry is a challenge. We still think it is more expensive to produce locally.

“The current challenge we have is with the devaluation of the naira and the fact that over 90 percent of the drugs we consume are imported. The crisis is real. We need to make sure people are encouraged to produce.”